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Montes J, Goodwin AM, McDermott MP, Uher D, Hernandez FM, Coutts K, Cocchi J, Hauschildt M, Cornett KM, Rao AK, Monani UR, Ewing Garber C, De Vivo DC. Diminished muscle oxygen uptake and fatigue in spinal muscular atrophy. Ann Clin Transl Neurol 2021; 8:1086-1095. [PMID: 33788421 PMCID: PMC8108417 DOI: 10.1002/acn3.51353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To estimate muscle oxygen uptake and quantify fatigue during exercise in ambulatory individuals with spinal muscular atrophy (SMA) and healthy controls. METHODS Peak aerobic capacity (VO2peak ) and workload (Wpeak ) were measured by cardiopulmonary exercise test (CPET) in 19 ambulatory SMA patients and 16 healthy controls. Submaximal exercise (SME) at 40% Wpeak was performed for 10 minutes. Change in vastus lateralis deoxygenated hemoglobin, measured by near-infrared spectroscopy, determined muscle oxygen uptake (ΔHHb) at rest and during CPET and SME. Dual energy X-ray absorptiometry assessed fat-free mass (FFM%). Fatigue was determined by percent change in workload or distance in the first compared to the last minute of SME (FatigueSME ) and six-minute walk test (Fatigue6MWT ), respectively. RESULTS ΔHHb-PEAK, ΔHHb-SME, VO2peak , Wpeak , FFM%, and 6MWT distance were lower (P < 0.001), and Fatigue6MWT and FatigueSME were higher (P < 0.001) in SMA compared to controls. ΔHHb-PEAK correlated with FFM% (r = 0.50) and VO2peak (r = 0.41) only in controls. Only in SMA, Fatigue6MWT was inversely correlated with Wpeak (r = -0.69), and FatigueSME was inversely correlated with FFM% (r = -0.55) and VO2peak (r = -0.69). INTERPRETATION This study provides further support for muscle mitochondrial dysfunction in SMA patients. During exercise, we observed diminished muscle oxygen uptake but no correlation with aerobic capacity or body composition. We also observed increased fatigue which correlated with decreased aerobic capacity, workload, and body composition. Understanding the mechanisms underlying diminished muscle oxygen uptake and increased fatigue during exercise in SMA may identify additional therapeutic targets that rescue symptomatic patients and mitigate their residual disease burden.
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Affiliation(s)
- Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Ashley M Goodwin
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael P McDermott
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA.,Department of Neurology, University of Rochester, Rochester, New York, USA
| | - David Uher
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Feliz Marie Hernandez
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Kayla Coutts
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Julia Cocchi
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Margarethe Hauschildt
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Kayla M Cornett
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Ashwini K Rao
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Umrao R Monani
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA.,Center for Motor Neuron Biology & Disease, New York, New York, USA
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Darryl C De Vivo
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.,Center for Motor Neuron Biology & Disease, New York, New York, USA
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Nyasavajjala SM, Phillips BE, Lund JN, Williams JP. Creatinine and myoglobin are poor predictors of anaerobic threshold in colorectal cancer and health. J Cachexia Sarcopenia Muscle 2015; 6:125-31. [PMID: 26136188 PMCID: PMC4458078 DOI: 10.1002/jcsm.12020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/25/2015] [Accepted: 02/03/2015] [Indexed: 01/06/2023] Open
Abstract
AIMS Myoglobin is a haem protein produced in skeletal muscles. Serum concentrations of myoglobin have been proposed as a surrogate marker of muscle mass and function in both cachectic cancer patients and healthy non-cancer individuals. Creatinine, a metabolite of creatine phosphate, an energy store found in skeletal muscle, is produced at a constant rate from skeletal muscle. Urinary and plasma creatinine have been used in clinical practice as indicators of skeletal muscle mass in health and disease. Our study aimed to test the hypothesis that plasma myoglobin and creatinine concentration could accurately predict skeletal muscle mass and aerobic capacity in colorectal cancer (CRC) patients and matched healthy controls and thereby an indicative of aerobic performance. METHODS We recruited 47 patients with CRC and matching number of healthy volunteers for this study. All participants had their body composition measured by dual-energy X-ray absorptiometry scan, aerobic capacity measured to anaerobic threshold (AT) by cardiopulmonary exercise testing and filled in objective questionnaires to assess the qualitative functions. This study was carried out in accordance with the Declaration of Helsinki, after approval by the local National Health Service (NHS) Research Ethics Committee. RESULTS Age-matched groups had similar serum myoglobin and creatinine concentrations in spite of differences in their aerobic capacity. AT was significantly lower in the CRC group compared with matched controls (1.18 ± 0.44 vs. 1.41 ± 0.71 L/min; P < 0.01). AT had significant correlation with lean muscle mass (LMM) among these groups, but myoglobin and creatinine had poor correlation with LMM and AT. CONCLUSIONS Serum myoglobin is a poor predictor of muscle mass, and serum myoglobin and creatinine concentrations do not predict aerobic performance in CRC patients or healthy matched controls.
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Affiliation(s)
- Sitaramachandra M Nyasavajjala
- Division of Surgery, School of Graduate Entry Medicine and Health, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - Beth E Phillips
- MRC/Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Jon N Lund
- Division of Surgery, School of Graduate Entry Medicine and Health, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - John P Williams
- Division of Surgery, School of Graduate Entry Medicine and Health, University of Nottingham, Royal Derby Hospital, Derby, UK.,MRC/Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
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Laferrère B, Abraham C, Awad M, Jean-Baptiste S, Hart AB, Garcia-Lorda P, Kokkoris P, Russell CD. Inhibiting endogenous cortisol blunts the meal-entrained rise in serum leptin. J Clin Endocrinol Metab 2006; 91:2232-8. [PMID: 16537679 PMCID: PMC2825044 DOI: 10.1210/jc.2005-0693] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
CONTEXT Administration of glucocorticoids increases serum leptin levels in lean and obese individuals. A morning meal produces an increase in insulin, a cortisol peak, and an increase in leptin; these changes do not occur during fasting. OBJECTIVE The objective of this study was to investigate whether inhibiting endogenous cortisol secretion with metyrapone decreases 24-h serum leptin levels and to determine whether a meal-related midmorning surge in cortisol is a prerequisite for the meal-entrained nocturnal rise in leptin. DESIGN This was a randomized, cross-over study. SETTING The study was performed at the General Clinical Research Center. PARTICIPANTS Lean males were studied. INTERVENTION In study 1, seven lean men were studied for 24 h while their endogenous cortisol secretions were manipulated as follows: 1) CONTROL; 2) cortisol suppression by metyrapone (MET); and 3) MET and oral hydrocortisone (at 0900 h) (MET + CORT). Subjects were all fed a eucaloric diet (two meals at 1100 and 1700 h). In study 2, six men were studied without pharmacological intervention for 24 h on two occasions: once under a complete fast (FAST) and once in a feeding condition (one meal at 1100 h; FED). MAIN OUTCOME MEASURE The main outcome measure was serum leptin. RESULTS MET significantly suppressed serum cortisol at 0800 h, midmorning, and over the 24-h period. As a result of cortisol suppression, 24-h serum leptin levels were decreased vs. control values despite similar insulin responses to meals. Administering a single dose of hydrocortisone to MET subjects potently stimulated serum leptin compared with the effect of MET alone. CONCLUSIONS Our data demonstrate that endogenous cortisol secretion is necessary for the maintenance of serum leptin levels over 24 h in lean, normally fed males.
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Affiliation(s)
- Blandine Laferrère
- Obesity Research Center, St. Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, New York 10025, USA
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Laferrère B, Caixas A, Fried SK, Bashore C, Kim J, Pi-Sunyer FX. A pulse of insulin and dexamethasone stimulates serum leptin in fasting human subjects. Eur J Endocrinol 2002; 146:839-45. [PMID: 12039705 PMCID: PMC2823632 DOI: 10.1530/eje.0.1460839] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES We have previously shown that dexamethasone increases serum leptin in fed but not in fasted human subjects. We hypothesized that insulin and/or glucose mediated the effect of food intake. The primary aim of this study was to determine whether the administration of a pulse of insulin with dexamethasone was sufficient to increase serum leptin in vivo in fasted human subjects. Whether the presence of transient hyperglycemia and the dose of insulin were important was tested as a secondary aim. METHODS Twenty-nine normal subjects were studied. In experiment 1 (meal-like), a pulse of insulin (0.03 U/kg s.c.) and of dexamethasone (2 mg i.v.) was given, and the blood glucose transiently elevated to 50 mg/dl above baseline for the first 2 h. In experiments 2 and 3 (dose-response), the effect of two doses of insulin (0.03 U/kg in experiment 2 and 0.06 U/kg in experiment 3) was tested in combination with dexamethasone, this time without transient hyperglycemia. Nine subjects were studied under fasting conditions, with or without dexamethasone, as a control experiment. RESULTS A meal-like transient hyperinsulinemia and hyperglycemia, with a pulse of dexamethasone, increased serum leptin levels from baseline by 54+/-21% at 9 h (P=0.038). In the absence of transient hyperglycemia, leptin increased significantly after doses of both insulin and dexamethasone. The effect of insulin was dose-dependent, with a larger increment of serum leptin at 9 h after the highest dose of insulin (75.2+/-15.7% vs 21.3+/-8.5%, P=0.013). Fasting, with or without dexamethasone, resulted in a significant 20% decrease in leptin from morning basal levels. Conversely, the administration of a pulse of insulin and glucose, in the absence of dexamethasone, prevented the drop in serum leptin observed during fasting, regardless of the insulin dose or the serum glucose elevation. CONCLUSIONS With the permissive effect of dexamethasone, a single pulse of insulin triggered a rise in serum leptin in humans, even in the absence of transient hyperglycemia. A single pulse of insulin with glucose can prevent the drop in serum leptin normally observed during fasting.
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Affiliation(s)
- B Laferrère
- Obesity Research Center, St Luke's/Roosevelt Hospital Center, Columbia University, 1111 Amsterdam Avenue, New York, New York 10025, USA.
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Laferrère B, Fried SK, Osborne T, Pi-Sunyer FX. Effect of one morning meal and a bolus of dexamethasone on 24-hour variation of serum leptin levels in humans. OBESITY RESEARCH 2000; 8:481-6. [PMID: 11068953 PMCID: PMC2840615 DOI: 10.1038/oby.2000.60] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We have previously shown that morning administration of dexamethasone in combination with food induces a doubling of serum leptin levels starting at 7 hours after dexamethasone administration, with a maximum effect at 10 hours, the latest time point that we have studied. However, dexamethasone given in the absence of food had no effect on serum leptin at 10 hours. The present experiment was undertaken to determine the duration of the effect of dexamethasone on 24-hour serum leptin under fasted and fed conditions in humans. RESEARCH METHODS AND PROCEDURES Six healthy non-obese male volunteers were studied under the following four conditions: 1) dexamethasone (2 mg intravenously, given at 0900 hours) with fasting; 2) dexamethasone with food (1,700 kcal, 55% carbohydrate, 15% protein, and 30% fat, given in one meal 2 hours after dexamethasone administration at 1100 hours); 3) saline with food (same meal); 4) saline with fasting. Serum leptin, glucose, insulin, and cortisol were monitored every 30 minutes for 24 hours. RESULTS 1) Under the fasting condition, dexamethasone increased leptin nocturnal secretion between 2100 and 2400 hours. 2) A single meal (1,700 kcal) at 1100 hours increased nocturnal leptin secretion when compared with the fasting condition. The peak increase of leptin was 123% over baseline between 2100 and 2400 hours, 10 to 14 hours after the meal. 3) In the fed + dexamethasone condition, leptin levels increased from baseline starting 8 hours after dexamethasone injection, reached a maximum increase of 260% between 2100 and 2400 hours, then decreased thereafter, remaining elevated compared to baseline for 16 hours. There was a correlation between 24-hour leptin secretion and insulin secretion after a single morning meal. DISCUSSION A single bolus of dexamethasone, given before a single large meal, produces a delayed (6-hour) but long-lasting increase in serum leptin (over 16 hours). Under fasted conditions, dexamethasone does not increase daytime leptin but does increase leptin during the night.
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Affiliation(s)
- B Laferrère
- Obesity Research Center, St. Luke's/Roosevelt Hospital Center, Columbia University, New York, New York 10025, USA.
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Laferrère B, Fried SK, Hough K, Campbell SA, Thornton J, Pi-Sunyer FX. Synergistic effects of feeding and dexamethasone on serum leptin levels. J Clin Endocrinol Metab 1998; 83:3742-5. [PMID: 9768694 PMCID: PMC2823637 DOI: 10.1210/jcem.83.10.5313] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objectives of this study were to determine the time course of the stimulatory effect of dexamethasone on serum leptin and whether it depends on food intake. Dexamethasone (4mg) was administered I.V. over 1 minute to healthy human volunteers (n=8) under fasting and feeding conditions (2000 kcal given at three meals over 7 hours). At 10 hours, serum leptin levels were increased only in the fed subjects (delta leptin 10.6+/-1.6 vs -2.4+/-1.9 ng/ml, p=0.01, n=8). To assess the interactive effect of food and dexamethasone on serum leptin, a subgroup (n=4) was studied under 4 conditions: 1) dexamethasone/fast; 2) dexamethasone/food; 3) saline/fast; 4) saline/food. Serum leptin declined from baseline under the fasting conditions, with or without dexamethasone. Feeding prevented the drop in serum leptin. In the dexamethasone/food condition, leptin levels rose from baseline after 7 hours and doubled after 10 hours (p<0.05). The rise in serum leptin was significantly greater in the food/dexamethasone condition compared to all other conditions (p<0.05). In summary, dexamethasone has no independent effect on serum leptin in the absence of food intake. Rather, dexamethasone appears to potentiate the food-induced increase in serum leptin. This synergism may be mediated by insulin and/or other factors associated with food ingestion.
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Affiliation(s)
- B Laferrère
- Obesity Research Center, St Luke's/Roosevelt Hospital Center, New York, NY 10025, USA
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Plourde G. The role of radiologic methods in assessing body composition and related metabolic parameters. Nutr Rev 1997; 55:289-96. [PMID: 9287478 DOI: 10.1111/j.1753-4887.1997.tb05487.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The measurement of body composition and related metabolic parameters has become an important issue in clinical nutrition. Numerous techniques to assess visceral fat, which is strongly associated with metabolic disorders, have been developed. Other techniques focus mainly on the measurement of specific body components related to metabolic disturbances. This paper reviews methods that directly assess body composition and associated metabolic parameters. The principles of these methods and their accuracy, reproducibility and safety, as well as the clinical implications of their use, are discussed. Recent studies have documented the safety and efficacy of radiologic methods of assessing visceral fat, muscle mass, and morphology to obtain body composition data related to metabolic disturbances. Because these techniques have been documented to be safe and effective, clinicians should consider using them in the evaluation and follow-up of patients with various conditions.
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Affiliation(s)
- G Plourde
- Herzl Family Practice Centre, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
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Gasperino J. Ethnic differences in body composition and their relation to health and disease in women. ETHNICITY & HEALTH 1996; 1:337-347. [PMID: 9395578 DOI: 10.1080/13557858.1996.9961803] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Differences in body composition between black and white women have been well established. Black women have more bone and muscle mass, but less fat, as a percentage of body weight, than white women, after controlling for ethnic differences in age, body weight, and height. In addition, black women have more upper-body fat than white women. These ethnic differences in body composition appear to be associated with disease risk in women. The greater skeletal and muscle mass in black compared to white women appears to protect them from osteoporosis. The relationship between fat distribution and cardiovascular disease also appears to be influenced by ethnicity. This review has two purposes: (1) To examine previous research investigating ethnic differences in body composition between black and white women; and (2) To demonstrate the relationship between body composition and disease in women as a function of ethnicity.
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Affiliation(s)
- J Gasperino
- Center for Research in Clinical Nutrition, St Luke's/Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York City, NY 10019, USA
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Heymsfield SB, Matthews D. Body composition: research and clinical advances--1993 A.S.P.E.N. research workshop. JPEN J Parenter Enteral Nutr 1994; 18:91-103. [PMID: 8201761 DOI: 10.1177/014860719401800291] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The 1993 ASPEN Research Workshop examined research and clinical advances in the study of human body composition. The workshop had two themes: (1) compartments of the body and their measurement, and (2) clinical applications of body composition measurements. There were 12 speakers of varied backgrounds who gave short lectures followed by panel discussions. Speakers explored the validity and potential uses of new body composition methodologies, including dual-energy x-ray absorptiometry, multiple frequency bioimpedance analysis, computerized axial tomography, magnetic resonance imaging, nuclear magnetic resonance spectroscopy, neutron inelastic scattering, and gamma-ray resonance. The application of these methods to chronically and acutely ill hospitalized patients was described. The study of body composition is an emerging distinct research area within the broad study of human biology. This conference provided an overview of important new advances in the study of human body composition.
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Affiliation(s)
- S B Heymsfield
- Obesity Research Center, Columbia University College of Physicians and Surgeons, New York, NY
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Skeletal differences between black and white men and their relevance to body composition estimates. Am J Hum Biol 1994; 6:255-262. [DOI: 10.1002/ajhb.1310060215] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/1993] [Accepted: 10/28/1993] [Indexed: 11/07/2022] Open
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Wang ZM, Heshka S, Heymsfield SB. Application of computerized axial tomography in the study of body composition: evaluation of lipid, water, protein, and mineral in healthy men. BASIC LIFE SCIENCES 1993; 60:343-4. [PMID: 8110146 DOI: 10.1007/978-1-4899-1268-8_80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Z M Wang
- St. Luke's/Roosevelt Hospital Center, Columbia University, New York, NY 10025
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Allison DB, Heshka S, Pierson RN, Wang J, Heymsfield SB. The analysis and identification of homologizer/moderator variables when the moderator is continuous: An illustration with anthropometric data. Am J Hum Biol 1992; 4:775-782. [DOI: 10.1002/ajhb.1310040609] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/1992] [Accepted: 07/03/1992] [Indexed: 11/10/2022] Open
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Heymsfield SB, Waki M. Body composition in humans: advances in the development of multicompartment chemical models. Nutr Rev 1991; 49:97-108. [PMID: 2046977 DOI: 10.1111/j.1753-4887.1991.tb02997.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Until recently it was practical to divide body weight into only two or three chemical compartments in living subjects due to an inability to quantify directly total body mineral, protein, and fat in vivo. The six-compartment chemical model is now the cornerstone of research in human body composition. Advanced technologies, including neutron activation analysis systems and dual photon absorptiometry, now enable investigators to extend body composition estimates and to construct near-complete chemical models in vivo. These new or refined approaches will advance our knowledge of human body composition and will also improve our accuracy in calibrating simpler epidemiologic and bedside body-composition techniques.
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Affiliation(s)
- S B Heymsfield
- Columbia University College of Physicians and Surgeons, New York
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