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Yılmaz D, Mathavan N, Wehrle E, Kuhn GA, Müller R. Mouse models of accelerated aging in musculoskeletal research for assessing frailty, sarcopenia, and osteoporosis - A review. Ageing Res Rev 2024; 93:102118. [PMID: 37935249 DOI: 10.1016/j.arr.2023.102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/01/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
Musculoskeletal aging encompasses the decline in bone and muscle function, leading to conditions such as frailty, osteoporosis, and sarcopenia. Unraveling the underlying molecular mechanisms and developing effective treatments are crucial for improving the quality of life for those affected. In this context, accelerated aging models offer valuable insights into these conditions by displaying the hallmarks of human aging. Herein, this review focuses on relevant mouse models of musculoskeletal aging with particular emphasis on frailty, osteoporosis, and sarcopenia. Among the discussed models, PolgA mice in particular exhibit hallmarks of musculoskeletal aging, presenting early-onset frailty, as well as reduced bone and muscle mass that closely resemble human musculoskeletal aging. Ultimately, findings from these models hold promise for advancing interventions targeted at age-related musculoskeletal disorders, effectively addressing the challenges posed by musculoskeletal aging and associated conditions in humans.
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Affiliation(s)
- Dilara Yılmaz
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | | | - Esther Wehrle
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; AO Research Institute Davos, Davos Platz, Switzerland
| | - Gisela A Kuhn
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
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Widjaja SS, Rusdiana R, Helvi TM, Simanullang RH, Jayalie VF, Amelia R, Arisa J. Finding a Link between Obesity and Senescence: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:12-22. [PMID: 38694856 PMCID: PMC11058390 DOI: 10.18502/ijph.v53i1.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/15/2023] [Indexed: 05/04/2024]
Abstract
Background Cell aging is associated with changes in telomeres due to DNA damage arising from chronic inflammation in obese patients. The aim of the systematic review and meta-analysis was to find the relationship between obesity and aging or senescence. Methods The systematic review was conducted through PRISMA guideline, beginning with literature search within 2012-2022 in several databases (PubMed, EBSCOHost, Science Direct, Scopus, and Cochrane) followed by screening process using predetermined PICO criteria. Original studies on the topic of obesity and senescence (aging), from preclinical studies to clinical research (cohort or cross-sectional studies) that were published within the last ten years. All studies were appraised using SYRCLE risk of bias tool for preclinical studies and Newcastle-Ottawa Scale (NOS) for cross-sectional and cohort studies. The data extraction on the studies' characteristic and outcome on aging or senescence were followed by quantitative analysis using MetaXL process on prevalence ratio and hazard ratio of obesity to comorbidities and mortality. Results Fifteen studies were enrolled. Obesity and white adipose tissue cause increased levels of pro-inflammatory and pro-senescence cytokine and macrophage whilst the aging process lowers metabolism with increased insulin resistance and linked to increased risk of obesity. Obesity occurs in 22% (95% CI 18%-26%) of elderly population with higher prevalence rate in the women population. Obesity is associated with significant increased risk of multimorbidity by 56% (OR = 1.58 [95% CI 1.48-1.96]). Conclusion The obesity and aging or senescence has reciprocal relationship between each other.
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Affiliation(s)
- Sry Suryani Widjaja
- Department of Biochemistry, Medical Faculty, Universitas Sumatera Utara, Medan, Sumatera Utara, Indonesia
| | - Rusdiana Rusdiana
- Department of Biochemistry, Medical Faculty, Universitas Sumatera Utara, Medan, Sumatera Utara, Indonesia
| | - Tengku Mardani Helvi
- Department of Biochemistry, Medical Faculty, Universitas Sumatera Utara, Medan, Sumatera Utara, Indonesia
| | | | - Vito Filbert Jayalie
- Department of Radiation Oncology, Murni Teguh Memorial Hospital, Medan, Sumatera Utara, Indonesia
| | - Rina Amelia
- Department of Community Health, Medical Faculty, Universitas Sumatera Utara, Medan, Sumatera Utara, Indonesia
| | - Jessie Arisa
- Department of Wellness, Murni Teguh Memorial Hospital, Medan, Sumatera Utara, Indonesia
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Fu C, Yan D, Wang L, Duan F, Gu D, Yao N, Sun M, Wang D, Lin X, Wu Y, Wang X, Cheng X, Zhang D. High prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis. Front Endocrinol (Lausanne) 2023; 14:1117438. [PMID: 37033264 PMCID: PMC10076821 DOI: 10.3389/fendo.2023.1117438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Sarcopenia is highly prevalent (28.5-40.3%) in patients undergoing hemodialysis and leads to poor clinical outcomes. However, the association between muscle quality and sarcopenia in patients receiving hemodialysis remains unclear. Therefore, we aimed to explore the association between muscle cross-sectional area (CSA) and proton-density fat-fraction (PDFF) in patients with sarcopenia undergoing hemodialysis. METHODS Seventy-six patients undergoing hemodialysis for > 3 months were enrolled. Their handgrip strength (HGS), short physical performance battery (SPPB) performance, and appendicular skeletal muscle mass index (ASMI) were measured. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus update. All patients underwent quantitative magnetic resonance imaging. CSA and PDFF were measured for the thigh, trunk, and gluteus muscles. RESULTS The prevalence of probable, confirmed, and severe sarcopenia in this study was 73.7%, 51.3%, and 22.4%, respectively. Older age (OR: 1.061, P < 0.003); lower body mass index (BMI) (OR: 0.837, P = 0.008), albumin (OR: 0.765, P = 0.004), prealbumin (OR: 0.987, P = 0.001), predialysis blood urea nitrogen (BUN) (OR: 0.842, P < 0.001), predialysis creatinine (OR: 0.993, P < 0.001), phosphorus (OR: 0.396, P = 0.047); lower CSA of the thigh (OR: 0.58, P = 0.035), third lumbar (L3) trunk (OR: 0.37, P = 0.004), gluteus minimus and medius (OR: 0.28, P = 0.001), and gluteus maximus (OR: 0.28, P= 0.001); and higher PDFF of the thigh (OR: 1.89, P = 0.036) and L3 trunk (OR: 1.71, P = 0.040) were identified as sarcopenia risk factors. The gluteus minimus and medius CSA was lower in patients with sarcopenia than in those without after adjusting for age and BMI (OR: 0.37, P = 0.017). Higher thigh (P = 0.031) and L3 trunk (P = 0.006) muscle PDFF were significantly associated with lower HGS. Furthermore, higher thigh (P = 0.011) and L3 trunk (P = 0.010) muscle PDFF were also inversely correlated with lower ASMI. CONCLUSION Our findings demonstrate the high prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis and might trigger a paradigm shift in intervention strategies for patients receiving hemodialysis.
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Affiliation(s)
- Chen Fu
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Dong Yan
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Fangfang Duan
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, China
| | - Dalong Gu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Ning Yao
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Mingke Sun
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Di Wang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Xuya Lin
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Yanglei Wu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Xiaofei Wang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaoguang Cheng, ; Dongliang Zhang,
| | - Dongliang Zhang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaoguang Cheng, ; Dongliang Zhang,
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Nguyen-Khac V, Bonnet-Lebrun A, Skalli W, Adamsbaum C, Linglart A, Wicart P. Changes in adipose bone marrow and bone morphology in X-linked hypophosphatemic rickets. Orthop Traumatol Surg Res 2022; 109:103529. [PMID: 36565743 DOI: 10.1016/j.otsr.2022.103529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/01/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION X-linked hypophosphatemic (XLH) rickets causes significant bone deformities in the lower limbs resulting from a bone mineralization defect. According to Frost's Mechanostat theory, compensatory modeling of the bones takes place during increased mechanical loads. In addition, mechanical stimuli modulate the differentiation of mesenchymal stem cells; common precursors to bone marrow adipocytes and osteoblasts. HYPOTHESIS Bone deformities of the lower limbs lead to increased femoral bone mass and decreased fatty infiltration of the bone marrow (FIBM) in children with XLH rickets compared to a control group. PATIENTS AND METHODS Eleven children (10.3years [6-17]) with XLH rickets and 22 healthy children (10.2years [5-15.5]) underwent lower limb Magnetic Resonance Imaging. A calculation of FIBM was performed at the mid-femur, as well as a calculation of the total bone cross-sectional area (CSA), the cortical CSA, the anteroposterior and mediolateral axes of the femur, bone marrow and the thickness of the femoral cortices. RESULTS Total bone CSA, total cortical CSA and bone marrow CSA were higher in the XLH group than in the control group (p<0.05). The mid-lateral diameters of the femur and bone marrow were more elongated than those of the control group (p<0.001). Only the anterior cortex was thinned in the XLH group (p=0.001), while there was no difference with the control group for the posterior, medial and lateral cortices. The total percentage of FIBM was 72.81% [±3.95] and 77.4% [±5.52] for the XLH and control groups respectively (p<0.001). DISCUSSION The increase in bone mass in the XLH population reflects an adaptation of bone tissue to the bone deformities present in this pathology. The decrease in FIBM indicates a lower risk of osteoporosis in the XLH population and may constitute a new monitoring parameter in this pathology. LEVEL OF STUDY III; Case-control study.
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Affiliation(s)
| | - Aurore Bonnet-Lebrun
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Wafa Skalli
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Catherine Adamsbaum
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Philippe Wicart
- Hospital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvre, 75015 Paris, France
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Emanuelsson EB, Berry DB, Reitzner SM, Arif M, Mardinoglu A, Gustafsson T, Ward SR, Sundberg CJ, Chapman MA. MRI characterization of skeletal muscle size and fatty infiltration in long-term trained and untrained individuals. Physiol Rep 2022; 10:e15398. [PMID: 35854646 PMCID: PMC9296904 DOI: 10.14814/phy2.15398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/21/2022] [Accepted: 07/02/2022] [Indexed: 06/15/2023] Open
Abstract
This study investigated body composition measures in highly trained and untrained individuals using whole-body magnetic resonance imaging (MRI). Additionally, correlations between these measures and skeletal muscle gene expression were performed. Thirty-six individuals were included: endurance-trained males (ME, n = 8) and females (FE, n = 7), strength-trained males (MS, n = 7), and untrained control males (MC, n = 8) and females (FC, n = 6). MRI scans were performed, and resting M. vastus lateralis (VL) biopsies were subjected to RNA sequencing. Liver fat fraction, visceral adipose tissue volume (VAT), total body fat, and total lean tissue were measured from MRI data. Additionally, cross-sectional area (CSA) and fat signal fraction (FSF) were calculated from Mm. pectoralis, M. erector spinae and M. multifidus combined, Mm. quadriceps, and Mm. triceps surae (TS). Liver fat fraction, VAT, and total body fat relative to body weight were lower in ME and FE compared with corresponding controls. MS had a larger CSA across all four muscle groups and lower FSF in all muscles apart from TS compared with MC. ME had a lower FSF across all muscle groups and a larger CSA in all muscles except TS than MC. FE athletes showed a higher CSA in Mm. pectoralis and Mm. quadriceps and a lower CSA in TS than FC with no CSA differences found in the back muscles investigated. Surprisingly, the only difference in FSF between FE and FC was found in Mm. pectoralis. Lastly, correlations between VL gene expression and VL CSA as well as FSF showed that genes positively correlated with CSA revealed an enrichment of the oxidative phosphorylation and thermogenesis pathways, while the genes positively correlated with FSF showed significant enrichment of the spliceosome pathway. Although limited differences were found with training in females, our study suggests that both regular endurance and resistance training are useful in maintaining muscle mass, reducing adipose tissue deposits, and reducing muscle fat content in males.
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Affiliation(s)
- Eric B. Emanuelsson
- Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
| | - David B. Berry
- Department of NanoengineeringUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of Orthopaedic SurgeryUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of RadiologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Stefan M. Reitzner
- Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
- Department for Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Muhammad Arif
- Science for Life LaboratoryKTH – Royal Institute of TechnologyStockholmSweden
| | - Adil Mardinoglu
- Science for Life LaboratoryKTH – Royal Institute of TechnologyStockholmSweden
- Centre for Host–Microbiome InteractionsFaculty of Dentistry, Oral & Craniofacial Sciences, King's College LondonLondonUK
| | - Thomas Gustafsson
- Department of Laboratory MedicineKarolinska InstitutetHuddingeSweden
- Unit of Clinical PhysiologyKarolinska University HospitalStockholmSweden
| | - Samuel R. Ward
- Department of Orthopaedic SurgeryUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of RadiologyUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of BioengineeringUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Carl Johan Sundberg
- Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
- Department of Laboratory MedicineKarolinska InstitutetHuddingeSweden
- Department of Learning, Informatics, Management and EthicsKarolinska InstitutetStockholmSweden
| | - Mark A. Chapman
- Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
- Department of Integrated EngineeringUniversity of San DiegoSan DiegoCaliforniaUSA
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Ko Y, Shin Y, Sung YS, Lee J, Lee JH, Kim JK, Park J, Ko HS, Kim KW, Huh J. A reliable and robust method for the upper thigh muscle quantification on computed tomography: toward a quantitative biomarker for sarcopenia. BMC Musculoskelet Disord 2022; 23:93. [PMID: 35086521 PMCID: PMC8796642 DOI: 10.1186/s12891-022-05032-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to evaluate the feasibility of the upper thigh level as a landmark to measure muscle area for sarcopenia assessment on computed tomography (CT). Methods In the 116 healthy subjects who performed CT scans covering from mid-abdomen to feet, the skeletal muscle area in the upper thigh level at the inferior tip of ischial tuberosity (SMAUT), the mid-thigh level (SMAMT), and L3 inferior endplate level (SMAL3) were measured by two independent readers. Pearson correlation coefficients between SMAUT, SMAMT, and SMAL3 were calculated. Inter-reader agreement between the two readers were evaluated using intraclass correlation coefficient (ICC) and Bland-Altman plots with 95% limit of agreement (LOA). Results In readers 1 and 2, very high positive correlations were observed between SMAUT and SMAMT (r = 0.91 and 0.92, respectively) and between SMAUT and SMAL3 (r = 0.90 and 0.91, respectively), while high positive correlation were observed between SMAMT and SMAL3 (r = 0.87 and 0.87, respectively). Based on ICC values, the inter-reader agreement was the best in the SMAUT (0.999), followed by the SMAL3 (0.990) and SMAMT (0.956). The 95% LOAs in the Bland-Altman plots indicated that the inter-reader agreement of the SMAUT (− 0.462 to 1.513) was the best, followed by the SMAL3 (− 9.949 to 7.636) and SMAMT (− 12.105 to 14.605). Conclusion Muscle area measurement at the upper thigh level correlates well with those with the mid-thigh and L3 inferior endpoint level and shows the highest inter-reader agreement. Thus, the upper thigh level might be an excellent landmark enabling SMAUT as a reliable and robust biomarker for muscle area measurement for sarcopenia assessment. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05032-2.
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Affiliation(s)
- Yousun Ko
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - Youngbin Shin
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - Yu Sub Sung
- Clinical Research Center, Asan Medical Center, Seoul, South Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jiwoo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jei Hee Lee
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Jai Keun Kim
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Jisuk Park
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Hye Sun Ko
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
| | - Jimi Huh
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea.
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Prasetyo M, Nindita N, Murdana IN, Prihartono J, Setiawan SI. Computed tomography evaluation of fat infiltration ratio of the multifidus muscle in chronic low back pain patients. Eur J Radiol Open 2020; 7:100293. [PMID: 33304941 PMCID: PMC7718153 DOI: 10.1016/j.ejro.2020.100293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022] Open
Abstract
Background and objectives Fat infiltration of multifidus muscle is an important parameter to assess the efficacy of spinal stabilization training in chronic low back pain (LBP) patients. As a CT scan shows a specific attenuation value for fat, it can be used as a ratio to evaluate fat infiltration of the muscle relative to its cross-sectional area. This study aims to compare the fat infiltration ratio of multifidus muscle between subjects with and without chronic LBP in Indonesia. Methods Comparative cross-sectional study of 20 subjects with chronic LBP and 20 subjects without LBP. Fat infiltration ratio calculation of the multifidus muscle was obtained from the database of abdominal CT at the level of the superior and inferior endplate of L4 and L5 vertebral body. Results The fat infiltration ratio of multifidus muscle in the chronic LBP subjects group was significantly higher than the subjects group without NPB (p < 0.05). The cut-off value of the fat infiltration ratio at the level of the inferior endplate of L4 was 0.125 (75 % sensitivity and 80 % specificity). Conclusion The calculation of the multifidus muscle fat infiltration ratio at the inferior endplate L4 using CT is a potential method to evaluate multifidus muscle quality in chronic LBP patients.
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Affiliation(s)
- Marcel Prasetyo
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Nadia Nindita
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - I Nyoman Murdana
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Joedo Prihartono
- Departement of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Stefanus Imanuel Setiawan
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
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Huber FA, Del Grande F, Rizzo S, Guglielmi G, Guggenberger R. MRI in the assessment of adipose tissues and muscle composition: how to use it. Quant Imaging Med Surg 2020; 10:1636-1649. [PMID: 32742957 DOI: 10.21037/qims.2020.02.06] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Body composition analysis based on the characterization of different tissue compartments is currently experiencing increasing attention by a broad range of medical disciplines for both clinical and research questions. However, body composition profiling (BCP) can be performed utilizing different modalities, which all come along with several technical and diagnostic strengths and limitations, respectively. Magnetic resonance imaging (MRI) demonstrates good soft tissue resolution, high contrast between fat and water, and is free from ionizing radiation. This review article represents an overview of imaging techniques for body composition assessment, focussing on qualitative and quantitative methods of assessing adipose tissue and muscles in MRI.
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Affiliation(s)
- Florian Alexander Huber
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Filippo Del Grande
- Istituto di imaging della Svizzera Italiana, Regional Hospital of Lugano, Lugano, Switzerland
| | - Stefania Rizzo
- Istituto di imaging della Svizzera Italiana, Regional Hospital of Lugano, Lugano, Switzerland
| | | | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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Neck circumference is associated with adipose tissue content in thigh skeletal muscle in overweight and obese premenopausal women. Sci Rep 2020; 10:8324. [PMID: 32433484 PMCID: PMC7239876 DOI: 10.1038/s41598-020-65204-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/27/2020] [Indexed: 12/15/2022] Open
Abstract
Neck circumference (NC) has been proposed as a simple and practical tool, independently associated with cardiometabolic risk factors. However, the association of NC with inter-muscular adipose tissue (IMAT) is still to be determined. We aimed to examine the association of NC with thigh IMAT, and visceral adipose tissue (VAT) measured with computed tomography (CT) in overweight/obese women. 142 premenopausal overweight and obese Caucasian women participated in this cross-sectional study. NC was measured with an inextensible metallic tape above the thyroid cartilage according to International Society for Advancement of Kinanthropometry protocol. Thigh IMAT and VAT volumes were measured with a single cross-sectional CT. Regarding the covariates, fat mass (FM) was assessed with dual-energy x-ray absorptiometry and physical activity was objectively measured with accelerometry. NC was positively associated with thigh IMAT and VAT volumes (standardized β coefficient: β = 0.45, P-value = ≤0.001, β = 0.60, P = ≤ 0.001; respectively), which persisted after adjusting for age, height, overall FM or moderate-to-vigorous physical activity. Our findings show that NC is associated with thigh IMAT volume in overweight and obese premenopausal Caucasian women, regardless of the amount of lower-body fatness. These results suggest underscoring the relevance of NC as a marker of adipose tissue content in thigh skeletal muscle.
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10
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Gilligan LA, Towbin AJ, Dillman JR, Somasundaram E, Trout AT. Quantification of skeletal muscle mass: sarcopenia as a marker of overall health in children and adults. Pediatr Radiol 2020; 50:455-464. [PMID: 31745597 DOI: 10.1007/s00247-019-04562-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/08/2019] [Accepted: 10/16/2019] [Indexed: 12/12/2022]
Abstract
Sarcopenia is defined as the loss of muscle mass or function and has been associated with increased morbidity and mortality in a variety of diseased populations. Sarcopenia results from a higher rate of muscle protein degradation compared to protein synthesis and is an important marker of metabolic status related to nutrition and physical activity. The diagnosis of sarcopenia is accomplished by clinical assessment demonstrating decreased muscle function and radiographic confirmation of decreased muscle mass, via dual X-ray absorptiometry, bioelectric impedance or cross-sectional imaging with CT or MRI. However, normative data for skeletal muscle mass are lacking, especially for children and young adults. Additionally, studies of skeletal muscle mass by cross-sectional imaging in children are scarce. Here, we review the concept of sarcopenia with an emphasis on its relevance in the pediatric population.
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Affiliation(s)
- Leah A Gilligan
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.
| | - Alexander J Towbin
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan R Dillman
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elanchezhian Somasundaram
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew T Trout
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Tilves C, Zmuda JM, Kuipers AL, Carr JJ, Terry JG, Wheeler V, Peddada S, Nair S, Miljkovic I. Associations of Thigh and Abdominal Adipose Tissue Radiodensity with Glucose and Insulin in Nondiabetic African-Ancestry Men. Obesity (Silver Spring) 2020; 28:404-411. [PMID: 31872575 PMCID: PMC6980942 DOI: 10.1002/oby.22695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/29/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Decreased radiodensity of adipose tissue (AT) located in the visceral AT (VAT), subcutaneous AT (SAT), and intermuscular AT (IMAT) abdominal depots is associated with hyperglycemia, hyperinsulinemia, and insulin resistance independent of AT volumes. These associations were sought in African-ancestry men, who have higher risk for type 2 diabetes and have been underrepresented in previous studies. METHODS This cross-sectional analysis included 505 nondiabetic men of African-Caribbean ancestry (median age: 61 years; median BMI: 26.8 kg/m2 ) from the Tobago Health Study. AT volumes and radiodensities were assessed using computed tomography, including abdominal (VAT and SAT) and thigh (IMAT) depots. Associations between AT radiodensities were assessed with fasting serum glucose and insulin and with insulin resistance (updated homeostatic model assessment of insulin resistance, HOMA2-IR). RESULTS Higher radiodensity in any AT depot was associated with lower log-insulin and log-HOMA2-IR (β range: -0.16 to -0.18 for each; all P < 0.0001). No AT radiodensity was associated with glucose. Thigh IMAT radiodensity associations were independent of, and similar in magnitude to, VAT radiodensities. Model fit statistics suggested that AT radiodensities were a better predictor for insulin and insulin resistance compared with AT volumes in individuals with overweight and obesity. CONCLUSIONS AT radiodensities at multiple depots are significantly associated with insulin and insulin resistance in African-ancestry men.
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Affiliation(s)
- Curtis Tilves
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph M. Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allison L. Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victor Wheeler
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago
| | - Shyamal Peddada
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Chambers TL, Burnett TR, Raue U, Lee GA, Finch WH, Graham BM, Trappe TA, Trappe S. Skeletal muscle size, function, and adiposity with lifelong aerobic exercise. J Appl Physiol (1985) 2019; 128:368-378. [PMID: 31829806 DOI: 10.1152/japplphysiol.00426.2019] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We examined the influence of lifelong aerobic exercise on skeletal muscle size, function, and adiposity. Young exercisers [YE; n = 20, 10 women (W), 25 ± 1 yr], lifelong exercisers (LLE; n = 28, 7 W, 74 ± 2 yr), and old healthy nonexercisers (OH; n = 20, 10 W, 75 ± 1 yr) were studied. On average, LLE exercised 5 days/wk for 7 h/wk over the past 52 ± 1 yr. The LLE men were subdivided by exercise intensity [Performance (LLE-P), n = 14; Fitness (LLE-F), n = 7]. Upper and lower leg muscle size and adiposity [intermuscular adipose tissue (IMAT)] were determined via MRI, and quadriceps isotonic and isometric function was assessed. For the quadriceps, aging decreased muscle size, isotonic and isometric strength, contraction velocity (men only), and power (P < 0.05). In women, LLE did not influence muscle size or function. In men, LLE attenuated the decline in muscle size and isometric strength by ~50% (P < 0.05). LLE did not influence other aspects of muscle function, nor did training intensity influence muscle size or function. For the triceps surae, aging decreased muscle size only in the women, whereas LLE (both sexes) and training intensity (LLE men) did not influence muscle size. In both sexes, aging increased thigh and calf IMAT by ~130% (P < 0.05), whereas LLE attenuated the thigh increase by ~50% (P < 0.05). In the LLE men, higher training intensity decreased thigh and calf IMAT by ~30% (P < 0.05). In summary, aging and lifelong aerobic exercise influenced muscle size, function, and adipose tissue infiltration in a sex- and muscle-specific fashion. Higher training intensity throughout the life span provided greater protection against adipose tissue infiltration into muscle.NEW & NOTEWORTHY This is the first study to examine skeletal muscle size, function, and adiposity in women and men in their eighth decade of life that have engaged in lifelong aerobic exercise. The findings reveal sex and upper and lower leg muscle group-specific benefits related to skeletal muscle size, function, and adiposity and that exercise intensity influences intermuscular adiposity. This emerging cohort will further our understanding of the health implications of maintaining exercise throughout the life span.
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Affiliation(s)
- Toby L Chambers
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Timothy R Burnett
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Ulrika Raue
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Gary A Lee
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - W Holmes Finch
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Bruce M Graham
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Scott Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana
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13
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Pedroso MG, de Almeida AC, Aily JB, de Noronha M, Mattiello SM. Fatty infiltration in the thigh muscles in knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2019; 39:627-635. [PMID: 30852623 DOI: 10.1007/s00296-019-04271-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/02/2019] [Indexed: 12/23/2022]
Abstract
Knee osteoarthritis is a chronic degenerative joint disease, influenced by inflammatory, mechanical and metabolic processes. Current literature shows that thigh muscles of people with knee osteoarthritis can have increased infiltration of fat, both between and within the muscles (inter- and intramuscular fat). The fatty infiltration in the thigh in this population is correlated to systemic inflammation, poor physical function, and muscle impairment and leads to metabolic impairments and muscle disfunction. The objective of this study is to systematically review the literature comparing the amount of fatty infiltration between people with knee osteoarthritis and healthy controls. A literature search on the databases MEDLINE, Embase, CINAHL SPORTDiscuss, Web of Science and Scopus from insertion to December 2018, resulted in 1035 articles, from which 7 met inclusion/exclusion criteria and were included in the review. All included studies analyzed the difference in intermuscular fat and only one study analyzed intramuscular fat. A meta-analysis (random effects model) transforming data into standardized mean difference was performed for intermuscular fat (six studies). The meta-analysis showed a standardized mean difference of 0.39 (95% confidence interval from 0.25 to 0.53), showing that people with knee osteoarthritis have more intermuscular fat than healthy controls. The single study analyzing intramuscular fat shows that people with knee osteoarthritis have more intramuscular fat fraction than healthy controls. People with knee osteoarthritis have more fatty infiltration around the thigh than people with no knee osteoarthritis. That conclusion is stronger for intermuscular fat than intramuscular fat, based on the quality and number of studies analyzed.
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Affiliation(s)
- Maria Gabriela Pedroso
- Department of Physical Therapy, Center of Biological and Health Sciences, Federal University of São Carlos, Washington Luiz Road, km 235, SP-310, Mailbox: 676, São Carlos, São Paulo, 13565-905, Brazil.
| | - Aline Castilho de Almeida
- Department of Physical Therapy, Center of Biological and Health Sciences, Federal University of São Carlos, Washington Luiz Road, km 235, SP-310, Mailbox: 676, São Carlos, São Paulo, 13565-905, Brazil
| | - Jéssica Bianca Aily
- Department of Physical Therapy, Center of Biological and Health Sciences, Federal University of São Carlos, Washington Luiz Road, km 235, SP-310, Mailbox: 676, São Carlos, São Paulo, 13565-905, Brazil
| | - Marcos de Noronha
- Community and Allied Health Department, Rural Health School, La Trobe University, Bendigo, VIC, 3660, Australia
| | - Stela Marcia Mattiello
- Department of Physical Therapy, Center of Biological and Health Sciences, Federal University of São Carlos, Washington Luiz Road, km 235, SP-310, Mailbox: 676, São Carlos, São Paulo, 13565-905, Brazil
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14
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Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48:16-31. [PMID: 30312372 PMCID: PMC6322506 DOI: 10.1093/ageing/afy169] [Citation(s) in RCA: 5858] [Impact Index Per Article: 1171.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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Affiliation(s)
| | - Gülistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Jürgen Bauer
- Center for Geriatric Medicine, University Heidelberg, Agaplesion Bethanien Krankenhaus, Heidelberg, Germany
| | - Yves Boirie
- Research Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, and Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton; Southampton, UK; and Department of Epidemiology, University of Oxford, OX, UK
| | - Francesco Landi
- Instituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Yves Rolland
- Department of Geriatrics, Hospital and University of Toulouse, Toulouse, France
| | - Avan Aihie Sayer
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Stéphane M Schneider
- Department of Gastroenterology and Clinical Nutrition, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Cornel C Sieber
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine and Ageing, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - Maurits Vandewoude
- Department Geriatrics, University of Antwerp, Ziekenhuisnetwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam; and the Amsterdam Public Health Research Institute; Amsterdam, The Netherlands
| | - Mauro Zamboni
- Department of Medicine, Geriatric section, University of Verona, Verona, Italy
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15
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Yoshiko A, Yamauchi K, Kato T, Ishida K, Koike T, Oshida Y, Akima H. Effects of post-fracture non-weight-bearing immobilization on muscle atrophy, intramuscular and intermuscular adipose tissues in the thigh and calf. Skeletal Radiol 2018; 47:1541-1549. [PMID: 29948037 DOI: 10.1007/s00256-018-2985-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/22/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Disuse and/or a non-weight-bearing condition changes muscle composition, with decreased skeletal muscle tissue and increased fat within (intramuscular adipose tissue, IntraMAT) and between (intermuscular adipose tissue, InterMAT) given muscles. Excessive adipose tissue contributes to dysfunctional and metabolically impaired muscle. How these adipose tissues change during orthopedic treatment (e.g., cast immobilization, daily use of crutches) is not well documented. This study aimed to quantify changes in IntraMAT, InterMAT, and thigh and calf muscle tissue during orthopedic treatment. MATERIALS AND METHODS We studied 8 patients with fifth metatarsal bone or fibular fractures. The ankle joint involved underwent plaster casting for approximately 4 weeks, with crutches used during that time. Axial T1-weighted MRI at the mid-thigh and a 30% proximal site at the calf were obtained to measure IntraMAT and InterMAT cross-sectional areas (CSAs) and skeletal muscle tissue CSA before treatment and 4 weeks afterward. RESULTS Thigh and calf muscle tissue CSAs were significantly decreased from before to after treatment: thigh, 85.8 ± 7.6 to 77.1 ± 7.3 cm2; calf, 53.3 ± 5.5 to 48.9 ± 5.0 cm2 (p < 0.05). None of the IntraMAT or InterMAT changes was statistically significant. There was a relation between the percentage change of thigh IntraMAT CSA and muscle tissue CSA (rs = -0.86, p < 0.01). CONCLUSIONS The 4 weeks of treatment primarily induced skeletal muscle atrophy with less of an effect on IntraMAT or InterMAT. There is a risk of increasing IntraMAT relatively by decreasing skeletal muscle tissue size during orthopedic treatment.
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Affiliation(s)
- Akito Yoshiko
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.
| | - Koun Yamauchi
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Orthopedic Surgery, Akita Hospital, Chiryu, Japan
| | - Takayuki Kato
- Department of Orthopedic Surgery, Akita Hospital, Chiryu, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
| | - Teruhiko Koike
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
| | - Yoshiharu Oshida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
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16
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Abstract
BACKGROUND Myosteatosis, characterized by inter- and intramyocellular fat deposition, is strongly related to poor overall survival after surgery for periampullary cancer. It is commonly assessed by calculating the muscle radiation attenuation on computed tomography (CT) scans. However, since magnetic resonance imaging (MRI) is replacing CT in routine diagnostic work-up, developing methods based on MRI is important. We developed a new method using MRI-muscle signal intensity to assess myosteatosis and compared it with CT-muscle radiation attenuation. METHODS Patients were selected from a prospective cohort of 236 surgical patients with periampullary cancer. The MRI-muscle signal intensity and CT-muscle radiation attenuation were assessed at the level of the third lumbar vertebra and related to survival. RESULTS Forty-seven patients were included in the study. Inter-observer variability for MRI assessment was low (R2 = 0.94). MRI-muscle signal intensity was associated with short survival: median survival 9.8 (95%-CI: 1.5-18.1) vs. 18.2 (95%-CI: 10.7-25.8) months for high vs. low intensity, respectively (p = 0.038). Similar results were found for CT-muscle radiation attenuation (low vs. high radiation attenuation: 10.8 (95%-CI: 8.5-13.1) vs. 15.9 (95%-CI: 10.2-21.7) months, respectively; p = 0.046). MRI-signal intensity correlated negatively with CT-radiation attenuation (r=-0.614, p < 0.001). CONCLUSIONS Myosteatosis may be adequately assessed using either MRI-muscle signal intensity or CT-muscle radiation attenuation.
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17
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Effects of daily walking on intermuscular adipose tissue accumulation with age: a 5-year follow-up of participants in a lifestyle-based daily walking program. Eur J Appl Physiol 2018; 118:785-793. [DOI: 10.1007/s00421-018-3812-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/06/2018] [Indexed: 01/14/2023]
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18
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Bergia RE, Kim JE, Campbell WW. Differential Relationship between Intermuscular Adipose Depots with Indices of Cardiometabolic Health. Int J Endocrinol 2018; 2018:2751250. [PMID: 30254672 PMCID: PMC6142737 DOI: 10.1155/2018/2751250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/29/2018] [Accepted: 08/02/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Globally, accumulation of intermuscular adipose tissue (IMAT) is positively associated with insulin resistance. Whether this association is observed consistently in different skeletal muscles and encompasses other markers of cardiometabolic health is not well known. OBJECTIVES The purpose of this secondary analysis study was to investigate associations among thigh or calf IMAT stores and indices of cardiometabolic health in adults who are overweight and obese participating in dietary interventions. A subset of calf data was analyzed to assess relations between IMAT in the gastrocnemius (type II fiber predominance) and soleus (type I fiber predominance) with markers of cardiometabolic health. MATERIALS AND METHODS Thigh and calf compositions were assessed via magnetic resonance imaging in 113 subjects (mean ± SD, age: 50 ± 16 y (range: 21-77 y), BMI: 31 ± 3 kg/m2), 103 of which completed dietary interventions with or without energy restriction-induced weight loss. A subset of data (n = 37) was analyzed for relations between muscle compartments (gastrocnemius and soleus) and cardiometabolic health. IMAT was regressed separately against fasting serum glucose concentrations, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), and lipids and lipoproteins. RESULTS In general, total thigh IMAT was predictive of markers of glucose control, while total calf IMAT was not. Specifically, baseline thigh IMAT was positively associated with fasting glucose, insulin, and HOMA-IR. IMAT content changes in any depot did not predict improvement in cardiometabolic health. CONCLUSIONS The strength of the relationship between IMAT and glucose control-related indices of cardiometabolic health is dependent on IMAT location. Specifically, greater IMAT in the thigh is a better predictor of cardiometabolic risk than greater IMAT in the calf in adults who are overweight and obese.
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Affiliation(s)
- Robert E. Bergia
- Department of Nutrition Science, Purdue University, West Lafayette IN 47907, USA
| | - Jung Eun Kim
- Food Science and Technology Programme, c/o Department of Chemistry, National University of Singapore, Singapore, Singapore 119077
| | - Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette IN 47907, USA
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19
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Gepner Y, Shelef I, Schwarzfuchs D, Cohen N, Bril N, Rein M, Tsaban G, Zelicha H, Yaskolka Meir A, Tene L, Sarusy B, Rosen P, Hoffman JR, Stout JR, Thiery J, Ceglarek U, Stumvoll M, Blüher M, Stampfer MJ, Shai I. Intramyocellular triacylglycerol accumulation across weight loss strategies; Sub-study of the CENTRAL trial. PLoS One 2017; 12:e0188431. [PMID: 29190720 PMCID: PMC5708655 DOI: 10.1371/journal.pone.0188431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 11/06/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Intramyocellular triacylglycerol (IMTG) is utilized as metabolic fuel during exercise and is linked to insulin resistance, but the long-term effect of weight loss strategies on IMTG among participants with abdominal fat, remain unclear. METHODS In an 18-month trial, sedentary participants with abdominal fat/dyslipidemia were randomized to either a low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC) diet (including 28g·day-1 of walnuts). After 6-months, the participants were re-randomized to moderate intense physical activity (PA+) or non-physical activity (PA-). Magnetic resonance imaging (MRI) was used to quantify changes of IMTG, abdominal sub-depots, hepatic and intermuscular fats. RESULTS Across the 277 participants [86% men, age = 48 years, body-mass-index (BMI) = 31kg/m2, visceral fat = 33%] 86% completed the 18-m trial. At baseline, women had higher IMTG than men (3.4% vs. 2.3%, p<0.001) and increased IMTG was associated with aging and higher BMI, visceral and intermuscular fats, HbA1c%, HDL-c and leptin(p<0.05), but not with intra-hepatic fat. After 18 month of intervention and a -3 kg mean weight loss, participants significantly increased IMTG by 25%, with a distinct effect in the MED/LCPA+ group as compared to the other intervention groups (57% vs. 9.5-18.5%, p<0.05). Changes in IMTG were associated with visceral and intermuscular fat, metabolic syndrome, insulin and leptin (p<0.05 for all), however, these associations did not remain after adjustment for visceral fat changes. CONCLUSIONS Lifestyle strategies differentially affect IMTG accumulation; combination of exercise with decreased carbohydrate/increased unsaturated fat proportion intake greatly increase IMTG. Our findings suggest that increased IMTG during diet-induced moderate weight loss may not be directly related to cardiometabolic risk. TRIAL REGISTRATION ClinicalTrials.gov NCT01530724.
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Affiliation(s)
- Yftach Gepner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Institute of Exercise Physiology and Wellness, Sport and Exercise Science; University of Central Florida, Orlando, FL, United States of America
| | - Ilan Shelef
- Soroka University Medical Center, Beer-Sheva, Israel
| | | | - Noa Cohen
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nitzan Bril
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michal Rein
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lilac Tene
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Philip Rosen
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Jay R. Hoffman
- Institute of Exercise Physiology and Wellness, Sport and Exercise Science; University of Central Florida, Orlando, FL, United States of America
| | - Jeffrey R. Stout
- Institute of Exercise Physiology and Wellness, Sport and Exercise Science; University of Central Florida, Orlando, FL, United States of America
| | - Joachim Thiery
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Meir J. Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA, United States of America
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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20
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Gepner Y, Shelef I, Schwarzfuchs D, Zelicha H, Tene L, Yaskolka Meir A, Tsaban G, Cohen N, Bril N, Rein M, Serfaty D, Kenigsbuch S, Komy O, Wolak A, Chassidim Y, Golan R, Avni-Hassid H, Bilitzky A, Sarusi B, Goshen E, Shemesh E, Henkin Y, Stumvoll M, Blüher M, Thiery J, Ceglarek U, Rudich A, Stampfer MJ, Shai I. Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: CENTRAL Magnetic Resonance Imaging Randomized Controlled Trial. Circulation 2017; 137:1143-1157. [PMID: 29142011 DOI: 10.1161/circulationaha.117.030501] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND We aimed to assess whether distinct lifestyle strategies can differentially affect specific body adipose depots. METHODS We performed an 18-month randomized controlled trial among 278 sedentary adults with abdominal obesity (75%) or dyslipidemia in an isolated workplace with a monitored provided lunch. Participants were randomized to isocaloric low-fat or Mediterranean/low-carbohydrate (MED/LC) diet+28 g walnuts/day with/without added moderate physical activity (PA; 80% aerobic; supervised/free gym membership). Overall primary outcome was body fat redistribution, and the main specific end point was visceral adipose tissue (VAT). We further followed the dynamics of different fat depots (deep and superficial subcutaneous, liver, pericardial, muscle, pancreas, and renal sinus) by magnetic resonance imaging. RESULTS Of 278 participants (age, 48 years, 89% men, body mass index, 30.8 kg/m2), 86% completed the trial with good adherence. The low-fat group preferentially decreased reported fat intake (-21.0% versus -11.5% for the MED/LC; P<0.001), and the MED/LC group decreased reported carbohydrates intake (-39.5% versus -21.3% for the low-fat group; P<0.001). The PA+ groups significantly increased the metabolic equivalents per week versus the PA- groups (19.0 versus 2.1; P=0.009). Whereas final moderate weight loss was indifferent, exercise attenuated the waist circumference rebound with the greatest effect in the MED/LCPA+ group (P<0.05). VAT (-22%), intrahepatic (-29%), and intrapericardial (-11%) fats declines were higher than pancreatic and femur intermuscular fats (1% to 2%) loss. Independent of weight loss, PA+ with either diet had a significantly greater effect on decreasing VAT (mean of difference, -6.67cm2; 95% confidence interval, -14.8 to -0.45) compared with PA-. The MED/LC diet was superior to the low-fat diet in decreasing intrahepatic, intrapericardial, and pancreatic fats (P<0.05 for all). In contrast, renal sinus and femoral intermuscular fats were not differentially altered by lifestyle interventions but by weight loss per se. In multivariate models further adjusted for weight loss, losing VAT or intrahepatic fat was independently associated with improved lipid profile, losing deep subcutaneous adipose tissue with improved insulin sensitivity, and losing superficial subcutaneous adipose tissue remained neutral except for an association with decreased leptin. CONCLUSIONS Moderate weight loss alone inadequately reflects the significant lifestyle effects on atherogenic and diabetogenic fat depots. The MED/LC diet mobilizes specific ectopic fat depots, and exercise has an independent contribution to VAT loss. Fat depots exhibit diverse responsiveness and are differentially related to cardiometabolic markers. Distinct lifestyle protocols may uniquely induce fat mobilization from specific anatomic sites. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01530724.
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Affiliation(s)
- Yftach Gepner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | | | - Dan Schwarzfuchs
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Lilac Tene
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.).,Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Noa Cohen
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Nitzan Bril
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Michal Rein
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Dana Serfaty
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Shira Kenigsbuch
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Oded Komy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Arik Wolak
- Department of Cardiology, Cardiac Imaging Unit, Shaare Zedek Medical Center, Jerusalem, Israel (A.W.)
| | - Yoash Chassidim
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Rachel Golan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Hila Avni-Hassid
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Avital Bilitzky
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | | | - Eyal Goshen
- Nuclear Research Center-Negev, Dimona, Israel (B.S., E.G.)
| | - Elad Shemesh
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Yaakov Henkin
- Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
| | - Michael Stumvoll
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Joachim Thiery
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Germany (M.S., M.B., J.T., U.C.)
| | - Assaf Rudich
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.)
| | - Meir J Stampfer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, MA (M.J.S.).
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.G., H.Z., L.T., A.Y.M., G.T., N.C., N.B., M.R., D.S., S.K., O.K., R.G., H.A.-H., A.B., E.S., A.R., I.S.). .,Soroka University Medical Center, Beer-Sheva, Israel (I.S., D.S., G.T., Y.C., Y.H.)
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21
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Looijaard WGPM, Dekker IM, Stapel SN, Girbes ARJ, Twisk JWR, Oudemans-van Straaten HM, Weijs PJM. Skeletal muscle quality as assessed by CT-derived skeletal muscle density is associated with 6-month mortality in mechanically ventilated critically ill patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:386. [PMID: 27903267 PMCID: PMC5131531 DOI: 10.1186/s13054-016-1563-3] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/08/2016] [Indexed: 01/06/2023]
Abstract
Background Muscle quantity at intensive care unit (ICU) admission has been independently associated with mortality. In addition to quantity, muscle quality may be important for survival. Muscle quality is influenced by fatty infiltration or myosteatosis, which can be assessed on computed tomography (CT) scans by analysing skeletal muscle density (SMD) and the amount of intermuscular adipose tissue (IMAT). We investigated whether CT-derived low skeletal muscle quality at ICU admission is independently associated with 6-month mortality and other clinical outcomes. Methods This retrospective study included 491 mechanically ventilated critically ill adult patients with a CT scan of the abdomen made 1 day before to 4 days after ICU admission. Cox regression analysis was used to determine the association between SMD or IMAT and 6-month mortality, with adjustments for Acute Physiological, Age, and Chronic Health Evaluation (APACHE) II score, body mass index (BMI), and skeletal muscle area. Logistic and linear regression analyses were used for other clinical outcomes. Results Mean APACHE II score was 24 ± 8 and 6-month mortality was 35.6%. Non-survivors had a lower SMD (25.1 vs. 31.4 Hounsfield Units (HU); p < 0.001), and more IMAT (17.1 vs. 13.3 cm2; p = 0.004). Higher SMD was associated with a lower 6-month mortality (hazard ratio (HR) per 10 HU, 0.640; 95% confidence interval (CI), 0.552–0.742; p < 0.001), and also after correction for APACHE II score, BMI, and skeletal muscle area (HR, 0.774; 95% CI, 0.643–0.931; p = 0.006). Higher IMAT was not significantly associated with higher 6-month mortality after adjustment for confounders. A 10 HU increase in SMD was associated with a 14% shorter hospital length of stay. Conclusions Low skeletal muscle quality at ICU admission, as assessed by CT-derived skeletal muscle density, is independently associated with higher 6-month mortality in mechanically ventilated patients. Thus, muscle quality as well as muscle quantity are prognostic factors in the ICU. Trial registration Retrospectively registered (initial release on 06/23/2016) at ClinicalTrials.gov: NCT02817646.
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Affiliation(s)
- Wilhelmus G P M Looijaard
- Department of Intensive Care Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands. .,Institute for Cardiovascular Research, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands. .,VU University Medical Center Amsterdam, Room ZH 7D174, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Ingeborg M Dekker
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Sandra N Stapel
- Department of Intensive Care Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.,Institute for Cardiovascular Research, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Armand R J Girbes
- Department of Intensive Care Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.,Institute for Cardiovascular Research, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center Amsterdam, van der Boechorststraat 7, Amsterdam, The Netherlands
| | - Heleen M Oudemans-van Straaten
- Department of Intensive Care Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.,Institute for Cardiovascular Research, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Peter J M Weijs
- Department of Intensive Care Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, Amsterdam, The Netherlands
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22
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Mitra S, Fernandez-Del-Valle M, Hill JE. The role of MRI in understanding the underlying mechanisms in obesity associated diseases. Biochim Biophys Acta Mol Basis Dis 2016; 1863:1115-1131. [PMID: 27639834 DOI: 10.1016/j.bbadis.2016.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
Obesity and its possible association with diseases including diabetes and cardiovascular diseases have been studied for decades for its impact on healthcare. Recent studies clearly indicate the need for developing accurate and reproducible methodologies for assessing body fat content and distribution. Body fat distribution plays a significant role in developing an insight in the underlying mechanisms in which adipose tissue is linked with various diseases. Among imaging technologies including computerized axial tomography (CAT or CT), magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS), MRI and MRS seem to be the best emerging techniques and together are being considered as the gold standard for body fat content and distribution. This paper reviews studies up to the present time involving different methodologies of these two emerging technologies and presents the basic concepts of MRI and MRS with required novel image analysis techniques in accurate, quantitative, and direct assessment of body fat content and distribution. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes/Obesity and Critical Illness Spectrum of Diseases - edited by P. Hemachandra Reddy.
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Affiliation(s)
| | | | - Jason E Hill
- Texas Tech University, Lubbock, TX, United States
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23
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Wang R, Zhang P, Gao C, Li Z, Lv X, Song Y, Yu Y, Li B. Prevalence of overweight and obesity and some associated factors among adult residents of northeast China: a cross-sectional study. BMJ Open 2016; 6:e010828. [PMID: 27456326 PMCID: PMC4964206 DOI: 10.1136/bmjopen-2015-010828] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aims to estimate the prevalence of overweight and obesity and determine potential influencing factors among adults in northeast China. METHODS A cross-sectional survey was conducted in Jilin Province, northeast China, in 2012. A total of 9873 men and 10 966 women aged 18-79 years from the general population were included using a multistage stratified random cluster sampling design. Data were obtained from face-to-face interview and physical examination. After being weighted according to a complex sampling scheme, the sample was used to estimate the prevalence of overweight (body mass index (BMI) 24-27.9 kg/m(2)) and obesity (BMI >28 kg/m(2)) in Jilin Province, and analyse influencing factors through corresponding statistical methods based on complex sampling design behaviours. RESULTS The overall prevalence of overweight was 32.3% (male 34.3%; female 30.2%), and the prevalence of obesity was 14.6% (male 16.3%; female 12.8%) in Jilin Province. The prevalence of both overweight and obesity were higher in men than women (p<0.001). Influencing factors included sex, age, marriage status, occupation, smoking, drinking, diet and hours of sleep (p<0.05). CONCLUSIONS This study estimated that the prevalence of overweight and obesity among adult residents of Jilin Province, northeast China, were high. The results of this study will be submitted to the Health Department of Jilin Province and other relevant departments as a reference, which should inform policy makers in developing education and publicity to prevent and control the occurrence of overweight and obesity.
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Affiliation(s)
- Rui Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Peng Zhang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Zhijun Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Xin Lv
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yuanyuan Song
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, China
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24
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Yaskolka Meir A, Shelef I, Schwarzfuchs D, Gepner Y, Tene L, Zelicha H, Tsaban G, Bilitzky A, Komy O, Cohen N, Bril N, Rein M, Serfaty D, Kenigsbuch S, Chassidim Y, Zeller L, Ceglarek U, Stumvoll M, Blüher M, Thiery J, Stampfer MJ, Rudich A, Shai I. Intermuscular adipose tissue and thigh muscle area dynamics during an 18-month randomized weight loss trial. J Appl Physiol (1985) 2016; 121:518-27. [PMID: 27402560 DOI: 10.1152/japplphysiol.00309.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/05/2016] [Indexed: 12/17/2022] Open
Abstract
It remains unclear whether intermuscular adipose tissue (IMAT) has any metabolic influence or whether it is merely a marker of abnormalities, as well as what are the effects of specific lifestyle strategies for weight loss on the dynamics of both IMAT and thigh muscle area (TMA). We followed the trajectory of IMAT and TMA during 18-mo lifestyle intervention among 278 sedentary participants with abdominal obesity, using magnetic resonance imaging. We measured the resting metabolic rate (RMR) by an indirect calorimeter. Among 273 eligible participants (47.8 ± 9.3 yr of age), the mean IMAT was 9.6 ± 4.6 cm(2) Baseline IMAT levels were directly correlated with waist circumference, abdominal subdepots, C-reactive protein, and leptin and inversely correlated with baseline TMA and creatinine (P < 0.05 for all). After 18 mo (86.3% adherence), both IMAT (-1.6%) and TMA (-3.3%) significantly decreased (P < 0.01 vs. baseline). The changes in both IMAT and TMA were similar across the lifestyle intervention groups and directly corresponded with moderate weight loss (P < 0.001). IMAT change did not remain independently associated with decreased abdominal subdepots or improved cardiometabolic parameters after adjustments for age, sex, and 18-mo weight loss. In similar models, 18-mo TMA loss remained associated with decreased RMR, decreased activity, and with increased fasting glucose levels and IMAT (P < 0.05 for all). Unlike other fat depots, IMAT may not represent a unique or specific adipose tissue, instead largely reflecting body weight change per se. Moderate weight loss induced a significant decrease in thigh muscle area, suggesting the importance of resistance training to accompany weight loss programs.
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Affiliation(s)
| | - Ilan Shelef
- Soroka University Medical Center, Beer-Sheva, Israel
| | | | - Yftach Gepner
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lilac Tene
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Tsaban
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Oded Komy
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Noa Cohen
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nitzan Bril
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michal Rein
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dana Serfaty
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | - Lior Zeller
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Joachim Thiery
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston, Massachusetts
| | - Assaf Rudich
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Iris Shai
- Ben-Gurion University of the Negev, Beer-Sheva, Israel;
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25
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Bang E, Tanabe K, Yokoyama N, Chijiki S, Kuno S. Relationship between thigh intermuscular adipose tissue accumulation and number of metabolic syndrome risk factors in middle-aged and older Japanese adults. Exp Gerontol 2016; 79:26-30. [PMID: 26994937 DOI: 10.1016/j.exger.2016.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND To evaluate the association between thigh intermuscular adipose tissue accumulation and number of metabolic syndrome risk factors in middle-aged and older Japanese adults. METHODS Thigh muscle cross-sectional area, subcutaneous adipose tissue, thigh intermuscular adipose tissue, abdominal subcutaneous adipose tissue, and visceral adipose tissue were measured in 166 middle-aged and older (mean age, 69years) Japanese adults using magnetic resonance imaging. Daily physical activity was calculated using pedometers, and energy intake per day was evaluated using 3-day dietary records. Multiple linear regression analysis was used to assess the association between intermuscular adipose tissue and the number of metabolic syndrome risk factors. RESULTS Multiple regression analysis indicated that intermuscular adipose tissue was significantly associated with the number of metabolic syndrome risk factors, after adjusting for age, sex, body mass index, daily physical activity, energy intake, thigh muscle cross-sectional area, and visceral adipose tissue (p<0.05). CONCLUSIONS Thigh intermuscular adipose tissue accumulation was significantly associated with the number of metabolic syndrome risk factors in middle-aged and older Japanese adults, independent of age, sex, body mass index, daily physical activity, energy intake, thigh muscle cross-sectional area, and visceral adipose tissue.
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Affiliation(s)
- Eunji Bang
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8577, Japan.
| | - Kai Tanabe
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8577, Japan.
| | - Noriko Yokoyama
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8577, Japan.
| | - Shoko Chijiki
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8577, Japan.
| | - Shinya Kuno
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305-8577, Japan.
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26
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Makrogiannis S, Fishbein KW, Moore AZ, Spencer RG, Ferrucci L. Image-Based Tissue Distribution Modeling for Skeletal Muscle Quality Characterization. IEEE Trans Biomed Eng 2015; 63:805-13. [PMID: 26336111 DOI: 10.1109/tbme.2015.2474305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The identification and characterization of regional body tissues is essential to understand changes that occur with aging and age-related metabolic diseases such as diabetes and obesity and how these diseases affect trajectories of health and functional status. Imaging technologies are frequently used to derive volumetric, area, and density measurements of different tissues. Despite the significance and direct applicability of automated tissue quantification and characterization techniques, these topics have remained relatively underexplored in the medical image analysis literature. We present a method for identification and characterization of muscle and adipose tissue in the midthigh region using MRI. We propose an image-based muscle quality prediction technique that estimates tissue-specific probability density models and their eigenstructures in the joint domain of water- and fat-suppressed voxel signal intensities along with volumetric and intensity-based tissue characteristics computed during the quantification stage. We evaluated the predictive capability of our approach against reference biomechanical muscle quality (MQ) measurements using statistical tests and classification performance experiments. The reference standard for MQ is defined as the ratio of muscle strength to muscle mass. The results show promise for the development of noninvasive image-based MQ descriptors.
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27
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Schweitzer L, Geisler C, Pourhassan M, Braun W, Glüer CC, Bosy-Westphal A, Müller MJ. What is the best reference site for a single MRI slice to assess whole-body skeletal muscle and adipose tissue volumes in healthy adults? Am J Clin Nutr 2015; 102:58-65. [PMID: 26016860 DOI: 10.3945/ajcn.115.111203] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 05/06/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Whole-body magnetic resonance imaging (MRI) is the gold standard for the assessment of skeletal muscle (SM) and adipose tissue volumes. It is unclear whether single-slice estimates can replace whole-body data. OBJECTIVE We evaluated the accuracy of the best single lumbar and midthigh MRI slice to assess whole-body SM, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). DESIGN Whole-body MRI was performed in 142 healthy adults aged 19-65 y [mean ± SD age: 37.0 ± 11.8 y; BMI (in kg/m(2)): 25.3 ± 5.9]. Single slices were taken at lumbar vertebrae L1-L5 plus intervertebral discs and the thigh (midthigh, 10 cm distally from the midthigh, and 10 cm proximally from the midthigh). The value of single-slice areas was also tested in a longitudinal study on 48 healthy volunteers during weight loss (8.2 ± 5.2 kg). RESULTS Cross-sectionally, all SM and adipose tissue single-slice areas correlated with total tissue volumes (P < 0.01). Because of the close associations between L3 areas and corresponding tissue volumes (r = 0.832-0.986, P < 0.01), this location was identified as the reference to estimate SM and adipose tissue in both sexes. SM, SAT, and VAT areas at L3 explained most of the variance of total tissue volumes (69-97%, with SEs of estimation of 1.96 and 2.03 L for SM, 0.23 and 0.61 L for VAT, and 4.44 and 2.47 L for SAT for men and women, respectively. There was no major effect on the explained variance compared with that for optimal slices. For SM, the optimal slice area was shown at midthigh. With weight-loss changes in total SM, VAT, and SAT, volumes were significantly different from those at baseline (SM changes: -2.8 ± 2.9 L; VAT changes: -0.7 ± 1.0 L; SAT changes: -5.1 ± 6.0 L). The area at L3 reflected changes in total VAT and SAT. To assess changes in total SM volumes, areas at midthigh showed the best evidence. CONCLUSION In both sexes, a single MRI scan at the level of L3 is the best compromise site to assess total tissue volumes of SM, VAT, and SAT. By contrast, L3 does not predict changes in tissue components. This trial was registered at clinicaltrials.gov as NCT01737034.
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Affiliation(s)
- Lisa Schweitzer
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Maryam Pourhassan
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Claus-Christian Glüer
- Clinic for Diagnostic Radiology, Section Biomedical Imaging, Molecular Imaging North Competence Center CC, University Medical Center Schleswig-Holstein, Kiel, Germany; and
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany; Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany;
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Muscle Quality in Aging: a Multi-Dimensional Approach to Muscle Functioning with Applications for Treatment. Sports Med 2015; 45:641-58. [DOI: 10.1007/s40279-015-0305-z] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Idoate F, Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Marcellán T, de Gordoa AR, Rodriguez-Mañas L, Bastarrika G, Marques MC, Martínez-Velilla N, Vicente-Campos D, Izquierdo M. Adipose tissue compartments, muscle mass, muscle fat infiltration, and coronary calcium in institutionalized frail nonagenarians. Eur Radiol 2014; 25:2163-75. [DOI: 10.1007/s00330-014-3555-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 10/21/2014] [Accepted: 12/04/2014] [Indexed: 12/25/2022]
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Wong AKO, Beattie KA, Min KKH, Gordon C, Pickard L, Papaioannou A, Adachi JD. Peripheral quantitative computed tomography-derived muscle density and peripheral magnetic resonance imaging-derived muscle adiposity: precision and associations with fragility fractures in women. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2014; 14:401-410. [PMID: 25524965 PMCID: PMC5092150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To determine the degree to which muscle density and fractures are explained by inter and intramuscular fat (IMF). METHODS Women ⋝50 years of age (Hamilton, ON, Canada) had peripheral magnetic resonance imaging and peripheral quantitative computed tomography scans at 66% of the tibial length. Muscle on computed tomography images was segmented from subcutaneous fat and bone using fixed thresholds, computing muscle density. IMF was segmented from muscle within magnetic resonance images using a region-growing algorithm, computing IMF volume. Fracture history over the last 14 years was obtained. Odds ratios for fractures were determined for muscle density, adjusting for IMF volume, total hip BMD, age and body mass index. RESULTS Women with a history of fractures were older (N=32, age:75.6±8.3 years) than those without (N=39, age: 67.0±5.2 years) (<0.01). IMF volume explained 49.3% of variance in muscle density (p<0.001). Odds for fractures were associated with lower muscle density even after adjusting for IMF volume but were attenuated after adjusting for age. CONCLUSIONS Muscle adiposity represents only 50% of the muscle density measurement. Properties of muscle beyond its adiposity may be related to fractures, but larger and prospective studies are needed to confirm these associations.
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Affiliation(s)
- A K O Wong
- Osteoporosis Program, University Health Network, Toronto, ON, Canada
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Age-related different relationships between ectopic adipose tissues and measures of central obesity in sedentary subjects. PLoS One 2014; 9:e103381. [PMID: 25051047 PMCID: PMC4106895 DOI: 10.1371/journal.pone.0103381] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/01/2014] [Indexed: 12/25/2022] Open
Abstract
Accumulation of fat at ectopic sites has been gaining attention as pivotal contributor of insulin resistance, metabolic syndrome and related cardiovascular complications. Intermuscular adipose tissue (IMAT), located between skeletal muscle bundles and beneath muscle fascia, has been linked to physical inactivity, ageing and body mass index, but little is known about its relationship with the other AT compartments, in particular with increasing age. To address this issue, erector spinae IMAT, epicardial (EAT), intraabdominal (IAAT) and abdominal subcutaneous adipose tissue (SAT) were simultaneously measured by Magnetic Resonance Imaging (MRI) and related to waist circumference measurements and age in 32 sedentary subjects without cardiovascular disease (18 men; 14 women; mean age 48.5±14 years). Fasting glucose, triglycerides and HDL-cholesterol were also assessed. We observed that, after dividing individuals according to age (≤ or >50 years), IMAT and EAT depots were significantly more expanded in older subjects (63.2±8.3 years) than in the younger ones (38.4±5.2 years) (p<0.001). Overall, both IMAT and EAT showed stronger positive associations with increasing age (β = 0.63 and 0.67, respectively, p<0.001 for both) than with waist circumference (β = 0.55 and 0.49, respectively, p<0.01 for both) after adjusting for gender. In addition, the gender-adjusted associations of IMAT and EAT with waist circumference and IAAT were significant in individuals ≤50 years only (p<0.05 for all) and not in the older ones. In contrast, no age-related differences were seen in the relationships of IAAT and SAT with waist circumference. Finally, serum triglycerides levels turned out not to be independently related with ectopic IMAT and EAT. In conclusion, the expansion of IMAT and EAT in sedentary subjects is more strongly related to age than waist circumference, and a positive association of these ectopic depots with waist circumference and IAAT amount can be postulated in younger individuals only.
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Cheuy VA, Commean PK, Hastings MK, Mueller MJ. Reliability and validity of a MR-based volumetric analysis of the intrinsic foot muscles. J Magn Reson Imaging 2013; 38:1083-93. [PMID: 23450691 DOI: 10.1002/jmri.24069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 01/11/2013] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To describe a semi-automated program that will segment subcutaneous fat, muscle, and adipose tissue in the foot using MR imaging, determine the reliability of the program between and within raters, and determine the validity of the program using MR phantoms. MATERIALS AND METHODS MR images were acquired from 19 subjects with and without diabetes and peripheral neuropathy. Two raters segmented and measured volumes from single MR slices at the forefoot, midfoot, and hindfoot at two different times. Intra- and inter-rater correlation coefficients were determined. Muscle and fat MR phantoms of known volumes were measured by the program. RESULTS Most ICC reliability values were over 0.950. Validity estimates comparing MR estimates and known volumes resulted in r(2) values above 0.970 for all phantoms. The root mean square error was less than 5% for all phantoms. CONCLUSION Subcutaneous fat, lean muscle, and adipose tissue volumes in the foot can be quantified in a reliable and valid way. This program can be applied in future studies investigating the relationship of these foot structures to functions in important pathologies, including the neuropathic foot or other musculoskeletal problems.
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Affiliation(s)
- Victor A Cheuy
- Applied Biomechanics Laboratory, Movement Science Program, and Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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Intermuscular adipose tissue is muscle specific and associated with poor functional performance. J Aging Res 2012; 2012:172957. [PMID: 22666591 PMCID: PMC3361226 DOI: 10.1155/2012/172957] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 02/23/2012] [Accepted: 03/07/2012] [Indexed: 12/25/2022] Open
Abstract
Purpose. People with obesity, diabetes, and peripheral neuropathy have high levels of intermuscular adipose tissue (IMAT) volume which has been inversely related to physical function. We determined if IMAT is muscle specific, if calf IMAT is different between a healthy obese group (HO), a group with diabetes mellitus (D), and a group with diabetes mellitus and peripheral neuropathy (DN), and if IMAT volume or the ratio of IMAT/muscle volume is related to physical function in these groups. Methods. 10 healthy obese people, 11 with type 2 diabetes, 24 with diabetes and peripheral neuropathy, had assessments of muscle morphology, physical function and muscle performance. Results. The gastrocnemius muscle had a higher ratio of IMAT/muscle volume than any other muscle or compartment. There were no differences between groups in calf muscle or IMAT volumes. Calf IMAT was inversely related to physical performance on the 6-minute walk test (r = −0.47) and physical performance test (r = −0.36). IMAT/muscle volume was inversely related to physical performance (PPT, r = −0.44; 6 MW r = −0.48; stair power, r = −0.30). Conclusions. IMAT accumulation varies in calf muscles, is highest in the gastrocnemius muscle, and is associated with poor physical performance.
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Blain GM, Limberg JK, Mortensen GF, Schrage WG. Rapid onset vasodilatation is blunted in obese humans. Acta Physiol (Oxf) 2012; 205:103-12. [PMID: 21981828 DOI: 10.1111/j.1748-1716.2011.02370.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Conduit artery function in obese humans is frequently assessed at rest, but very little is known about resistance artery function in response to muscle contraction. We tested the hypothesis that obese adults will exhibit reduced contraction-induced rapid onset vasodilatation. Single and brief forearm contractions were used to isolate the local effects of muscle contraction on the forearm vasodilatory response, independent of systemic haemodynamic and sympathetic neural influence. METHODS We measured forearm blood flow (Doppler ultrasound), blood pressure (finger photoplethysmography) and heart rate (electrocardiogram) on a beat-by-beat basis in 14 obese (body mass index = 36.2 ± 1.7 kg m(-2)) and 14 lean (body mass index = 21.6 ± 0.7 kg m(-2)) young (18-40 years) adults. Percent changes from baseline in forearm vascular conductance (FVC(%) ) were calculated in response to single, brief forearm contractions performed in random order at 15, 20, 25, 30, 40 and 50% of maximal voluntary contraction (MVC). RESULTS In both groups, each single contraction evoked a significant (P < 0.05), immediate (within one cardiac cycle) and graded FVC(%) increase from one up to six cardiac cycles post-contraction. Immediate (20-50% MVC), peak (15-50% MVC) and total (area under the curve, 20-50% MVC) vasodilatory responses were reduced with obesity. The degree of impaired vasodilatation increased with increasing workloads. CONCLUSIONS These novel findings demonstrate a blunted contraction-induced rapid onset vasodilatation with obesity that is exercise intensity dependent. Impaired rapid onset vasodilatation may negatively impact haemodynamic responses to everyday intermittent activities performed by obese humans.
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Affiliation(s)
- G M Blain
- Department of Population Health Sciences, The John Rankin Laboratory of Pulmonary Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, USA
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A moderate-intensity weight-bearing exercise program for a person with type 2 diabetes and peripheral neuropathy. Phys Ther 2012; 92:133-41. [PMID: 21921252 PMCID: PMC3258413 DOI: 10.2522/ptj.20110048] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The exercise guidelines for people with diabetes mellitus and peripheral neuropathy (DM+PN) have recently changed to allow moderate-intensity weight-bearing exercise, but there are few reports in the literature describing appropriate weight-bearing exercise for those with DM+PN. This case report describes a successful and safe progressive exercise program for an individual with DM+PN. CASE DESCRIPTION The patient was a 76-year-old man with a 30-year history of DM+PN. He participated in a 12-week, moderate-intensity, progressive exercise program (heart rate approximately 75% of maximum heart rate; rate of perceived exertion=11-13; 3 times per week) involving walking on a treadmill, balance exercises, and strengthening exercises for the lower extremities using body weight resistance. OUTCOMES Measurements were taken before and after the 12 weeks of exercise. The patient's Six-Minute Walk Test distance increased from 1,200 to 1,470 ft. His Physical Performance Test score did not change. His Foot and Ankle Ability Measure questionnaire score improved from 89 to 98. Dorsiflexor and plantar-flexor peak torque increased (dorsiflexor peak torque: right side=4.5-4.6 N·m, left side=2.8-3.8 N·m; plantar-flexor peak torque: right side=44.7-62.4 N·m, left side=40.8-56.0 N·m), as did his average daily step count (6,176-8,273 steps/day). Close monitoring of the plantar surface of the feet indicated that the exercise program was well tolerated and there were no adverse events. DISCUSSION AND CONCLUSION This case report describes a moderate-intensity exercise program that was successful in increasing some measures of muscle strength, physical function, and activity without causing injury in an individual with DM+PN.
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Makrogiannis S, Serai S, Fishbein KW, Schreiber C, Ferrucci L, Spencer RG. Automated quantification of muscle and fat in the thigh from water-, fat-, and nonsuppressed MR images. J Magn Reson Imaging 2011; 35:1152-61. [PMID: 22170747 DOI: 10.1002/jmri.22842] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 09/19/2011] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To introduce and validate an unsupervised muscle and fat quantification algorithm based on joint analysis of water-suppressed (WS), fat-suppressed (FS), and water and fat (nonsuppressed) volumetric magnetic resonance imaging (MRI) of the mid-thigh region. MATERIALS AND METHODS We first segmented the subcutaneous fat by use of a parametric deformable model, then applied centroid clustering in the feature domain defined by the voxel intensities in WS and FS images to identify the intermuscular fat and muscle. In the final step we computed volumetric and area measures of fat and muscle. We applied this algorithm on datasets of water-, fat-, and nonsuppressed volumetric MR images acquired from 28 participants. RESULTS We validated our tissue composition analysis against fat and muscle area measurements obtained from semimanual analysis of single-slice mid-thigh computed tomography (CT) images of the same participants and found very good agreement between the two methods. Furthermore, we compared the proposed approach with a variant that uses nonsuppressed images only and observed that joint analysis of WS and FS images is more accurate than the nonsuppressed only variant. CONCLUSION Our MRI algorithm produces accurate tissue quantification, is less labor-intensive, and more reproducible than the original CT-based workflow and can address interparticipant anatomic variability and intensity inhomogeneity effects.
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Affiliation(s)
- Sokratis Makrogiannis
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
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Commean PK, Tuttle LJ, Hastings MK, Strube MJ, Mueller MJ. Magnetic resonance imaging measurement reproducibility for calf muscle and adipose tissue volume. J Magn Reson Imaging 2011; 34:1285-94. [PMID: 21964677 DOI: 10.1002/jmri.22791] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 07/29/2011] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To describe a new semiautomated method for segmenting and measuring the volume of the muscle, bone, and adipose (subcutaneous and intermuscular) tissue in calf muscle compartments using magnetic resonance (MR) images and determine the intrarater and interrater reproducibility of the measures. MATERIALS AND METHODS Proton-density weighted MR images were acquired from the right calf of 21 subjects. Three raters segmented and measured the volumes of bones, adipose tissue, and five individual muscle compartments. Two raters repeated the segmentations. The intra- and interrater reproducibility of the measures (intraclass correlation coefficients; ICC) were determined using generalizability theory. RESULTS All ICC values were greater than 0.96. The average standard error of the mean (SEM) of all measures was 1.21 cm(3) and none were greater than 2.3 cm(3) . Essentially all variation (≥97% for all measures) was due to subject differences, indicating low error in the measurements. CONCLUSION The volumetric measurements for the bones, adipose tissue, and muscle in each of the compartments using MRI were highly reproducible. MRI can provide quantitative, reproducible volumetric measures of bone, adipose tissue, and individual muscle compartments in the calf. We believe these methods can be used to quantify specific muscle or adipose volumetric measures for other clinical or research purposes.
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Affiliation(s)
- Paul K Commean
- Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
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Smith SR, Stenlof KS, Greenway FL, McHutchison J, Schwartz SM, Dev VB, Berk ES, Kapikian R. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring) 2011; 19:1796-803. [PMID: 21720429 DOI: 10.1038/oby.2011.143] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It is well established that abdominal obesity or upper body fat distribution is associated with increased risk of metabolic and cardiovascular disease. The purpose of the present study was to determine if a 24 week weight loss program with orlistat 60 mg in overweight subjects would produce a greater change in visceral adipose tissue (VAT) as measured by computed tomography (CT) scan, compared to placebo. The effects of orlistat 60 mg on changes in total fat mass (EchoMRI-AH and BIA), ectopic fat (CT) and glycemic variables were assessed. One-hundred thirty-one subjects were randomized into a multicenter, double-blind placebo controlled study in which 123 subjects received at least one post baseline efficacy measurement (intent-to-treat population). Both orlistat-and placebo-treated subjects significantly decreased their VAT at 24 weeks with a significantly greater loss of VAT by orlistat treated subjects (-15.7% vs. -9.4%, P < 0.05). In addition, orlistat-treated subjects had significantly greater weight loss (-5.93 kg vs. -3.94 kg, P < 0.05), total fat mass loss (-4.65 kg vs. -3.01 kg, P < 0.05) and trended to a greater loss of intermuscular adipose tissue and content of liver fat compared with placebo-treated subjects. This is the first study to demonstrate that orlistat 60 mg significantly reduces VAT in addition to total body fat compared to placebo treated subjects after a 24 week weight loss program. These results suggest that orlistat 60 mg may be an effective weight loss tool to reduce metabolic risk factors associated with abdominal obesity.
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Affiliation(s)
- Steven R Smith
- BioImaging, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
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Lower physical activity is associated with higher intermuscular adipose tissue in people with type 2 diabetes and peripheral neuropathy. Phys Ther 2011; 91:923-30. [PMID: 21474636 PMCID: PMC3107439 DOI: 10.2522/ptj.20100329] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Increased lipid accumulation in skeletal muscle has been linked to insulin resistance, impaired muscle performance, and impaired physical function. It is unclear whether physical activity is associated with lipid content in skeletal muscle, muscle performance, or overall physical function. OBJECTIVE The purpose of this study was to characterize physical activity levels (average daily step count) in a sample of people with diabetes and peripheral neuropathy and to determine the relationship among step count, intermuscular adipose tissue volume (IMAT), muscle performance (peak torque, power), and physical function. DESIGN A cross-sectional design was used in this study. METHODS Twenty-two people with diabetes and peripheral neuropathy (15 men and 7 women, mean age=64.5 years [SD=12.7], and mean body mass index=33.2 kg/m(2) [SD=6.4]) participated. Average daily step count, glycosylated hemoglobin, modified 9-item Physical Performance Test scores, Six-Minute Walk Test distance, calf intermuscular adipose tissue volume (via magnetic resonance imaging), and isokinetic dynamometry of the ankle muscles were recorded. RESULTS Average daily step count was 7,754 (SD=4,678; range=3,088-20,079). Five participants had an average daily step count greater than 10,000. Average IMAT volume was 84 cm(3) (SD=88). Greater average daily step count was associated with younger age (r=-.39, P<.05) and with lower IMAT volume in the calf (r=-.44, P<.05). Lower IMAT volume was associated with greater muscle performance (r=-.45) and physical function (r=-.43 to -.48). LIMITATIONS The sample in this study may be biased toward people with high levels of activity because participants were recruited for an exercise study. The results should not be generalized to people taking fewer than 3,000 steps/day or to those with a current foot ulcer, peripheral arterial disease, or severe foot deformity or amputation or who weigh more than 136 kg (300 lb). CONCLUSIONS Average daily step count was inversely related to IMAT, and IMAT was inversely related to muscle performance and overall physical function. In addition, we found that people with diabetes and peripheral neuropathy and without severe foot deformity appear to be able to take a large number of steps per day.
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Zoico E, Rossi A, Di Francesco V, Sepe A, Olioso D, Pizzini F, Fantin F, Bosello O, Cominacini L, Harris TB, Zamboni M. Adipose tissue infiltration in skeletal muscle of healthy elderly men: relationships with body composition, insulin resistance, and inflammation at the systemic and tissue level. J Gerontol A Biol Sci Med Sci 2009; 65:295-9. [PMID: 19864639 DOI: 10.1093/gerona/glp155] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Association between inflammatory markers and intermuscular adipose tissue (IMAT) has been reported. We hypothesized that subclinical inflammation of adipose tissue surrounding and infiltrating muscle could be related to the metabolic and functional abnormalities of the "aging muscle." METHODS In 20 healthy elderly men undergoing elective vertebral surgery, IMAT within erector spinae was evaluated by magnetic resonance imaging and body composition by dual-energy x-ray absorptiometry. Fasting glucose, insulin, high-sensitive C-reactive protein (hs-CRP), leptin, adiponectin, and interleukin 6 (IL-6) were measured, and insulin resistance was estimated by homeostasis model assessment (HOMA) index. In subcutaneous adipose tissue (SAT) biopsies near the erector spinae, quantification of gene expression was performed. RESULTS IMAT showed a significant association with body mass index and total and regional body fat, even after adjustment for age. Insulin, HOMA, and leptin were significantly correlated with IMAT, whereas hs-CRP presented an association of borderline significance. IL-6 expression in SAT was significantly associated with IMAT; IL-6 messenger RNA (mRNA) was negatively associated with adiponectin and peroxisome proliferator-activated receptor gamma expression. In multivariate regression analysis, 68% of IMAT variance was explained by fat mass and age, independent of waist circumference, leptin, HOMA, and IL-6 mRNA. CONCLUSION IMAT was primarily related to age and total body adiposity; subclinical inflammation in fat significantly contributes to IMAT.
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Affiliation(s)
- Elena Zoico
- Division of Geriatric Medicine, University of Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126 Verona, Italy
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Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study. Int J Obes (Lond) 2009; 33:1211-8. [PMID: 19721451 DOI: 10.1038/ijo.2009.170] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Boettcher M, Machann J, Stefan N, Thamer C, Häring HU, Claussen CD, Fritsche A, Schick F. Intermuscular adipose tissue (IMAT): association with other adipose tissue compartments and insulin sensitivity. J Magn Reson Imaging 2009; 29:1340-5. [PMID: 19422021 DOI: 10.1002/jmri.21754] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To quantify intermuscular adipose tissue (IMAT) of the lower leg as well as to investigate associations with other adipose tissue (AT) compartments. The relationship between IMAT and insulin sensitivity was also examined. MATERIALS AND METHODS Standardized quantification of IMAT was performed in a large cohort (N = 249) at increased risk for type 2 diabetes in the right calf by T1-weighted fast spin-echo imaging at 1.5T (Magnetom Sonata; Siemens Healthcare). Additionally, whole-body AT distribution was assessed. Insulin sensitivity was determined by glucose clamp. RESULTS Males showed significantly more IMAT than females (2.1 +/- 1.1 cm(2) vs. 1.5 +/- 0.9 cm(2); P < 0.001). IMAT correlated well with other AT depots, especially with visceral AT (VAT; r(females) = 0.52, P < 0.0001 vs. r(males) = 0.42, P < 0.0001). Moreover, IMAT showed a negative correlation with the glucose infusion rate (GIR; r(females) = -0.43, P = 0.0002 vs. r(males) = -0.40, P = 0.0007). CONCLUSION Quantification of IMAT is possible by standard MR techniques. AT distribution of the lower leg is comparable to the visceral compartment with males having higher IMAT/VAT but lower subcutaneous AT (SCAT). IMAT seems to be involved in the pathogenesis of insulin resistance, as shown by the significant negative correlation with GIR.
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Affiliation(s)
- Michael Boettcher
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Tübingen, Germany
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Positano V, Christiansen T, Santarelli MF, Ringgaard S, Landini L, Gastaldelli A. Accurate segmentation of subcutaneous and intermuscular adipose tissue from MR images of the thigh. J Magn Reson Imaging 2009; 29:677-84. [DOI: 10.1002/jmri.21699] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Phys Ther 2008; 88:1336-44. [PMID: 18801853 PMCID: PMC2579904 DOI: 10.2522/ptj.20080079] [Citation(s) in RCA: 241] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE The primary purpose of this study was to report differences in calf intermuscular adipose tissue (IMAT), muscle strength (peak torque), power, and physical function in individuals with obesity, diabetes mellitus (DM), and peripheral neuropathy (PN) compared with those without these impairments. A secondary purpose was to assess the relationship between IMAT and muscle strength, power, and physical function. SUBJECTS AND METHODS Six participants with obesity, DM, and PN (2 women, 4 men; mean age=58 years, SD=10; mean body mass index=36.3, SD=5; mean modified Physical Performance Test [PPT] score=22, SD=3) and 6 age- and sex-matched control subjects without these impairments were assessed and compared in muscle strength, muscle power, physical functioning, and muscle and fat volume, including IMAT in the calf muscles. Muscle, adipose tissue, and IMAT volumes of each calf were quantified by noninvasive magnetic resonance imaging. Muscle strength and power of the plantar-flexor and dorsiflexor muscles were quantified using isokinetic dynamometry. The modified PPT was used to assess physical function. RESULTS Leg muscle and fat volumes were similar between groups, although IMAT volumes were 2.2-fold higher in the subjects with obesity, DM, and PN (X=120 cm(3), SD=47) than in the control subjects (X=54 cm(3), SD=41). Muscle strength, muscle power, ratio of leg muscle power to leg muscle volume, and modified PPT scores were lower in subjects with obesity, DM, and PN compared with the control subjects. DISCUSSION AND CONCLUSION The data indicate that excess fat infiltration in leg skeletal muscles is associated with low calf muscle strength, low calf muscle power, and impaired physical function in individuals who are obese with DM and PN.
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