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At least 1,351 records · Page 75Linked to original sources
PubMed1994

Relationship between Quetelet's index and cancer of breast and female genital tract in 47,000 women followed for 25 years.

The relationship between Quetelet's index and subsequent risk for cancer of endocrine target organs was studied in a cohort of 47,003 women, examined for height and weight in the years 1963-65, and followed up in the Swedish Cancer Register until 1987. High Quetelet's index was associated with a decreased risk for breast cancer among women less than 55 years of age at risk, while a high Quetelet's index predicted an increased risk among older women. Among women > or = 55 years of age, the excess relative risk for breast cancer associated with high Quetelet's index declined significantly during the follow-up period. Cancer of the ovaries and the uterine cervix were not significantly related to Quetelet's index in any age group. In women > or = 55 years of age, the relative risk for cancer of the uterine corpus associated to Quetelet's index was higher than that for breast cancer, and this association persisted during the entire follow-up period of more than 20 years. In spite of the fact that endometrial cancer is less common than breast cancer, because of the stronger relation between overweight and endometrial cancer, more endometrial cancer would be attributable to obesity than breast cancer.

Adult↗
PubMed2002

Use of the health and activities limitation index as a measure of quality of life in obesity.

OBJECTIVE: Obesity reduces the quality of life (QOL); however, quantification of obesity's impact on QOL is cumbersome. Utility indices reduce QOL measurements to a single numerical value that can be used in the calculation of Quality-Adjusted Life-Years and the cost effectiveness for obesity treatment. The purpose of this investigation is to assess the sensitivity of the Health and Activities Limitation Index (HALex) utility index to obesity. RESEARCH METHODS AND PROCEDURES: The answers to five questions regarding an individual's self-perception of his or her health status and information about limitation in daily and work activities were collected from 32,440 adults in the 1998 National Health Information Survey. Answers to the questions were scored and converted to a utility index score ranging from 0 (near-death state) to 1 (perfect health) with no limitations. Average values for indices corresponding to differing body mass indices were obtained and significance determined by ANOVA. RESULTS: The utility index for normal weight males and females was 0.86 +/- 0.19 and fell to 0.68 +/- 0.27 for superobese males and 0.60 +/- 0.28 in superobese females. Utility indices fell linearly with increasing body mass index and were lower for respondents having obesity-related comorbid conditions known to reduce the quality of life. DISCUSSION: There is a statistically significant decrease in the QOL with increasing obesity, slightly worse for women compared with men. The Health and Activities Limitation Index can quantitate the effect obesity and its complications have on quality of life.

Adolescent↗
PubMed2003

The glycaemic index of dates and date/yoghurt mixed meals. Are dates 'the candy that grows on trees'?

OBJECTIVE: To determine the glycaemic index of one variety of date, alone and in mixed meals with plain full-milk yoghurt. DESIGN: An experimental study involving the measurement of the glycaemic responses of participants to the ingestion of dates, alone and with yoghurt. SETTING: Within the Department of Family Medicine, Faculty of Medicine and Health Sciences, UAE University. SUBJECTS: Healthy male and female volunteers aged 32-67 y. INTERVENTION: Glycaemic responses to date and date/yoghurt meal ingestion were plotted for each subject. Glycaemic indexes were calculated as the ratios of the incremental areas under these response curves to those for glucose ingestion. Results are presented using means and standard deviations. Glycaemic indexes were compared using paired t-tests. RESULTS: Mean glycaemic indexes of the dates were 47.2, 45.3, 35.5, 37.3, 28.9 for rutab, traditionally stored, commercial, rutab/yoghurt and commercial tamer/yoghurt preparations, respectively. There was a significant difference between the results for rutab vs commercial tamer dates (P<0.05), but other comparisons failed to reach statistical significance. CONCLUSIONS: Khalas dates, when eaten alone or in mixed meals with plain yoghurt have low glycaemic indexes. The consumption of dates may be of benefit in glycaemic and lipid control of diabetic patients. The consumption of dates in mixed meals with yoghurt appears to have, at most, a minimal effect on the glycaemic index.

Adult↗
PubMed1999

Prediction of hypertension, diabetes, dyslipidaemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese.

OBJECTIVE: It is important to determine what values of simple anthropometric measurements are associated with the presence of adverse cardiovascular risk factors such as diabetes or hypertension to provide an indication for further detailed investigations. In this analysis, we aimed to assess which anthropometric cutoff values are best at predicting the likelihood of diabetes, hypertension, dyslipidaemia and albuminuria in Hong Kong Chinese. DESIGN AND SETTING: The data were obtained from a previously reported prevalence survey for glucose intolerance in a representative Hong Kong Chinese working population. SUBJECTS: 1513 subjects (910 men and 603 women) with mean age+/-s.d. 37.5+/-9.2 y. MEASUREMENTS: We examined the likelihood ratios of having diabetes, hypertension, dyslipidaemia and albuminuria in subjects with various cutoff values of the four simple anthropometric indexes, namely, body mass index, waist-hip ratio, waist circumference and the ratio of waist-to-height. RESULTS: We developed a nomogram to show the predictive values of different indexes for the cardiovascular risk factors using likelihood ratio analysis. Using Caucasian mean levels of the simple anthropometric indexes to predict diabetes or hypertension in Hong Kong Chinese gave a high likelihood ratio of 2:3:5. CONCLUSION: Higher levels of body mass index, waist-hip ratio, waist circumference and the ratio of waist-to-height are associated with risk of having diabetes mellitus or hypertension in Hong Kong Chinese as in Caucasians. However, the cutoff values of those anthropometric indexes to define obesity used in Caucasians may not be applicable to Chinese.

Adult↗
PubMed2001

Food intake patterns and body mass index in observational studies.

OBJECTIVE: To review studies of patterns of food intake, as assessed by diet index, factor analysis or cluster analysis, and their associations with body mass index or obesity (BMI/Ob). DESIGN: Systematic literature review MEDLINE search with crosscheck of references. STUDIES: Thirty observational studies relating food intake patterns to anthropometric information were identified and reviewed. Food intake patterns were defined using a diet index, factor or cluster analysis in 12, nine and nine studies, respectively. Measures of body mass were made concurrently with the diet assessment in all studies, and only in a few cases were the primary outcomes related to BMI/Ob. RESULTS: The food intake patterns identified could, in most factor or cluster analysis studies, be categorised as: (a) meat, fatty, sweet or energy dense foods; (b) vegetables, fruit, whole grain and low-fat foods; or (c) by high alcohol consumption. The diet indexes were designed to capture a high diversity and/or food combinations matching the recommendations. The relationships with BMI/Ob were inconsistent-ten studies found that intake patterns, which we categorised as fatty, sweet or energy dense were positively associated with BMI/Ob, while similar patterns in four other studies were negatively associated with BMI. The significant associations between diet index score and BMI/Ob were consistently negative, while the associations between factor scores or cluster membership and BMI/Ob were less clear in terms of food intake pattern. Men and women had similar food intake patterns, but food intake patterns were less often positively associated with BMI/Ob in women. In 11 studies, there were no significant associations between food intake pattern and BMI/Ob. CONCLUSION: This review showed that no consistent associations could be identified between BMI or Ob and food intake patterns, derived from diet index, factor analysis or cluster analysis. However, the heterogeneity of food intake patterns identified by such analyses and the lack of gold standards for the application of these techniques hampers consistent analysis of a relation between food intake patterns and health.

Adolescent↗
PubMed1999

Evaluation of orthodontists' perception of treatment need and the peer assessment rating (PAR) index.

This paper examines the relationship between orthodontists' subjective assessment of treatment need and objective measurements obtained during standardized intra- and extraoral examinations. Logistic regression modeling was used to develop predictive models of treatment need. Data were obtained from 1155 eighth-grade students by four orthodontists who used standardized examination forms to assess demographics, trauma, skeletal relationships, morphologic malocclusion traits, and mandibular function. At the conclusion of the examination, the orthodontist rated the subjective treatment need as none, elective, recommended, soon, or immediate. For some analyses, the categories were collapsed to represent no need and need. The peer assessment rating (PAR) index (American validated version) was computed from the clinical exam findings and scoring of dental models; PAR scores were used to document malocclusion severity and treatment difficulty. Spearman rank correlation coefficients quantified the relationship between PAR scores and need categories. Logistic regression analysis modeled treatment need using components of the PAR index as well as other variables. The components of these models, as well as sensitivity and specificity, were compared with malocclusion severity/treatment difficulty scores obtained from malocclusion assessments using the PAR index. The five subjective treatment need categories and the PAR index scores were significantly correlated (rho = 0.62, p<0.001). Significant differences were detected between the need and no need groups for all PAR components (p<0.001). PAR index scores and predicted probabilities from logistic regression models performed equally well for classification purposes (no need, need). The data suggest that the PAR index is highly correlated with orthodontists' subjective assessment of treatment need when that assessment is made in the absence of financial considerations and patient desires.

Adolescent↗
PubMed2002

Validity of the Index of Complexity, Outcome, and Need (ICON) in determining orthodontic treatment need.

Occlusal indices are used to determine eligibility for orthodontic treatment in several publicly funded programs. The Index of Complexity, Outcome, and Need (ICON), based on the perception of 97 orthodontists from 9 countries, has been proposed as a multipurpose occlusal index. The aim of this study was to investigate the validity of the ICON as an index of orthodontic treatment need compared with the perception of need as determined by a panel of US orthodontists. One hundred seventy study casts, representing a full spectrum of malocclusion types and severity, were scored for orthodontic treatment need by an examiner calibrated in the ICON. The results were compared with the decisions of an expert panel of 15 orthodontic specialists from the central Ohio area. The simple kappa statistic (0.81) indicated very high agreement of the index with the decisions of the expert panel. The sensitivity (94%), specificity (85%), positive predictive value (92%), negative predictive value (90%), and overall accuracy of the ICON (91%) also confirmed good agreement with the orthodontic specialists. The panel found that 64% of the casts required orthodontic treatment; the ICON scores indicated that 65% of the cases needed treatment. There was agreement between the expert panel and the index in 155 of the 170 cases. These results support the use of the ICON as a validated index of orthodontic treatment need.

Dental Health Surveys↗
PubMed1997

IBMTR Severity Index for grading acute graft-versus-host disease: retrospective comparison with Glucksberg grade.

Acute graft-versus-host disease (GVHD) severity is graded by pattern of organ involvement and clinical performance status using a system introduced by Glucksberg and colleagues 21 years ago. We examined how well Glucksberg grade predicted transplant outcome and constructed a Severity Index not requiring subjective assessment of performance in 2881 adults receiving an HLA-identical sibling T-cell-depleted (n = 752) or non-T-cell-depleted (n = 2129) bone marrow transplant for leukaemia between 1986 and 1992. Relative risks (RR) of relapse, treatment-related mortality (TRM) and treatment failure (TF) (relapse or death) were calculated for patients with (Glucksberg Grade I, II or III/IV acute (GVHD) versus those without acute GVHD and for patients with distinct patterns of organ involvement regardless of Glucksberg grade. Using data for non-T-cell-depleted transplants, a Severity Index was developed grouping patients with patterns of organ involvement associated with similar risks of TRM and TF. Higher Glucksberg grade predicted poorer outcome; however, patients with the same grade but different patterns of skin, liver or gut involvement often had significantly different outcomes. The revised Severity Index groups patients in four categories, A-D. Compared to patients without acute GVHD, RRs (95% confidence interval) of TF were 0.85 (0.69, 1.05) for patients with Index A, 1.21 (1.02, 1.43) with B, 2.19 (1.78, 2.71) with C, and 5.69 (4.57, 7.08) with D. Prognostic utility of the Index was tested in patients receiving T-cell-depleted transplants; similar RRs of TF were observed. An acute GVHD Severity Index is proposed to enhance design and interpretation of clinical trials in the current era of allogeneic blood and bone marrow transplantation.

Adolescent↗
PubMed2001

Body mass index and metabolic risk factors for coronary heart disease in women.

AIMS: Prospective epidemiological studies demonstrate an increase in coronary heart disease mortality in women beginning at values of body mass index > or = 22 kg. m(-2). However, the metabolic basis for this observation has not been adequately studied in women. Our aim was to examine the association between body mass index, metabolic coronary heart disease risk factors and a predicted 10-year coronary heart disease risk score in a large occupational cohort of women in the U.K. METHODS AND RESULTS: We carried out a cross-sectional survey of cardiovascular risk factors in 14 077 women, aged 30-64 years. The main outcome measures were systolic and diastolic blood pressure, serum total cholesterol, HDL cholesterol, total cholesterol/HDL cholesterol ratio, LDL-cholesterol, triglycerides, apolipoprotein A1, apolipoprotein B, lipoprotein(a), fasting blood glucose and a predicted 10-year coronary risk score. Across seven categories of body mass index, i.e. < 20, 20-, 22-, 24-, 26-, 28- and > or = 30 kg. m(-2), there were highly significant age-adjusted increases in the risk factors (all P < 0.001), except for a decrease in HDL cholesterol and ApoA1 (all P<0.001) and no relationship with lipoprotein(a) (P = 0.05). Based on a multifactorial 10-year coronary heart disease risk estimate, odds ratios for being in the highest quintile of risk for each category of body mass index, were 1 (< 20 kg. m(-2)), 0.91, 1.56, 2.18, 2.97, 3.83 and 4.21 (> or = 30 kg. m(-2)). CONCLUSION: The significant rise in metabolic coronary heart disease risk at 22 kg. m(-2)observed in this study is consistent with prospective epidemiological studies in women which have reported an increase in coronary heart disease mortality starting at 22 kg. m(-2). However, body mass index was a poor discriminator of women at different levels of coronary heart disease risk. The primary goal of weight loss in individuals should be the correction of dysmetabolism, irrespective of the level of body mass index.

Adult↗
PubMed2002

Algo-functional assessment of knee osteoarthritis: comparison of the test-retest reliability and construct validity of the WOMAC and Lequesne indexes.

OBJECTIVE: To assess and compare the test-retest reliability and the construct validity of the Lequesne and the French-Canadian version of the WOMAC indexes. DESIGN: Patients with symptomatic knee osteoarthritis (OA) fulfilling the revised criteria of the American College of Rheumatology completed both the Lequesne and the French-Canadian version of the WOMAC indexes twice at a 3-h interval. Impairment outcome measures, patients' perceived discomfort in walking and handicap were recorded. For both questionnaires, an analysis was performed item by item. Repeatability was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated using the Spearman rank correlation coefficient and a factor analysis was performed. RESULTS: 88 patients were included. Eight questions of the WOMAC section C and one question of the Lequesne index had insufficient psychometric properties. Although repeatability of questionnaires was fair to excellent (0.82, 0.68, 0.74, 0.95 for the WOMAC sections A, B, C and Lequesne index respectively), construct validity could not be demonstrated. Factor analysis of the WOMAC extracted five factors which differed from the a priori triple stratification. Factor analysis of the WOMAC section C extracted two factors explaining 71% of the variance which could not be clinically characterized. For the Lequesne index, expected convergent correlations were not always achieved. Three factors were extracted by factor analysis explaining 58% of the variance. CONCLUSION: Despite their good test-retest reliability, the two composite indexes evaluated are not valid to assess the concept of functional disability induced by knee OA in a French population.

Adult↗
PubMed2005

[Does HRCT-emphysema index represent the entire lung?].

PURPOSE: : Comparison of emphysema index derived of thin section MD-CT of the entire lung volume and HRCT, simulated by calculation of every twentieth image of the whole data-set. MATERIALS AND METHODS: Pulmonary emphysema was quantified by semiautomatic, segmentation of lung borders and assessment of lung volume and emphysema volume within these borders. The emphysema index (pixel index) was calculated. Statistical analysis was done by the sign-test and Bland-Altman-analysis. RESULTS: Median lung volume, emphysema volume and emphysema index are significantly higher in simulated HRCT. Median lung volume (emphysema volume) calculated by HRCT is 5118 ml (407 ml) and 5040 ml (367 ml) calculated by the entire MD-CT data-set, representing differences of 1 and 8 % related to the median lung and emphysema volumes. Emphysema index is 0.09 (HRCT) and 0.08 (MD-CT). CONCLUSION: HRCT overrates emphysema index compared to thin section MD-CT of the entire lung volume.

Adolescent↗
PubMed2002

Determination of the mitotic index by microinjection of fluorescently labelled tubulin.

The microneedle injection technique is one of the most established procedures for the introduction of proteins into living cells. To analyse injected proteins which are important in cell cycle progression it is often necessary to determine the mitotic index. Measuring the mitotic index after microinjection is complicated because only a limited number of cells of the whole cell population is microinjected. Therefore, we attempted to establish a new method to determine the mitotic index using microinjection of fluorescently labelled alpha/beta-tubulin into mammalian cells which allows to monitor the injected cells simultaneously with the determination of the mitotic index. We demonstrated that fluorescently labelled tubulin incorporates efficiently into the mitotic spindle apparatus. Fluorescence remains stable for several hours which is sufficient to observe the progression of cells through the M-phase of the cell cycle. The determination of the mitotic index with the method presented here gave similar results to those determined using other methods. With this method also different stages of mitosis can be visualized by analysing various steps of spindle formation. Thus, this rapid method allows the monitoring of the injected cells after microneedle injection and simultaneously the determination of the mitotic index.

Animals↗
PubMed2006

The Pregnancy Mobility Index: a mobility scale during and after pregnancy.

BACKGROUND: During pregnancy, every second woman will experience some degree of back or pelvic pain. While several validated instruments to assess back pain exist for the general population, these are not suitable for application in a pregnant population and have not been validated for this purpose. A pregnant population not only differs from the general population regarding the type of back pain--frequently a pelvic girdle component is added--but pregnant women also have different mobility patterns and expectations. We therefore present in this study a self-report mobility scale specifically designed for a pregnant population: the Pregnancy Mobility Index. METHODS: Longitudinal cohort study including 672 nulliparous women with a singleton low-risk pregnancy. The Pregnancy Mobility Index consists of items concerning day-to-day activities selected through literature research and clinical experience. Participating women completed the questionnaire at 12 and 36 weeks' gestation and one year after delivery. Reliability, construct and criterion validity were tested. RESULTS: The internal consistency (Cronbach's alpha) was 0.8 or higher. The Pregnancy Mobility Index scales correlated best with the physical and pain scale of the RAND-36, indicating a good construct validity. The assumptions that the Pregnancy Mobility Index scores increase during pregnancy and decrease after delivery and that women with back or pelvic problems scored higher on the Pregnancy Mobility Index domains than women without back or pelvic pain were confirmed, indicating a good criterion validation. CONCLUSION: The Pregnancy Mobility Index has been shown to be a reliable and valid questionnaire well suited for use during and after pregnancy.

Activities of Daily Living↗
PubMed1995

Diet, body mass index, and colonic epithelial cell proliferation in a healthy population.

Using 63 healthy subjects, we conducted an observational study to assess associations between colonic epithelial cell proliferation and dietary intake of selected nutrients. Study subjects exhibited no personal or family history of colon carcinoma, familial polyposis coli, sporadic adenomas, or chronic inflammatory bowel diseases. In this study population, a negative association between the tritiated thymidine-labeling index and dietary intake of calcium (p < 0.003) was found after the effects of age, sex, body mass index (kg/m2), dietary fat, and total energy were controlled in a linear regression model. The association for calcium indicated that a daily calcium intake of 1,200 mg was associated with a predicted thymidine-labeling index of 6%. In the same model, a positive association with the thymidine-labeling index was found for body mass index (p < 0.002) and was suggested for female gender (p < 0.09). No association was found between the thymidine-labeling index and intake of fat, protein, carbohydrate, retinol, ascorbic acid, phosphorus, or iron. Repeat measures of diet in this investigation were used to estimate a subject's daily intake of selected nutrients.

Adult↗
PubMed1995

Preoperative nutritional status and prognostic nutritional index in patients with benign disease undergoing abdominal operations--Part II.

OBJECTIVES: Part II of this study was undertaken to develop a prognostic nutritional index for the identification of high risk patients with benign disease undergoing abdominal operations at the Universitas Hospital in Bloemfontein. METHODS: To accomplish this goal, 52 consecutive adult non-cancer surgical patients, admitted to the Universitas Hospital for a period of one year, were studied prospectively. The postoperative outcome was monitored until discharge or death. Various discriminant analyses were performed on the obtained data. Four prognostic indexes were compiled, including two nutritional and two mixed models. A short and medium length index were derived for both the nutritional and the mixed models. RESULTS/DISCUSSION: The results suggest that the short nutritional index may be the most practical for the prediction of surgical outcome in this specific set of patients. The short nutritional index included diet risk, serum albumin, body mass index, % ideal body weight, triceps skinfold and grip strength. It is further suggested that these indices be tested in another set of patients and be compared with other available prognostic models.

Abdomen↗
PubMed2005

A comparison of three dietary pattern indexes for predicting biomarkers of diet and disease.

OBJECTIVE: Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes-Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)-for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes. METHODS: We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged > or =20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates. RESULTS: All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p < or = 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p < or = 0.03). CONCLUSIONS: The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.

Adult↗
PubMed2006

Taxonomic indexing--extending the role of taxonomy.

Taxonomic indexing refers to a new array of taxonomically intelligent network services that use nomenclatural principles and elements of expert taxonomic knowledge to manage information about organisms. Taxonomic indexing was introduced to help manage the increasing amounts of digital information about biology. It has been designed to form a near basal layer in a layered cyberinfrastructure that deals with biological information. Taxonomic Indexing accommodates the special problems of using names of organisms to index biological material. It links alternative names for the same entity (reconciliation), and distinguishes between uses of the same name for different entities (disambiguation), and names are placed within an indefinite number of hierarchical schemes. In order to access all information on all organisms, Taxonomic indexing must be able to call on a registry of all names in all forms for all organisms. NameBank has been developed to meet that need. Taxonomic indexing is an area of informatics that overlaps with taxonomy, is dependent on the expert input of taxonomists, and reveals the relevance of the discipline to a wide audience.

Abstracting and Indexing↗
PubMed2005

Dietary glycemic index and load, measures of glucose metabolism, and body fat distribution in older adults.

BACKGROUND: Recent evidence suggests that the rate of carbohydrate digestion and absorption may influence the development of type 2 diabetes. OBJECTIVE: The aim of this study was to examine associations of dietary glycemic index and glycemic load with predictors of type 2 diabetes in older adults. DESIGN: This study evaluated cross-sectional relations of dietary glycemic index and glycemic load with measures of glucose metabolism and body fat distribution in participants of the Health, Aging and Body Composition Study, a prospective cohort study of adults aged 70-80 y (n = 2248). RESULTS: In men, dietary glycemic index was positively associated with 2-h glucose (P for trend = 0.04) and fasting insulin (P for trend = 0.004), inversely associated with thigh intramuscular fat (P for trend = 0.02), and not significantly associated with fasting glucose, glycated hemoglobin, or visceral abdominal fat. Dietary glycemic load was inversely associated in men with visceral abdominal fat (P for trend = 0.02) and not significantly associated with fasting glucose, 2-h glucose, glycated hemoglobin, fasting insulin, or thigh intramuscular fat. In women, although dietary glycemic index and load were not significantly related to any measures of glucose metabolism or body fat distribution, the association between dietary glycemic index and 2-h glucose was nearly significant (P for trend = 0.06). CONCLUSION: The findings of this cross-sectional study indicate an association between dietary glycemic index and selected predictors of type 2 diabetes in older adults, particularly in men.

Adipose Tissue↗