Complement component C3 is associated with body composition parameters and sarcopenia in community-dwelling older adults: a cross-sectional study in Japan

BACKGROUND

Chronic inflammation is a factor in the pathogenesis of sarcopenia, which is characterized by low muscle mass and reduced strength. Complement C3 is important in the management of the immune network system. This study seeks to determine the relationship between serum C3 levels and body composition and sarcopenia-related status in community-dwelling older adults.

METHODS

Study participants were 269 older adults living in rural Japan. A bioelectrical impedance analysis device was used to measure body composition parameters including body mass index (BMI), body fat percentage, waist-hip-ratio, and appendicular skeletal muscle mass index (SMI). Muscle function was measured by handgrip strength and 6-m walking speed. The correlation coefficients for C3 level and measurements were calculated using Pearson correlation analysis. Participants were categorized into normal, pre-sarcopenia, dynapenia, or sarcopenia groups. Sarcopenia was defined according to 2019 Asian Working Group for Sarcopenia definition, dynapenia was defined as low muscle function without low muscle mass, and pre-sarcopenia was defined as the presence of low muscle mass only. The C3 threshold score for sarcopenia status was evaluated by receiver operating characteristic curve (ROC) analysis.

RESULTS

Significant positive correlations were found between C3 and BMI, body fat percentage, and waist-hip ratio in both sexes, and further positive correlations with SMI were found in women. The relationship with body fat percentage was particularly strong. Body composition measurements (BMI, body fat percentage, and waist- hip ratio) and C3 levels were lowest in the sarcopenia group compared with the others. ROC analysis showed that the significant threshold of C3 for discriminating between the normal and sarcopenia groups was 105 mg/dL. Multiple logistic regression analysis showed that participants with C3 < 105 mg/dL had an odds ratio of 3.27 (95% confidence interval, 1.49-7.18) for sarcopenia adjusted by sex, age and body fat percentage.

CONCLUSION

C3 levels are suggested to be related to body composition and pathophysiological functions of sarcopenia. C3 is expected to become a useful biomarker for sarcopenia, for predicting the onset of the disease and for predicting the effectiveness of interventions.

Body composition changes in patients with differentiated thyroid cancer after iodine-131 treatment and short-term levothyroxine replacement and suppression therapy

PURPOSE

The purposes of this study were to assess the changes in body composition in patients who underwent thyroidectomy due to differentiated thyroid cancer (DTC) after radioactive iodine therapy (RAI) and short-term levothyroxine (LT4) supplementation and to explore the correlations between body composition distribution and corresponding blood indices.

METHODS

Fifty-seven thyroidectomized DTC patients were included. Serum was tested for several biochemical indices of thyroid function, lipids, and bone metabolism, and body composition parameters were measured via dual-energy X-ray absorptiometry before and 4-6 weeks after RAI and LT4 supplementation.

RESULTS

The body composition of DTC patients changed after RAI. Fat mass in all parts of the body decreased (range of relative change (RRC) -12.97--2.80%). Bone mineral content (BMC) increased throughout the body (relative change (RC) 12.12%), head (RC 36.23%), pelvis (RC 9.00%), and legs (RC 3.15%). Similarly, bone mineral density (BMD) increased in different regions (RRC 3.60-26.43%), except for the arms. Notably, lean mass in the arms (RC 4.30%) and legs (RC 3.67%) increased, while that in the head decreased (RC -2.75%), while total lean mass did not change at 4-6 weeks after LT4 supplementation. Furthermore, changes in fat distribution in the android region were related to the changes in total cholesterol (r = -0.390) and low-density lipoprotein cholesterol (r = -0.354), and changes in the BMC and BMD of the lumbar spine were positively associated with the changes in calcitonin (r = 0.302 and 0.325, respectively).

CONCLUSIONS

After RAI and short-term LT4 supplementation in DTC patients, body composition rapidly and positively changed and was characterized by decreased fat mass and increased BMC and BMD.

Skeletal muscle index together with body mass index is associated with secondary osteoporosis in patients with rheumatoid arthritis

OBJECTIVE

The objective of this study was to explore the associations of body mass index (BMI), fat mass index (FMI), skeletal mass index (SMI) and secondary osteoporosis (OP) in patients with rheumatoid arthritis (RA).

METHODS

The bone mineral density (BMD) at sites of the femur neck (Neck), total hip (Hip) and lumbar vertebrae 1-4 (L1-4) was measured by dual-energy X-ray absorptiometry. The skeletal muscle index, body fat percentage and mineral content were measured by biological electrical impedance for calculating BMI, FMI and SMI.

RESULTS

A total of 433 patient with RA and 158 healthy controls were enrolled. The BMDs at each site of the RA patients were lower compared with those of the healthy controls (p < 0.0001), and the prevalence of OP (36.1%, 160/443) and sarcopenia (65.2%, 288/443) in the RA patients were higher than those in the controls (12.7%, 20/158, p < 0.0001; 9.0%, 14/156, p < 0.0001). Significant differences in the BMD, FMI, SMI, mineral content, body fat percentage and skeletal muscle mass were found among the RA patients in the different BMI groups (p < 0.05). In RA patients with BMI < 18.5 kg/m2, the prevalence of OP in the RA patients with sarcopenia was similar to that in those without sarcopenia (44.4% vs. 66. 7%, χ2 = 0. 574, p = 0.449). In the RA patients with a normal BMI or who were overweight or obese, prevalence of OP in the RA patients with sarcopenia was significantly higher than that in the RA patients without sarcopenia (42.8% vs. 21.7%, χ2 = 10.951, p = 0.001; 61.1% vs. 13.0%, χ2 = 26.270, p < 0.0001). In the RA patients without sarcopenia, the prevalence of OP in the RA patients in the different BMI groups was different (p = 0.039). In the RA patients with sarcopenia, there was no significant difference in the prevalence of OP among the RA patients in the different BMI groups (p = 0. 128). The linear correlation analysis showed that the SMI in RA patients was positively correlated with the BMD of each site measured and BMI and FMI (p < 0.0001). However, there was a negative linear correlation between SMI and disease duration (p = 0.048). The logistic regression analysis found that SMI (OR = 0.569, p = 0.002, 95% CI 0.399-0.810), BMI (OR = 0.884, p = 0.01, 95% CI 0.805-0.971) and gender (1 = female, 2 = male) (OR = 0.097, p < 0.0001, 95% CI 0.040-0.236) were protective factors for OP in RA, while age (OR = 1.098, p < 0.0001, 95% CI 1.071-1.125) was the risk factor.

CONCLUSION

BMI and SMI are associated with the occurrence of OP in RA patients, and both SMI and BMI are important protective factors for OP secondary to RA.

Monitoring training, performance, biomarkers, and psychological state throughout a competitive season: a case study of a triathlete

INTRODUCTION

Ironman triathletes undergo high workloads during competition preparation which can result in nonfunctional overreaching or overtraining syndrome if not matched with adequate recovery.

PURPOSE

The purpose of this case study was to observe changes in physiological and psychological status over the course of a competitive season in a free-living triathlete.

METHODS

The subject was a 41-year-old triathlete competing in three 113.1-km events. Over the course of a 40-week period, the participant arrived at the laboratory every 4 weeks and underwent body composition testing via air displacement plethysmography, a blood draw for analysis of various biomarkers, and a treadmill-based lactate threshold test. Workload during training and competitions was monitored via a wearable heart rate-monitoring device.

RESULTS

Throughout the season, training volume remained high (12.5 ± 3.4 h/week) and body mass and fat-free mass (FFM) continuously decreased, while biomarkers including cortisol, testosterone, and markers of immunological status exhibited minor changes. Laboratory performance remained relatively consistent, while competition performance continually improved. Following the completion of the competitive period, training volume decreased, FFM remained below baseline levels, free cortisol increased, and both free and total testosterone decreased.

CONCLUSIONS

Workload and recovery seem to have been properly managed throughout the season, evidenced by minimal fluctuations in endocrine and immunological markers. The reason for changes observed in testosterone, cortisol, and body composition following the last competition is unclear, though it may be attributed to changes in stressors and recovery practices outside of training. It is recommended that athletes follow a structured plan during the transition period into the offseason to ensure recovery of physiological state and to set up a productive offseason.

Physical performance determinants in competitive youth swimmers: a systematic review

BACKGROUND

Youth swimming performance is determined by several physiological, biomechanical and anthropometric characteristics. This review aimed to identify physical performance determinants of youth swimming performance, assessing strength, power, anaerobic, aerobic and body composition measures. ̇ METHODS: Searches were conducted in electronic databases (PubMed and Web of Science) using keywords relating to swimming and physiological measures, supplemented by citation searching of similar reviews. A total of 843 studies were identified in the initial search. The following inclusion criteria were used: participants were competitive/trained swimmers; swimming time-trial or event was conducted; data was provided on one or more physiological parameters; study was published in English and peer-reviewed. A total of 43 studies met the inclusion criteria. Risk of bias was assessed using Joanna Briggs Institute (JBI) checklist.

RESULTS

Cross-sectional studies scored between 4-8 and randomised-controlled trials scored 8-9 on their respective JBI checklists. Youth swimming performance was determined by muscle strength, muscle power, lean body mass, anaerobic and aerobic metabolism measures in most studies, where improved performance values of these variables were conducive to swimming performance. Body fat percentage did not have a clear relationship in youth swimming performance.

CONCLUSIONS

Findings of this review suggest that greater levels of muscle strength, muscle power and lean body mass are favourable in swimming performance, with muscle strength and muscle power particularly beneficial for start and turn performance. Anaerobic and aerobic metabolism measures were good determinants of swimming performance, with middle- and long-distance events more influenced by the latter. Body fat percentage has a nuanced relationship with swimming performance, where further investigation is required. Findings were inconsistent across studies, potentially due to unidentified confounding factors.

KEY POINTS

• Greater muscular strength and power qualities, anaerobic and aerobic capacities, and lean body mass are conducive to swimming performance. • Body fat percentage has a nuanced relationship with swimming performance. • Practitioners should consider general strength and power training as a useful tool to enhance performance in their youth competitors.

SGLT2 Inhibitors Decrease Overhydration and Proteasuria in Patients with Chronic Kidney Disease: A Longitudinal Observational Study

INTRODUCTION

SGLT2 inhibitors are used to reduce the risk of progression of chronic kidney disease (CKD). In patients with type 2 diabetes, they have been found to reduce extracellular volume. Given the high prevalence of extracellular volume expansion and overhydration (OH) in CKD, we investigated whether SGLT2 inhibitors might correct these disturbances in CKD patients.

METHODS

CKD patients who started treatment with an SGLT2 inhibitor were investigated in this prospective observational study for 6 months. Body composition and fluid status were measured by bioimpedance spectroscopy. In addition, spot urine samples were analyzed for albuminuria, glucosuria, and urinary aprotinin-sensitive serine protease activity.

RESULTS

Forty-two patients (29% with diabetic/hypertensive CKD, 31% with IgA nephropathy; 88% dapagliflozin 10 mg, 10% dapagliflozin 5 mg, 2% empagliflozin 20 mg; median eGFR 46 mL/min/1.73 m2 and albuminuria 1,911 mg/g creatinine) participated in the study. Median glucosuria increased to 14 (10-19) g/g creatinine. At baseline, patients displayed OH with +0.4 (-0.2 to 2.2) L/1.73 m2, which decreased by 0.5 (0.1-1.2) L/1.73 m2 after 6 months. Decrease of OH correlated with higher OH at BL, decrease of albuminuria, glucosuria, and urinary aprotinin-sensitive protease activity. Adipose tissue mass was not significantly reduced after 6 months.

CONCLUSION

SGLT2 inhibitors reduce OH in patients with CKD, which is pronounced in the presence of high albuminuria, glucosuria, and urinary aprotinin-sensitive protease activity.

Implication of Bone Mineral Density and Body Composition Parameters for Length of Hospital Stay in Patients with COVID-19

BACKGROUND

Multisystem information, including musculoskeletal information, can be captured from chest CT scans of patients with COVID-19 without further examination.

AIMS

This study aims to assess the relationship between chest CT-extracted baseline bone mineral density (BMD) and body composition parameters and the length of hospital stay in these patients.

METHODS

A retrospective analysis was performed in a cohort of 88 patients with COVID-19. Correlation analysis and a generalized linear model (GLM) were used to assess the associations between the length of hospital stay and covariates, including age, sex, body mass index (BMI), BMD and body composition variables.

RESULTS

The mean length of hospital stay was 27.4±8.7 days. The length of hospital stay was significantly positively associated with age (r=0.202, p=0.046) and the paraspinal muscle fat ratio (r=0.246, p=0.021). The GLM involving age, sex, BMD, paraspinal muscle fat ratio, subcutaneous adipose tissue (SAT) area, visceral adipose tissue (VAT) area, and liver fat fraction (LFF) showed that the length of hospital stay was positively correlated with VAT area (β coefficients, 95% CI: 9.304, 1.141-17.478, p=0.025).

CONCLUSION

The musculoskeletal features extracted from chest CT correlated with the prognosis of COVID-19 patients. Factors including old age, a higher paraspinal muscle fat ratio and a larger VAT area in patients with COVID-19 were associated with longer hospital stays.

Effect of Zinc Supplementation on Lipid Profile and Body Composition in Patients with Type 2 Diabetes Mellitus: A GRADE-Assessed Systematic Review and Dose-Response Meta-analysis

The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to investigate the overall effects of zinc supplementation on lipid profile and body composition such as body weight (BW), body mass index (BMI), triglycerides (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) in patients with type 2 diabetes mellitus (T2DM). Scopus, Web of Science, PubMed, and Embase databases were searched from inception through October, 2023. The I2 and Cochran's Q tests were used to assess heterogeneity between studies. Nineteen RCTs (n = 1357 participants) were included in the meta-analysis. Zinc supplementation significantly reduced TG (WMD = - 17.41 mg/dL; 95% CI: - 22.60, - 12.22; P < 0.001), TC (WMD: - 19.60 mg/dL; 95% CI: - 28.46, - 10.73, P < 0.001), LDL-C (WMD = - 8.80 mg/dL; 95% CI: - 14.80, - 2.81; P = 0.004), and BMI (WMD = - 0.53 kg/m2; 95% CI: - 1.05, - 0.01; P = 0.046) but not BW (WMD: - 0.51 kg, 95 % CI: - 1.99, 0.97, P = 0.498). Moreover, zinc supplementation increased HDL-C (WMD = 4.82 mg/dL; 95% CI: 0.88, 8.76; P = 0.016) in patients with T2DM. Our results propose that zinc supplementation may be an effective strategy for improving lipid profile and body composition in patients with T2DM.

Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND

In recent years, the prevalence of obesity and metabolic syndrome in type 1 diabetes (T1DM) patients has gradually increased. Insulin resistance in T1DM deserves attention. It is necessary to clarify the relationship between body composition, metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.

AIM

To assess body composition (BC) in T1DM patients and evaluate the relationship between BC, metabolic syndrome (MS), and insulin resistance in these indi-viduals.

METHODS

A total of 101 subjects with T1DM, aged 10 years or older, and with a disease duration of over 1 year were included. Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters. Clinical and laboratory data were collected, and insulin resistance was calculated using the estimated glucose disposal rate (eGDR).

RESULTS

MS was diagnosed in 16/101 patients (15.84%), overweight in 16/101 patients (15.84%), obesity in 4/101 (3.96%), hypertension in 34/101 (33.66%%) and dyslipidemia in 16/101 patients (15.84%). Visceral fat index (VFI) and trunk fat mass were significantly and negatively correlated with eGDR (both P < 0.001). Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients. Binary logistic regression analysis revealed that significant factors for MS included eGDR [P = 0.017, odds ratio (OR) = 0.109], VFI (P = 0.030, OR = 3.529), and a family history of diabetes (P = 0.004, OR = 0.228). Significant factors for hypertension included eGDR (P < 0.001, OR = 0.488) and skeletal muscle mass (P = 0.003, OR = 1.111). Significant factors for dyslipidemia included trunk fat mass (P = 0.033, OR = 1.202) and eGDR (P = 0.037, OR = 0.708).

CONCLUSION

Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM. BC analysis, specifically identifying visceral fat (trunk fat), may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Effect of body fat mass loss on prognosis of radical resection for pancreatic ductal adenocarcinoma based on bioelectrical impedance analysis

BACKGROUND

Few reports have performed a prognostic analysis based on bioelectrical impedance analysis in patients with radical resection of pancreatic ductal adenocarcinoma (PDAC), and its usefulness in prognostic analysis remains unclear. This study aimed to evaluate body composition changes in patients undergoing radical resection for PDAC and analyze its impact on prognosis.

METHODS

The medical records of radical resection for patients with PDAC were retrospectively reviewed, and the parameters of body composition, including body weight, skeletal muscle mass, body fat mass (BFM), and extracellular water-total body water ratio, from preoperatively to 12 months postoperatively, for each surgical procedure were measured based on direct segmental multifrequency bioelectrical impedance analysis with an InBody 770 (InBody Inc., Tokyo, Japan) device. The clinicopathological and prognostic factors were analyzed.

RESULTS

Among 79 patients who underwent radical resection for PDAC, 36 (46%), 7 (8%), and 36 (46%) underwent pancreatoduodenectomy, total pancreatectomy, and distal pancreatectomy, respectively. The multivariate overall survival analysis demonstrated that BFM loss percentage at 1 month postoperatively ≧14% (p = 0.021), lymph node metastasis (p = 0.014), and non-adjuvant chemotherapy (p <  0.001) were independent poor prognostic factors. Multivariate analysis revealed that preoperative BFM < 12 kg and preoperative albumin < 3.5 g/dL were independently associated with BFM loss percentage at 1 month postoperatively ≧14% (p = 0.021 and p = 0.047, respectively).

CONCLUSIONS

Loss of BFM in the early postoperative period may have a poor prognosis in radical resection of PDAC.

Connections between body composition and dysregulation of islet α- and β-cells in type 2 diabetes

BACKGROUND

Accompanying islet α- and β-cell dysregulation in type 2 diabetes (T2D) at the microscopic scale, alterations in body composition at the macroscopic scale may affect the pathogenesis of T2D. However, the connections between body composition and islet α-cell and β-cell functions in T2D have not been thoroughly explored.

METHODS

For this cross-sectional study, we recruited a total of 729 Chinese Han patients with T2D in a consecutive manner. Dual-energy X-ray absorptiometry (DXA) was used to measure body composition, which included total bone-free mass, total fat and lean mass, trunk fat and lean mass and limb fat and lean mass. Every patient underwent an oral glucose tolerance test to simultaneously detect glucose, C-peptide and glucagon. The indices of islet α-cell function included fasting glucagon levels and the area under the curve of glucagon after a challenge (AUCglucagon), while the indices of β-cell function included the insulin sensitivity index derived from C-peptide (ISIC-peptide) and the area under the curve of C-peptide after a challenge (AUCC-peptide).

RESULTS

Among all patients, fat mass, especially trunk fat mass, was significantly correlated with ISIC-peptide and AUCC-peptide levels (r = - 0.330 and 0.317, respectively, p < 0.001), while lean mass, especially limb lean mass, was significantly correlated with fasting glucagon and AUCglucagon levels (r = - 0.196 and - 0.214, respectively, p < 0.001). Moreover, after adjusting for other relevant variables via multivariate linear regression analysis, increased trunk fat mass was independently associated with decreased ISIC-peptide (β = - 0.247, t = - 3.628, p < 0.001, partial R2 = 10.9%) and increased AUCC-peptide (β = 0.229, t = 3.581, p < 0.001, partial R2 = 8.2%), while decreased limb lean mass was independently associated with increased fasting glucagon (β = - 0.226, t = - 2.127, p = 0.034, partial R2 = 3.8%) and increased AUCglucagon (β = - 0.218, t = - 2.050, p = 0.041, partial R2 = 2.3%). Additionally, when separate analyses were performed with the same concept for both sexes, we found that increased trunk fat mass was still independently associated with decreased ISIC-peptide and increased AUCC-peptide, while decreased limb lean mass was still independently associated with increased fasting glucagon and AUCglucagon.

CONCLUSIONS

Increased trunk fat mass may partly account for decreased insulin sensitivity and increased insulin secretion, while decreased limb lean mass may be connected to increased fasting glucagon and postprandial glucagon secretion.

Total body water percentage and 3rd space water are novel risk factors for training-related lower extremity muscle injuries in young males

PURPOSE

To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis.

METHODS

A total of 282 healthy young male volunteers aged 18 - 20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conforms to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q1, Q3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy.

RESULTS

Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4 % (66 cases). These patients showed higher percentages of lean body mass (p = 0.001), total body water (TBW, p = 0.006), extracellular water (p = 0.020) and intracellular water (p = 0.010) as well as a larger ratio of basal metabolic rate/total weight (p = 0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat (p = 0.001) and body fat mass index (p = 0.002) was lower. Logistic regression analysis showed that TBW percentage > 65.35% (p = 0.050, OR = 3.114) and 3rd space water > 0.95% (p = 0.045, OR = 2.342) were independent risk factors for lower extremity muscle injuries.

CONCLUSION

TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.

Comprehensive evaluation of body composition in a wide age range of Iranian adults using bioelectrical impedance analysis: Tehran Lipid and Glucose Study

OBJECTIVE

To evaluate sex- and age-stratified body composition (BC) parameters in subjects with wide age range of 20-79 years.

DESIGN

Cross-sectional.

SETTING

Participants of Tehran Lipid and Glucose Study (TLGS).

PARTICIPANTS

Two thousand nine hundred seventy participants met our inclusion criteria. They were divided into five age groups, and BC parameters were analysed based on sex and age using a bioelectrical impedance analyser (BIA).

RESULT

The mean age of the participants was 42·1 ± 12·5 years, and 54 % of them were males. The mean BMI was 26·7 ± 3·7 kg/m2. Obesity indices were significantly higher in females (P < 0·001); however, skeletal muscle mass (SMM) and fat-free mass (FFM) were significantly higher in males (P < 0·001). Both SMM and FFM decreased significantly after the age of 50 years. Obesity indices significantly increased from the age group of 20-29 to 30-39 years in males and the age groups of 30-39 to 40-49 years and 40-49 to 50-59 years in females. The fat mass ratio (fat mass/SMM) showed two peaks in both sexes (after the ages of 30 and 50 years in males and 40 and 50 years in females). A strong correlation was found between BMI and percentage of body fat (r = 0·823 in females v. r = 0·768 in males).

CONCLUSION

This is the first community-based study in the MENA region identifying sex- and age-stratified BC values using BIA. Our findings can be used as a reference for comparison in appropriate settings.

Poor vitamin D status was associated with increased appendicular fat deposition in US Adults: Data from 2011-2018 National Health and Nutrition Examination Survey

The aim of the study was to explore the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and regional body fat deposition in 2011-2018 National Health and Nutrition Examination Survey participants aged 18 to 59 years. We hypothesized that serum 25(OH)D concentrations were negatively associated with total, appendicular, and truncal fat deposition. Serum 25(OH)D concentration was categorized into sufficient (≥75.0 nM), insufficient (50.0-74.9 nM), and deficient (<50.0 nM) groups. Fat mass (FM) was measured by dual-energy X-ray absorptiometry, and FM index (FMI) was calculated by dividing FM (kg) with height2 (m2). Multivariant linear regression and Granger causal analysis were performed to assess the causal relationship between vitamin D status and regional FMIs. Overall serum 25(OH)D concentrations were negatively associated with total (β = -0.029, standard error [SE] = 0.002), trunk (β = -0.015, SE = 0.001), arms (β = -0.004, SE = 3.09 × 10-4), and legs (β = -0.010, SE = 0.001) FMIs in all participants (P < .001, respectively); however, after stratified by vitamin D status and BMI, the negative associations were only observed in individuals with vitamin D deficiency and obesity. The causal analysis indicated that serum 25(OH)D concentrations may causally reduce the arms (F = 4.917, probability [P] = 0.007), legs (F = 5.783, P = 0.003), and total (F = 3.202, P = 0.041) FMIs except for trunk FMI but not vice versa. In conclusion, poor vitamin D status was associated with increased total and appendicular body fat deposition in US adults, particularly in participants with obesity.

High-protein diet with immediate post-exercise protein drink: Impact on appetite in middle-aged obesity

Successful management of obesity can be challenging if individuals constantly experience cravings. The present study investigated the effects of a high-protein diet, including a high-protein drink consumed immediately after high-intensity interval training (HIIT), on appetite and weight loss in obese middle-aged individuals. A total of 52 obese middle-aged individuals (58.2 ± 4.11 years old) were randomly assigned to one of three groups: the exercise group (E, n=19), exercise and high-protein diet group (ED, n=21), and a control group (n=12). The E and ED groups engaged in cycling HIIT (comprising 90 % of peak heart rate (HRpeak) for 3 min, followed by 70 % of HRpeak for 3 min, for a total of 5 cycles) three times a week for 3 months. The ED group consumed a high-protein drink immediately after HIIT and had a daily protein intake of 1.6g/kg. Body composition and eating behavior were assessed before and after the intervention. Additionally, appetite levels were measured before and after each exercise session, before dinner, and before bedtime during three phases of the intervention: the first phase (weeks 3-4), the second phase (weeks 5-8), and the third phase (weeks 9-12). Results showed that only the ED group experienced a decrease in body mass index (from 27.4 ± 4.28 to 26.8 ± 4.09 kg/m2, p=0.04). Appetite significantly increased after exercise in both E and ED groups (p values for the three phases ranged from 0.04 to 0.001 for the E group and from 0.042 to 0.003 for the ED group). The desire to eat significantly increased after exercise in the E group (phase 1: p = 0.026; phase 2: p = 0.011; phase 3: p = 0.003), but not in the ED group. Furthermore, the frequency of late-night snacking decreased in the ED group (the score changed from 2.4 ± 0.86 to 2.7 ± 0.80, p = 0.034). Notably, the E group tended to have a higher pre-dinner appetite score than the ED group in the third phase (p = 0.063). In summary, a high daily protein intake, combined with the consumption of high-protein drinks after exercise, resulted in reduced post-exercise appetite and a decrease in the frequency of late-night snacking.

Bisphenol S, bisphenol F, bisphenol a exposure and body composition in US adults

Bisphenol S (BPS) and bisphenol F (BPF) are increasingly used to replace bisphenol A (BPA), an endocrine-disrupting chemical with putative obesogenic properties; whether and how BPS and BPF affect adiposity in humans remains to be determined. Therefore, we examined the association of BPA, BPS， and BPF with body composition among US adults. We included 1787 participants aged 20-59 years old in the National Health and Nutrition Examination Survey 2013-2016 who had information on urinary BPA, BPS, and BPF concentrations, and body composition measured using dual-energy x-ray absorptiometry. After full adjustment for potential confounders in linear regression models, BPA was significantly associated with the % body fat of the whole body, arm, and leg, with the β (95% CI) for the highest quartile vs. the lowest quartile of 1.34 (95%CI [0.11, 2.58], P = 0.03), 1.60 (95%CI [0.20, 3.00], P = 0.03), and 1.63 (95%CI [0.24, 3.02], P = 0.02), respectively. No association between BPA and lean mass was found. For BPS, significant associations were found for % body fat of the whole body (β [95% CI] = 1.42 [0.49, 2.36], P = 0.004), trunk (β[95% CI] = 1.92 [0.86, 2.97], P = 0.001), and arm (β [95% CI] = 1.60 [0.49, 2.70], P = 0.01), as well as lean mass of the whole body (β [95% CI] = 2610.6 [1324.3, 3896.8], P < 0.001), trunk (β [95% CI] = 1467.0 [745.3, 2188.7], P < 0.001), arm (β [95% CI] = 113.4 [10.3, 216.5], P = 0.03), and leg (β [95% CI] = 431.5 [219.6, 643.4], P < 0.001), comparing the third quartile vs. the lowest quartile. No significant association was observed between BPF and % body fat and lean mass. Results suggest that higher BPA levels were significantly associated with greater % body fat of the whole body and limbs, and there was suggestive evidence that BPS levels were associated with both % body fat and lean mass of the whole body and body parts in a nonmonotonic relationship.

Correlation Analysis between Hypogonadal Symptoms and Changes in Body Composition and Physical Fitness after Testosterone Treatment in Men with Testosterone Deficiency

PURPOSE

This study analyzed changes in body composition and physical fitness in men with testosterone deficiency (TD) after testosterone treatment (TT) and examined the correlations of body composition and physical fitness with serum testosterone levels and hypogonadal symptoms.

MATERIALS AND METHODS

Seventy patients with TD were divided into control (group I, n=23) and experimental (group II, n=47) groups. Patients in the experimental group were administered intramuscular testosterone enanthate (250 mg) for six months. The aging males symptom scale (AMS) score, international prostate symptom score (IPSS), body mass index, waist circumference, and serum laboratory values were measured at baseline and at the end of the study. Bioelectrical impedance analysis was used to assess the patients' body composition. Seven types of basic exercise tests were used to evaluate the patients' physical fitness.

RESULTS

After six months, there were no significant differences in group I, while group II had significantly improved IPSS and AMS scores; increased hemoglobin, hematocrit, prostate-specific antigen, and testosterone levels and skeletal muscle mass; and waist circumference, and body fat mass. All elements of the physical fitness test were significantly improved in group II, with the exceptions of flexibility and endurance. Decreased waist circumference was correlated with changes in testosterone levels in group II, and the IPSS, cardiorespiratory fitness, and agility were correlated with improved hypogonadal symptoms.

CONCLUSIONS

TT improved the hypogonadal and lower urinary tract symptoms in patients with TD and improved body composition, physical fitness, and metabolic syndrome parameters. Increased testosterone and improved hypogonadal symptoms were correlated with a decrease in waist circumference and an improvement in cardiorespiratory fitness and agility. As such, when implementing TT, we should consider whether these areas may be improved, as this can help to predict the effect.

Correlation of lipocalin 2 and glycolipid metabolism and body composition in a large cohort of children with osteogenesis imperfecta

PURPOSE

Lipocalin 2 (LCN2) is a newly recognized bone-derived factor that is important in regulation of energy metabolism. We investigated the correlation of serum LCN2 levels and glycolipid metabolism, and body composition in a large cohort of patients with osteogenesis imperfecta (OI).

METHODS

A total of 204 children with OI and 66 age- and gender-matched healthy children were included. Circulating levels of LCN2 and osteocalcin were measured by enzyme-linked immunosorbent assay. Serum levels of fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and low- and high-density lipoprotein cholesterol (LDL-C, HDL-C) were measured by automated chemical analyzers. The body composition was measured by dual-energy X-ray absorptiometry. Grip strength and timed-up-and-go (TUG) were tested to evaluate the muscle function.

RESULTS

Serum LCN2 levels were 37.65 ± 23.48 ng/ml in OI children, which was significantly lower than those in healthy control (69.18 ± 35.43 ng/ml, P < 0.001). Body mass index (BMI) and serum FBG level were significantly higher and HDL-C levels were lower in OI children than healthy control (all P < 0.01). Grip strength was significantly lower (P < 0.05), and the TUG was significantly longer in OI patients than healthy control (P < 0.05). Serum LCN2 level was negatively correlated to BMI, FBG, HOMA-IR, HOMA-β, total body, and trunk fat mass percentage, and positively correlated to total body and appendicular lean mass percentage (all P < 0.05).

CONCLUSIONS

Insulin resistance, hyperglycemia, obesity, and muscle dysfunction are common in OI patients. As a novel osteogenic cytokine, LCN2 deficiency may be relevant to disorders of glucose and lipid metabolism, and dysfunction of muscle in OI patients.

Limb-specific isometric and isokinetic strength in adults: The potential role of regional bioelectrical impedance analysis-derived phase angle

BACKGROUND & AIMS

It is not yet known whether regional bioelectrical impedance (BIA) phase angle (PhA) may be informative of different types of strength performed by the lower and upper limbs, independently of lean soft tissue mass (LSTM). Using a sample of healthy adults, we aimed to examine the association and relevance of regional PhA relative to isometric and isokinetic strength of each limb.

METHODS

A total of 57 participants (32.7 ± 12.9 years; 24.7 ± 3.5 kg/m2) were included in the present investigation. Regional raw BIA variables were determined using a phase-sensitive BIA device. Dual-energy X-ray absorptiometry was used to evaluate LSTM. Absolute isometric and isokinetic (i.e., 60°/s and 180°/s) strength of each limb (extension and flexion) was assessed using an isokinetic dynamometer and used to calculate relative strength.

RESULTS

In absolute strength, only dominant leg PhA was associated with isometric extension strength (β = 0.283) and isokinetic 180°/s flexion strength (β = 0.354), regardless of LSTM (p < 0.05). In relative strength, a significant association of regional PhA was found for dominant arm flexion isometric strength (β = 0.336), and non-dominant arm and dominant leg extension isometric strength (β = 0.377, β = 0.565, respectively; p < 0.05), independently of LSTM. Similarly, for isokinetic 180°/s strength, regional PhA significantly explained the variance in the relative strength of both arms and dominant leg (β = 0.350 to 0.506), regardless of LSTM (p < 0.05). Relative isokinetic 60°/s strength was not consistently associated with regional PhA (p ≥ 0.05).

CONCLUSIONS

Regional PhA significantly explained relative (isometric and 180°/s isokinetic strength of both arms and dominant leg), but not absolute muscle strength, independently of regional LSTM. Thus, after accounting for body size, regional PhA seems to have its own characteristics that explain relative strength independently of LSTM.

Fat-Free Mass Index in a Large Sample of Collegiate American Football Athletes

High levels of fat-free mass (FFM) are favorable for athletes and are related to sport performance. However, fat-free mass index (FFMI), which includes adjustments for height, may offer a better way to characterize FFM beyond raw values. As FFMI is understudied relative to sport, the purpose of the current study was to assess position and age group differences in FFMI among collegiate American football players. National Collegiate Athletic Association DIII (n=111) football players underwent body composition assessment via bioelectrical impedance analysis. FFMI was calculated by dividing FFM by height squared. One-way analyses of variance with Bonferroni post-hoc tests were conducted to evaluate differences in FFMI by position and age groups (α<0.05). The overall mean FFMI was 23.50 ± 2.04 kg · m-2, with values ranging from 18.1-27.7 kg · m-2. FFMI was highest in linemen (24.8 ± 1.5 kg · m-2) and lowest in specialty players (20.6 ± 1.4 kg · m-2) (p<0.05). No differences in FFMI were apparent across age groups (p>0.05). Current findings demonstrate that an athlete's upper limit for FFMI may exceed 25 kg · m-2, and differences exist across positions, likely due to position-specific demands. These measurements serve as a foundation for tailoring nutritional and exercise plans, forecasting athletic performance, and supplying coaches with standardized data about the potential for additional FFM accretion in collegiate American football players.

Small animal DXA instrument comparison and validation

Several new peripheral dual-energy X-ray absorptiometry (DXA) devices designed for assessment of bone and body composition in rodents have been developed. We compared the performance (accuracy and precision) of two of these devices, the InAlyzer and the iNSiGHT, to those of an established device, the PIXImus. We measured total body bone mineral content (BMC), bone mineral density (BMD), and body composition (lean and fat mass) on the three DXA devices in 18 male C57Bl/6 J mice (6 each of ages 8, 14, and 24 weeks, weighing 22 to 33 g). DXA body composition measures were compared to whole-body nuclear magnetic resonance (NMR) outcomes. BMC of the femur was also compared to ex vivo micro-computed tomography (microCT). Total body BMD from the InAlyzer and iNSiGHT devices was strongly correlated to that from PIXImus (R2 = 0.83 and 0.82, respectively), but was ~25 % higher than PIXImus. Total body BMC measures by InAlyzer were strongly associated with those from PIXImus (R2 = 0.86), whereas those from iNSiGHT were only weakly correlated (R2 = 0.29). Femur BMC from InAlyzer was strongly correlated with microCT outcomes, whereas iNSiGHT was only weakly correlated. InAlyzer and iNSiGHT fat mass measures were very strongly correlated with PIXImus and NMR outcomes (R2 = 0.91 to 0.97), with slightly weaker associations for lean mass (R2 = 0.81 to 0.76). Short-term precision of InAlyzer and iNSiGHT measurements were excellent, and akin to those from the PIXImus for both body composition and bone measures, ranging between 0.39 and 3.2 %. With faster scan times, closed X-ray source and excellent precision, the new devices are both satisfactory replacements for the now discontinued PIXImus system. However, given the accuracy of the bone and body composition measures, the InAlyzer may be preferable for studies where musculoskeletal changes are the main interest.

Importance of training volume through the use of step trackers apps promoted from the subject of physical education to change body composition, physical fitness and physical activity in adolescents and the influence of gender✰,✰✰

The aim of the present study was to determine the changes in physical activity level (PA), kinanthropometric and derived variables, and physical fitness in adolescents, as a result of an out-of-school intervention with mobile step tracker apps promoted from the field of physical education, according to the volume of training completed and gender. A randomized controlled trial was carried out with 400 adolescents (210 males and 190 females) aged 12 to 16 years old (mean age: 13.96 ± 1.21 years-old). Adolescents were divided into experimental group (EG) (n = 240) and control group (CG) (n = 160). Two measurements were carried out, separated by a 10-week intervention, and PA, kinanthropometric variables and physical condition were measured. During the intervention, EG must use Strava (n = 74); Pokémon Go (n = 59); Pacer (n = 60); and MapMyWalk (n = 47) a minimum of 3 times per week, covering an incremental distance from 7,000 steps per day (week 1) to 12,500 steps per day (week 10). After that, EG were divided in quartile according to the volume of training completed. The results obtained showed a significant increase between pre-and post in PA (p = 0.009-0.044) and curl-up (p < 0.001-0.040) in EG regardless the quartile of compliance, and a reduction in fat variables (p < 0.001) and an increase in CMJ in 75-100 % compliance group (p = 0.005). The introduction of the covariate gender did not introduce changes in the intra-group evolution. On inter-group differences, differences were only found for the post-test values between 0-25 % Vs 25-50 % and between 50-75 % Vs 75-100 % with the group that completed a longer distance being the one that showed the lowest values in the post-test in both cases. When including the covariate gender, no significant differences were found for either the pre-test or the post-test on either variable. To conclude, a higher training volume with mobile apps seems to be relevant in the increase PA and strength and decrease of fat mass. The gender factor is not influential in the intra-group changes, but it is influential in the inter-group differences.

Effects of chromium supplementation on body composition in patients with type 2 diabetes: A dose-response systematic review and meta-analysis of randomized controlled trials

INTRODUCTION

Several randomized controlled trials (RCTs) have demonstrated the beneficial effects of chromium supplementation in managing type 2 diabetes mellitus (T2DM). The current systematic review and meta-analysis aimed to investigate the associations between chromium supplementation and body composition in patients with T2DM.

METHODS

To achieve this, PubMed, Scopus, Embase, Cochrane Library, and Web of Science were searched for randomized clinical trials (RCTs) that reported the effects of chromium supplementation on body composition such as body weight (BW), body mass index (BMI), fat mass (FM), and waist circumference (WC) in patients with T2DM from inception until July 2023. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model.

RESULTS

The meta-analysis included a total of 14 RCTs. The results showed that chromium supplementation did not have any significant effect on FM (WMD = -0.43%; 95% CI -0.94, 0.09), BMI (WMD: 0.09 kg/M2, 95% CI: -0.03, 0.20), WC (WMD: -0.47 cm, 95% CI: -1.10, 0.16), and BW (WMD: -0.26 kg, 95% CI: -0.69, 0.16). However, subgroup analysis revealed that chromium intake decreased FM in subjects aged ≥ 55 years and when chromium picolinate was used as an intervention. Additionally, there was a non-linear association between the dose of chromium supplementation and BW.

CONCLUSIONS

The meta-analysis suggests that chromium supplementation does not significantly reduce BW, BMI, WC, and FM in patients with T2DM. Further RCTs with large-scale are required to determine the possible anti-obesity effects of chromium in patients with T2DM.

Low skeletal muscle quality extracted from CT is associated with poor outcomes in severe acute pancreatitis patients

PURPOSE

To evaluate the association between body composition parameters derived from computed tomography (CT) scans and clinical outcomes in patients with severe acute pancreatitis (AP).

METHODS

Patients who have been diagnosed AP with a CT scan at ICU admission were included. Body composition parameters were measured on a single slice at L2-3 of the unenhanced CT scans. The intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), skeletal muscle area (SMA) and skeletal muscle density (SMD) were assessed using HUs by image analysis software. Univariable and multivariable analyses were performed to analyze the association between body composition parameters and clinical outcomes including all-cause mortality or prolonged ICU stay. The area under the curve (AUC) of a receiver operating characteristic curve was used to explore the predictive value of the body composition on treatment clinical outcomes.

RESULTS

A total of 158 patients were included. The IMAT (8.3 cm2 vs 6.0 cm2, P = 0.001) and VAT (190.3 cm2 vs 143.7 cm2, P < 0.001) were significantly higher in the severe AP group than in the moderately severe group, but were notassociatedwithoutcomes. For 1 HU of SMD increased, the risk of poor clinical outcomes decresed 11 % (adjusted OR 0.892, 95 %CI 0.806-0.987, P = 0.026), while an SMD below the median value (32.1 HU for males and 28.5 HU for females) was independently associated with worse outcomes in the multivariable analysis (adjusted OR 8.868, 95 % CI 2.146-36.650, P = 0.003). The SMD had a good predictive ability for clinical outcomes, AUC was 0.824 (95 % CI, 0.715-0.933) for males and 0.803 (95 % CI, 0.639-0.967) for females.

CONCLUSION

Low SMD was associated with poor outcomes in patients with severe and moderately severe AP and might be used as a novel marker to predict outcomes in patients suffering from severe and moderately severe AP.

Accuracy and precision of multiple body composition methods and associations with muscle strength in athletes of varying hydration: The Da Kine Study

BACKGROUND

Athletes vary in hydration status due to ongoing training regimes, diet demands, and extreme exertion. With water being one of the largest body composition compartments, its variation can cause misinterpretation of body composition assessments meant to monitor strength and training progress. In this study, we asked what accessible body composition approach could best quantify body composition in athletes with a variety of hydration levels.

METHODS

The Da Kine Study recruited collegiate and intramural athletes to undergo a variety of body composition assessments including air-displacement plethysmography (ADP), deuterium-oxide dilution (D2O), dual-energy X-ray absorptiometry (DXA), underwater-weighing (UWW), 3D-optical (3DO) imaging, and bioelectrical impedance (BIA). Each of these methods generated 2- or 3-compartment body composition estimates of fat mass (FM) and fat-free mass (FFM) and was compared to equivalent measures of the criterion 6-compartment model (6CM) that accounts for variance in hydration. Body composition by each method was used to predict abdominal and thigh strength, assessed by isokinetic/isometric dynamometry.

RESULTS

In total, 70 (35 female) athletes with a mean age of 21.8 ± 4.2 years were recruited. Percent hydration (Body Water6CM/FFM6CM) had substantial variation in both males (63-73 %) and females (58-78 %). ADP and DXA FM and FF M had moderate to substantial agreement with the 6C model (Lin's Concordance Coefficient [CCC] = 0.90-0.95) whereas the other measures had lesser agreement (CCC <0.90) with one exception of 3DO FFM in females (CCC = 0.91). All measures of FFM produced excellent precision with %CV < 1.0 %. However, FM measures in general had worse precision (% CV < 2.0 %). Increasing quartiles (significant p < 0.001 trend) of 6CM FFM resulted in increasing strength measures in males and females. Moreover, the stronger the agreement between the alternative methods to the 6CM, the more robust their correlation with strength, irrespective of hydration status.

CONCLUSION

The criterion 6CM showed the best association to strength regardless of the hydration status of the athletes for both males and females. Simpler methods showed high precision for both FM and FFM and those with the strongest agreement to the 6CM had the highest strength associations.

SUMMARY BOX

This study compared various body composition analysis methods in 70 athletes with varying states of hydration to the criterion 6-compartment model and assessed their relationship to muscle strength. The results showed that accurate and precise estimates of body composition can be determined in athletes, and a more accurate body composition measurement produces better strength estimates. The best laboratory-based techniques were air displacement plethysmography and dual-energy x-ray absorptiometry, while the commercial methods had moderate-poor agreement. Prioritizing accurate body composition assessment ensures better strength estimates in athletes.

Impact of Body Composition and Anemia on Accuracy of a Real-Time Continuous Glucose Monitor in Diabetes Patients on Continuous Ambulatory Peritoneal Dialysis

Continuous glucose monitoring (CGM) is proposed as an alternative for glycemic assessment in peritoneal dialysis, but volume overload and anemia may affect sensor accuracy. This is an exploratory analysis of a study of Guardian Connect™ with Guardian Sensor™ 3 in 30 participants with diabetes on continuous ambulatory peritoneal dialysis (CAPD) (age [mean ± standard deviation] 64.7 ± 5.6 years, 23 men, body mass index [BMI] 25.4 ± 3.9 kg/m2, blood hemoglobin [Hb] 10.7 ± 1.3 g/dL). The mean absolute relative difference (MARD) was calculated between paired sensor and YSI 2300 STAT venous glucose readings (n = 941) during an 8-h in-clinic session with glucose challenge. Body composition was evaluated using bioimpedance. The overall MARD was 10.4% (95% confidence interval 9.6-11.7). There were no correlations between BMI, extracellular water, relative hydration index, and lean or fat mass with MARD. No correlations were observed between MARD and Hb (r = 0.016, P > 0.05). In summary, this real-time CGM demonstrated good accuracy in CAPD with minimal influence from body composition and anemia.

Inferring condition in wild mammals: body condition indices confer no benefit over measuring body mass across ecological contexts

Many studies assume that it is beneficial for individuals of a species to be heavier, or have a higher body condition index (BCI), without accounting for the physiological relevance of variation in the composition of different body tissues. We hypothesized that the relationship between BCI and masses of physiologically important tissues (fat and lean) would be conditional on annual patterns of energy acquisition and expenditure. We studied three species with contrasting ecologies in their respective natural ranges: an obligate hibernator (Columbian ground squirrel, Urocitellus columbianus), a facultative hibernator (black-tailed prairie dog, Cynomys ludovicianus), and a food-caching non-hibernator (North American red squirrel, Tamiasciurus hudsonicus). We measured fat and lean mass in adults of both sexes using quantitative magnetic resonance (QMR). We measured body mass and two measures of skeletal structure (zygomatic width and right hind foot length) to develop sex- and species-specific BCIs, and tested the utility of BCI to predict body composition in each species. Body condition indices were more consistently, and more strongly correlated, with lean mass than fat mass. The indices were most positively correlated with fat when fat was expected to be very high (pre-hibernation prairie dogs). In all cases, however, BCI was never better than body mass alone in predicting fat or lean mass. While the accuracy of BCI in estimating fat varied across the natural histories and annual energetic patterns of the species considered, measuring body mass alone was as effective, or superior in capturing sufficient variation in fat and lean in most cases.

Intrauterine growth restriction defined by increased brain-to-liver weight ratio affects postnatal growth and protein efficiency in pigs

Intrauterine growth restriction (IUGR) refers to impaired foetal growth during gestation, resulting in permanent stunting effects on the offspring. This study aimed to investigate the effects of IUGR on growth performance, body composition, blood metabolites, and meat quality of pigs from birth (n = 268) to slaughter (n = 93). IUGR piglets have prioritised brain development as a foetal adaptive reaction to placental insufficiency. This survival mechanism results in a higher brain-to-liver weight ratio (BrW/LW). One day (±1) after birth, computed tomography (CT) was performed on each piglet to assess their brain and liver weights. A threshold value of 0.78 (mean + SD) was chosen to divide the piglets into two categories - NORM (BrW/LW < 0.78) and IUGR (BrW/LW > 0.78). Moreover, each piglet was classified as either normal (score 1), mild IUGR (score 2), or severe IUGR (score 3) based on the head morphology. BW was recorded weekly, and average daily gain (ADG) was calculated for lactation, starter, grower, and finisher periods. Body composition was assessed after weaning (29.6 ± 0.7 d), at 20 kg (64 ± 7.2 d), 100 kg (165 ± 12.3 d), and on the carcasses using Dual-energy X-ray absorptiometry (DXA). Content and deposition rates of single nutrients, as well as energy and CP efficiency, were measured at 20 and 100 kg. Feed intake was recorded from 20 kg to slaughter. Meat quality was assessed on the carcasses. A total of 70% of the piglets assigned a score of 3 were NORM according to their BrW/LW. The IUGR category showed a lower ADG in the lactation (P < 0.01), starter (P = 0.07), and grower phases (P < 0.05) and a reduced CP efficiency in the grower-finisher period (P < 0.01) compared to the NORM group. IUGR pigs had a lower gain-to-feed ratio in the finisher period (P = 0.01) despite similar average daily feed intake, and they required more days (P < 0.01) to reach the slaughter weight. Additionally, their meat was darker (P = 0.01) than that of NORM pigs. The BrW/LW was inversely proportional to the ADG from birth to slaughter and negatively correlated with the CP deposition rate and efficiency in the grower-finisher period (P < 0.01). Furthermore, the higher the BrW/LW, the longer it took the pigs to reach the slaughter weight (P < 0.01). In conclusion, the identification of IUGR piglets based on the head morphology does not always agree with an increased BrW/LW. IUGR affects growth performance from birth to slaughter, CP efficiency in the grower-finisher period and meat quality.

Athletic bioimpedance-based equations underestimate fat free mass components in male elite soccer players: development and validation of new soccer-specific predictive models

BACKGROUND

Bioelectrical impedance analysis (BIA) is a rapid and user-friendly technique for assessing body composition in sports. Currently, no sport-specific predictive equations are available, and the utilization of generalized formulas can introduce systematic bias. The objectives of this study were as follows: (i) to develop and validate new predictive models for estimating fat-free mass (FFM) components in male elite soccer players; (ii) to evaluate the accuracy of existing predictive equations.

METHODS

A total of 102 male elite soccer players (mean age 24.7 ± 5.7 years), participating in the Italian first league, underwent assessments during the first half of the in-season period and were randomly divided into development and validation groups. Bioelectrical resistance (R) and reactance (Xc), representing the bioimpedance components, were measured using a foot-to-hand BIA device at a single frequency of 50 kHz. Dual-energy X-ray absorptiometry was employed to acquire reference data for FFM, lean soft tissue (LST), and appendicular lean soft tissue (ALST). The validation of the newly developed predictive equations was conducted through regression analysis, Bland-Altman tests, and the area under the curves (AUC) of regression receiver operating characteristic (RROC) curves.

RESULTS

Developed models were: FFM = - 7.729 + (body mass × 0.686) + (stature2/R × 0.227) + (Xc × 0.086) + (age × 0.058), R2 = 0.97, Standard error of estimation (SEE) = 1.0 kg; LST = - 8.929 + (body mass × 0.635) + (stature2/R × 0.244) + (Xc × 0.093) + (age × 0.048), R2 = 0.96, SEE = 0.9 kg; ALST = - 24.068 + (body mass × 0.347) + (stature2/R × 0.308) + (Xc × 0.152), R2 = 0.88, SEE = 1.4 kg. Train-test validation, performed on the validation group, revealed that generalized formulas for athletes underestimated all the predicted FFM components (p < 0.01), while the new predictive models showed no mean bias (p > 0.05), with R2 values ranging from 0.83 to 0.91, and no trend (p > 0.05). The AUC scores of the RROC curves indicated an accuracy of 0.92, 0.92, and 0.74 for FFM, LST, and ALST, respectively.

CONCLUSIONS

The utilization of generalized predictive equations leads to an underestimation of FFM and ALST in elite soccer players. The newly developed soccer-specific formulas enable valid estimations of body composition while preserving the portability of a field-based method.

Opposite causal effects of birthweight on myocardial infarction and atrial fibrillation and the distinct mediating pathways: a Mendelian randomization study

BACKGROUND

Previous observational studies have documented an inverse association of birthweight with myocardial infarction (MI) but a positive association with atrial fibrillation (AF). However, the causality of these associations and the underlying mediating pathways remain unclear. We aimed to investigate the causal effects of birthweight, incorporating both fetal and maternal genetic effects, on MI and AF, and identify potential mediators in their respective pathways.

METHODS

We performed Mendelian randomization (MR) analyses using genome-wide association study summary statistics for birthweight (N = 297,356 for own birthweight and 210,248 for offspring birthweight), MI (Ncase=61,000, Ncontrol=577,000), AF (Ncase=60,620, Ncontrol=970,216), and 52 candidate mediators (N = 13,848-1,295,946). Two-step MR was employed to identify and assess the mediation proportion of potential mediators in the associations of birthweight with MI and AF, respectively. As a complement, we replicated analyses for fetal-specific birthweight and maternal-specific birthweight.

RESULTS

Genetically determined each 1-SD lower birthweight was associated with a 40% (95% CI: 1.22-1.60) higher risk of MI, whereas each 1-SD higher birthweight was causally associated with a 29% (95% CI: 1.16-1.44) higher risk of AF. Cardiometabolic factors, including lipids and lipoproteins, glucose and insulin, blood pressure, and fatty acids, each mediated 4.09-23.71% of the total effect of birthweight on MI, followed by body composition and strength traits (i.e., appendicular lean mass, height, and grip strength) and socioeconomic indicators (i.e., education and household income), with the mediation proportion for each factor ranging from 8.08 to 16.80%. By contrast, appendicular lean mass, height, waist circumference, childhood obesity, and body mass index each mediated 15.03-45.12% of the total effect of birthweight on AF. Both fetal-specific birthweight and maternal-specific birthweight were inversely associated with MI, while only fetal-specific birthweight was positively associated with AF. Psychological well-being and lifestyle factors conferred no mediating effect in either association.

CONCLUSIONS

Cardiometabolic factors mainly mediated the association between lower birthweight and MI, while body composition and strength traits mediated the association between higher birthweight and AF. These findings provide novel evidence for the distinct pathogenesis of MI and AF and advocate adopting a life-course approach to improving fetal development and subsequent causal mediators to mitigate the prevalence and burden of cardiovascular diseases.

Association of intradialysis blood sodium level, blood pressure variability, and hydration status with hemodialysis-related headache: a prospective cohort study

OBJECTIVE

To identify primary factors contributing to hemodialysis-related headache (HRH) in maintenance hemodialysis (MHD) patients.

METHODS

Adult outpatients receiving MHD were prospectively enrolled from a hemodialysis (HD) center of a tertiary hospital in China. Twelve dialysis sessions were successively monitored for each patient. HRH is defined as having at least three headache episodes that begin during HD and resolve within 72 h of HD session completion. Blood gas analysis during headache episodes and body composition analysis after dialysis were conducted. Hour-to-hour vital sign variability during dialysis was assessed using the metric of average real variability (ARV). Multivariable logistic regression analysis was conducted to explore the factors triggering HRH.

RESULTS

A total of 95 Chinese MHD patients were enrolled, with 92 patients (60.9% were males) included in the final analysis. The mean age of the 92 patients was 59.3 ± 17.5 years, and the median dialysis vintage was 27.1 (12-46.2) months. Among them, 12 patients (13%) complained of 42 headache attacks, and eight (8.7%) were diagnosed with HRH. For eight patients with HRH, headache occurred 100.3 ± 69.5 min after the start of dialysis, with a mean VAS score of 4.3 ± 1 points. The quality of headaches was dull (six patients), pulsating (one patient), or stabbing pain (one patient); all the headaches were bilateral, with one having concomitant vomiting. The intradialysis headache duration and the whole headache duration were 98.8 ± 68.1 and 120 (65-217.5) minutes, respectively. Younger age (OR = 0.844, 95% CI 0.719-0.991, p = 0.039), decreased blood sodium level (OR = 0.309 in the range of 133-142 mmol/L, 95% CI 0.111-0.856, p = 0.024), increased ARV of intradialysis systolic blood pressure (OR = 3.067, 95% CI 1.006-9.348, p = 0.049) and ratio of overhydration to dry weight (OR = 1.990, 95% CI 1.033-3.832, p = 0.040) were found to be independent risk factors for HRH.

CONCLUSIONS

This study suggested a significant attribution of blood sodium, hydration status and blood pressure variability to HRH.

The determination of sarcopenia in older adults using a practical measure

BACKGROUND

Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management.

OBJECTIVE

To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling older adults.

METHODS

Older adults (n= 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT.

RESULTS

Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia.

CONCLUSION

The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness.

FTO and MC4R polymorphisms, and selected pre-, peri- and postnatal factors as determinants of body mass index and fatness in children: a thorough analysis of the associations

BACKGROUND

Overweight and obesity among children have become significant global health concerns. Previous studies have highlighted the potential role of genetic factors, particularly polymorphisms in the FTO and MC4R genes, as well as environmental factors in the development of childhood obesity. This study aimed to investigate the relationships between genetic, socioeconomic and perinatal factors, adverse childhood events (ACEs), and lifestyle, and their impact on overweight, obesity and body composition parameters in children. Additionally, we explored potential interactions between genetic factors and ACEs.

METHODS

Four hundred fifty-six children aged 6-12 years participated in our study. Information on the socioeconomic status, perinatal factors, ACEs and lifestyle of the children was collected with a questionnaire completed by their parents/guardians. We examined the children's body weight and conducted an electrical bioimpedance analysis. Overweight and obesity were diagnosed based on the International Obesity Task Force and McCarthy criteria. We genotyped two selected polymorphisms in the FTO and MC4R genes using the TaqMan SNP allelic discrimination method.

RESULTS

Higher BMI (Body Mass Index) z scores were related to higher paternal BMI and lower maternal age at the child's birth. Higher FMI (Fat Mass Index) z scores were associated with higher paternal BMI, increased gestational weight, lower maternal education and the presence of the FTO risk allele. Higher FatM (fat mass in kg) z scores were linked to lower maternal education, lower maternal age at the child's birth, higher maternal body weight gain, paternal BMI and the presence of the FTO risk allele. Moreover, interaction effects were observed on BMI z scores between ACE and FTO AA, and on FMI z scores and FatM z scored between ACE and MC4R CC.

CONCLUSIONS

The contribution of environmental factors is more strongly related to changes in body composition than genetic ones. Additionally, the presence of the risk allele combined with unfavourable environmental factors like ACEs leads to visible interaction effects, resulting in increased BMI z scores and FMI z scores in children.

The Effects of Training Load During Dietary Intervention Upon Fat Loss: A Randomized Crossover Trial

Purpose: To date no studies have compared resistance training loading strategies combined with dietary intervention for fat loss. Methods: Thus, we performed a randomised crossover design comparing four weeks of heavier- (HL; ~80% 1RM) and lighter-load (LL; ~60% 1RM) resistance training, combined with calorie restriction and dietary guidance, including resistance trained participants (n=130; males=49, females=81). Both conditions performed low-volume, (single set of 9 exercises, 2x/week) effort matched (to momentary failure), but non-work-matched protocols. Testing was completed pre- and post-each intervention. Fat mass (kg) was the primary outcome, and a smallest effect size of interest (SESOI) was established at 3.3% loss of baseline bodyweight. Body fat percentage, lean mass, and strength (7-10RM) for chest press, leg press, and pull-down exercises were also measured. An 8-week washout period of traditional training with normal calorie interspersed each intervention. Results: Both interventions showed small statistically equivalent (within the SESOI) reductions in fat mass (HL: -0.67 kg [95%CI -0.91 to 0.42]; LL: -0.55 kg [95%CI -0.80 to -0.31]) which were also equivalent between conditions (HL - LL: -0.113 kg [95%CI -0.437 kg to 0.212 kg]). Changes in body fat percentage and lean mass were also minimal. Strength increases were small, similar between conditions, and within a previously determined SESOI for the population included (10.1%). Conclusions: Fat loss reductions are not impacted by resistance training load; both HL and LL produce similar, yet small, changes to body composition over a 4-week intervention. However, the maintenance of both lean mass and strength highlights the value of resistance training during dietary intervention.

Sugary and salty former food products in pig diets affect energy and nutrient digestibility, feeding behaviour but not the growth performance and carcass composition

Former foodstuff products (FFPs) are promising alternative ingredients for reducing the waste of natural resources and the environmental impact of food production. This study investigates the effects of salty and sugary FFPs on growth performance, apparent total tract digestibility (ATTD), and growing-finishing pigs' empty body and carcass composition. Thirty-six Swiss Large White male castrated pigs were assigned to three growing (G) and finishing (F) diets: (1) standard diet (ST), 0% FFPs; (2) 30% conventional ingredients replaced by sugary FFPs (SU); and (3) 30% conventional ingredients replaced by salty FFPs (SA). Faecal samples from 24 selected pigs were collected to assess the ATTD of gross energy, crude fibres, and CP. The BW was measured weekly, while feed intake was determined daily. Average daily gain (ADG), average daily feed intake (ADFI), feed conversion ratio (FCR), and ATTD were calculated for both the growing and finishing periods. Pigs' body composition was determined at ≥20 and ≥98 kg using dual-energy X-ray absorptiometry. In the growing but not finishing period, the FCR was lower (P < 0.05) in ST compared to SA and SU pigs. Considering the entire growing and finishing period, neither the inclusion level nor the type of FFPs influenced (P > 0.05) ADG, ADFI, FCR, or BW at slaughter. In both the growing and finishing periods, the gross energy ATTD was higher (P < 0.05) in the SA than in the ST group, with intermediate values in the SU group. In the growing period, the CP ATTD was higher (P < 0.05) in the SA than in the SU and ST groups. In the finishing period, the crude fibre ATTD was lower (P < 0.05) in the SA and SU than in the ST group. Throughout the overall period, the average daily fat intake was higher (P < 0.05) in pigs fed an SU diet, even though both categories of FFPs had no (P > 0.05) effects on the parameters related to the pigs' body composition (e.g., average daily fat weight gain). Finally, the carcasses of the SU group had the thickest belly fat, even though the total fat content was similar among the groups. This study confirms that including FFPs has no detrimental effects on growth performance or live body/carcass composition in growing and finishing pigs.

Weekly minutes of moderate to vigorous physical activity is associated with movement quality in overweight and obese older adults, independent of age

BACKGROUND

Physical activity can improve function and decrease healthcare spending among overweight and obese older adults. Although unstructured physical activity has been related to cardiometabolic improvements, the relationship between unstructured activity and movement quality is unclear.

AIMS

This study aimed to evaluate the association of amount of unstructured free-living moderate-vigorous physical activity (MVPA) with measures of movement quality in overweight and obese older adults.

METHODS

The association of MVPA with movement quality was assessed in 165 overweight and obese older adults (Age: 77.0(8.0) years; Body mass index (BMI): 29.2(5.3) kg/m2). Participants performed overground walking, the Figure of 8 Walk test, and the Five-Times Sit to Stand. Weekly physical activity was measured using a waist-worn Actigraph activity monitor.

RESULTS

Movement quality during straight path [gait speed (ρ = 0.30, p < 0.01), stride length (ρ = 0.33, p < 0.01), double-limb support time (ρ = -0.26, p < 0.01), and gait symmetry (ρ = 0.17, p = 0.02)] and curved path [F8W time (ρ = -0.22, p < 0.01) and steps (ρ = -0.22, p < 0.01)] walking were associated with weekly minutes of MVPA after controlling for age. Five-Times Sit to Stand performance was not significantly associated with weekly minutes of MVPA (ρ = -0.10, p = 0.13).

CONCLUSIONS

Older adults with high BMIs who are less active also demonstrate poorer movement quality, independent of age. Physical activity engagement and task-specific training should be targeted in interventions to promote healthy aging, decrease falls, and delay disability development. Future work should consider the interconnected nature of movement quality with physical activity engagement and investigate if targeting one influences the other.

Body composition in healthy singleton term infants using the three-dimensional photonic scanning method: A multicenter cross-sectional study

OBJECTIVES

Body composition is an integral part of the nutritional assessment during infancy as it is closely related to future health. The three-dimensional photonic body surface scanning (3-DPS) method is a promising new technique for measuring body composition in children because of its advantages of easy operation, low cost, and no exposure to radiation. Using 3-DPS, this study aimed to illustrate the growth trajectories of body composition indicators during infancy according to sex and age.

METHODS

This was a multicenter cross-sectional study. The body compositions of 9644 singleton term infants from four centers in Shandong Province, China, were assessed using 3-DPS. The data of 8769 healthy infants (52.0% boys), whose z scores of weight-for-length, length-for-age, and weight-for-age, according to World Health Organization standards, were in the range of -2 to 2, -3 to 3, and -3 to 3, respectively, were sampled to construct percentile curves of fat mass (FM), fat-free mass (FFM), FM percentage (FM%), FM index (FMI), and FFM index (FFMI) with the generalized additive model for location, scale, and shape method.

RESULTS

Percentile charts for FM, FFM, FM%, FMI, and FFMI were developed based on age and sex. FM and FFM presented consistent trajectories with that of weight, with the fastest growth occurring at 1 to 3 mo of age. FM%, FMI, and FFMI increased with age, peaked at 6 mo, and gradually declined, which was consistent with the body mass index trend. All indicators, except for FFMI, were always significantly higher in boys than in girls ages 1 to 12 mo, indicating that sex differences in body composition existed mainly in FM rather than in lean body mass.

CONCLUSIONS

The body composition of healthy singleton term infants during infancy varies with age; boys may have more FM accumulation than girls.

Obesity and Severity of Menopausal Symptoms: a Contemporary Review

PURPOSE OF REVIEW

Vasomotor symptoms are frequently experienced by women during menopause and have been linked to obesity. Severity of menopausal symptoms is a distinct construct from presence of symptoms, and the relation between severity of symptoms and obesity is less established. The purpose of this brief narrative review was to summarize evidence from recent studies on associations between menopausal symptom severity and measures of obesity.

RECENT FINDINGS

Sixteen articles were identified that specifically assessed and reported on the severity of menopausal symptoms in relation to measures of obesity including body mass index (BMI), waist circumference, and waist-to-hip ratio. Most studies to date show that greater BMI, waist size, and waist-to-hip ratio are associated with greater severity of menopausal symptoms. Given the large segment of women who will experience symptoms and that severity of symptoms influences treatment decisions, future studies are needed to determine how weight management efforts may reduce the severity of menopausal symptoms.

Increased adipose tissue is associated with improved overall survival, independent of skeletal muscle mass in non-small cell lung cancer

BACKGROUND

The prognostic significance of non-cancer-related prognostic factors, such as body composition, has gained extensive attention in oncological research. Compared with sarcopenia, the prognostic significance of adipose tissue for overall survival in non-small cell lung cancer remains unclear. We investigated the prognostic value of skeletal muscle and adipose tissue in patients with non-small cell lung cancer.

METHODS

This retrospective study included 4434 patients diagnosed with non-small cell lung cancer between January 2014 and December 2016. Cross-sectional areas of skeletal muscle and subcutaneous fat were measured, and the pericardial fat volume was automatically calculated. The skeletal muscle index and subcutaneous fat index were calculated as skeletal muscle area and subcutaneous fat area divided by height squared, respectively, and the pericardial fat index was calculated as pericardial fat volume divided by body surface area. The association between body composition and outcomes was evaluated using Cox proportional hazards model.

RESULTS

A total of 750 patients (501 males [66.8%] and 249 females [33.2%]; mean age, 60.9 ± 9.8 years) were included. Sarcopenia (60.8% vs. 52.7%; P < 0.001), decreased subcutaneous fat index (51.4% vs. 25.2%; P < 0.001) and decreased pericardial fat index (55.4% vs. 16.5%; P < 0.001) were more commonly found in the deceased group than survived group. In multivariable Cox regression analysis, after adjusting for clinical variables, increased subcutaneous fat index (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.47-0.66, P < 0.001) and increased pericardial fat index (HR = 0.47, 95% CI: 0.40-0.56, P < 0.001) were associated with longer overall survival. For stage I-III patients, increased subcutaneous fat index (HR = 0.62, 95% CI: 0.48-0.76, P < 0.001) and increased pericardial fat index (HR = 0.43, 95% CI: 0.34-0.54, P < 0.001) were associated with better 5-year overall survival rate. Similar results were recorded in stage IV patients. For patients with surgery, the prognostic value of increased subcutaneous fat index (HR = 0.60, 95% CI: 0.44-0.80, P = 0.001) and increased pericardial fat index (HR = 0.51, 95% CI: 0.38-0.68, P < 0.001) remained and predicted favourable overall survival. Non-surgical patients showed similar results as surgical patients. No association was noted between sarcopenia and overall survival (P > 0.05).

CONCLUSIONS

Increased subcutaneous fat index and pericardial fat index were associated with a higher 5-year overall survival rate, independent of sarcopenia, in non-small cell lung cancer and may indicate a reduced risk of non-cancer-related death.

The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities

PURPOSE OF REVIEW

This review examines lifestyle modification for obesity management with the goal of identifying treatment components that could support the use of a new generation of anti-obesity medications (AOMs).

RECENT FINDINGS

Semaglutide reliably reduces baseline body weight by approximately 15% at 68 weeks, in contrast to 5-10% for lifestyle modification. Tirzepatide induces mean losses as great as 20.9%. Both medications reduce energy intake by markedly enhancing satiation and decreasing hunger, and they appear to lessen the need for traditional cognitive and behavioral strategies (e.g., monitoring food intake) to achieve calorie restriction. Little, however, is known about whether patients who lose weight with these AOMs adopt healthy diet and activity patterns needed to optimize body composition, cardiometabolic health, and quality of life. When used with the new AOMs, the focus of lifestyle modification is likely to change from inducing weight loss (through calorie restriction) to facilitating patients' adoption of dietary and activity patterns that will promote optimal changes in body composition and overall health.

The effect of chronic high-intensity interval training programs on glycaemic control, aerobic resistance, and body composition in type 2 diabetic patients: a meta-analysis

BACKGROUND

Type 2 diabetes is an increasing health problem worldwide. HIIT has been proposed as an exercise alternative to be part of integral type 2 diabetes treatment.

OBJECTIVE

The aim of this meta-analysis was to determine the effect of different types of chronic HIIT on glycaemic control, aerobic resistance, and body composition in individuals above 18 years with T2D.

DESIGN

This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and was registered with PROSPERO on November 21st, 2021.

DATA SOURCES

A systematic literature search of the following databases: EbscoHost (Academic Search Ultimate, Fuente Académica Plus, MEDline and SportDiscus), Web of Science, PubMed, and EMBASE between April of 2021 and April of 2023 was conducted.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Eligibility criteria included (1) participants aged ≥ 18 years with a diagnosis of type 2 diabetes, (2) an HIIT protocol with detailed description, (3) control group and/or continuous aerobic training comparison group, (4) report of pre-test and post-test values for at least one of the studied variables (from glycaemic control, aerobic resistance, and/or body composition), and (5) experimental or quasi-experimental intervention design.

ANALYSES

Meta-analysis was made by a pre-post-test between-group analysis following the inverse variance heterogeneity model for each variable, and then, a subgroup analysis by type of HIIT was conducted.

RESULTS

Of the 2817 records obtained, 180 records were included for meta-analysis. Significant improvements were found in the most part of the variables when HIIT was compared to control group, while fat-free mass kept without changes. HIIT vs. continuous aerobic training results showed and advantage in favor of HIIT for fasting blood glycemia. Subgroup analysis refers a possible advantage of SI-HIIT and SIT-HIIT in the improvement of fasting glycemia and SIT-HIIT advantage in HOMA 1-IR decrease.

CONCLUSIONS

HIIT improves glycaemic control, aerobic resistance, and % fat and waist circumference, and kept fat-free mass unchanged in individuals with T2D. SI-HIIT and SIT-HIIT could be better than the other types of HIIT. HIIT benefit is similar to continuous aerobic training except for fasting blood glycemia.

Skeletal muscle quality, measured via phase angle, and cardiorespiratory fitness in patients with obesity and heart failure with preserved ejection fraction

OBJECTIVES

Cardiorespiratory fitness (CRF) is influenced by body composition quantity and quality in heart failure with preserved ejection fraction (HFpEF) and obesity. Bioelectrical impedance analysis (BIA) provides a noninvasive quantitative and qualitative body composition assessment. The aim of this study was to determine the role of phase angle (PhA), a BIA-measure of skeletal muscle quality and body cell mass, on CRF in patients with obesity and HFpEF.

METHODS

Fifty-nine consecutive outpatients with HFpEF underwent cardiopulmonary exercise testing to measure CRF. Single-frequency segmental BIA was used to measure PhA and body composition quantity. Resting Doppler echocardiography and biomarkers were measured to assess cardiac function and systemic inflammation.

RESULTS

Compared with patients with lower PhA, patients with higher PhA (above mean 5.8°) presented a greater absolute peak oxygen consumption (VO2; 1.83 [1.3-2.1] versus 1.39 [1.1-1.6] L/min, P = 0.003), VO2 peak adjusted for body weight (17.5 [12.3-18.1] versus 13.3 [12.7-15.2] mL/kg/min, P = 0.040), and a lower edema index (48.7 [2.9] versus 51.4% [2.7], P < 0.001) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; 64 [50-121] versus 183 [68-343.5] pg/dL, P < 0.001). In the overall sample, PhA was correlated with absolute VO2 peak (r = 0.468, P < 0.001), VO2 peak adjusted for body weight (r = 0.368, P = 0.004), VO2 peak adjusted for fat-free mass (r = 0.315, P = 0.015), edema index (r = -0.508, P < 0.001), and NT-proBNP (r = -0.579, P < 0.001). PhA remained a significant predictor for CRF even after adjustment for potential confounders and HFpEF severity.

CONCLUSION

In patients with obesity and HFpEF, a greater PhA is an independent predictor for favorable CRF.

Body composition analysis using convolutional neural network in predicting postoperative pancreatic fistula and survival after pancreatoduodenectomy for pancreatic cancer

PURPOSE

To evaluate whether body composition measurements acquired using convolutional neural networks (CNNs) from preoperative CT images could predict postoperative pancreatic fistula (POPF) and overall survival (OS) after pancreaticoduodenectomy in patients with pancreatic ductal adenocarcinoma (PDAC).

METHODS

257 patients (160 men; median age [interquartile range], 67 [60-74]) who underwent pancreaticoduodenectomy for PDAC between January 2013 and December 2017 were included in this retrospective study. Body composition measurements were based on a CNN trained to segment CT images into skeletal muscle area, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Skeletal muscle area, VAT, and SAT were normalized to height square and labeled as skeletal muscle, VAT, and SAT indices, respectively. The independent risk factors for clinically relevant POPF (grade B or C) were determined using a multivariate logistic regression model, and prognostic factors for OS were assessed using Cox proportional hazards regression analyses.

RESULTS

After pancreatioduodenectomy, 27 patients developed POPF grade B or C (10.5 %, 27/257). The VAT index (odds ratio [OR] = 7.43, p < 0.001) was the only independent prognostic factor for POPF grade B or C. During the median follow-up period of 23 months, 205 (79.8 % [205/257]) patients died. For prediction of OS, skeletal muscle index (hazard ratio [HR] = 0.58, p = 0.018) was a significant factor, along with vascular invasion (HR = 1.85, p < 0.001) and neoadjuvant therapy (HR = 0.58, p = 0.011).

CONCLUSIONS

A high VAT index and a low skeletal muscle index can be utilized in predicting the occurrence of POPF grade B or C and poor OS, respectively.

A prospective study to assess the impact of a novel CFTR therapy combination on body composition in patients with cystic fibrosis with F508del mutation

BACKGROUND & AIM

Malnutrition is a prevalent condition in Cystic Fibrosis (CF) and can result in worsening of pulmonary function and other comorbidities. Cystic fibrosis transmembrane regulator (CFTR) modulator therapies are improving the CF-related care and outcomes. Body Mass Index (BMI) is the most commonly used parameter to assess nutritional status, albeit it is a very unspecific indicator. Hence, current guidelines recommend body composition analysis as a part of nutritional assessment. The aim of our study was to evaluate the impact of elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA) treatment on body composition and respiratory function.

METHODS

We recruited patients with CF from University Hospital La Princesa, with follow-up in the Adult Cystic Fibrosis Unit. All patients were eligible to initiate ELX/TEZ/IVA therapy. Body composition was assessed with a Bioelectrical Impedance Analysis (BIA) and spirometry data were obtained before and after 6 months of treatment.

RESULTS

Our study sample was composed of 36 patients with CF. We observed a significant increase in BMI after 6 months of treatment (p < 0.001), as well as an increase in fat mass (p = 0.008) and visceral fat area (p = 0.026). The other body composition parameters did not yield significant changes. Overall, %FEV1 increased from 72.67 % (±17.39) to 84.74 % (±18.18) after 6 months of treatment. Interestingly, we found an inverse correlation between %FEV1 and fat mass (r = -0,476; p = 0,0058), %FEV1 and age (r = -0,411; p = 0,0196) and between %FEV1 and visceral fat area (r = -0,515; p = 0,0025). On the contrary, we found a direct correlation between %FEV1 and body cell mass (r = 0,367; p = 0,038).

CONCLUSIONS

Novel CFTR modulators are emerging for the treatment of CF. Specifically, triple combination with ELX/TEZ/IVA has shown to effectively improve both pulmonary and nutritional status in patients with CF with F508del mutation. Body composition should be a part of the routine assessment for patients with CF.

The Relationship Between Low Back Pain and Sagittal Spinal Alignment and Back Muscle Mass in Korean Fishery Workers

OBJECTIVE

To investigate the relationship between low back pain (LBP) and sagittal spino-pelvic parameters along with the relationship between LBP and back muscle mass in Korean male and female fishery workers.

METHODS

This retrospective study included a total of 146 subjects who underwent Fishermen's health survey conducted between June 2018 and August 2020. LBP was evaluated through visual analogue scale (VAS) and Oswestry Disability Index (ODI). Sagittal spino-pelvic parameters were measured from whole spine standing X-rays. Back muscle cross-sectional areas were identified through lumbar spine magnetic resonance imaging and body composition was analyzed through bioelectrical impedance analysis.

RESULTS

The study included 75 males and 71 females, with an average age of 58.33 years for males and 56.45 years for females. Female subjects exhibited higher VAS and ODI scores, larger pelvic tilt (PT) and trunk fat mass and smaller trunk muscle mass compared to males. In female, ODI positively correlated with sagittal vertical axis (SVA) and PT. No significant correlations were found between ODI scores and body composition in either sex. The high ODI group showed greater SVA, PT, and pelvic incidence-lumbar lordosis and higher trunk fat/muscle ratio. Psoas muscle mass, total and skeletal muscle mass and trunk muscle mass of that group were smaller than those of low ODI group.

CONCLUSION

Spino-pelvic parameters and back muscle mass were associated with ODI and there were differences between Korean male and female fishery workers.

Association of change in fat and lean mass with incident cardiovascular events for women in midlife and beyond: A prospective study using dual-energy x-ray absorptiometry (DXA)

OBJECTIVE

To determine whether changes in fat and lean mass over time, quantified using dual-energy x-ray absorptiometry (DXA), are related to incident cardiovascular events. Previous studies using surrogate anthropometric methods have had inconsistent findings.

STUDY DESIGN

Prospective, longitudinal observational study of women aged 40 to 80 randomly selected from the electoral roll and stratified into decades: 40-49, 50-59, 60-69 and 70-79 years.

MAIN OUTCOME MEASURES

Changes in anthropometric measurements (body mass index and waist-to-hip ratio) and DXA-quantified fat mass and lean mass between the first and fifth years of the study. Incident cardiovascular events recorded from the sixth to the 12th year.

RESULTS

In total 449 participants (87.9 %) were analyzed. A 10 % or greater decrease in total fat mass index was associated with a 67 % lower likelihood of any cardiovascular event (OR = 0.33, 95%CI 0.15-0.71); no association was observed for an increase. A 10 % or greater decrease in abdominal fat mass index was associated with a 62 % lower likelihood of incident stroke (OR = 0.38, 95%CI 0.16-0.91); no association was observed for an increase. A 10 % or greater decrease in appendicular lean mass index resulted in increased odds ratio of 2.91 for incident peripheral artery events (OR = 2.91, 95%CI 1.18-7.20).

CONCLUSIONS

Reducing fat mass for women in midlife and beyond may decrease the risk of cardiovascular events. An increase in fat mass may not contribute to additional cardiovascular events. A reduction in limb muscle mass may provide an independent marker for cardiometabolic risk and peripheral artery disease. No independent association was found using anthropometric measurements and incident cardiovascular events.

Higher Fat-Related Body Composition Measurement and Lower Resting-State Inter-Network Functional Connectivity of APOE ε4 Carrier in Mild Cognitive Impairment Patients With Aβ Deposition

OBJECTIVE

We aimed to evaluate the impact of interaction between APOE ε4 carrier status and body composition measurements on intra- and inter-regional functional connectivity (FC) in mild cognitive impairment (MCI) patients with Aβ deposition.

METHODS

MCI patients with and without APOE ε4 allele (carrier, n=86; non-carrier, n=95) underwent neuropsychological battery, resting-state functional magnetic resonance imaging scans, positron emission tomography scans with [18F]flutemetamol, and bioelectrical impedance analysis for measuring body composition. We employed a priori defined regions of interest to investigate the intra- and inter-network FC profiles of default mode network (DMN), central executive network (CEN), and salience network.

RESULTS

There was a significant interaction of APOE ε4 carrier status with body fat mass index, visceral fat area, and waist-hip circumference ratio for inter-network FC between DMN and CEN, contributing higher fat-related body composition measurements in the APOE ε4 carrier with lower DMN-CEN FC.

CONCLUSION

The present results highlight the detrimental effect of APOE ε4 carrier status on the associations between the fat-related body composition measurements and FC in the MCI patients with Aβ accumulation.

Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis

Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and change in coronary artery calcium score (CAC) in women, and these relationships would vary by central obesity. In the Multi-Ethnic Study of Atherosclerosis Stress Ancillary study, cortisol was quantified by 12-h overnight urine collection. Central obesity was estimated by waist-hip ratio (WHR). Multivariable Cox models estimated the relationship between cortisol and cardiovascular events and assessed for moderation by WHR. The relationship between cortisol and change in CAC Agatston score was assessed by Tobit regression models. 918 patients were analyzed with median follow up of 11 years. There was no association between urinary cortisol and cardiovascular events in the cohort. However, in individuals with below median WHR, higher urinary cortisol levels (upper tertile) were associated with higher cardiovascular event rates in the full cohort, women, and men, but not in groups with above median WHR. There was significant moderation by WHR in women, but not men, whereby the association between elevated cortisol and increased cardiovascular events diminished as WHR increased. Urinary cortisol was associated with increased change in CAC in women (P = 0.003) but not men, without moderation by WHR. Our study highlights associations between cortisol and subclinical atherosclerosis in women, and moderation of the relationship between cortisol and cardiovascular events by central obesity in both genders.

CT-based body composition in diffuse large B cell lymphoma patients: changes after treatment and association with survival

PURPOSE

Primary purpose was to assess changes of bone mineral density (BMD) in diffuse large B cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R-CHOP (like) chemotherapy regimen. Secondary purposes were to assess other body composition features changes and to assess the association of pre-therapy values and their changes over time with survival.

MATERIAL AND METHODS

Patients selected underwent R-CHOP(like) regimen for DLBCL, and underwent PET-CT before and after treatment. Main clinical data collected included body mass index, date of last follow-up, date of progression, and date of death. From the low-dose CT images, BMD was assessed at the L1 level; the other body composition values, including muscle and fat distribution, were assessed at the L3 level by using a dedicated software. Descriptive statistics were reported as median and interquartile range, or frequencies and percentages. Statistical comparisons of body composition variables between pre- and post-treatment assessments were performed using the Wilcoxon matched pairs signed rank test. Non-normal distribution of variables was tested with the Shapiro-Wilk test. For qualitative variables, the Fisher exact test was used. Log rank test was used to compare survival between different subgroups of the study population defined by specific body composition cutoffs. The significance level was set at p < 0.05.

RESULTS

Eighty-two patients were included. The mean follow-up was 37.5 ± 21.4 months. A significant difference was found in mean BMD before and after R-CHOP(like) treatment (p < 0.0001). The same trend was observed for mean skeletal muscle area (SMA) (p = 0.004) and mean skeletal muscle index (SMI) (p = 0.006). No significant association was demonstrated between body composition variables, PFS and OS.

CONCLUSION

R-CHOP(like) treatment in DLBCL patients was associated with significant reduction of BMD, SMA and SMI.

Efficacy of multidisciplinary interventions in preventing metabolic syndrome and improving body composition in prostate cancer patients treated with androgen deprivation therapy: A systematic review and meta-analysis

BACKGROUND

Exercise is known to reduce adverse side effects of androgen-deprivation therapy (ADT) on quality of life, bone health and fatigue for prostate cancer (PCa) patients. We conducted a systematic review with meta-analysis to evaluate the effect of multidisciplinary interventions on body composition and metabolic syndrome (MetS) in ADT-treated PCa patients.

METHODS

A systematic review and meta-analysis were conducted based on searches of EMBASE, MEDLINE, CENTRAL and Scopus databases from inception to March 2023. Participants included ADT-treated PCa patients who received multidisciplinary interventions including exercise, diet, nutrition, pharmacotherapy, bariatric surgery, or psychological/behavioural therapy. Primary outcomes were changes in body composition and MetS, with prostate-specific antigen (PSA) as a secondary outcome. After meta-analysis, results were reported in mean difference, 95% confidence interval and p-value, with forest plots. Additionally, we conducted subgroup analyses to compare the effect of different interventions.

RESULTS

Thirty-three articles met the eligibility criteria out of 1443 articles and 28 studies were included in meta-analysis. Of 33 studies, 17 included exercise-only interventions and 10 included exercise + diet/nutrition interventions, but no studies included diet/nutrition-only interventions. All studies employed multidisciplinary approaches in developing or delivering the interventions. Most studies (85%) had low-moderate risk of bias, thus providing good evidence to this review. Overall, interventions had a positive effect on body composition measures; lean mass (LM):0.82 kg (95% CI:0.47,1.17;p < 0.00001), body fat mass (BFM):-0.68 kg (95% CI:-1.12,-0.24;p = 0.002), fat-free mass:0.75 kg (95% CI:0.14,1.37;p = 0.02) and body fat percentage (BFP):-0.99% (95% CI:-1.29,-0.68;p < 0.00001), as well as on MetS; waist circumference:-1.95 cm (95% CI:-3.10,-0.79;p = 0.0009), systolic blood pressure:-3.43 mmHg (95% CI:-6.36,-0.50;p = 0.02) and diastolic blood pressure:-2.48 mmHg (95% CI:-4.19,-0.76;p = 0.005). Subgroup-analyses showed that a combined approach including exercise + diet/nutrition was most effective in improving BFP, WC, SBP and DBP whereas exercise was more effective in improving LM and BFM.

CONCLUSIONS

In ADT-treated PCa patients, multidisciplinary interventions, especially those combining exercise and diet/nutrition, can improve body composition and metabolic health.