Validation of Three Body Composition Techniques with a Comparison of Ultrasound Abdominal Fat Depths against an Octopolar Bioelectrical Impedance Device

International Journal of Exercise Science 5(3) : 205-213, 2012. The aims of this study were to cross-validate three clinical-grade measures of body composition, using an octopolar Bioelectrical Impedance (BIA), an ultrasound analyzer (US) and Air-Displacement Plethysmography (ADP) and second to compare the US scans of total abdominal, subcutaneous and visceral fat depths (mm) against the trunk percent fat (%BF) from the octopolar BIA. Twenty-six college-aged (22.9 ± 1.35 years) men (n = 18) and women (n = 8) volunteered to participate in this study. Body composition was assessed using BIA (total and by segments), ADP and US. In addition, total abdominal, subcutaneous and visceral fat layers were measured using the US. All measurements were done in accordance with manufacturers’ guidelines. The %BF comparing the three clinical grade machines were all significantly correlated and no significant differences were found using a 1-way ANOVA. All three fat depths were significantly correlated to the trunk fat % via BIA, while significant differences were found for the 1-way ANOVA. A Tukey post-hoc test showed significant differences between the BIA trunk %BF and both subcutaneous and visceral US fat depths. Having valid ways to measure body composition and visceral fat that is accessible in terms of being transportable, cost effective, and simple to use, should become a part of preventive medicine

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable