1
|
Hardy EJO, Inns TB, Hatt J, Doleman B, Bass JJ, Atherton PJ, Lund JN, Phillips BE. The time course of disuse muscle atrophy of the lower limb in health and disease. J Cachexia Sarcopenia Muscle 2022; 13:2616-2629. [PMID: 36104842 PMCID: PMC9745468 DOI: 10.1002/jcsm.13067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/01/2022] [Accepted: 07/20/2022] [Indexed: 12/15/2022] Open
Abstract
Short, intermittent episodes of disuse muscle atrophy (DMA) may have negative impact on age related muscle loss. There is evidence of variability in rate of DMA between muscles and over the duration of immobilization. As yet, this is poorly characterized. This review aims to establish and compare the time-course of DMA in immobilized human lower limb muscles in both healthy and critically ill individuals, exploring evidence for an acute phase of DMA and differential rates of atrophy between and muscle groups. MEDLINE, Embase, CINHAL and CENTRAL databases were searched from inception to April 2021 for any study of human lower limb immobilization reporting muscle volume, cross-sectional area (CSA), architecture or lean leg mass over multiple post-immobilization timepoints. Risk of bias was assessed using ROBINS-I. Where possible meta-analysis was performed using a DerSimonian and Laird random effects model with effect sizes reported as mean differences (MD) with 95% confidence intervals (95% CI) at various time-points and a narrative review when meta-analysis was not possible. Twenty-nine studies were included, 12 in healthy volunteers (total n = 140), 18 in patients on an Intensive Therapy Unit (ITU) (total n = 516) and 3 in patients with ankle fracture (total n = 39). The majority of included studies are at moderate risk of bias. Rate of quadriceps atrophy over the first 14 days was significantly greater in the ITU patients (MD -1.01 95% CI -1.32, -0.69), than healthy cohorts (MD -0.12 95% CI -0.49, 0.24) (P < 0.001). Rates of atrophy appeared to vary between muscle groups (greatest in triceps surae (-11.2% day 28), followed by quadriceps (-9.2% day 28), then hamstrings (-6.5% day 28), then foot dorsiflexors (-3.2% day 28)). Rates of atrophy appear to decrease over time in healthy quadriceps (-6.5% day 14 vs. -9.1% day 28) and triceps surae (-7.8% day 14 vs. -11.2% day 28), and ITU quadriceps (-13.2% day 7 vs. -28.2% day 14). There appears to be variability in the rate of DMA between muscle groups, and more rapid atrophy during the earliest period of immobilization, indicating different mechanisms being dominant at different timepoints. Rates of atrophy are greater amongst critically unwell patients. Overall evidence is limited, and existing data has wide variability in the measures reported. Further work is required to fully characterize the time course of DMA in both health and disease.
Collapse
Affiliation(s)
- Edward J O Hardy
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Thomas B Inns
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jacob Hatt
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Brett Doleman
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,Department of Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Joseph J Bass
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Philip J Atherton
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jonathan N Lund
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Bethan E Phillips
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| |
Collapse
|
2
|
Bass JJ, Hardy EJO, Inns TB, Wilkinson DJ, Piasecki M, Morris RH, Spicer A, Sale C, Smith K, Atherton PJ, Phillips BE. Atrophy Resistant vs. Atrophy Susceptible Skeletal Muscles: "aRaS" as a Novel Experimental Paradigm to Study the Mechanisms of Human Disuse Atrophy. Front Physiol 2021; 12:653060. [PMID: 34017264 PMCID: PMC8129522 DOI: 10.3389/fphys.2021.653060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Disuse atrophy (DA) describes inactivity-induced skeletal muscle loss, through incompletely defined mechanisms. An intriguing observation is that individual muscles exhibit differing degrees of atrophy, despite exhibiting similar anatomical function/locations. We aimed to develop an innovative experimental paradigm to investigate Atrophy Resistant tibialis anterior (TA) and Atrophy Susceptible medial gastrocnemius (MG) muscles (aRaS) with a future view of uncovering central mechanisms. METHOD Seven healthy young men (22 ± 1 year) underwent 15 days unilateral leg immobilisation (ULI). Participants had a single leg immobilised using a knee brace and air-boot to fix the leg (75° knee flexion) and ankle in place. Dual-energy X-ray absorptiometry (DXA), MRI and ultrasound scans of the lower leg were taken before and after the immobilisation period to determine changes in muscle mass. Techniques were developed for conchotome and microneedle TA/MG muscle biopsies following immobilisation (both limbs), and preliminary fibre typing analyses was conducted. RESULTS TA/MG muscles displayed comparable fibre type distribution of predominantly type I fibres (TA 67 ± 7%, MG 63 ± 5%). Following 15 days immobilisation, MG muscle volume (-2.8 ± 1.4%, p < 0.05) and muscle thickness decreased (-12.9 ± 1.6%, p < 0.01), with a positive correlation between changes in muscle volume and thickness (R2 = 0.31, p = 0.038). Importantly, both TA muscle volume and thickness remained unchanged. CONCLUSION The use of this unique "aRaS" paradigm provides an effective and convenient means by which to study the mechanistic basis of divergent DA susceptibility in humans, which may facilitate new mechanistic insights, and by extension, mitigation of skeletal muscle atrophy during human DA.
Collapse
Affiliation(s)
- Joseph J. Bass
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Edward J. O. Hardy
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, United Kingdom
| | - Thomas B. Inns
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Daniel J. Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Mathew Piasecki
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Robert H. Morris
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Abi Spicer
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Ken Smith
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Philip J. Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- Philip J. Atherton,
| | - Bethan E. Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Bethan E. Phillips,
| |
Collapse
|
3
|
Herrod PJJ, Gharahdaghi N, Rudrappa SS, Phillips HG, Ranat RA, Hardy EJO, Rathmacher JA, Atherton PJ, Phillips BE. The impact of acute beta-hydroxy-beta-methylbutyrate (HMB) ingestion on glucose and insulin kinetics in young and older men. J Funct Foods 2020; 73:104163. [PMID: 33101462 PMCID: PMC7573812 DOI: 10.1016/j.jff.2020.104163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Insulin resistance (IR) is a key feature in the development of numerous metabolic diseases. The cornerstone for treatment for IR remains diet and exercise, however these have poor rates of adherence. Beta-hydroxy-beta-methylbutyrate (HMB) is a nutraceutical with contentious effects on IR in animal models. The aim of this study was to evaluate the impact of acute HMB on IR in humans during an oral glucose tolerance test (OGTT). Young and older male volunteers underwent two 75 g OGTT with or without 3 g HMB. In young men, HMB significantly reduced the insulin area-under-the-curve (AUC), with no difference in glucose AUC, resulting in a numerical increase in the Cederholm index of insulin sensitivity. In older men, HMB had no effect on insulin or glucose responses. In conclusion, acute HMB may improve IR following a glucose load in young men; however, this does not appear to be sustained into older age.
Collapse
Affiliation(s)
- Philip J J Herrod
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK.,Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Nima Gharahdaghi
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Supreeth S Rudrappa
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Hannah G Phillips
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Reesha A Ranat
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Edward J O Hardy
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK.,Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - John A Rathmacher
- Metabolic Technologies Inc., Iowa State University Research Park, Iowa, USA
| | - Philip J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Bethan E Phillips
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| |
Collapse
|