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Demonstration of protein AA in subcutaneous fat tissue obtained by fine needle biopsy.

Polarisation microscopy of material obtained by fine needle biopsy of subcutaneous tissue and stained with Congo red is a simple and reliable method for the diagnosis of systemic amyloidosis. It cannot, however, be used to differentiate histologically between different forms of amyloidosis. In the present study extracts of material obtained by fine needle biopsy of subcutaneous fat tissue from 13 patients were examined by double immunodiffusion with an antiserum against protein AA, a unique protein which forms a major part of the fibrils in secondary amyloidosis. Five of the patients showed amyloid deposits round the fat cells by conventional microscopy. In 3 of these, all with rheumatoid arthritis, protein AA was detected. Eight patients without amyloidosis and 2 with myelomatosis and amyloidosis showed no reaction with antiprotein AA antiserum. Thus the material obtained by fine needle biopsy of subcutaneous tissue could be used not only for the histological diagnosis of amyloidosis but also for a classification of systemic amyloidosis into secondary or primary based on the type of amyloid fibril protein involved.

Adipose Tissue↗

Esterification of fatty acids by bovine intramuscular and subcutaneous adipose tissues.

Exogenous fatty acid esterification in intramuscular and subcutaneous adipose tissues from 72-hr fasted or ad libitum fed Angus cattle was investigated. Intramuscular (interfascicular) and subcutaneous adipose tissue snips were obtained from the longissimus dorsi muscle and were incubated with radioisotopically labeled fatty acids (palmitate, stearate, oleate, linoleate or linolenate) at three different concentrations (0.3 mM, 0.6 mM and 2.0 mM) to assess rates of fatty acid incorporation into glycerolipids. Rates of fatty acid esterification in vitro increased with fatty acid concentration in both intramuscular and subcutaneous adipose tissues. For all of the fatty acids investigated, triglycerides were the predominant products (60-85%). Subcutaneous adipose tissue had larger adipocytes and more actively (P less than 0.05) esterified fatty acids, with the exception of palmitate, than intramuscular adipose tissue. The rate of palmitate esterification was not different between tissues, although intramuscular adipose tissue esterified a greater proportion (P less than 0.10) of palmitate as triglyceride (85%) than did subcutaneous adipose tissue (75%). Relative rates of incorporation of fatty acids into lipids in intramuscular and subcutaneous adipose tissues were: palmitate greater than linolenate greater than linoleate greater than stearate. In general, 72-hr fasting did not significantly reduce the rates of fatty acid incorporation in bovine adipose tissues. Results of this study revealed that:i) rates of exogenous fatty acid incorporation into adipose tissue lipids were dependent on the medium fatty acid concentration and adipose tissue depot; and ii) the relative esterification rates of the various fatty acids in vitro did not necessarily reflect the proportion of these fatty acids in bovine adipose tissues.

Adipose Tissue↗

Does measurement site for visceral and abdominal subcutaneous adipose tissue alter associations with the metabolic syndrome?

OBJECTIVE: To determine whether the associations between visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), and the metabolic syndrome are altered depending on measurement site for VAT and ASAT and the definition used to identify the metabolic syndrome. RESEARCH DESIGN AND METHODS: Total VAT and ASAT volume was derived using approximately 37 contiguous computed tomography (CT) images from T10-T11 to L5-S1 in 85 men. CT images obtained at eight intervertebral locations (e.g., L4-L5, L3-L4, etc.) were used to determine the associations between partial volumes (single images) and metabolic syndrome. Metabolic syndrome was defined using the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria. Logistic regression was used to calculate the odds ratio (OR) per SD increase in adipose tissue. RESULTS: For total and all partial volumes, VAT was more strongly associated with metabolic syndrome than ASAT independent of metabolic syndrome criteria. The OR (per SD) for NCEP metabolic syndrome was higher for total VAT volume (OR = 7.26) and for the partial volumes at T12-L1 (7.46) and L1-L2 (8.77) than those at the L4-L5 level (3.94). The OR for metabolic syndrome ( approximately 2.6) was not substantially different among the ASAT measures. A similar pattern of association was observed using the IDF metabolic syndrome criteria. CONCLUSIONS: The measurement site for VAT, but not for ASAT, has a substantial influence on the magnitude of the association with both metabolic syndrome definitions. However, because VAT remained significantly associated with metabolic syndrome regardless of measurement site, the clinical interpretation was unaltered by measurement protocol or metabolic syndrome definition.

Abdominal Fat↗

Expression of peroxisome proliferator-activated receptor-gamma1 and peroxisome proliferator-activated receptor-gamma2 in visceral and subcutaneous adipose tissue of obese women.

Data regarding the expression of peroxisome proliferator-activated receptor (PPAR)-gamma(1) and PPAR-gamma(2) in human visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) are conflicting. To clarify this issue, we studied 50 women who had a BMI >35 kg/m(2) were undergoing gastric reduction surgery. Phenotyping included recording of anthropometric parameters and of a biological profile. Quantification of the expression of PPAR-gamma(1) and PPAR-gamma(2) in samples of VAT and SAT was performed by real-time RT-PCR. In both SAT and VAT, the level of expression of PPAR-gamma(2) were >20-fold that of PPAR-gamma(1) (P < 0.001 for both). However, only PPAR-gamma(1) was differentially expressed, its levels in SAT being 216 +/- 34% those in VAT (P < 0.001). In a stepwise, multivariate regression analysis, the levels of PPAR-gamma(1) in both SAT and VAT were the major determinants of waist circumference (R(2) = 21% for both; P < 0.01). Finally, leptin but not PPARs appeared as the single parameter explaining the largest part of the variability of BMI in our cohort of patients (R(2) = 22%, P < 0.001). These results are consistent with the putative roles of PPAR-gamma(1) and PPAR-gamma(2) in carbohydrate metabolism and energy homeostasis, respectively. As such, they constitute an important step toward the identification of potential targets for novel therapeutic strategies in the fields of obesity.

Adipose Tissue↗

Thoracic epidural anesthesia increases tissue oxygenation during major abdominal surgery.

UNLABELLED: Intraoperative surgical stress may markedly increase adrenergic nerve activity and plasma catecholamine concentrations, which causes peripheral vasoconstriction and decreased tissue oxygen partial pressure possibly leading to tissue hypoxia. Tissue hypoxia is associated with an increased incidence of surgical wound infections. Thoracic epidural anesthesia blocks afferent neural stimuli and inhibits efferent sympathetic outflow in response to painful stimuli. Consequently, we tested the hypothesis that supplemental thoracic epidural anesthesia during major abdominal surgery improves tissue perfusion and subcutaneous oxygen tension. Thirty patients were randomly assigned to two groups: general (n = 15) or combined general and epidural anesthesia (n = 15). Anesthesia technique and fluid management were standardized. Subcutaneous tissue oxygen tension was measured continuously in the upper arm with a Clark type electrode. Data were compared with unpaired, two-tailed t-tests, Wilcoxon's ranked sum test, or repeated-measures analysis of variance and Scheffé F tests as appropriate; P < 0.05 was considered statistically significant. After 60 min, intraoperative tissue oxygen tension was significantly larger during combined anesthesia than during general anesthesia (54.3 +/- 7.4 mm Hg versus 42.1 +/- 8.6 mm Hg; P = 0.0002). Subcutaneous tissue oxygen tension remained significantly higher in the combined general/epidural anesthesia group throughout the observation period. Hemodynamic responses and global oxygen variables were similar in the groups. Thoracic epidural anesthesia improved intraoperative tissue oxygen tension outside the area of the epidural block. Thus, our results give evidence that supplemental neural nociceptive block blunts generalized vasoconstriction caused by surgical stress and adrenergic responses. IMPLICATIONS: Thoracic epidural anesthesia blunts the decrease of subcutaneous tissue oxygen tension caused by surgical stress and adrenergic vasoconstriction during major abdominal surgery. Consequently, combined general and epidural anesthesia helps to provide sufficient tissue oxygenation.

Abdomen↗

Oxygen uptake and tissue oxygen tension during adrenergic stimulation in canine subcutaneous adipose tissue.

The effect of sympathetic nerve stimulation (NS) and injected noradenaline (NA) or isoprenaline (Iso) on PVO2, VO2 and PtO2 was studied in isolated canine subcutaneous adipose tissue. These effects were compared to those produced by mechanical blood flow reduction (clamping). Resting VO2 measured 13.0+/- 2.3 mumol X min-1 X 100 g-1. When blood flow was reduced by 20% or less there was no significant change of VO2. Reducing blood flow to 50% of control or less by NS caused a parallel reduction in VO2, while clamping reduced VO2 significantly less. NA gave effects similar to those of NS. After NS or NA there was a period of hyperemia and increased oxygen extraction which more than compensated for the decrease in VO2 during vasoconstriction. Such a net increase in VO2 was not produced by clamping. Control PtO2 averaged 29+/-2 mmHg. NA reduced it by 70% and clamping to the same blood flow level only by 14% (p less than 0.01). Thus, a mere reduction in blood flow has little effect on PtO2, while blood flow reduction combined with redistribution of blood flow and an increased oxygen deman can lead to tissue hypoxia.

Adipose Tissue↗

[MRI of lymphedema using short-TI-IR (STIR)].

Thirty four cases with lymphedema of the extremities were examined with MRI at 0.5 tesla. On T1-weighted image, the enlarged subcutaneous tissue and the subcutaneous trabecular structures were seen in all cases. Moreover, the trabecular structures in the enlarged subcutaneous tissue showed low signal intensity on T1-weighted image and high signal intensity on T2-weighted image in all cases. Additionally, in 12 of 15 cases examined by Short-TI-IR (STIR) image, the trabecular structures and fluid collections in the subcutaneous tissue were shown more definitely in high signal intensity than by T2-weighted image. We consider MRI using STIR is to be useful in the evaluation of edematous disease.

Female↗

TNF and TNF receptor expression and insulin sensitivity in human omental and subcutaneous adipose tissue--influence of BMI and adipose distribution.

Tumour necrosis factor (TNF)alpha is implicated in the relationship between obesity and insulin resistance/ type 2 diabetes. In an effort to understand this association better we (i) profiled gene expression patterns of TNF, TNFR1 and TNFR2 and (ii) investigated the effects of TNF on glucose uptake in isolated adipocytes and adipose tissue explants from omental and subcutaneous depots from lean, overweight and obese individuals. TNF expression correlated with expression of TNFR2, but not TNFR1, and TNF and TNFR2 expression increased in obesity. TNFR1 expression was higher in omental than in subcutaneous adipocytes. Expression levels of TNF or either receptor did not differ between adipocytes from individuals with central and peripheral obesity. TNF only suppressed glucose uptake in insulin-stimulated subcutaneous tissue and this suppression was only observed in tissue from lean subjects. These data support a relationship between the TNF system and body mass index (BMI), but not fat distribution, and suggest depot specificity of the TNF effect on glucose uptake. Furthermore, adipose tissue from obese subjects already appears insulin 'resistant' and this may be a result of the increased TNF levels.

Abdominal Fat↗

[Study of atherosclerosis in different geographical zones of the Soviet Union. 1. Comparative study of fatty acid composition of subcutaneous adipose tissue].

Gas-liquid chromatography was used for the study of the fat-acid composition of the subcutaneous tissue in males, aged 20 to 70 years, who had died in accidents. The investigation was conducted in the cities of Samarkand, Tashkent, Riga and Moscow. A significantly higher relative level of linoleic acid in the subcutaneous tissue of the native population of Central Asia than in the non-native residents of the same regions was found (19.4 and 13.7%, respectively). It is accounted for by a high consumption of cotton oil rich in linoleic acid by the native population of Uzbekistan. No significant differences in the proportion of linoleic, oleic and other fatty acids in the adipose tissue of the Russian population of Samarkand and Tashkent, as well as Riga and Moscow were found. No differences were either found in the composition of the adipose tissue of the native and non-native residents of Riga. The lower incidence of atherosclerosis among the native population of Central Asia in comparison with the non-native population of the same region and the population of the Baltic region is emphasized.

Adipose Tissue↗

Diabetic microangiopathy in subcutaneous fatty tissue.

To evaluate diabetic microangiopathy in the subcutaneous fatty tissue objectively and to clarify the relation between pathogenesis of membranocystic lesion (MCL) and diabetic microangiopathy, specimens obtained from 23 diabetics and 23 nondiabetics were examined histologically. Ten of 23 diabetics and 7 of 23 non-diabetics were examined electron microscopically. Using electron micrographs measurements were made of the following areas; entire microvessel section, basal laminae, luminal space, endothelial cells, pericytes, and we scored the following findings: veil cells, cellular debris and vacuoles in the thickened basal laminae, abnormal densities of the endothelial cells. In diabetics, the area of luminal space was smaller and the area of basal laminae was larger than those of non-diabetics. Scored assessment of the veil cells, cellular debris and vacuoles in the thickened basal laminae were statistically significant in diabetics. Veil cells around the subcutaneous microvessels were less frequent and possessed fewer cytoplasmic processes than those around the dermal microvessels. Histologically, MCLs were frequently demonstrated in skin disorders resulting from diabetic microangiopathy, including 3 cases of pigmented pretibial patches, and 1 case of diabetic bulla. MCLs were more frequently demonstrated in diabetic cases with retinopathy, neuropathy, and nephropathy than those without complications. MCLs were detected only on the shins and the feet. MCLs were more frequently seen in cases with larger area of basal laminae than those with smaller area of basal laminae in morphometric measurement of electron micrographs. The present studies suggest that microangiopathy in the subcutaneous tissue is a pathological feature of diabetes mellitus and is a contributory factor to the formation of MCL.

Adipose Tissue↗

Proliferation and triglyceride synthesizing activities of fibroblast-like cells derived from epididymal and subcutaneous adipose tissues of rats.

Fibroblast-like cells from subcutaneous adipose tissue and epididymal adipose tissue were prepared from rats and their proliferation and [14C]deoxy-glucose uptake and triglyceride synthesis from [14C]palmitate were investigated. The proliferation of fibroblast-like cells from subcutaneous adipose tissue was greater than that from epididymal adipose tissue. Insulin enhanced the proliferation of fibroblast-like cells derived from subcutaneous adipose tissue, but not from epididymal adipose tissue. The uptake of [14C]deoxy-glucose by fibroblast-like cells from the two sources was similar. Triglyceride synthesis from [14C]palmitate by epididymal fibroblast-like cells was higher than that by subcutaneous fibroblast-like cells. The [14C]deoxy-glucose uptake and triglyceride synthesis from [14C]palmitate by fibroblast-like cells from the two sources were not enhanced by the addition of insulin. These findings suggest the existence of different types of adipocytes in subcutaneous and epididymal adipose tissues in terms of proliferation, and show that the proliferation of fibroblast-like cells from subcutaneous adipose tissue is regulated by insulin. The triglyceride synthesis by immature adipocytes from both adipose tissues was not affected by insulin.

Adipose Tissue↗

Myoepithelioma of soft tissue.

A myoepithelioma occurred in the subcutaneous tissue of the right shoulder of a 28-year-old man. The well-demarcated nodular tumor (3. 0 x 2.8 cm) was located in the subcutaneous tissue with no adhesion to the deltoid muscle. The tumor was composed of a fascicular proliferation of spindle cells with variable amounts of stroma and showed areas of sheets of epithelioid cells. In most areas, the tumor cells had uniform nuclei, but pleomorphic epithelioid cells were focally present. Mitotic activity was three per 10 high-power fields. No ductular structure was found throughout the tumor. Immunohistochemical and ultrastructural studies confirmed the myoepithelial origin of the tumor cells. The occurrence of myoepithelioma in the subcutaneous tissue has been rarely reported. Even though the tumor showed no aggressive behavior on the 2-year follow-up, it is still too early to comment definitely on the behav- ior of myoepithelioma of the subcutaneous tissue. This case provides further information about soft tissue myoepithelioma.

Adult↗

Subcutaneous microdialysis before and after an oral glucose tolerance test: a method to determine insulin resistance in the subcutaneous adipose tissue in diabetes mellitus.

AIMS: Subcutaneous microdialysis has been used for continuous glucose monitoring in patients with diabetes mellitus (DM) to facilitate tight regulation of blood glucose levels. The aims of this study were therefore to investigate (i) the relationship between capillary and interstitial glucose in patients with type 1 or 2 DM and healthy subjects and (ii) the feasibility of using microdialysis to assess local insulin sensitivity in adipose tissue. METHODS: Using subcutaneous microdialysis, interstitial glucose, lactate, pyruvate and glycerol were determined as measures of glucose and lipid metabolism in adipose tissue, before and after an oral glucose tolerance test (OGTT) in 14 patients and seven controls. The results were correlated to whole-body insulin sensitivity and insulin sensitivity in liver estimated from the levels of insulin-like growth factor-binding protein 1 (IGFBP-1). RESULTS: Capillary and interstitial glucose correlated before and after OGTT in healthy subjects and in type 1 DM but not in type 2 DM. In fasting state, the glycerol levels were higher in both type 1 and type 2 DM compared with controls. After the OGTT, the insulin levels were sufficient to suppress lipolysis in type 1 but not in type 2 DM. The glucose/lactate ratio was higher at fasting in type 1 DM and after OGTT in type 1 and 2 DM. In type 1 DM, basal interstitial glycerol levels correlated to whole-body glucose utilization. In type 2 DM, correlations were found between the basal glycerol levels and whole-body insulin sensitivity and between glucose/lactate and per cent decrease in IGFBP-1 levels 120 min after OGTT. CONCLUSION: Capillary and interstitial glucose correlated before and after OGTT in healthy subjects and patients with type 1 DM. Correlations were also found between insulin sensitivity in whole body and in adipose tissue in both type 1 and type 2 DM and between insulin sensitivity in subcutaneous adipose tissue and liver in type 2 DM. This study shows that microdialysis technique can be used to study in vivo insulin sensitivity in adipose tissue over time and may be useful in the evaluation of, for example, the effects of new drugs on insulin sensitivity.

Adult↗

[Gender differences in adiponectin and leptin expression in epicardial and subcutaneous adipose tissue. Findings in patients undergoing cardiac surgery].

INTRODUCTION AND OBJECTIVES: The high level of metabolic activity present in visceral adipose tissue is associated with the development of atherothrombosis. Subcutaneous adipose tissue secretes larger quantities of the adipocytokines leptin and adiponectin than visceral adipose tissue. Epicardial adipose tissue secretes inflammatory mediators, and the resulting proinflammatory activity is greater than that associated with subcutaneous adipose tissue. The aim of this study was to compare adiponectin and leptin expression in human epicardial and subcutaneous adipose tissue. METHODS: Samples of both epicardial and subcutaneous adipose tissue were taken from 46 patients who were undergoing heart surgery, coronary artery bypass surgery, or aortic or mitral valve replacement. Levels of protein and gene expression of leptin and adiponectin were assessed immunohistochemically and by RT-PCR, respectively. Levels of mRNA expression in the 2 adipose tissue types were compared by real-time quantitative PCR. RESULTS: Significant differences were found between adiponectin and leptin mRNA expression in epicardial and subcutaneous adipose tissue, with epicardial adipose tissue exhibiting lower levels of adiponectin and leptin expression. Moreover, adiponectin and leptin mRNA expression in epicardial adipose tissue was higher in women than men. CONCLUSIONS: Adiponectin and leptin expression is lower in epicardial than in subcutaneous adipose tissue. Moreover, there are differences in adiponectin and leptin expression in epicardial adipose tissue between women and men.

Adiponectin↗

Cell size and the antilipolytic effect of insulin in human subcutaneous adipose tissue.

Lipolysis was studied in subcutaneous adipose tissue removed under local or general anaesthesia from subjects with marked difference in body weight and from obese subjects before and after intestinal shunt operations. The release of glycerol was measured in sections of adipose tissue incubated for two hours in bicarbonate buffer containing 4 per cent bovine albumin with no glucose added. The larger fat cells were more insulin sensitive than the smaller. A positive relationship was observed between the fat cell size and the antilipolytic effect of insulin (100 muU/ml). Insulin had no significant effect on the lipolytic effect of the catecholamines, when this is calculated as the increment in the glycerol release above the basal.

Adipose Tissue↗

Expression of c-Fos in subcutaneous adipose tissue of the fetal pig.

Subcutaneous adipose tissue from fetal pigs was examined for c-Fos expression in developing adipocytes. Enhanced c-Fos expression was found in the nuclei of adipocytes and cells closely associated with fat cell clusters from 75 and 105 day old fetuses. 50 day old fetuses which had no adipocytes showed no enhanced c-Fos expression in undifferentiated cells. c-Fos expression in adipocytes was not transient, but persisted through the gestational period from 75 to 105 days. The timing of c-Fos induction appears to be closely related to adipocyte differentiation and was found only in developing adipocytes and cells closely associated with fat cell cluster and was not found in independent stromal-vascular cells.

Adipocytes↗

Influence of hypoxia and hyperoxia on subcutaneous adipose tissue blood flow in man.

Subcutaneous adipose tissue blood flow (ATBF) was measured by the 133Xe washout method in normal men breathing oxygen at partial pressures from 0.1 to 2 atmospheres. Breathing oxygen at partial pressures of 0.1 and 1 atm. increased and reduced ATBF by 56% and 26%, respectively as compared to air breathing. These effects were highly significant. Breathing of oxygen at 2 atm. partial pressure had no consistent effect on ATBF, although considerable changes--positive or negative--could been seen in some experiments. Oxygen-breathing at 1 atm. partial pressure is associated with a slight hyperventilation and fall in PACO2. This was shown to be without importance for the effect of oxygen on adipose tissue blood flow.

Adipose Tissue↗