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Petković Ramadža D, Kuhtić I, Žarković K, Lochmüller H, Čavka M, Kovač I, Barić I, Prutki M. Case Report: Advanced Skeletal Muscle Imaging in S-Adenosylhomocysteine Hydrolase Deficiency and Further Insight Into Muscle Pathology. Front Pediatr 2022; 10:847445. [PMID: 35463910 PMCID: PMC9026168 DOI: 10.3389/fped.2022.847445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION S-Adenosylhomocysteine hydrolase deficiency (SAHHD) is a rare inherited multisystemic disease with muscle involvement as one of the most prominent and poorly understood features. To get better insight into muscle involvement, skeletal muscles were analyzed by magnetic resonance imaging (MRI) and MR spectroscopy (MRS) in three brothers with SAHHD in the different age group. METHOD The study was based on analysis of MRI and MRS of skeletal muscles of the lower and the proximal muscle groups of the upper extremities in three SAHHD patients. RESULTS Three siblings presented in early infancy with similar signs and symptoms, including motor developmental delay. All manifested myopathy, more pronounced in the lower extremities and the proximal skeletal muscle groups, and permanently elevated creatine kinase. At the time of MRI and MRS study, the brothers were at the age of 13, 11, and 8 years, respectively. MRI revealed lipid infiltration, and the MRS curve showed an elevated muscle lipid fraction (higher peak of lipid), which increased with age, and was more prominent in the proximal skeletal muscles of the lower extremities. These results were consistent with muscle biopsy findings in two of them, while the third patient had no specific pathological changes in the examined muscle tissue. CONCLUSIONS These findings demonstrate that an accessible and non-invasive method of MRI and MRS is useful for an insight into the extent of muscle involvement, monitoring disease progression, and response to treatment in SAHHD.
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Affiliation(s)
- Danijela Petković Ramadža
- Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Kuhtić
- Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Kamelija Žarković
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Division of Neurology, Department of Medicine, The Ottawa Hospital, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Mislav Čavka
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ida Kovač
- Department of Rehabilitation and Orthopaedic Devices, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivo Barić
- Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Maja Prutki
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
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2
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Wanger L, Gar C, Rippl M, Kern-Matschilles S, Potzel A, Haschka S, Seissler J, Hesse N, Lechner A. Function outperforms morphology in the assessment of muscular contribution to insulin sensitivity in premenopausal women. Diab Vasc Dis Res 2022; 19:14791641211070281. [PMID: 35358403 PMCID: PMC8977731 DOI: 10.1177/14791641211070281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Skeletal muscle contributes significantly to insulin sensitivity in humans. However, which non-invasive measurement best reflects this contribution remains unknown. Consequently, this paper compares morphologic and functional measurements. RESEARCH METHODS AND DESIGN We conducted a cross-sectional analysis of 144 premenopausal women enrolled in the "Prediction, Prevention, and Sub-classification of Type 2 Diabetes" (PPSDiab) cohort study. For the analysis, we quantified insulin sensitivity by oral glucose tolerance testing and, in a subgroup of 30 women, euglycemic clamp. To assess skeletal muscle, we measured volume by magnetic resonance imaging, intramyocellular lipid content by magnetic resonance spectroscopy, and physical fitness by cardiopulmonary exercise testing. RESULTS The mean age of the cohort was 35.7 ± 4.1 years and 94 participants (65%) had a history of gestational diabetes mellitus. Of the morphologic and functional muscle parameters, the maximum workload achieved during cardiopulmonary exercise testing associated most closely with insulin sensitivity (standardized beta = 0.39; p < .001). Peak oxygen uptake also demonstrated significant associations, whereas muscle volume and intramyocellular lipid content displayed none. CONCLUSION Functional measurements provided a better assessment of the muscular contribution to insulin sensitivity than morphologic measurements in premenopausal women. In particular, exercise testing rendered an easy and cost-effective method applicable in clinical settings and other human studies.
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Affiliation(s)
- Lorena Wanger
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Christina Gar
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Michaela Rippl
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Stefanie Kern-Matschilles
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Anne Potzel
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Stefanie Haschka
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Jochen Seissler
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Nina Hesse
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Andreas Lechner
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
- Andreas Lechner, Diabetes Research Group,
Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ziemssenstr 1, München
80336, Germany.
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3
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Kern-Matschilles S, Gar C, Wanger L, Haschka SJ, Potzel AL, Hesse N, Then C, Seissler J, Lechner A. Association of Serum Myostatin with Body Weight, Visceral Fat Volume, and High Sensitivity C-Reactive Protein But Not With Muscle Mass and Physical Fitness in Premenopausal Women. Exp Clin Endocrinol Diabetes 2021; 130:393-399. [PMID: 34407549 DOI: 10.1055/a-1500-4605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The myokine myostatin regulates muscle mass and has been linked to insulin resistance and metabolic syndrome. However, data on its role in humans is still limited. We, therefore, investigated the associations of serum myostatin with muscle mass, physical fitness, and components of the metabolic syndrome in a cohort of premenopausal women. METHODS We undertook a cross-sectional analysis of 233 women from the monocenter study PPSDiab, conducted in Munich, Germany. Participants had recently completed a pregnancy with or without gestational diabetes. Our analysis included medical history, anthropometrics, oral glucose tolerance testing, laboratory chemistry, cardiopulmonary exercise testing, and magnetic resonance imaging (n=142) of visceral fat volume, left quadriceps muscle mass, and muscle fat content. Serum myostatin was quantified by a competitive enzyme-linked immunosorbent assay. RESULTS We observed positive correlations of serum myostatin with body mass index (ρ=0.235; p=0.0003), body fat percentage (ρ=0.166; p=0.011), waist circumference (ρ=0.206; p=0.002), intraabdominal fat volume (ρ=0.182; p=0.030) and high-sensitivity C-reactive protein (ρ=0.175; p=0.008). These correlations were reproduced in linear regression analyses with adjustment for age and time after delivery. We saw no correlations with muscle mass, physical fitness, insulin sensitivity, triglycerides, HDL cholesterol, and blood pressure. CONCLUSIONS Our observation of elevated serum myostatin in women with a higher body fat percentage, visceral obesity, and elevated c-reactive protein suggests that this myokine contributes to the altered muscle-adipose tissue crosstalk in metabolic syndrome. Elevated myostatin may advance this pathophysiologic process and could also impair the efficacy of exercise interventions. Further mechanistic studies, therefore, seem warranted.
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Affiliation(s)
- Stefanie Kern-Matschilles
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Christina Gar
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Lorena Wanger
- Klinik und Poliklinik für Radiologie, LMU Klinikum, München, Germany
| | - Stefanie J Haschka
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Anne L Potzel
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Nina Hesse
- Klinik und Poliklinik für Radiologie, LMU Klinikum, München, Germany
| | - Cornelia Then
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Jochen Seissler
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
| | - Andreas Lechner
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.,Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,German Center for Diabetes Research (DZD)
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4
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Ogon I, Iba K, Takashima H, Yoshimoto M, Morita T, Oshigiri T, Terashima Y, Emori M, Teramoto A, Takebayashi T, Yamashita T. Magnetic Resonance Spectroscopic Analysis of Multifidus Muscle Lipid Contents and Association with Nociceptive Pain in Chronic Low Back Pain. Asian Spine J 2020; 15:441-446. [PMID: 33108847 PMCID: PMC8377217 DOI: 10.31616/asj.2020.0247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022] Open
Abstract
Study Design Cross-sectional study. Purpose This study aimed to analyze the differences in the lipid contents in chronic low back pain (CLBP) patients with nociceptive pain (NocP) and neuropathic pain (NeP) using magnetic resonance spectroscopy (MRS) of the multifidus muscle (Mm). Overview of Literature Early identification of the pain characteristics with CLBP is important because specific treatment approaches are required, depending on NocP and NeP. Methods The participants were 50 patients with CLBP (23 men and 27 women; mean age, 63.1±17.8 years; range, 41–79 years). We compared the Visual Analog Scale (VAS) scores, intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) of the Mm in NocP and NeP groups, as evaluated with the Japanese NeP screening questionnaire. Results The patients were categorized into the NocP (n=32) and NeP (n=18) groups. The mean VAS score of the NocP group was 59.3±3.1 mm and that of the NeP group was 73.6±4.6 mm. The mean VAS score was significantly higher in the NeP group as compared to that in the NocP group (p<0.01). As per the analysis of covariance for the VAS score, the mean IMCL levels of the Mm in the NocP and NeP groups were 722.3 mmol/L (95% confidence interval [CI], 611.4–833.1) and 484.8 mmol/L (95% CI, 381.1–588.5), respectively. The mean IMCL level was significantly higher in the NocP group than in the NeP group (p<0.05). The mean EMCL levels of the Mm for the NocP and NeP groups were 6,022.9 mmol/L (95% CI, 4,510.6–7,535.2) and 5,558.1 mmol/L (95% CI, 4,298.3–6,817.9), respectively; however, the difference was not significant (p=0.72). Conclusions The results indicated an association between the IMCL level of the Mm and NocP. Our results suggest that MRS of the Mm might be beneficial for the assessment of CLBP as well as appropriate targeted analgesic therapies.
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Affiliation(s)
- Izaya Ogon
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kouske Iba
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroyuki Takashima
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsunori Yoshimoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomonori Morita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsutomu Oshigiri
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshinori Terashima
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Makoto Emori
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsuneo Takebayashi
- Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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5
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Hemke R, Buckless C, Torriani M. Quantitative Imaging of Body Composition. Semin Musculoskelet Radiol 2020; 24:375-385. [PMID: 32992366 DOI: 10.1055/s-0040-1708824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Body composition refers to the amount and distribution of lean tissue, adipose tissue, and bone in the human body. Lean tissue primarily consists of skeletal muscle; adipose tissue comprises mostly abdominal visceral adipose tissue and abdominal and nonabdominal subcutaneous adipose tissue. Hepatocellular and myocellular lipids are also fat pools with important metabolic implications. Importantly, body composition reflects generalized processes such as increased adiposity in obesity and age-related loss of muscle mass known as sarcopenia.In recent years, body composition has been extensively studied quantitatively to predict overall health. Multiple imaging methods have allowed precise estimates of tissue types and provided insights showing the relationship of body composition to varied pathologic conditions. In this review article, we discuss different imaging methods used to quantify body composition and describe important anatomical locations where target tissues can be measured.
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Affiliation(s)
- Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Colleen Buckless
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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6
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Giraudo C, Cavaliere A, Lupi A, Guglielmi G, Quaia E. Established paths and new avenues: a review of the main radiological techniques for investigating sarcopenia. Quant Imaging Med Surg 2020; 10:1602-1613. [PMID: 32742955 PMCID: PMC7378089 DOI: 10.21037/qims.2019.12.15] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022]
Abstract
Sarcopenia is a clinical condition mainly affecting the elderly that can be associated in a long run with severe consequences like malnutrition and frailty. Considering the progressive ageing of the world population and the socio-economic impact of this disease, much effort is devoted and has to be further focused on an early and accurate diagnostic assessment of muscle loss. Currently, several radiological techniques can be applied for evaluating sarcopenia. If dual-energy X-ray absorptiometry (DXA) is still considered the main tool and it is even recommended as reference by the most current guidelines of the European working group on sarcopenia in older people (EWGSOP), the role of ultrasound (US), computed tomography (CT), peripheral quantitative CT (pQCT), and magnetic resonance imaging (MRI) should not be overlooked. Indeed, such techniques can provide robust qualitative and quantitative information. In particular, regarding MRI, the use of sequences like diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS) and mapping that could provide further insights into the physiopathological features of sarcopenia, should be fostered. In an era pointing to the quantification and automatic evaluation of diseases, we call for future research extending the application of organ tailored protocols, taking advantage of the most recent technical developments.
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Affiliation(s)
- Chiara Giraudo
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Annachiara Cavaliere
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Amalia Lupi
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, University of Foggia, Foggia, Italy
| | - Emilio Quaia
- Radiology Institute, Department of Medicine—DIMED, University of Padova, Padova, Italy
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7
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Chan Z, Chooi YC, Ding C, Choo J, Sadananthan SA, Michael N, Velan SS, Leow MK, Magkos F. Sex Differences in Glucose and Fatty Acid Metabolism in Asians Who Are Nonobese. J Clin Endocrinol Metab 2019; 104:127-136. [PMID: 30252100 DOI: 10.1210/jc.2018-01421] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023]
Abstract
CONTEXT The prevalence of diabetes is increasing throughout Asia, even in the absence of obesity, and is lower in women than in men. The underlying mechanisms are not well understood. OBJECTIVE To evaluate the sex differences in glucose and fatty acid metabolism in Asians who are nonobese. DESIGN Cross-sectional study. SETTING Clinical Nutrition Research Centre, Singapore. PARTICIPANTS Healthy Asian men (n = 32; body mass index, 21.8 ± 1.5 kg/m2; age, 42 ± 14 years) and women (n = 28; body mass index, 21.4 ± 2.0 kg/m2; age, 41 ± 13 years). MAIN OUTCOME MEASURES Insulin sensitivity (insulin-mediated glucose uptake normalized for steady-state insulin; hyperinsulinemic-euglycemic clamp), postprandial glucose, insulin and fatty acid concentrations, insulin secretion (mixed meal tolerance test with mathematical modeling), insulin clearance, body composition and fat distribution (dual-energy X-ray absorptiometry, MRI, and spectroscopy), cardiorespiratory fitness (maximal oxygen uptake; graded exercise test), and handgrip strength (dynamometry). RESULTS Women had more total body fat but less visceral fat than men; liver and muscle lipid contents were not different. Maximal oxygen uptake and handgrip strength were lower in women than men. The postprandial glucose concentrations were ~8% lower, the insulin-mediated glucose uptake was ~16% greater, and the meal-induced suppression of fatty acid concentrations was significantly greater in women than in men (P < 0.05 for all). However, muscle insulin sensitivity was not different between the sexes. No differences were found in postprandial insulin secretion and clearance rates; however, the steady-state insulin clearance was ~17% lower in women. CONCLUSIONS Asian women who are nonobese are more insulin-sensitive than men at the level of adipose tissue but not skeletal muscle. Therefore, sex differences in glucose tolerance are likely the result of sexual dimorphism in hepatic insulin action.
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Affiliation(s)
- Zhiling Chan
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - Yu Chung Chooi
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - Cherlyn Ding
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - John Choo
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore
| | - Melvin Khee Leow
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
- Program in Cardiovascular and Metabolic Disorders, Duke-National University of Singapore Medical School, Singapore
- Department of Metabolic Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Faidon Magkos
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research and National University Health System, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Section for Obesity Research, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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8
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Abstract
Body composition differs between men and women. Men have more lean mass, and women have more fat mass than men. Men are more likely to accumulate adipose tissue around the trunk and abdomen, whereas women usually accumulate adipose tissue around the hips and thighs. Less is known about sex differences in ectopic fat depots. Advances in imaging allow the noninvasive assessment of abdominal and femorogluteal fat compartments, intramyocellular lipids, intrahepatic lipids, pericardial adipose tissue, and neck adipose tissue including brown adipose tissue and tongue adipose tissue. In this review, sex differences of regional adipose tissue, muscle mass, ectopic lipids, and brown adipose tissue and their effects on cardiometabolic risk will be discussed. In addition, novel imaging techniques to quantify these body composition compartments noninvasively will be described.
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9
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Takashima H, Takebayashi T, Ogon I, Yoshimoto M, Morita T, Imamura R, Nakanishi M, Nagahama H, Terashima Y, Yamashita T. Analysis of intra and extramyocellular lipids in the multifidus muscle in patients with chronic low back pain using MR spectroscopy. Br J Radiol 2018; 91:20170536. [PMID: 29227152 DOI: 10.1259/bjr.20170536] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To analyse the intra- (IMCL) and extramyocellular lipids (EMCL) concentration in the multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with low back pain (LBP), and to evaluate the correlation between those lipid concentrations and age, obesity, atrophy of the Mm and LBP intensity. METHODS 60 LBP patients underwent routine diagnostic MRI of the lumbar spine before undergoing imaging for the study. Body mass index, as an indicator of obesity and visual analogue scale, as an indicator of LBP were also measured. Proton MRS was acquired with a single-voxel point-resolved spectroscopy sequence. Furthermore, the MRS volume of interest for measuring the IMCL and EMCL concentration at L4/5 for the right Mm was determined, and we measured the cross-sectional area of Mm as an indicator of muscle atrophy. RESULTS Age showed correlation with EMCL concentration (r = 0.314, p = 0.008). The body mass index showed correlation with EMCL concentration (r = 0.358, p = 0.005). The cross-sectional area of Mm showed correlation with EMCL concentration (r = -0.543, p < 0.001). Moreover, the LBP visual analogue scale showed correlation with IMCL concentration (r = 0.367, p = 0.004). CONCLUSION There were correlations between age, obesity, muscle atrophy, and EMCL concentration in Mm. IMCL concentration in Mm showed a correlation with LBP intensity. This may suggest that IMCL concentration could become an effective objective indicator of chronic LBP intensity. Advances in knowledge: We investigated the characteristics of fat content in Mm with LBP patients. This study was demonstrated the association of the IMCL and EMCL concentration in Mm with various patient parameters.
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Affiliation(s)
- Hiroyuki Takashima
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan.,2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital , Sapporo, Hokkaido , Japan
| | - Tsuneo Takebayashi
- 3 Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital , Sapporo, Hokkaido , Japan
| | - Izaya Ogon
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan
| | - Mitsunori Yoshimoto
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan
| | - Tomonori Morita
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan
| | - Rui Imamura
- 2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital , Sapporo, Hokkaido , Japan
| | - Mitsuhiro Nakanishi
- 2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital , Sapporo, Hokkaido , Japan
| | - Hiroshi Nagahama
- 2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital , Sapporo, Hokkaido , Japan
| | - Yoshinori Terashima
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan
| | - Toshihiko Yamashita
- 1 Department Orthopaedic Surgery, Sapporo Medical University School of Medicine , Sapporo, Hokkaido , Japan
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10
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Bhogal AA, Schür RR, Houtepen LC, van de Bank B, Boer VO, Marsman A, Barker PB, Scheenen TWJ, Wijnen JP, Vinkers CH, Klomp DWJ. 1 H-MRS processing parameters affect metabolite quantification: The urgent need for uniform and transparent standardization. NMR IN BIOMEDICINE 2017; 30:e3804. [PMID: 28915314 DOI: 10.1002/nbm.3804] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
Proton magnetic resonance spectroscopy (1 H-MRS) can be used to quantify in vivo metabolite levels, such as lactate, γ-aminobutyric acid (GABA) and glutamate (Glu). However, there are considerable analysis choices which can alter the accuracy or precision of 1 H-MRS metabolite quantification. It is currently unknown to what extent variations in the analysis pipeline used to quantify 1 H-MRS data affect outcomes. The purpose of this study was to evaluate whether the quantification of identical 1 H-MRS scans across independent and experienced research groups would yield comparable results. We investigated the influence of model parameters and spectral quantification software on fitted metabolite concentration values. Sixty spectra in 30 individuals (repeated measures) were acquired using a 7-T MRI scanner. Data were processed by four independent research groups with the freedom to choose their own individualized and optimal parameter settings using LCModel software. Data were processed a second time in one group using an independent software package (NMRWizard) for an additional comparison with a different post-processing platform. Correlations across research groups of the ratio between the highest and, arguably, the most relevant resonances for neurotransmission [N-acetyl aspartate (NAA), N-acetyl aspartyl glutamate (NAAG) and Glu] over the total creatine [creatine (Cr) + phosphocreatine (PCr)] concentration, using Pearson's product-moment correlation coefficient (r), were calculated. Mean inter-group correlations using LCModel software were 0.87, 0.88 and 0.77 for NAA/Cr + PCr, NAA + NAAG/Cr + PCr and Glu/Cr + PCr, respectively. The mean correlations when comparing NMRWizard results with LCModel fitting results at University Medical Center Utrecht (UMCU) were 0.87, 0.89 and 0.71 for NAA/Cr + PCr, NAA + NAAG/Cr + PCr and Glu/Cr + PCr, respectively. Metabolite quantification using identical 1 H-MRS data was influenced by processing parameters, basis sets and software choice. Locally preferred processing choices affected metabolite quantification, even when using identical software. Our results reinforce the notion that standard practices should be established to regularize outcomes of 1 H-MRS studies, and that basis sets used for processing should be made available to the scientific community.
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Affiliation(s)
- Alex A Bhogal
- Radiology Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Remmelt R Schür
- Psychiatry Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lotte C Houtepen
- Psychiatry Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Bart van de Bank
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Vincent O Boer
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Anouk Marsman
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Peter B Barker
- Department of Radiology and Radiological Science - Neuroradiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tom W J Scheenen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jannie P Wijnen
- Radiology Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Christiaan H Vinkers
- Psychiatry Department, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dennis W J Klomp
- Radiology Department, University Medical Center Utrecht, Utrecht, the Netherlands
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11
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Wang T, Chen P, Bian D, Chen J. Application of spectroscopy ( 1HMRS) to assess liver metabolite concentrations in rats with intrauterine growth restriction. J Matern Fetal Neonatal Med 2016; 30:1001-1004. [PMID: 27050741 DOI: 10.1080/14767058.2016.1174989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Proton magnetic resonance spectroscopy (1H-MRS) measurement of liver metabolism in intrauterine growth restriction rats has seldom been reported. This study investigated the application of 1H-MRS in assessing liver metabolism in newborn pups that experienced intrauterine growth restriction. METHODS Intra-uterine growth restriction was established by feeding rats low-protein diets during pregnancy. Newborn pups received conventional magnetic resonance imaging and 1H-MRS using a 3.0T whole body MR scanner at 3, 8 and 12 weeks post birth. RESULTS The success rate of 1H-MRS was 83.33%. Significantly lower body weight, BMI and body length at 3 weeks as well as significantly lower body weight, BMI and waist circumference at 8 and 12 weeks were observed in newborn pups of IUGR rats compared with pups of control rats. Significant differences in ACho/H2O, ACr/H2O, AGlx/H2O and ALipid/H2O at 3 and 8 weeks as well as significant differences in ACr/H2O, ALipid/H2O and AGlx/H2O at 12 weeks were observed between pups of control rats and pups of IUGR rats. CONCLUSION 1H-MRS allows noninvasive assessment of liver metabolism in the rat and demonstrated the poor liver development of rats that experienced IUGR.
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Affiliation(s)
- Tao Wang
- a Department of Neonatology , Children's Medical Center, Second Xiangya Hospital, Central South University , Changsha , P.R. China and
| | - Pingyang Chen
- a Department of Neonatology , Children's Medical Center, Second Xiangya Hospital, Central South University , Changsha , P.R. China and
| | - Dujun Bian
- b Department of Radiology , Second Xiangya Hospital, Central South University , Changsha , P.R. China
| | - Juncao Chen
- a Department of Neonatology , Children's Medical Center, Second Xiangya Hospital, Central South University , Changsha , P.R. China and
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Makimura H, Stanley TL, Suresh C, De Sousa-Coelho AL, Frontera WR, Syu S, Braun LR, Looby SE, Feldpausch MN, Torriani M, Lee H, Patti ME, Grinspoon SK. Metabolic Effects of Long-Term Reduction in Free Fatty Acids With Acipimox in Obesity: A Randomized Trial. J Clin Endocrinol Metab 2016; 101:1123-33. [PMID: 26691888 PMCID: PMC4803166 DOI: 10.1210/jc.2015-3696] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
CONTEXT Increased circulating free fatty acids (FFAs) have been proposed to contribute to insulin resistance in obesity. Short-term studies have investigated the effects of acipimox, an inhibitor of hormone-sensitive lipase, on glucose homeostasis, but longer-term studies have not been performed. OBJECTIVE To test the hypothesis that long-term treatment with acipimox would reduce FFA and improve insulin sensitivity among nondiabetic, insulin-resistant, obese subjects. DESIGN, SETTING, PATIENTS, AND INTERVENTION At an academic medical center, 39 obese men and women were randomized to acipimox 250 mg thrice-daily vs identical placebo for 6 months. MAIN OUTCOME MEASURES Plasma lipids, insulin sensitivity, adiponectin, and mitochondrial function via assessment of the rate of post-exercise phosphocreatine recovery on (31)P-magnetic resonance spectroscopy as well as muscle mitochondrial density and relevant muscle gene expression. RESULTS Fasting glucose decreased significantly in acipimox-treated individuals (effect size, -6 mg/dL; P = .02), in parallel with trends for reduced fasting insulin (effect size, -6.8 μU/mL; P = .07) and HOMA-IR (effect size, -1.96; P = .06), and significantly increased adiponectin (effect size, +668 ng/mL; P = .02). Acipimox did not affect insulin-stimulated glucose uptake, as assessed by euglycemic, hyperinsulinemic clamp. Effects on muscle mitochondrial function and density and on relevant gene expression were not seen. CONCLUSION These data shed light on the long-term effects of FFA reduction on insulin sensitivity, other metabolic parameters, and muscle mitochondrial function in obesity. Reduced FFA achieved by acipimox improved fasting measures of glucose homeostasis, lipids, and adiponectin but had no effect on mitochondrial function, mitochondrial density, or muscle insulin sensitivity.
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Affiliation(s)
- Hideo Makimura
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Takara L Stanley
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Caroline Suresh
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Ana Luisa De Sousa-Coelho
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Walter R Frontera
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Stephanie Syu
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Laurie R Braun
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Sara E Looby
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Meghan N Feldpausch
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Martin Torriani
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Hang Lee
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Mary-Elizabeth Patti
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
| | - Steven K Grinspoon
- Program in Nutritional Metabolism and Neuroendocrine Unit (H.M., T.L.S., C.S., S.S., L.R.B., S.E.L., M.N.F., S.K.G.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard Medical School (H.M., T.L.S., A.L.D.S.-C., L.R.B., S.E.L., M.T., H.L., M.-E.P., S.K.G.), Boston, Massachusetts 02115; Pediatric Endocrine Unit (T.L.S., L.R.B.), Massachusetts General Hospital, Boston, Massachusetts 02114; Research Division (A.L.D.S.-C., M.-E.P.), Joslin Diabetes Center, Boston, Massachusetts 02215; Department of Physical Medicine and Rehabilitation (W.R.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.R.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.R.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; Department of Radiology (M.T.), Massachusetts General Hospital, Boston, Massachusetts 02114; and MGH Biostatistics Center (H.L.), Massachusetts General Hospital and Harvard Medical Center, Boston, Massachusetts 02114
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Livingstone RS, Grunnet LG, Thomas N, Eapen A, Antonisamy B, Mohan VR, Spurgeon R, Frank ID, Bygbjerg IC, Vaag A. Are hepatic and soleus lipid content, assessed by magnetic resonance spectroscopy, associated with low birth weight or insulin resistance in a rural Indian population of healthy young men? Diabet Med 2016; 33:365-70. [PMID: 26172248 DOI: 10.1111/dme.12852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2015] [Indexed: 12/22/2022]
Abstract
AIMS To assess young healthy men from rural India, who had normal or low birth weights, using magnetic resonance spectroscopy to determine the potential differences in ectopic fat storage between birth weight groups, and to determine if ectopic fat storage was associated with insulin resistance in this population. METHODS A total of 54 lean men with normal birth weight and 49 lean men with low birth weight (age range 18-22 years) from rural India were recruited. All the men underwent anthropometry, magnetic resonance spectroscopy, a hyperinsulinaemic-euglycaemic clamp and a dual-energy X-ray absorptiometry. RESULTS The median (interquartile range) values for hepatic cellular lipids, intramyocellular lipids and extramyocellular lipids, measured using magnetic resonance spectroscopy were 0.76 (0.1-1.8)%, 1.27 (1.0-2.3)% and 1.89 (1.3-3.2)%, respectively, for the normal birth weight group and 0.4 (0.1-1.3)%, 1.38 (0.9-2.2)% and 2.07 (1.2-2.8)%, respectively, for the low birth weight group (P > 0.05). No difference in ectopic fat storage was observed between the low and normal birth weight groups, with or without adjustment for age and total fat percentage. Homeostatic model assessment of insulin resistance values were not associated with hepatic cellular, intramyocellular or extramyocellular lipid content in any of the groups. Total fat percentage was the only independent predictor of intramyocellular and extramyocellular lipid content. CONCLUSION Young and lean men from rural India with low birth weight were not observed to have ectopic fat storage in the liver or muscle, and the amount of liver and muscle fat was unrelated to insulin resistance. Older age and/or an urban affluent lifestyle may be required to show a potential role of ectopic fat storage on insulin resistance in Indian people with low or normal birth weight.
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Affiliation(s)
- R S Livingstone
- Department of Radiology, Christian Medical College and Hospital, Vellore, India
| | - L G Grunnet
- Diabetes and Metabolism, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - N Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - A Eapen
- Department of Radiology, Christian Medical College and Hospital, Vellore, India
| | - B Antonisamy
- Department of Biostatistics, Christian Medical College and Hospital, Vellore, India
| | - V R Mohan
- Department of Community Health, Christian Medical College and Hospital, Vellore, India
| | - R Spurgeon
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - I D Frank
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - I C Bygbjerg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A Vaag
- Diabetes and Metabolism, Copenhagen University Hospital (Rigshospitalet), Denmark
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14
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Vigneswaran S, Rojas JHV, Garvey L, Taylor-Robinson S, Winston A. Differences in the variability of cerebral proton magnetic resonance spectroscopy (1H-MRS) measurements within three HIV-infected cohorts. Neuroradiol J 2015; 28:545-54. [PMID: 26493269 DOI: 10.1177/1971400915609867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Cerebral functional impairment remains prevalent in effectively treated HIV-infected subjects. As the results of formal cognitive testing are highly variable, surrogate markers to accurately measure cerebral function parameters are needed. Such markers include measurement of cerebral metabolite ratios (CMR) using proton magnetic resonance spectroscopy (1H-MRS). However, data on the inter-subject variability of CMR are sparse. Our aim was to assess inter-subject variability in CMRs within three different HIV-infected cohorts. METHODS Cerebral 1H-MRS was performed using a Phillips Achieva™ 1.5 Tesla magnetic resonance scanner in HIV-infected subjects as follows: 12 subjects before (group 1) and after intensification of antiretroviral therapy with maraviroc (group 2) and 13 subjects with acute viral hepatitis C (HCV) co-infection (group 3). The coefficients of variation (CV) for CMRs in each group were determined and compared using non-parametric tests to determine whether the inter-subject variability differed significantly. All baseline characteristics between the groups were similar. RESULTS Overall CVs for all CMRs in groups 1, 2 and 3 were 32.3%, 33.2% and 23.4%, respectively (group 1 vs. 2, p=0.863; group 1 vs. 3, p=0.076). On testing for differences in variability between individual CMRs, two metabolites in the right basal ganglia (RBG) had statistically significantly different CVs when comparing group 1 with group 3: N-acetyl aspartate/creatine (NAA/Cr), p=0.029 and myo-Inositol/creatine (mI/Cr), p=0.016. CONCLUSION The variability of 1H MRS-measurable CMRs in HIV-infected individuals was lower in those with acute HCV co-infection (group 3).We can conclude that the use of these CMRs in 1H MRS imaging in patients with HIV/acute HCV co-infection is more reliable to assess cerebral function than in patients with HIV infection alone. This has implications for future sample size estimations.
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Affiliation(s)
| | - Jaime H Vera Rojas
- Division of medicine, Brighton and Sussex Medical School Department of HIV and GU Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Lucy Garvey
- Department of HIV and GU Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Simon Taylor-Robinson
- Department of Medicine, Faculty of Medicine, Imperial College London, St Mary's Hospital Campus, London, UK
| | - Alan Winston
- Department of HIV and GU Medicine, Imperial College Healthcare NHS Trust, London, UK
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Ipavec-Levasseur S, Croci I, Choquette S, Byrne NM, Cowin G, O'Moore-Sullivan TM, Prins JB, Hickman IJ. Effect of 1-h moderate-intensity aerobic exercise on intramyocellular lipids in obese men before and after a lifestyle intervention. Appl Physiol Nutr Metab 2015; 40:1262-8. [PMID: 26575100 DOI: 10.1139/apnm-2015-0258] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intramyocellular lipids (IMCL) are depleted in response to an acute bout of exercise in lean endurance-trained individuals; however, it is unclear whether changes in IMCL content are also seen in response to acute and chronic exercise in obese individuals. We used magnetic resonance spectroscopy in 18 obese men and 5 normal-weight controls to assess IMCL content before and after an hour of cycling at the intensity corresponding with each participant's maximal whole-body rate of fat oxidation (Fatmax). Fatmax was determined via indirect calorimetry during a graded exercise test on a cycle ergometer. The same outcome measures were reassessed in the obese group after a 16-week lifestyle intervention comprising dietary calorie restriction and exercise training. At baseline, IMCL content decreased in response to 1 h of cycling at Fatmax in controls (2.8 ± 0.4 to 2.0 ± 0.3 A.U., -39%, p = 0.02), but not in obese (5.4 ± 2.1 vs. 5.2 ± 2.2 A.U., p = 0.42). The lifestyle intervention lead to weight loss (-10.0 ± 5.4 kg, p < 0.001), improvements in maximal aerobic power (+5.2 ± 3.4 mL/(kg·min)), maximal fat oxidation rate (+0.19 ± 0.22 g/min), and a 29% decrease in homeostasis model assessment score (all p < 0.05). However, when the 1 h of cycling at Fatmax was repeated after the lifestyle intervention, there remained no observable change in IMCL (4.6 ± 1.8 vs. 4.6 ± 1.9 A.U., p = 0.92). In summary, there was no IMCL depletion in response to 1 h of cycling at moderate intensity either before or after the lifestyle intervention in obese men. An effective lifestyle intervention including moderate-intensity exercise training did not impact rate of utilisation of IMCL during acute exercise in obese men.
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Affiliation(s)
| | - Ilaria Croci
- a The University of Queensland Diamantina Institute, Brisbane, Australia.,b School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,c Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Stéphane Choquette
- d Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Nuala M Byrne
- e Bond Institute of Health and Sport, Bond University, Robina, Australia.,f Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Gary Cowin
- g Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Trisha M O'Moore-Sullivan
- c Mater Research Institute, University of Queensland, Brisbane, Australia.,h Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia
| | - Johannes B Prins
- c Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Ingrid J Hickman
- a The University of Queensland Diamantina Institute, Brisbane, Australia.,c Mater Research Institute, University of Queensland, Brisbane, Australia
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16
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Gillinder L, Goo SY, Cowin G, Strudwick M, van der Geest RJ, Wang WYS, Ng ACT. Quantification of Intramyocardial Metabolites by Proton Magnetic Resonance Spectroscopy. Front Cardiovasc Med 2015; 2:24. [PMID: 26664896 PMCID: PMC4671339 DOI: 10.3389/fcvm.2015.00024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/26/2015] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To define intramyocardial triglyceride (TG), creatine (Cr), and choline (Cho) in healthy volunteers, and determine the feasibilities, scan durations and agreements between cardiac proton magnetic resonance spectroscopy ([(1)H]-MRS) performed with fewer signal averages versus a reference standard with 128 signal averages. MATERIALS AND METHODS Thirty-one participants underwent [(1)H]-MRS using 16, 32, 64, and 128 signal averages. Intramyocardial TG, Cr, or Cho contents relative to water were calculated and expressed as a percentage. RESULTS Mean intramyocardial TG, Cr, and Cho were 1.30 ± 1.13, 0.19 ± 0.18, and 0.24 ± 0.28%, respectively. The feasibilities for quantifying intramyocardial TG, Cr, and Cho using fewer signal averages ranged from 93.5 to 100, 90.3 to 93.5, and 90.3 to 96.8%, respectively. Scan durations for 16, 32, 64, and 128 signal averages were 1.1 ± 0.5, 2.6 ± 0.9, 5.9 ± 2.0, and 13.2 ± 4.5 min, respectively (p < 0.001). Agreements with the reference standard 128 signal average was higher for quantification of intramyocardial TG compared to Cr and Cho. CONCLUSION Quantification of intramyocardial TG with [(1)H]-MRS with only 64 signal averages was highly feasible, showed excellent agreement with 128 signal averages, and had significantly shorter scan duration. By contrast, quantifying Cr and Cho using fewer signal averages had lower feasibilities and agreements compared to 128 signal averages.
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Affiliation(s)
- Lisa Gillinder
- Department of Cardiology, Princess Alexandra Hospital, The University of Queensland , Brisbane, QLD , Australia
| | - Shi Yi Goo
- Department of Cardiology, Princess Alexandra Hospital, The University of Queensland , Brisbane, QLD , Australia
| | - Gary Cowin
- Centre for Advanced Imaging, The University of Queensland , Brisbane, QLD , Australia
| | - Mark Strudwick
- Centre for Advanced Imaging, The University of Queensland , Brisbane, QLD , Australia
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center , Leiden , Netherlands
| | - William Y S Wang
- Department of Cardiology, Princess Alexandra Hospital, The University of Queensland , Brisbane, QLD , Australia ; Centre for Advanced Imaging, The University of Queensland , Brisbane, QLD , Australia
| | - Arnold C T Ng
- Department of Cardiology, Princess Alexandra Hospital, The University of Queensland , Brisbane, QLD , Australia ; Centre for Advanced Imaging, The University of Queensland , Brisbane, QLD , Australia
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Hussein MO, Hoad CL, Stephenson MC, Cox EF, Placidi E, Pritchard SE, Costigan C, Ribeiro H, Ciampi E, Rayment P, Nandi A, Hedges N, Sanderson P, Peters HP, Kruse I, Marciani L, Spiller RC, Gowland PA. Magnetic resonance spectroscopy measurements of intragastric fat fraction of oil emulsions in humans. EUR J LIPID SCI TECH 2014. [DOI: 10.1002/ejlt.201400058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mahamoud O. Hussein
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Caroline L. Hoad
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Mary C. Stephenson
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Eleanor F. Cox
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Elisa Placidi
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Susan E. Pritchard
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | - Carolyn Costigan
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
| | | | | | - Pip Rayment
- Unilever Discover; Colworth Science Park; Sharnbrook UK
| | - Asish Nandi
- Unilever Discover; Colworth Science Park; Sharnbrook UK
| | - Nick Hedges
- Unilever Discover; Colworth Science Park; Sharnbrook UK
| | | | | | - Irmela Kruse
- Unilever Discover; Colworth Science Park; Sharnbrook UK
| | - Luca Marciani
- Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit; University of Nottingham; Nottingham UK
| | - Robin C. Spiller
- Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit; University of Nottingham; Nottingham UK
| | - Penny A. Gowland
- Sir Peter Mansfield Magnetic Resonance Centre; School of Physics and Astronomy; University of Nottingham; Nottingham UK
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18
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Deshmukh S, Subhawong T, Carrino JA, Fayad L. Role of MR spectroscopy in musculoskeletal imaging. Indian J Radiol Imaging 2014; 24:210-6. [PMID: 25114383 PMCID: PMC4126135 DOI: 10.4103/0971-3026.137024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Magnetic resonance spectroscopy (MRS) is an imaging approach that allows for the noninvasive molecular characterization of a region of interest. By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response. Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged. The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.
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Affiliation(s)
- Swati Deshmukh
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA
| | - Ty Subhawong
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA
| | - John A Carrino
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA
| | - Laura Fayad
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA
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Stanley TL, Feldpausch MN, Oh J, Branch KL, Lee H, Torriani M, Grinspoon SK. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA 2014; 312:380-9. [PMID: 25038357 PMCID: PMC4363137 DOI: 10.1001/jama.2014.8334] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Among patients infected with human immunodeficiency virus (HIV), visceral adiposity is associated with metabolic dysregulation and ectopic fat accumulation. Tesamorelin, a growth hormone-releasing hormone analog, specifically targets visceral fat reduction but its effects on liver fat are unknown. OBJECTIVE To investigate the effect of tesamorelin on visceral and liver fat. DESIGN, SETTING, AND PATIENTS Double-blind, randomized, placebo-controlled trial conducted among 50 antiretroviral-treated HIV-infected men and women with abdominal fat accumulation at Massachusetts General Hospital in Boston. The first patient was enrolled on January 10, 2011; for the final patient, the 6-month study visit was completed on September 6, 2013. INTERVENTIONS Participants were randomized to receive tesamorelin, 2 mg (n=28), or placebo (n=22), subcutaneously daily for 6 months. MAIN OUTCOMES AND MEASURES Primary end points were changes in visceral adipose tissue and liver fat. Secondary end points included glucose levels and other metabolic end points. RESULTS Forty-eight patients received treatment with study drug. Tesamorelin significantly reduced visceral adipose tissue (mean change, -34 cm2 [95% CI, -53 to -15 cm2] with tesamorelin vs 8 cm2 [95% CI, -14 to 30 cm2] with placebo; treatment effect, -42 cm2 [95% CI, -71 to -14 cm2]; P = .005) and liver fat (median change in lipid to water percentage, -2.0% [interquartile range {IQR}, -6.4% to 0.1%] with tesamorelin vs 0.9% [IQR, -0.6% to 3.7%] with placebo; P = .003) over 6 months, for a net treatment effect of -2.9% in lipid to water percentage. Fasting glucose increased in the tesamorelin group at 2 weeks (mean change, 9 mg/dL [95% CI, 5-13 mg/dL] vs 2 mg/dL [95% CI, -3 to 8 mg/dL] in the placebo group; treatment effect, 7 mg/dL [95% CI, 1-14 mg/dL]; P = .03), but changes at 6 months in fasting glucose (mean change, 4 mg/dL [95% CI, -2 to 10 mg/dL] with tesamorelin vs 2 mg/dL [95% CI, -4 to 7 mg/dL] with placebo; treatment effect, 2 mg/dL [95% CI, -6 to 10 mg/dL]; P = .72 overall across time points) and 2-hour glucose (mean change, -1 mg/dL [95% CI, -18 to 15 mg/dL] vs -8 mg/dL [95% CI, -24 to 8 mg/dL], respectively; treatment effect, 7 mg/dL [95% CI, -16 to 29 mg/dL]; P = .53 overall across time points) were not significant. CONCLUSIONS AND RELEVANCE In this preliminary study of HIV-infected patients with abdominal fat accumulation, tesamorelin administered for 6 months was associated with reductions in visceral fat and additionally with modest reductions in liver fat. Further studies are needed to determine the clinical importance and long-term consequences of these findings. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01263717.
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Affiliation(s)
- Takara L Stanley
- Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Meghan N Feldpausch
- Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jinhee Oh
- Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Karen L Branch
- Clinical Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Martin Torriani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Steven K Grinspoon
- Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Mosconi E, Sima DM, Osorio Garcia MI, Fontanella M, Fiorini S, Van Huffel S, Marzola P. Different quantification algorithms may lead to different results: a comparison using proton MRS lipid signals. NMR IN BIOMEDICINE 2014; 27:431-43. [PMID: 24493129 DOI: 10.1002/nbm.3079] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 01/01/2014] [Accepted: 01/02/2014] [Indexed: 05/24/2023]
Abstract
Proton magnetic resonance spectroscopy (MRS) is a sensitive method for investigating the biochemical compounds in a tissue. The interpretation of the data relies on the quantification algorithms applied to MR spectra. Each of these algorithms has certain underlying assumptions and may allow one to incorporate prior knowledge, which could influence the quality of the fit. The most commonly considered types of prior knowledge include the line-shape model (Lorentzian, Gaussian, Voigt), knowledge of the resonating frequencies, modeling of the baseline, constraints on the damping factors and phase, etc. In this article, we study whether the statistical outcome of a biological investigation can be influenced by the quantification method used. We chose to study lipid signals because of their emerging role in the investigation of metabolic disorders. Lipid spectra, in particular, are characterized by peaks that are in most cases not Lorentzian, because measurements are often performed in difficult body locations, e.g. in visceral fats close to peristaltic movements in humans or very small areas close to different tissues in animals. This leads to spectra with several peak distortions. Linear combination of Model spectra (LCModel), Advanced Method for Accurate Robust and Efficient Spectral fitting (AMARES), quantitation based on QUantum ESTimation (QUEST), Automated Quantification of Short Echo-time MRS (AQSES)-Lineshape and Integration were applied to simulated spectra, and area under the curve (AUC) values, which are proportional to the quantity of the resonating molecules in the tissue, were compared with true values. A comparison between techniques was also carried out on lipid signals from obese and lean Zucker rats, for which the polyunsaturation value expressed in white adipose tissue should be statistically different, as confirmed by high-resolution NMR measurements (considered the gold standard) on the same animals. LCModel, AQSES-Lineshape, QUEST and Integration gave the best results in at least one of the considered groups of simulated or in vivo lipid signals. These outcomes highlight the fact that quantification methods can influence the final result and its statistical significance.
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Affiliation(s)
- E Mosconi
- Department of Computer Science, University of Verona, Verona, Italy
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21
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1H Magnetic resonance spectroscopy findings in idiopathic inflammatory myopathies at 3 T: feasibility and first results. Invest Radiol 2014; 48:509-16. [PMID: 23563194 DOI: 10.1097/rli.0b013e3182823562] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the feasibility and potential use of quantitative proton magnetic resonance spectroscopy (MRS) for determining metabolite concentrations in patients with suspected inflammatory myopathies. MATERIALS AND METHODS In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 35 patients with a suspected inflammatory myopathy and 6 age-matched healthy volunteers underwent magnetic resonance imaging (MRI) (T1-weighted and short tau inversion recovery [STIR] sequences) and single-voxel MRS (point-resolved spectroscopy; repetition time/echo time, 2000/135 milliseconds; voxel size, 2.0 × 2.0 × 4.0 cm) at 3 T. The voxel was placed in a thigh muscle and targeted to one with abnormal STIR signal when possible. Absolute trimethylamine, creatine (Cr), and bulk lipid concentrations in each voxel were determined using the phantom replacement method. The MRS results of patients and healthy subjects were compared using the Wilcoxon rank sum test. RESULTS Twenty-one patients were diagnosed with an active idiopathic inflammatory myopathy (IIM). In 20 of these patients, MRI showed increased intramuscular STIR signal; however, the muscle where the voxel was placed was normal in 9 patients. Patients with an IIM demonstrated higher mean intramuscular Cr concentration compared with controls (62.1 vs 35.3 IU; P = 0.01), but there were no differences in the mean trimethylamine or lipid concentrations. In IIM patients with no intravoxel signal abnormality (9/21), the mean Cr concentration was still higher than that in healthy subjects (63.2 vs 35.3 IU; P = 0.001). CONCLUSIONS Quantitative 3-T MRS is feasible and may supplement the role of conventional MRI in the evaluation of patients with inflammatory myopathies, especially where MRI shows no obvious muscle abnormalities.
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Metabolic imaging of human kidney triglyceride content: reproducibility of proton magnetic resonance spectroscopy. PLoS One 2013; 8:e62209. [PMID: 23620813 PMCID: PMC3631161 DOI: 10.1371/journal.pone.0062209] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/18/2013] [Indexed: 01/08/2023] Open
Abstract
Objective To assess the feasibility of renal proton magnetic resonance spectroscopy for quantification of triglyceride content and to compare spectral quality and reproducibility without and with respiratory motion compensation in vivo. Materials and Methods The Institutional Review Board of our institution approved the study protocol, and written informed consent was obtained. After technical optimization, a total of 20 healthy volunteers underwent renal proton magnetic resonance spectroscopy of the renal cortex both without and with respiratory motion compensation and volume tracking. After the first session the subjects were repositioned and the protocol was repeated to assess reproducibility. Spectral quality (linewidth of the water signal) and triglyceride content were quantified. Bland-Altman analyses and a test by Pitman were performed. Results Linewidth changed from 11.5±0.4 Hz to 10.7±0.4 Hz (all data pooled, p<0.05), without and with respiratory motion compensation respectively. Mean % triglyceride content in the first and second session without respiratory motion compensation were respectively 0.58±0.12% and 0.51±0.14% (P = NS). Mean % triglyceride content in the first and second session with respiratory motion compensation were respectively 0.44±0.10% and 0.43±0.10% (P = NS between sessions and P = NS compared to measurements with respiratory motion compensation). Bland-Altman analyses showed narrower limits of agreement and a significant difference in the correlated variances (correlation of −0.59, P<0.05). Conclusion Metabolic imaging of the human kidney using renal proton magnetic resonance spectroscopy is a feasible tool to assess cortical triglyceride content in humans in vivo and the use of respiratory motion compensation significantly improves spectral quality and reproducibility. Therefore, respiratory motion compensation seems a necessity for metabolic imaging of renal triglyceride content in vivo.
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Delli Pizzi S, Rossi C, Di Matteo V, Esposito E, Guarnieri S, Mariggiò MA, Franciotti R, Caulo M, Thomas A, Onofrj M, Tartaro A, Bonanni L. Morphological and metabolic changes in the nigro-striatal pathway of synthetic proteasome inhibitor (PSI)-treated rats: a MRI and MRS study. PLoS One 2013; 8:e56501. [PMID: 23431380 PMCID: PMC3576393 DOI: 10.1371/journal.pone.0056501] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 01/10/2013] [Indexed: 12/25/2022] Open
Abstract
Systemic administration of a Synthetic Proteasome Inhibitor (PSI) in rats has been described as able to provide a model of Parkinson's disease (PD), characterized by behavioral and biochemical modifications, including loss of dopaminergic neurons in the substantia nigra (SN), as assessed by post-mortem studies. With the present study we aimed to assess in-vivo by Magnetic Resonance (MR) possible morphological and metabolic changes in the nigro-striatal pathway of PSI-treated rats. 10 animals were subcutaneously injected with PSI 6.0 mg/kg dissolved in DMSO 100%. Injections were made thrice weekly over the course of two weeks. 5 more animals injected with DMSO 100% with the same protocol served as controls. The animals underwent MR sessions before and at four weeks after the end of treatment with either PSI or vehicle. MR Imaging was performed to measure SN volume and Proton MR Spectroscopy ((1)H-MRS) was performed to measure metabolites changes at the striatum. Animals were also assessed for motor function at baseline and at 4 and 6 weeks after treatment. Dopamine and dopamine metabolite levels were measured in the striata at 6 weeks after treatment. PSI-treated animals showed volumetric reduction of the SN (p<0.02) at 4 weeks after treatment as compared to baseline. Immunofluorescence analysis confirmed MRI changes in SN showing a reduction of tyrosine hydroxylase expression as compared to neuron-specific enolase expression. A reduction of N-acetyl-aspartate/total creatine ratio (p = 0.05) and an increase of glutamate-glutamine-γ amminobutirrate/total creatine were found at spectroscopy (p = 0.03). At 6 weeks after treatment, PSI-treated rats also showed motor dysfunction compared to baseline (p = 0.02), accompanied by dopamine level reduction in the striatum (p = 0.02). Treatment with PSI produced morphological and metabolic modifications of the nigro-striatal pathway, accompanied by motor dysfunction. MR demonstrated to be a powerful mean to assess in-vivo the nigro-striatal pathway morphology and metabolism in the PSI-based PD animal model.
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Affiliation(s)
- Stefano Delli Pizzi
- ITAB, “G. D’Annunzio University”, Chieti, Italy
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Cosmo Rossi
- Aging Research Center, Ce.S.I., “Gabriele d’Annunzio” University Foundation, Chieti, Italy
| | - Vincenzo Di Matteo
- Laboratory of Neurophysiology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Santa Maria Imbaro (Chieti), Italy
| | - Ennio Esposito
- Laboratory of Neurophysiology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Santa Maria Imbaro (Chieti), Italy
| | - Simone Guarnieri
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Maria Addolorata Mariggiò
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | | | - Massimo Caulo
- ITAB, “G. D’Annunzio University”, Chieti, Italy
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Astrid Thomas
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Marco Onofrj
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Armando Tartaro
- ITAB, “G. D’Annunzio University”, Chieti, Italy
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
| | - Laura Bonanni
- Department of Neuroscience and Imaging and CE.S.I. Aging Research Center, University G.d’Annunzio of Chieti-Pescara, Italy
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Altin SE, Schulze PC. Metabolism of the right ventricle and the response to hypertrophy and failure. Prog Cardiovasc Dis 2012; 55:229-33. [PMID: 23009918 DOI: 10.1016/j.pcad.2012.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Profound transcriptional, translational and energetic derangements develop in the right ventricle (RV) in response to physiologic and pathophysiologic stress. The transition from pressure and volume overload to cardiac hypertrophy and subsequent failure is accompanied by a distinct switch from preferential fatty acid to glucose utilization for ATP generation. The failing RV is characterized by an energy-starved state with insufficient ATP levels. Modern non-invasive imaging using positron emission tomography using specific radioactive tracers allows a detailed spatial and temporal characterization of RV metabolism. While the current role for pharmacologic interventions on RV metabolic abnormalities is unclear, several potentially promising molecular targets have been identified and clinical trials targeting molecular dysfunction in RV hypertrophy and failure have been designed.
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Affiliation(s)
- S Elissa Altin
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York 10032, USA
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Srikanthan P, Singhal A, Lee CC, Nagarajan R, Wilson N, Roberts CK, Hahn TJ, Thomas MA. Characterization of Intra-myocellular Lipids using 2D Localized Correlated Spectroscopy and Abdominal Fat using MRI in Type 2 Diabetes. MAGNETIC RESONANCE INSIGHTS 2012; 5:29-36. [PMID: 23471581 DOI: 10.4137/mri.s10489] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A major goal of this pilot study was to quantify intramyocellular lipids (IMCL), extramyocellular lipids (EMCL), unsaturation index (UI) and metabolites such as creatine (Cr), choline (Ch) and carnosine (Car), in the soleus muscle using two-dimensional (2D) localized correlated spectroscopy (L-COSY). Ten subjects with type 2 diabetes (T2D), controlled by lifestyle management alone, and 9 healthy control subjects, were studied. In T2D patients only, the following measurements were obtained: body mass index (BMI); waist circumference (WC); abdominal visceral and subcutaneous fat quantified using breath-held magnetic resonance imaging (MRI); a fasting blood draw for assessment of glucose, insulin, and estimation of homeostasis model assessment of insulin resistance (HOMA-IR), HbA1c, and high-sensitivity c-reactive protein (hs-CRP). Analysis of the soleus muscle 2D L-COSY spectral data showed significantly elevated IMCL ratios with respect to Cr and decreased IMCL UI in T2D when compared to healthy subjects (P < 0.05). In T2D subjects, Pearson correlation analysis showed a positive correlation of IMCL/Cr with EMCL/Cr (0.679, P < 0.05) and HOMA-IR (0.633, P < 0.05), and a non-significant correlation of visceral and subcutaneous fat with magnetic resonance spectroscopy (MRS) and other metrics. Characterization of muscle IMCL and EMCL ratios, UI, and abdominal fat, may be useful for the noninvasive assessment of the role of altered lipid metabolism in the pathophysiology of T2D, and for assessment of the effects of future therapeutic interventions designed to alter metabolic dysfunction in T2D.
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Sato T, Katabami T, Furukawa K, Narimatsu H, Hashimoto T, Nakajima Y, Ohta A, Sasaoka T, Tanaka Y. Intracellular lipid content of liver and skeletal muscle in patients with adult growth hormone deficiency without diabetes mellitus. Obes Res Clin Pract 2012; 6:e263-346. [DOI: 10.1016/j.orcp.2011.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 08/24/2011] [Accepted: 09/01/2011] [Indexed: 01/07/2023]
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Delli Pizzi S, Madonna R, Caulo M, Romani GL, De Caterina R, Tartaro A. MR angiography, MR imaging and proton MR spectroscopy in-vivo assessment of skeletal muscle ischemia in diabetic rats. PLoS One 2012; 7:e44752. [PMID: 23028603 PMCID: PMC3448608 DOI: 10.1371/journal.pone.0044752] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 08/06/2012] [Indexed: 02/04/2023] Open
Abstract
To prospectively evaluate the feasibility of using magnetic resonance (MR) techniques for in-vivo assessing a rat diabetic model of limb ischemia. Unilateral hind limb ischemia was induced by ligation of the iliac-femoral artery in male streptozotocin-treated and non-diabetic control rats. Four weeks after ligation, rats underwent MR Angiography (MRA), T1-weighted and Short Time Inversion Recovery (STIR) sequences and muscle Proton MR Spectroscopy (1H-MRS) on both hind limbs. After MR examinations, immunoblotting and immunofluorescence analysis were performed. MRA showed a signal void due to flow discontinuation distal to the artery ligation. T1-weighted and STIR images showed, respectively, the presence of tissue swelling (p = 0.018 for non-diabetic; p = 0.027 for diabetic rats) and signal hyperintensity in tissue affected by occlusion. Mean total creatine/water for the occluded limb was significantly lower than for the non-occluded limbs in both non-diabetic (5.46×10−4 vs 1.14×10−3, p = 0.028) and diabetic rats (1.37×10−4 vs 1.10×10−3; p = 0.018). MR Imaging and 1H-MRS changes were more pronounced in diabetic than in non-diabetic occluded limbs (p = 0.032). MR findings were confirmed by using histological findings. Combined MR techniques can be used to demonstrate the presence of structural and metabolic changes produced by iliac-femoral artery occlusion in rat diabetic model of limb ischemia.
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Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Rosalinda Madonna
- Department of Neuroscience and Imaging, Cardiology Division of Center of Excellence on Aging, University “G. d'Annunzio”, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Gian Luca Romani
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
| | - Raffaele De Caterina
- Department of Neuroscience and Imaging, Cardiology Division of Center of Excellence on Aging, University “G. d'Annunzio”, Chieti, Italy
| | - Armando Tartaro
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, “G. d'Annunzio University” Foundation, Chieti, Italy
- * E-mail:
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Glund S, Schoelch C, Thomas L, Niessen HG, Stiller D, Roth GJ, Neubauer H. Inhibition of acetyl-CoA carboxylase 2 enhances skeletal muscle fatty acid oxidation and improves whole-body glucose homeostasis in db/db mice. Diabetologia 2012; 55:2044-53. [PMID: 22532389 DOI: 10.1007/s00125-012-2554-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 03/12/2012] [Indexed: 01/13/2023]
Abstract
AIMS/HYPOTHESIS Excessive ectopic lipid deposition contributes to impaired insulin action in peripheral tissues and is considered an important link between obesity and type 2 diabetes mellitus. Acetyl-CoA carboxylase 2 (ACC2) is a key regulatory enzyme controlling skeletal muscle mitochondrial fatty acid oxidation; inhibition of ACC2 results in enhanced oxidation of lipids. Several mouse models lacking functional ACC2 have been reported in the literature. However, the phenotypes of the different models are inconclusive with respect to glucose homeostasis and protection from diet-induced obesity. METHODS Here, we studied the effects of pharmacological inhibition of ACC2 using as a selective inhibitor the S enantiomer of compound 9c ([S]-9c). Selectivity was confirmed in biochemical assays using purified human ACC1 and ACC2. RESULTS (S)-9c significantly increased fatty acid oxidation in isolated extensor digitorum longus muscle from different mouse models (EC(50) 226 nmol/l). Accordingly, short-term treatment of mice with (S)-9c decreased malonyl-CoA levels in skeletal muscle and concomitantly reduced intramyocellular lipid levels. Treatment of db/db mice for 70 days with (S)-9c (10 and 30 mg/kg, by oral gavage) resulted in improved oral glucose tolerance (AUC -36%, p < 0.05), enhanced skeletal muscle 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) uptake, as well as lowered prandial glucose (-31%, p < 0.01) and HbA(1c) (-0.7%, p < 0.05). Body weight, liver triacylglycerol, plasma insulin and pancreatic insulin content were unaffected by the treatment. CONCLUSIONS/INTERPRETATION In conclusion, the ACC2-selective inhibitor (S)-9c revealed glucose-lowering effects in a mouse model of diabetes mellitus.
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Affiliation(s)
- S Glund
- CardioMetabolic Diseases Research, Boehringer Ingelheim Pharma GmbH& Co. KG, 88397, Biberach an der Riss, Germany
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Effects of lifestyle modification and metformin on atherosclerotic indices among HIV-infected patients with the metabolic syndrome. AIDS 2012; 26:587-97. [PMID: 22112605 DOI: 10.1097/qad.0b013e32834f33cc] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Metabolic abnormalities including diabetes, dyslipidemia, hypertension, and abdominal obesity occur commonly in HIV patients, are associated with increased coronary artery calcification (CAC), and contribute to increased cardiovascular disease (CVD) in this population. We hypothesized that lifestyle modification (LSM) and metformin would improve CVD indices in HIV patients with metabolic syndrome. DESIGN A randomized, placebo-controlled trial to investigate LSM and metformin, alone and in combination, over 1 year, among 50 HIV-infected patients with metabolic syndrome. METHODS We assessed CAC, cardiovascular and metabolic indices. RESULTS Among the participants, duration of HIV-infection was 14 ± 1 year and duration of antiretroviral therapy was 6 ± 1 year. Metformin-treated patients demonstrated significantly less progression of CAC (-1 ± 2 vs. 33 ± 17, P = 0.004, metformin vs. placebo), whereas the effect of LSM on CAC progression was not significant (8 ± 6 vs. 21 ± 14, P = 0.82, LSM vs. no-LSM). Metformin had a significantly greater effect on CAC than LSM (P = 0.01). Metformin-treated patients also demonstrated less progression in calcified plaque volume (-0.4 ± 1.9 vs. 27.6 ± 13.8 μl, P = 0.008) and improved homeostatic model of assessment-insulin resistance (HOMA-IR) (P = 0.05) compared with placebo. Participants randomized to LSM vs. no-LSM showed significant improvement in HDL (P = 0.03), high-sensitivity C-reactive protein (hsCRP) (P = 0.05), and cardiorespiratory fitness. Changes in CAC among the four groups--no-LSM-placebo (43 ± 30); LSM-placebo (19 ± 7); no-LSM-metformin (1 ± 1) and LSM-metformin (-4 ± 6)--were different (P = 0.03 for ANOVA and linear trend across groups), and the majority of this effect was mediated by metformin. Results are mean ± SEM. CONCLUSION Metformin prevents plaque progression in HIV-infected patients with the metabolic syndrome.
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Proton MR spectroscopy in metabolic assessment of musculoskeletal lesions. AJR Am J Roentgenol 2012; 198:162-72. [PMID: 22194493 DOI: 10.2214/ajr.11.6505] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods. CONCLUSION Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods.
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Cerebral magnetic resonance spectroscopy at 7 Tesla: standard values and regional differences. Acad Radiol 2011; 18:584-7. [PMID: 21377907 DOI: 10.1016/j.acra.2010.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Revised: 11/29/2010] [Accepted: 12/16/2010] [Indexed: 12/27/2022]
Abstract
RATIONALE AND OBJECTIVES At lower magnetic field strengths, regional differences of cerebral metabolite distributions have been described, but these data are controversial. Magnetic resonance spectroscopy at 7 T is expected to deliver high spectral resolution and good differentiation, but there are problems arising at high magnetic field strengths that may diminish spectral quality. Because there have been only a few studies in humans so far, there are no standard values for 7 T concerning regional metabolite distributions and concentrations. MATERIALS AND METHODS In the present study, the metabolites detectable with (1)H magnetic resonance spectroscopy, N-acetyl-aspartate, choline, and creatine (Cr), were evaluated with a single-voxel sequence. Five voxels were placed in the frontal and parietal white matter and the insular, thalamic, and occipital gray matter. RESULTS For N-acetyl-aspartate, the lowest values were found in frontal white matter and the highest in thalamic gray matter. Choline displayed the lowest values in frontal white matter and the highest in insular gray matter. Cr showed the lowest values in frontal white matter and the highest in thalamic gray matter. The highest ratio of choline to Cr was found in parietal white matter and the lowest in thalamic gray matter. The highest ratio of N-acetyl-aspartate to Cr was found in thalamic gray matter and the lowest in frontal white matter. CONCLUSIONS In the present study, regional cerebral metabolite differences were verified with high-field magnetic resonance spectroscopy. Quantitative values and metabolite ratios could be a basis for further clinical studies.
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Ren J, Sherry AD, Malloy CR. 1H MRS of intramyocellular lipids in soleus muscle at 7 T: spectral simplification by using long echo times without water suppression. Magn Reson Med 2011; 64:662-71. [PMID: 20578068 DOI: 10.1002/mrm.22345] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The popular short echo time (1)H MR spectroscopy acquisition method for detection of intramyocellular lipids suffers from spectral overlap due to the large, broad, and asymmetric extramyocellular lipid signals, the time-consuming practice of selecting "lean" voxels for spectroscopy, and the overlap of the extramyocellular lipid signal with the creatine methyl (1)H signal at approximately 3 parts per million (ppm), commonly used as an internal standard. Using an alternative acquisition strategy, spectra with well-resolved intramyocellular lipids resonances were acquired from large volumes (10 to 15 mL) of human soleus muscle in less than 5 min by single-voxel 7-T (1)H MR spectroscopy, using an echo time of 280 ms. From the high-resolution spectra, an average intramyocellular lipid concentration of 7.7 +/- 3.5 mmol/kg muscle was found for 25 healthy subjects (male/female 17/8; age 29.4 +/- 6.6 years). Since water suppression was not required, the (1)H signals from unsaturated intracellular triglycerides at about 5.3 ppm were easily detected, which, in combination with the well-determined -(CH(2))(n)-/CH(3) intensity ratio at long echo time, enabled assessment of the composition of triglycerides in the intramyocellular lipids compartment. Long-echo single-voxel spectroscopy at 7 T offers rapid and convenient acquisition of high-resolution spectra from human soleus muscle.
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Affiliation(s)
- Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8568, USA
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O'Connor RD, Xu J, Ewald GA, Ackerman JJH, Peterson LR, Gropler RJ, Bashir A. Intramyocardial triglyceride quantification by magnetic resonance spectroscopy: In vivo and ex vivo correlation in human subjects. Magn Reson Med 2011; 65:1234-8. [PMID: 21500254 DOI: 10.1002/mrm.22734] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 09/28/2010] [Accepted: 10/27/2010] [Indexed: 01/21/2023]
Abstract
Accumulation of triglycerides (TG) in heart tissue has been associated with changes in left ventricular function. Proton magnetic resonance spectroscopy is currently the only noninvasive in vivo method to measure myocardial triglycerides content. The primary aim of this study was to determine if these in vivo measurements are specific to myocardial triglycerides in human subjects. Thus, in vivo proton magnetic resonance spectroscopy measurements were conducted on orthotopic heart transplant patients (n = 8) immediately before they underwent routine biopsies and ex vivo measurements were made on the endomyocardial biopsy samples. The correlation coefficient between the two measurements was 0.97, with P < 0.005, demonstrating for the first time the specificity of the in vivo measurement in human heart. From accompanying reliability experiments, the standardized typical error for the in vivo proton magnetic resonance spectroscopy method was estimated to be 7.0%, with a 95% confidence interval from 5.5 to 9.4%. These results suggest that proton magnetic resonance spectroscopy provides a specific and reliable measurement of myocardial triglycerides content and is suitable for routine studies.
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Affiliation(s)
- Robert D O'Connor
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA.
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Bredella MA, Ghomi RH, Thomas BJ, Miller KK, Torriani M. Comparison of 3.0 T proton magnetic resonance spectroscopy short and long echo-time measures of intramyocellular lipids in obese and normal-weight women. J Magn Reson Imaging 2010; 32:388-93. [PMID: 20677267 DOI: 10.1002/jmri.22226] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To compare correlations of intramyocellular lipids (IMCL) measured by short and long echo-time proton magnetic resonance spectroscopy (1H-MRS) with indices of body composition and insulin resistance in obese and normal-weight women. MATERIALS AND METHODS We quantified IMCL of tibialis anterior (TA) and soleus (SOL) muscles in 52 premenopausal women (37 obese and 15 normal weight) using single-voxel 1H-MRS PRESS at 3.0 T with short (30 msec) and long (144 msec) echo times. Statistical analyses were performed to determine correlations of IMCL with body composition as determined by computed tomography (CT) and insulin resistance indices and to compare correlation coefficients from short and long echo-time data. Signal-to-noise ratio (SNR), linewidth, and coefficients of variation (CV) of short and long echo-time spectra were calculated. RESULTS Short and long echo-time IMCL from TA and SOL significantly correlated with body mass index (BMI) and abdominal fat depots (r = 0.32 to 0.70, P = <0.05), liver density (r = -0.39 to -0.50, P < 0.05), and glucose area under the curve as a measure of insulin resistance (r = 0.47 to 0.49, P < 0.05). There was no significant difference between correlation coefficients of short and long echo-time spectra (P > 0.5). Short echo-time IMCL in both muscles showed significantly higher SNR (P < 0.0001) and lower CVs when compared to long echo-time acquisitions. Linewidth measures were not significantly different between groups. CONCLUSION IMCL quantification using short and long echo-time 1H-MRS at 3.0 T is useful to detect differences in muscle lipid content in obese and normal-weight subjects. In addition, IMCL correlates with body composition and markers of insulin resistance in this population with no significant difference in correlations between short and long echo-times. Short echo-time IMCL quantification of TA and SOL muscles at 3.0 T was superior to long echo-time due to better SNR and better reproducibility.
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Affiliation(s)
- Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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Abstract
Magnetic resonance (MR) spectroscopy allows the demonstration of relative tissue metabolite concentrations along a two- or three-dimensional spectrum based on the chemical shift phenomenon. An MR spectrum is a plot of the signal intensity and frequency of a chemical or metabolite within a given voxel. At proton MR spectroscopy, the frequency at which a chemical or compound occurs depends on the configuration of the protons within the structure of that chemical. At in vivo proton MR spectroscopy, the frequency location of water is used as the standard of reference to identify a chemical. The frequency shift or location of chemicals relative to that of water allows generation of qualitative and quantitative information about the chemicals that occur within tissues, forming the basis of tissue characterization by MR spectroscopy. MR spectroscopy also may be used to quantify liver fat by measuring lipid peaks and to diagnose malignancy, usually by measuring the choline peak. Interpretation of MR spectroscopic data requires specialized postprocessing software and is subject to technical limitations including low signal-to-noise ratio, masking of metabolite peaks by dominant water and lipid peaks, partial-volume averaging from other tissue within the voxel, and phase and frequency shifts from motion. MR spectroscopy of the liver is an evolving technology with potential for improving the diagnostic accuracy of tissue characterization when spectra are interpreted in conjunction with MR images.
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Affiliation(s)
- Aliya Qayyum
- Department of Radiology, University of California San Francisco, Box 0628, L-307, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA.
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Neumaier M, Niessen HG, Kaulisch T, Stiller D. Inductively coupled Helmholtz coil on a dedicated imaging platform for the in vivo 1H-MRS measurement of intramyocellular lipids in the hind leg of rats. Magn Reson Med 2010; 62:1036-41. [PMID: 19672950 DOI: 10.1002/mrm.22149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Skeletal muscle triglycerides are markers for insulin resistance in type 2 diabetes. Recently, MR spectroscopy was adapted for in vivo measurement of triglycerides in animal models and for the characterization of new therapeutic approaches. Because of small MR spectroscopy voxel sizes used in skeletal muscles, surface coils are used for signal reception. Furthermore, to obtain well-resolved and undistorted lipid spectra, muscle fibers must be aligned parallel to the magnetic field. Consequently, to achieve a high signal-to-noise ratio and spectral quality, a coil setup must combine high sensitivity with a reliable and reproducible positioning of muscle and voxel. These demands are difficult to match using surface coils. Here, a coil platform is described, which uses inductively coupled Helmholtz coil setup combined with a leg retainer system for rats. The new system allows for measurement of intramyocellular lipids with high signal-to-noise ratio and for significantly improved animal handling, positioning, and throughput.
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Affiliation(s)
- Michael Neumaier
- Boehringer Ingelheim Pharma GmbH & Co. KG, Department of Drug Discovery Support, In-Vivo Imaging Unit, Biberach, Germany
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van der Meer RW, Hammer S, Lamb HJ, Frölich M, Diamant M, Rijzewijk LJ, de Roos A, Romijn JA, Smit JWA. Effects of short-term high-fat, high-energy diet on hepatic and myocardial triglyceride content in healthy men. J Clin Endocrinol Metab 2008; 93:2702-8. [PMID: 18430773 DOI: 10.1210/jc.2007-2524] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT An association has been suggested between elevated plasma nonesterified fatty acid (NEFA) levels, myocardial triglyceride (TG) accumulation, and myocardial function. OBJECTIVE Our objective was to investigate the effects of an elevation of plasma NEFA by a high-fat, high-energy (HFHE) diet on hepatic and myocardial TG accumulation, and on myocardial function. DESIGN There were 15 healthy males (mean +/- sd age: 25.0 +/- 6.6 yr) subjected to a 3-d HFHE diet consisting of their regular diet, supplemented with 800 ml cream (280 g fat) every day. METHODS (1)H-magnetic resonance spectroscopy was performed for assessing hepatic and myocardial TGs. Furthermore, left ventricular function was assessed using magnetic resonance imaging. RESULTS The HFHE diet increased hepatic TGs compared with baseline (from 2.01 +/- 1.79 to 4.26 +/- 2.78%; P = 0.001) in parallel to plasma TGs and NEFA. Myocardial TGs did not change (0.38 +/- 0.18 vs. 0.40 +/- 0.12%; P = 0.7). The HFHE diet did not change myocardial systolic function. Diastolic function, assessed by dividing the maximum flow across the mitral valve of the early diastolic filling phase by the maximum flow of the atrial contraction (E/A ratio), decreased compared with baseline (from 2.11 +/- 0.39 to 1.89 +/- 0.33; P = 0.031). This difference was no longer significant after adjustment for heart rate (P = 0.12). CONCLUSIONS Short-term HFHE diet in healthy males results in major increases in plasma TG and NEFA concentrations and hepatic TGs, whereas it does not influence myocardial TGs or myocardial function. These observations indicate differential, tissue-specific partitioning of TGs and/or fatty acids among nonadipose organs during HFHE diet.
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Shen W, Mao X, Wolper C, Heshka S, Dashnaw S, Hirsch J, Heymsfield SB, Shungu DC. Reproducibility of single- and multi-voxel 1H MRS measurements of intramyocellular lipid in overweight and lean subjects under conditions of controlled dietary calorie and fat intake. NMR IN BIOMEDICINE 2008; 21:498-506. [PMID: 17955571 PMCID: PMC2892914 DOI: 10.1002/nbm.1218] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The reproducibility of repeated single-voxel 1H MRS (SV-MRS) and spectroscopic imaging (MRSI) measurements of intramyocellular lipid (IMCL) in the tibialis anterior muscle of five lean and five overweight female Caucasians, during 7 days of controlled dietary fat and calorie intake, was assessed at 1.5 T. Duplicate measures of IMCL relative to total muscle creatine (IMCL/tCr) obtained 3 days apart by both SV-MRS and MRSI correlated well (r = 0.65 and r = 0.95, respectively, P < 0.05). The coefficients of variation for repeated measures of IMCL/tCr by SV-MRS and MRSI were 24.4% and 10.7%, respectively. IMCL/tCr measured by MRSI was higher in overweight subjects than in lean subjects (8.3 +/- 3.8 vs 4.3 +/- 2.4, P < 0.05). Although both methods achieved good reproducibility in measuring IMCL in vivo, MRSI was found to offer greater flexibility and reliability, and higher sensitivity to IMCL differences, whereas SV-MRS was advantageous with respect to shorter scan time and ease of implementation.
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Affiliation(s)
- Wei Shen
- Obesity Research Center, St Luke’s-Roosevelt Hospital and Institute of Human Nutrition, Columbia University, New York, USA
| | - Xiangling Mao
- Department of Radiology, Weill Medical College of Cornell University, New York, USA
| | - Carla Wolper
- Obesity Research Center, St Luke’s-Roosevelt Hospital and Institute of Human Nutrition, Columbia University, New York, USA
| | - Stanley Heshka
- Obesity Research Center, St Luke’s-Roosevelt Hospital and Institute of Human Nutrition, Columbia University, New York, USA
| | - Stephen Dashnaw
- fMRI Research Center, Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, USA
| | - Joy Hirsch
- fMRI Research Center, Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, USA
| | - Steven B. Heymsfield
- Obesity Research Center, St Luke’s-Roosevelt Hospital and Institute of Human Nutrition, Columbia University, New York, USA
| | - Dikoma C. Shungu
- Department of Radiology, Weill Medical College of Cornell University, New York, USA
- Correspondence to: D. C. Shungu, Department of Radiology, Citigroup Biomedical Imaging Center, Weill Medical College of Cornell University, 516 East 72nd Street, New York, NY 10021, USA.
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van der Meer RW, Hammer S, Smit JWA, Frölich M, Bax JJ, Diamant M, Rijzewijk LJ, de Roos A, Romijn JA, Lamb HJ. Short-term caloric restriction induces accumulation of myocardial triglycerides and decreases left ventricular diastolic function in healthy subjects. Diabetes 2007; 56:2849-53. [PMID: 17717279 DOI: 10.2337/db07-0768] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Diabetes and obesity are associated with increased plasma nonesterified fatty acid (NEFA) levels, myocardial triglyceride accumulation, and myocardial dysfunction. Because a very low-calorie diet (VLCD) also increases plasma NEFA levels, we studied the effect of a VLCD on myocardial triglyceride content and cardiac function in healthy subjects. RESEARCH DESIGN AND METHODS Fourteen healthy nonobese men underwent (1)H-magnetic resonance spectroscopy (MRS) to determine myocardial and hepatic triglyceride content, (31)P-MRS to assess myocardial high-energy phosphate (HEP) metabolism (phosphocreatine/ATP), and magnetic resonance imaging of myocardial function at baseline and after a 3-day VLCD. RESULTS After the dietary intervention, plasma NEFA levels increased compared with those at baseline (from 0.5 +/- 0.1 to 1.1 +/- 0.1 mmol/l, P < 0.05). Concomitantly, myocardial triglyceride content increased by approximately 55% compared with that at baseline (from 0.38 +/- 0.05 to 0.59 +/- 0.06%, P < 0.05), whereas liver triglyceride content decreased by approximately 32% (from 2.2 +/- 0.5 to 1.5 +/- 0.4%, P < 0.05). The VLCD did not change myocardial phosphocreatine-to-ATP ratio (2.33 +/- 0.15 vs. 2.33 +/- 0.08, P > 0.05) or systolic function. Interestingly, deceleration of the early diastolic flow across the mitral valve decreased after the VLCD (from 3.37 +/- 0.20 to 2.91 +/- 0.16 ml/s(2) x 10(-3), P < 0.05). This decrease in diastolic function was significantly correlated with the increase in myocardial triglyceride content. CONCLUSIONS Short-term VLCD induces accumulation of myocardial triglycerides. In addition, VLCD decreases left ventricular diastolic function, without alterations in myocardial HEP metabolism. This study documents diet-dependent physiological variations in myocardial triglyceride content and diastolic function in healthy subjects.
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Affiliation(s)
- Rutger W van der Meer
- Department of Radiology, C2S, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, Netherlands.
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van der Meer RW, Doornbos J, Kozerke S, Schär M, Bax JJ, Hammer S, Smit JWA, Romijn JA, Diamant M, Rijzewijk LJ, de Roos A, Lamb HJ. Metabolic Imaging of Myocardial Triglyceride Content: Reproducibility of1H MR Spectroscopy with Respiratory Navigator Gating in Volunteers. Radiology 2007; 245:251-7. [PMID: 17885193 DOI: 10.1148/radiol.2451061904] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Institutional review board approval and informed consent were obtained. The purpose of the study was to prospectively compare spectral resolution and reproducibility of hydrogen 1 (1H) magnetic resonance (MR) spectroscopy, with and without respiratory motion compensation based on navigator echoes, in the assessment of myocardial triglyceride content in the human heart. In 20 volunteers (14 men, six women; mean age+/-standard error, 31 years+/-2.8 [range, 19-60 years]; body mass index, 19-30 kg/m2) without history of cardiovascular disease, 1H MR spectroscopy of the myocardium was performed at rest, with and without respiratory motion compensation. Unsuppressed water signal linewidth changed from 11.9 Hz to 10.7 Hz (P<.001) with the use of the navigator, which indicated better spectral resolution. The navigator improved the intraclass correlation coefficient for the assessment of myocardial triglyceride content from 0.32 to 0.81. Therefore, the authors believe that respiratory motion correction is essential for reproducible assessment of myocardial triglycerides.
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Affiliation(s)
- Rutger W van der Meer
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, C2-S, 2333 ZA Leiden, the Netherlands
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Affiliation(s)
- Martin Torriani
- Musculoskeletal Radiology, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, YAW 6048, Boston, MA 02114, USA.
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Torriani M, Thomas BJ, Bredella MA, Ouellette H. Intramyocellular lipid quantification: comparison between 3.0- and 1.5-T (1)H-MRS. Magn Reson Imaging 2007; 25:1105-11. [PMID: 17707173 PMCID: PMC2034287 DOI: 10.1016/j.mri.2006.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 12/04/2006] [Accepted: 12/05/2006] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to prospectively compare measurement precision of calf intramyocellular lipid (IMCL) quantification at 3.0 and 1.5 T using (1)H magnetic resonance spectroscopy ((1)H-MRS). MATERIALS AND METHODS We examined the soleus and tibialis anterior (TA) muscles of 15 male adults [21-48 years of age, body mass index (BMI)=21.9-38.0 kg/m(2)]. Each subject underwent 3.0- and 1.5-T single-voxel, short-echo-time, point-resolved (1)H-MRS both at baseline and at 31-day follow-up. The IMCL methylene peak (1.3 ppm) was scaled to unsuppressed water peak (4.7 ppm) using the LCModel routine. Full width at half maximum (FWHM) and signal-to-noise ratios (SNRs) of unsuppressed water peak were measured using jMRUI software. Measurement precision was tested by comparing interexamination coefficients of variation (CV) between different field strengths using Wilcoxon matched pairs signed rank test in all subjects. Overweight subjects (BMI>25 kg/m(2)) were analyzed separately to examine the benefits of 3.0-T acquisitions in subjects with increased adiposity. RESULTS No significant difference between 3.0 and 1.5 T was noted in CVs for IMCL of soleus (P=.5). CVs of TA were significantly higher at 3.0 T (P=.02). SNR was significantly increased at 3.0 T for soleus (64%, P<.001) and TA (62%, P<.001) but was lower than the expected improvement of 100%. FWHM at 3.0 T was significantly increased for soleus (19%, P<.001) and TA (7%, P<.01). Separate analysis of overweight subjects showed no significant difference between 3.0- and 1.5-T CVs for IMCL of soleus (P=.8) and TA (P=.4). CONCLUSION Using current technology, (1)H-MRS for IMCL at 3.0 T did not improve measurement precision, as compared with 1.5 T.
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Affiliation(s)
- Martin Torriani
- Division of Musculoskeletal Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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Hadigan C, Liebau J, Torriani M, Andersen R, Grinspoon S. Improved triglycerides and insulin sensitivity with 3 months of acipimox in human immunodeficiency virus-infected patients with hypertriglyceridemia. J Clin Endocrinol Metab 2006; 91:4438-44. [PMID: 16940448 PMCID: PMC3196527 DOI: 10.1210/jc.2006-1174] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Metabolic abnormalities such as hypertriglyceridemia remain a challenge for optimizing long-term health in HIV-infected patients. OBJECTIVE Elevation of free fatty acids (FFAs) may contribute to hyperlipidemia and insulin resistance in HIV. We evaluated the efficacy and safety of chronic inhibition of lipolysis in HIV-infected men and women with hypertrigyceridemia. We hypothesized that acipimox would lead to significant reductions in triglycerides and improved insulin sensitivity, compared with placebo. DESIGN A 3-month, randomized, double-blind, controlled trial of acipimox (250 mg thrice daily) vs. placebo was conducted in 23 HIV-infected men and women with hypertriglyceridemia (>150 mg/dl), abnormal fat distribution, and no current lipid-lowering therapy. The primary outcome variable was triglyceride concentration, and insulin sensitivity measured by hyperinsulinemic euglycemic clamp was a secondary outcome. SETTING The study was conducted at an academic medical center. RESULTS Acipimox resulted in significant reductions in FFAs [mean change -0.38 (0.06) vs. 0.08 (0.06) mEq/liter with placebo, -68 vs. +17% change from mean baseline, P < 0.0001], decreased rates of lipolysis (P < 0.0001), and a median triglyceride decrease from 238 mg/dl at baseline to 190 mg/dl, compared with an increase from 290 to 348 mg/dl in the placebo group (P = 0.01). Acipimox improved insulin sensitivity [acipimox +2.31 (0.74) vs. placebo -0.21 (0.90) mg glucose per kilogram lean body mass per minute, or +31 vs. -2% change from mean baseline values, P = 0.04]. Improvements in insulin sensitivity were significantly correlated with reductions in FFAs (r = -0.62, P = 0.003) and lipolysis (r = -0.59, P = 0.005). CONCLUSIONS Acipimox resulted in significant sustained reductions in lipolysis, improved glucose homeostasis, and significant but modest reductions in triglycerides in HIV-infected individuals with abnormal fat distribution and hypertriglyceridemia. Improvement in overall metabolic profile with acipimox suggests a potential clinical utility for this agent that requires further investigation.
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Affiliation(s)
- Colleen Hadigan
- Program in Nutritional Metabolism, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Boesch C, Machann J, Vermathen P, Schick F. Role of proton MR for the study of muscle lipid metabolism. NMR IN BIOMEDICINE 2006; 19:968-88. [PMID: 17075965 DOI: 10.1002/nbm.1096] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
1H-MR spectroscopy (MRS) of intramyocellular lipids (IMCL) became particularly important when it was recognized that IMCL levels are related to insulin sensitivity. While this relation is rather complex and depends on the training status of the subjects, various other influences such as exercise and diet also influence IMCL concentrations. This may open insight into many metabolic interactions; however, it also requires careful planning of studies in order to control all these confounding influences. This review summarizes various historical, methodological, and practical aspects of 1H-MR spectroscopy (MRS) of muscular lipids. That includes a differentiation of bulk magnetic susceptibility effects and residual dipolar coupling that can both be observed in MRS of skeletal muscle, yet affecting different metabolites in a specific way. Fitting of the intra- (IMCL) and extramyocellular (EMCL) signals with complex line shapes and the transformation into absolute concentrations is discussed. Since the determination of IMCL in muscle groups with oblique fiber orientation or in obese subjects is still difficult, potential improvement with high-resolution spectroscopic imaging or at higher field strength is considered. Fat selective imaging is presented as a possible alternative to MRS and the potential of multinuclear MRS is discussed. 1H-MRS of muscle lipids allows non-invasive and repeated studies of muscle metabolism that lead to highly relevant findings in clinics and patho-physiology.
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Affiliation(s)
- Chris Boesch
- Department of Clinical Research (AMSM), University of Bern, Bern, Switzerland.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight recent methodological advances that have helped us to understand the role of intramuscular triglycerides in human health as well as prevention and treatment of disease. In addition to both invasive (muscle biopsy) and noninvasive methods, techniques to assess other lipids within muscle will be reviewed. RECENT FINDINGS In addition to intramuscular triglycerides, other lipids contained within skeletal muscle such as diacylglycerol and ceramides may have an important role in human metabolic disease. Both ex-vivo and in-vivo methods to obtain serial measurements of these muscle lipids as a result of experimental perturbation have recently provided unique insight into their respective roles in human metabolism. SUMMARY Triglyceride accumulation within skeletal muscle has received considerable interest due to its potential role in insulin resistance and fatty acid metabolism of obesity, aging and type 2 diabetes. Observations that triglycerides themselves may be used as a fuel source for exercising muscle, and thus may not be detrimental in all circumstances, has in part prompted the development and implementation of analytical methods to quantify the fatty acid composition of muscle triglycerides as well as other lipid species within muscle, e.g. diacylglycerol and ceramides. In addition, noninvasive computed tomography, magnetic resonance spectroscopy and magnetic resonance imaging methods have been applied to examine the serial effects of intervention on muscle triglycerides.
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Affiliation(s)
- John Dubé
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
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Skoch A, Jírů F, Dezortová M, Krusinová E, Kratochvílová S, Pelikánová T, Grodd W, Hájek M. Intramyocellular lipid quantification from1H long echo time spectra at 1.5 and 3 T by means of the LCModel technique. J Magn Reson Imaging 2006; 23:728-35. [PMID: 16568428 DOI: 10.1002/jmri.20574] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To introduce a method of independent determination of CH2 and CH3 components of intramyocellular lipids (IMCLs) by using long TE for spectra measurement and LCModel for spectra evaluation, to test this technique in controls and insulin-resistant subjects, and to compare results at 1.5 and 3 T. MATERIALS AND METHODS Eight healthy volunteers and 11 patients with type 2 diabetes mellitus underwent measurement using a 1.5-T MR scanner; six healthy volunteers were measured using a 3-T MR scanner. Spectra from the tibialis anterior muscle were acquired by using a point resolved spectroscopy (PRESS) sequence with the following parameters: TR/TE/ACQ = 2000 msec/270 msec/256. Spectra were processed by LCModel 6.1 software with two types of adopted basis-set. RESULTS Spectra with good separation of both CH2 and CH3 components of IMCL and extramyocellular lipids (EMCLs) were obtained and the LCModel routine was successfully applied. The reproducibility comparison (N= 7 at 1.5 T vs. N = 5 at 3 T) showed that better results can be obtained at higher B0 values. The comparison of the healthy and insulin-resistant subjects proved that both IMCL_CH2/Cr and IMCL_CH3/Cr ratios significantly differ. CONCLUSION Long TE spectroscopy of the human muscle with IMCL quantification using the LCModel technique can detect changes in IMCL levels as well as help in the study of fatty acyl chain composition. Using a higher field strength increased the intra-individual reproducibility by approximately 150%.
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Affiliation(s)
- Antonín Skoch
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Torriani M, Thomas BJ, Barlow RB, Librizzi J, Dolan S, Grinspoon S. Increased intramyocellular lipid accumulation in HIV-infected women with fat redistribution. J Appl Physiol (1985) 2005; 100:609-14. [PMID: 16223978 PMCID: PMC3205444 DOI: 10.1152/japplphysiol.00797.2005] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The human immunodeficiency virus (HIV)-lipodystrophy syndrome is associated with fat redistribution and metabolic abnormalities, including insulin resistance. Increased intramyocellular lipid (IMCL) concentrations are thought to contribute to insulin resistance, being linked to metabolic and body composition variables. We examined 46 women: HIV infected with fat redistribution (n = 25), and age- and body mass index-matched HIV-negative controls (n = 21). IMCL was measured by 1H-magnetic resonance spectroscopy, and body composition was assessed with computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging. Plasma lipid profile and markers of glucose homeostasis were obtained. IMCL was significantly increased in tibialis anterior [135.0 +/- 11.5 vs. 85.1 +/- 13.2 institutional units (IU); P = 0.007] and soleus [643.7 +/- 61.0 vs. 443.6 +/- 47.2 IU, P = 0.017] of HIV-infected subjects compared with controls. Among HIV-infected subjects, calf subcutaneous fat area (17.8 +/- 2.3 vs. 35.0 +/- 2.5 cm2, P < 0.0001) and extremity fat by DEXA (11.8 +/- 1.1 vs. 15.6 +/- 1.2 kg, P = 0.024) were reduced, whereas visceral abdominal fat (125.2 +/- 11.3 vs. 74.4 +/- 12.3 cm2, P = 0.004), triglycerides (131.1 +/- 11.0 vs. 66.3 +/- 12.3 mg/dl, P = 0.0003), and fasting insulin (10.8 +/- 0.9 vs. 7.0 +/- 0.9 microIU/ml, P = 0.004) were increased compared with control subjects. Triglycerides (r = 0.39, P = 0.05) and extremity fat as percentage of whole body fat by DEXA (r = -0.51, P = 0.01) correlated significantly with IMCL in the HIV but not the control group. Extremity fat (beta = -633.53, P = 0.03) remained significantly associated with IMCL among HIV-infected patients, controlling for visceral abdominal fat, abdominal subcutaneous fat, and antiretroviral medications in a regression model. These data demonstrate increased IMCL in HIV-infected women with a mixed lipodystrophy pattern, being most significantly associated with reduced extremity fat. Further studies are necessary to determine the relationship between extremity fat loss and increased IMCL in HIV-infected women.
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Affiliation(s)
- Martin Torriani
- Division of Musculoskeletal Radiology, Dept. of Radiology, Massachusetts General Hospital, 55 Fruit St., YAW 6048, Boston, MA 02114, USA.
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