Analysis of Superficial Subcutaneous Fat Camper's and Scarpa's Fascia in a United States Cohort

Overview

Journal J Cardiovasc Dev Dis

Specialty Cardiology & Vascular Diseases

Date 2023 Aug 25

PMID 37623360

Authors

David Z Chen

Aravinda Ganapathy

Yash Nayak

Christopher Mejias

Grace L Bishop

Vincent M Mellnick

David H Ballard

Affiliations

Soon will be listed here.

Abstract

Together, the Camper's and Scarpa's fasciae form the superficial fat layer of the abdominal wall. Though they have clinical and surgical relevance, little is known about their role in body composition across diverse patient populations. This study aimed to determine the relationship between patient characteristics, including sex and body mass index, and the distribution of Camper's and Scarpa's fascial layers in the abdominal wall. A total of 458 patients' abdominal CT examinations were segmented via CoreSlicer 1.0 to determine the surface area of each patient's Camper's, Scarpa's, and visceral fascia layers. The reproducibility of segmentation was corroborated by an inter-rater analysis of segmented data for 20 randomly chosen patients divided between three study investigators. Pearson correlation and Student's t-test analyses were performed to characterize the relationship between fascia distribution and demographic factors. The ratios of Camper's fascia, both as a proportion of superficial fat (r = -0.44 and < 0.0001) and as a proportion of total body fat (r = -0.34 and < 0.0001), showed statistically significant negative correlations with BMI. In contrast, the ratios of Scarpa's fascia, both as a proportion of superficial fat (r = 0.44 and < 0.0001) and as a proportion of total body fat (r = 0.41 and < 0.0001), exhibited statistically significant positive correlations with BMI. Between sexes, the females had a higher ratio of Scarpa's facia to total body fat compared to the males (36.9% vs. 31% and < 0.0001). The ICC values for the visceral fat, Scarpa fascia, and Camper fascia were 0.995, 0.991, and 0.995, respectively, which were all within the 'almost perfect' range (ICC = 0.81-1.00). These findings contribute novel insights by revealing that as BMI increases the proportion of Camper's fascia decreases, while the ratio of Scarpa's fascia increases. Such insights expand the scope of body composition studies, which typically focus solely on superficial and visceral fat ratios.

References

Shea J, King M, Yi Y, Gulliver W, Sun G . Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects. Nutr Metab Cardiovasc Dis. 2011; 22(9):741-7. DOI: 10.1016/j.numecd.2010.11.009. View

CONGDON E, Edson J, YANITELLI S . Gross structure of the subcutaneous layer of the anterior and lateral trunk in the male. Am J Anat. 2010; 79:399-429. DOI: 10.1002/aja.1000790304. View

Ali Khan F, Fatima M . Abdominoplasty without Drains or Progressive Tension Suturing. Aesthetic Plast Surg. 2021; 45(4):1660-1666. DOI: 10.1007/s00266-021-02177-8. View

Hakim O, Bello O, Ladwa M, Peacock J, Umpleby A, Charles-Edwards G . The Link between Obesity and Inflammatory Markers in the Development of Type 2 Diabetes in Men of Black African and White European Ethnicity. Nutrients. 2020; 12(12). PMC: 7764810. DOI: 10.3390/nu12123796. View

Wijaya W, Liu Y, He Y, Qing Y, Li Z . Abdominoplasty with Scarpa Fascia Preservation: A Systematic Review and Meta-analysis. Aesthetic Plast Surg. 2022; 46(6):2841-2852. DOI: 10.1007/s00266-022-02835-5. View

Golan R, Shelef I, Rudich A, Gepner Y, Shemesh E, Chassidim Y . Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes. Diabetes Care. 2012; 35(3):640-7. PMC: 3322677. DOI: 10.2337/dc11-1583. View

Lancerotto L, Stecco C, Macchi V, Porzionato A, Stecco A, De Caro R . Layers of the abdominal wall: anatomical investigation of subcutaneous tissue and superficial fascia. Surg Radiol Anat. 2011; 33(10):835-42. DOI: 10.1007/s00276-010-0772-8. View

Murouchi T . Transient obturator nerve block with fascia iliaca compartment block following local infiltration for open inguinal herniorrhaphy. JA Clin Rep. 2020; 4(1):63. PMC: 6967327. DOI: 10.1186/s40981-018-0200-3. View

Tatsumi Y, Nakao Y, Masuda I, Higashiyama A, Takegami M, Nishimura K . Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan. BMJ Open. 2017; 7(1):e013831. PMC: 5253636. DOI: 10.1136/bmjopen-2016-013831. View

10.

Harley O, Pickford M . CT analysis of fat distribution superficial and deep to the Scarpa's fascial layer in the mid and lower abdomen. J Plast Reconstr Aesthet Surg. 2013; 66(4):525-30. DOI: 10.1016/j.bjps.2012.12.003. View

11.

Konschake M, Zwierzina M, Moriggl B, Fugger R, Mayer F, Brunner W . The inguinal region revisited: the surgical point of view : An anatomical-surgical mapping and sonographic approach regarding postoperative chronic groin pain following open hernia repair. Hernia. 2019; 24(4):883-894. PMC: 7395915. DOI: 10.1007/s10029-019-02070-z. View

12.

Liberato S, Maple-Brown L, Bressan J, Hills A . The relationships between body composition and cardiovascular risk factors in young Australian men. Nutr J. 2013; 12:108. PMC: 3750304. DOI: 10.1186/1475-2891-12-108. View

13.

Smith S, Lovejoy J, Greenway F, Ryan D, DeJonge L, de la Bretonne J . Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Metabolism. 2001; 50(4):425-35. DOI: 10.1053/meta.2001.21693. View

14.

Frank K, Hamade H, Casabona G, Gotkin R, Kaye K, Tiryaki T . Influences of Age, Gender, and Body Mass Index on the Thickness of the Abdominal Fatty Layers and its Relevance for Abdominal Liposuction and Abdominoplasty. Aesthet Surg J. 2019; 39(10):1085-1093. DOI: 10.1093/asj/sjz131. View

15.

Brand T, van den Munckhof I, van der Graaf M, Schraa K, Dekker H, Joosten L . Superficial vs Deep Subcutaneous Adipose Tissue: Sex-Specific Associations With Hepatic Steatosis and Metabolic Traits. J Clin Endocrinol Metab. 2021; 106(10):e3881-e3889. PMC: 8571813. DOI: 10.1210/clinem/dgab426. View

16.

Serfaty D, Rein M, Schwarzfuchs D, Shelef I, Gepner Y, Bril N . Abdominal fat sub-depots and energy expenditure: Magnetic resonance imaging study. Clin Nutr. 2016; 36(3):804-811. DOI: 10.1016/j.clnu.2016.05.009. View

17.

Zaidi H, Aksnes T, Akra S, Eggesbo H, Byrkjeland R, Seljeflot I . Abdominal Adipose Tissue Associates With Adiponectin and TNFα in Middle-Aged Healthy Men. Front Endocrinol (Lausanne). 2022; 13:874977. PMC: 9301307. DOI: 10.3389/fendo.2022.874977. View

18.

Koenen M, Hill M, Cohen P, Sowers J . Obesity, Adipose Tissue and Vascular Dysfunction. Circ Res. 2021; 128(7):951-968. PMC: 8026272. DOI: 10.1161/CIRCRESAHA.121.318093. View

19.

Odobescu A, Keith J . Preshaping DIEP Flaps: Simplifying and Optimizing Breast Reconstruction Aesthetics. Plast Reconstr Surg. 2021; 147(5):1059-1061. DOI: 10.1097/PRS.0000000000007889. View

20.

Pokrywczynska M, Jundzill A, Rasmus M, Adamowicz J, Balcerczyk D, Buhl M . Understanding the role of mesenchymal stem cells in urinary bladder regeneration-a preclinical study on a porcine model. Stem Cell Res Ther. 2018; 9(1):328. PMC: 6260700. DOI: 10.1186/s13287-018-1070-3. View