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Liu S, He Y, Yu G, Song C, Wang D, Liu L, Liang H, Wan H, Shen J. Association of muscle mass, grip strength and fat-to-muscle ratio and metabolic dysfunction-associated steatotic liver disease in a middle-to-elderly aged population. Ann Med 2024; 56:2390169. [PMID: 39129458 PMCID: PMC11321103 DOI: 10.1080/07853890.2024.2390169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/05/2024] [Accepted: 06/26/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVE The association of appendicular skeletal muscle mass (ASM), grip strength and fat-to-muscle ratio (FMR) and the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) are not well known. MATERIALS AND METHODS This study included participants older than 40 years who underwent bioelectrical impedance assessment in Prevalence of Metabolic Diseases and Risk Factors in Shunde (SPEED-Shunde). We measured grip strength with an electronic grip strength metre. ASM and grip strength were adjusted by dividing body mass index (BMI). FMR was calculated as total fat mass to total muscle mass. Liver steatosis and liver fibrosis were evaluated by vibration-controlled transient elastography. Multifactorial logistic regression was used to analyse the relationship between ASM, grip strength, FMR, and MASLD or MASLD-associated liver fibrosis. We performed subgroup analyses according to sex, age and BMI. Interaction tests and linear trend tests were also conducted. RESULTS This study included a total of 3277 participants. FMR was positively associated with MASLD (OR: 1.89, 95% CI: 1.66-2.15) and MASLD-associated liver fibrosis (OR: 1.70, 95% CI: 1.22-2.37). While ASM/BMI (OR: 0.59, 95% CI: 0.52-0.67) or grip strength/BMI (OR: 0.72, 95% CI: 0.66-0.78) were negatively associated with MASLD. Interactions were observed between ASM/BMI and age, grip strength and sex in MASLD, as well as FMR and MASLD-associated liver fibrosis. CONCLUSION In a middle-to-elderly aged population, FMR was positively associated with the risk of MASLD and MASLD-associated liver fibrosis, and muscle mass and grip strength were negatively associated with MASLD, rather than MASLD-associated liver fibrosis.
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Affiliation(s)
- Siyang Liu
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Yajun He
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Genfeng Yu
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Cheng Song
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Dongmei Wang
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Lan Liu
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Hua Liang
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Jie Shen
- Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
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Kakita D, Harada K, Kurita S, Morikawa M, Nishijima C, Fujii K, Shimada H. Impact of fat to muscle ratio with risk of disability on community-dwelling Japanese older adults: A 5-year longitudinal study. Arch Gerontol Geriatr 2024; 126:105524. [PMID: 38954986 DOI: 10.1016/j.archger.2024.105524] [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: 01/23/2024] [Revised: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Sarcopenic obesity is a combination of sarcopenia and obesity, which is associated with the onset of disability. Fat to muscle ratio (FMR) is a screening measure that assesses the ratio of muscle mass to fat mass. However, the relationship between the FMR and disability has not been investigated. METHODS This study included 11,427 community-dwelling older adults aged ≥65 years enrolled in NCGG-SGS (National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes), a national cohort study in Japan. FMR was measured by the bioelectrical impedance analysis and calculated by dividing fat mass by muscle mass. Cox proportional hazard regression analysis adjusted for covariates was used to investigate the association between FMR and the risk of developing new care needs at 5 years. FMR was divided by about quintile, with quintile 5 as the high. RESULTS The high FMR group had the highest incidence of disability at 20.8 % for women and 20.1 % for men. In women, the association between FMR and disability was significantly different for the FMR (hazard risk [HR]: 1.43, 95 % confidence interval [CI]: 1.16-1.75). There was no association between FMR and disability in men (HR: 0.98, 95 %CI: 0.76-1.25). Lagged analyses accounting for reverse causality did not change the relationship. CONCLUSIONS FMR is associated with increased risk of disability in women community-dwelling older adults but not among men. Because the rate of decreased muscle strength is faster in men than in women, early decreased muscle strength may affect men's risk of disability more than muscle mass or fat mass.
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Affiliation(s)
- Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Nagano, Japan.
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Ushiro K, Matsui M, Fukuda A, Onishi S, Nishikawa T, Asai A, Kim SK, Nishikawa H. Fatty liver index and somatic composition in subjects receiving medical health checkup. Hepatol Res 2024. [PMID: 39431362 DOI: 10.1111/hepr.14127] [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: 08/06/2024] [Revised: 09/11/2024] [Accepted: 09/27/2024] [Indexed: 10/22/2024]
Abstract
AIMS To elucidate the relationship between fatty liver index (FLI) and somatic composition among health checkup recipients (4533 men and 4877 women). METHODS Fat (F) index, fat-free (FF) index, and fat mass to fat-free mass (F-FF) ratio was measured by bioimpedance analysis. Skeletal muscle mass (SMM) loss was defined as FF index <18 kg/m2 in men and FF index <15 kg/m2 in women. The impact of FLI on the somatic composition (i.e., F index, FF index, and F-FF ratio) was retrospectively investigated. RESULTS The median age in men and women was 54 and 52 years (p < 0.0001). The median body mass index in men and women was 23.4 and 21.1 kg/m2 (p < 0.0001). The prevalence of fatty liver on ultrasonography was 52.5% in men and 22.1% in women. The median FLI in men and women was 25.1 and 6.9 (p < 0.0001). Fatty liver index correlated significantly with F index (r > 0.5 in all analyses). In all analyses, the decreased SMM group had significantly lower FLI than the nondecreased SMM group. In receiver operating characteristic (ROC) curve analysis for the SMM decrease, in both genders, area under the ROCs of FLI were all over 0.80 (optimal cut-off point: 19.7 in men and 8.4 in women). The FLI correlated significantly with F-FF ratio (r > 0.5 in all analyses). CONCLUSION The FLI can be a good indicator of not only fat mass but also FF mass and body composition balance in health checkup subjects. The FLI may not be just a marker of hepatic steatosis.
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Affiliation(s)
- Kosuke Ushiro
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Masahiro Matsui
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Akira Fukuda
- Osaka Medical and Pharmaceutical University Health Science Clinic, Takatsuki, Osaka, Japan
| | - Saori Onishi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Tomohiro Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Akira Asai
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Soo Ki Kim
- Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Hyogo, Japan
| | - Hiroki Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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Lu Z, Hu Y, Chen X, Ou Q, Liu Y, Xu T, Tu J, Li A, Lin B, Liu Q, Xi T, Wang W, Huang H, Xu D, Chen Z, Wang Z, He H, Shan G. Sex-specific associations between total and regional Fat-to-muscle Mass ratio and cardiometabolic risk: findings from the China National Health Survey. Nutr J 2024; 23:104. [PMID: 39252042 PMCID: PMC11385979 DOI: 10.1186/s12937-024-01007-2] [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: 04/19/2024] [Accepted: 08/28/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The fat-to-muscle mass ratio (FMR), integrating the antagonistic effects of fat and muscle mass, has been suggested as a valuable indicator to assess cardiometabolic health independent of overall adiposity. However, the specific associations of total and regional FMR with cardiometabolic risk are poorly understood. We aimed to examine sex-specific associations of total and regional FMR with single and clustered cardiometabolic risk factors (CRFs). METHODS 13,505 participants aged 20 years and above were included in the cross-sectional study. Fat mass and muscle mass were assessed using a bioelectrical impedance analysis device. FMR was estimated as fat mass divided by muscle mass in corresponding body parts (whole body, arm, leg, and trunk). Clustered CRFs was defined as the presence of two or more risk factors, including hypertension, elevated blood glucose, dyslipidemia, insulin resistance (IR), and hyperuricemia. IR was assessed by the triglyceride glucose (TyG) index. Multivariable logistic regression models were applied to explore the associations of FMR in the whole body and body parts with single and clustered CRFs. RESULTS The odds ratios (ORs) increased significantly for all single and clustered CRFs with the per quartile increase of total and regional FMR in both sexes (P for trend < 0.001), following adjustment for confounders. Among the regional parts, FMRs of the legs presented the strongest associations for clustered CRFs in both men and women, with adjusted OR of 8.54 (95% confidence interval (CI): 7.12-10.24) and 4.92 (95% CI: 4.24-5.71), respectively. Significant interactions (P for interaction < 0.05) were identified between age and FMRs across different body parts, as well as between BMI status and FMRs in different regions for clustered CRFs. Restricted cubic splines revealed significant non-linear relationships between FMRs of different body parts and clustered CRFs in both sexes (P for nonlinear < 0.05). CONCLUSIONS FMRs in the whole body and different regions were significantly associated with single and clustered CRFs in the general Chinese population. The association between FMR and clustered CRFs was more pronounced in youngers than in the elderly.
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Affiliation(s)
- Zhiming Lu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Qiong Ou
- Sleep Center, Department of Respiratory and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Ang Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Qihang Liu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Tianshu Xi
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Weihao Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Haibo Huang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Da Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Zhili Chen
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Zichao Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China.
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China.
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Nematollahi MA, Askarinejad A, Asadollahi A, Bazrafshan M, Sarejloo S, Moghadami M, Sasannia S, Farjam M, Homayounfar R, Pezeshki B, Amini M, Roshanzamir M, Alizadehsani R, Bazrafshan H, Bazrafshan drissi H, Tan RS, Acharya UR, Islam MSS. A cohort study on the predictive capability of body composition for diabetes mellitus using machine learning. J Diabetes Metab Disord 2024; 23:773-781. [PMID: 38932891 PMCID: PMC11196543 DOI: 10.1007/s40200-023-01350-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/08/2023] [Indexed: 06/28/2024]
Abstract
Purpose We applied machine learning to study associations between regional body fat distribution and diabetes mellitus in a population of community adults in order to investigate the predictive capability. We retrospectively analyzed a subset of data from the published Fasa cohort study using individual standard classifiers as well as ensemble learning algorithms. Methods We measured segmental body composition using the Tanita Analyzer BC-418 MA (Tanita Corp, Japan). The following features were input to our machine learning model: fat-free mass, fat percentage, basal metabolic rate, total body water, right arm fat-free mass, right leg fat-free mass, trunk fat-free mass, trunk fat percentage, sex, age, right leg fat percentage, and right arm fat percentage. We performed classification into diabetes vs. no diabetes classes using linear support vector machine, decision tree, stochastic gradient descent, logistic regression, Gaussian naïve Bayes, k-nearest neighbors (k = 3 and k = 4), and multi-layer perceptron, as well as ensemble learning using random forest, gradient boosting, adaptive boosting, XGBoost, and ensemble voting classifiers with Top3 and Top4 algorithms. 4661 subjects (mean age 47.64 ± 9.37 years, range 35 to 70 years; 2155 male, 2506 female) were analyzed and stratified into 571 and 4090 subjects with and without a self-declared history of diabetes, respectively. Results Age, fat mass, and fat percentages in the legs, arms, and trunk were positively associated with diabetes; fat-free mass in the legs, arms, and trunk, were negatively associated. Using XGBoost, our model attained the best excellent accuracy, precision, recall, and F1-score of 89.96%, 90.20%, 89.65%, and 89.91%, respectively. Conclusions Our machine learning model showed that regional body fat compositions were predictive of diabetes status.
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Affiliation(s)
| | - Amir Askarinejad
- Student research committee, Shiraz University of Medical Science, Shiraz, Iran
| | - Arefeh Asadollahi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Bazrafshan
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Zand St, PO Box: 71348-14336, Shiraz, Iran
| | - Shirin Sarejloo
- Cardiology research Fellow at Northern Health, Northern Hospital, Melbourne, VIC Australia
| | - Mana Moghadami
- Student research committee, Shiraz University of Medical Science, Shiraz, Iran
| | - Sarvin Sasannia
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Babak Pezeshki
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Roshanzamir
- Department of Computer Engineering, Faculty of Engineering, Fasa University, Fasa, 74617-81189 Iran
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, Australia
| | - Hanieh Bazrafshan
- Department of Neurology, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Bazrafshan drissi
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Zand St, PO Box: 71348-14336, Shiraz, Iran
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore, Singapore
| | - U. Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Springfield, Australia
| | - Mohammed Shariful Sheikh Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC Australia
- Cardiovascular Division, The George Institute for Global Health, Newtown, Australia
- Sydney Medical School, University of Sydney, Camperdown, Australia
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Nishikori S, Fujita S. Association of fat-to-muscle mass ratio with physical activity and dietary protein, carbohydrate, sodium, and fiber intake in a cross-sectional study. Sci Rep 2024; 14:10631. [PMID: 38724633 PMCID: PMC11082163 DOI: 10.1038/s41598-024-61289-8] [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: 10/17/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
Higher fat-to-muscle mass ratio (FMR) is reported to be a risk factor for various diseases, including type 2 diabetes and cardiovascular diseases, and mortality. Although this association suggests that reducing FMR may help to prevent certain diseases and mortality, the relationship between FMR and lifestyle factors is unclear. Therefore, we performed a cross-sectional study with the aim to elucidate this relationship. This cross-sectional study included 1518 healthy Japanese adults aged 30 to 64 years. We measured FMR in the whole body, arms, legs, and trunk and assessed various lifestyle factors. Then, we performed forced entry multiple regression analyses for FMR with the following variables: sex, age, physical activity, dietary intake, sleep quality, cigarette smoking, stress levels, and body mass index. As a result, whole-body and regional FMRs were correlated with female sex (β = 0.71); age (β = 0.06); physical activity (β = - 0.07); dietary intake of protein (β = - 0.12), carbohydrate (β = 0.04), sodium (β = 0.13), and fiber (β = - 0.16); and body mass index (β = 0.70). The results suggest that in the Japanese middle-aged population, low FMR is associated with certain lifestyle factors, i.e. higher physical activity and a diet with higher protein and fiber and lower carbohydrate and sodium, independent of age, sex, and body mass index.
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Affiliation(s)
- Shu Nishikori
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Japan
- Frontier Research Center, POLA Chemical Industries, Inc., 560 Kashio-cho, Totsuka-ku, Yokohama, Japan
| | - Satoshi Fujita
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Japan.
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Li A, Zhang Q, Zhou L, Luo H, Yu K, Meng X, Chen R, Kan H. Long-term exposure to ambient air pollution and incident gout: A prospective cohort study in the UK Biobank. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123540. [PMID: 38341067 DOI: 10.1016/j.envpol.2024.123540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/25/2024] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
Gout is a chronic disorder characterized by the accumulation of uric acid in the body, leading to recurrent episodes of joint inflammation and pain. There remains a lack of studies investigating the association between long-term exposure to ambient air pollution and the incidence of gout. We conducted this prospective cohort study involving participants aged 38-70 from the UK Biobank who were enrolled in 2006-2010 and followed until 2023. Baseline residential concentrations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2) and nitrogen oxides (NOx) were predicted using land-use regression models. Cox proportional hazards models were employed to examine the relationship between air pollution and incident gout events. A total of 443,587 individuals were included in the analyses and a total of 6589 incident gout cases were identified over a follow-up of 6,130,439 person-years. There were significant associations between higher levels of air pollution and an increased incidence risk of gout. Higher risk of incident gout was associated with each interquartile range increase in concentrations of PM2.5 (hazard ratio:1.05, 95% confidence intervals: 1.02-1.09), PM10 (1.04, 1.00-1.07), NO2 (1.08, 1.05-1.12) and NOx (1.04, 1.02-1.07). The magnitude of associations was larger at higher concentrations. The association was more prominent among older adults, smokers, and individuals with lower and moderate physical activity. This prospective cohort study provides novel and compelling evidence of increased risk of incident gout associated with long-term air pollution exposures.
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Affiliation(s)
- Anni Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Qingli Zhang
- Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu Zhou
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Huihuan Luo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Kexin Yu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China.
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Klapp R, Nimptsch K, Pischon T, Wilkens LR, Lim U, Guillermo C, Setiawan VW, Shepherd JA, Le Marchand L, Maskarinec G. The association of a healthy lifestyle index and imaging-based body fat distribution with glycemic status and Type 2 diabetes in the Multi Ethnic Cohort: a cross-sectional analysis. Eur J Clin Nutr 2024; 78:236-242. [PMID: 38097807 PMCID: PMC11323202 DOI: 10.1038/s41430-023-01381-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 03/13/2024]
Abstract
INTRODUCTION As several behaviors captured by the Lifestyle Risk Factor Index (LSRI) are protective against Type 2 diabetes (T2D) and may affect body fat distribution, we examined its relation with both outcomes. METHODS In a subset of the Multiethnic Cohort, participants from five ethnic groups (60-77 years) were assigned LSRI scores (one point each for consuming <1 (women)/<2 (men) alcoholic drinks/day, ≥1.5 physical activity hours/week, not smoking, and adhering to ≥3/7 dietary recommendations). All participants completed an extensive Quantitative Food Frequency Questionnaire to allow estimation of adherence to intake recommendations for fruits, vegetables, refined and whole grains, fish, processed and non-processed meat. Glycemic/T2D status was classified according to self-reports and fasting glucose. We estimated prevalence odds ratios (POR) of LSRI with glycemic/T2D status and DXA- and MRI-based body fat distribution using logistic regression. RESULTS Of 1713 participants, 43% had normoglycemia, 30% Pre-T2D, 9% Undiagnosed T2D, and 18% T2D. Overall, 39% scored 0-2, 49% 3, and 12% 4 LSRI points. T2D prevalence was 55% (POR 0.45; 95% confidence intervals 0.27, 0.76) lower for 4 vs. 0-2 LSRI points with weaker associations for abnormal glycemic status. Despite the low adherence to dietary recommendations (22%), this was the only component related to lower T2D prevalence. The inverse LSRI-T2D association was only observed among Latinos and Japanese Americans in ethnic-specific models. Visceral fat measures were higher in T2D patients and attenuated the LSRI-T2D association. CONCLUSION These findings support the role of a healthy lifestyle, especially diet, in T2D prevention with differences across ethnicity.
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Affiliation(s)
- Rebecca Klapp
- University of Hawai'i Cancer Center, Honolulu, HI, USA
| | | | - Tobias Pischon
- Max Delbrück Centrum für Molekulare Medizin, Berlin, Germany
| | | | - Unhee Lim
- University of Hawai'i Cancer Center, Honolulu, HI, USA
| | | | | | | | | | - Gertraud Maskarinec
- University of Hawai'i Cancer Center, Honolulu, HI, USA.
- Max Delbrück Centrum für Molekulare Medizin, Berlin, Germany.
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Liu D, Li N, Zhou Y, Wang M, Song P, Yuan C, Shi Q, Chen H, Zhou K, Wang H, Li T, Pan XF, Tian H, Li S. Sex-specific associations between skeletal muscle mass and incident diabetes: A population-based cohort study. Diabetes Obes Metab 2024; 26:820-828. [PMID: 37997500 DOI: 10.1111/dom.15373] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/31/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023]
Abstract
AIMS To investigate the sex-specific associations between predicted skeletal muscle mass index (pSMI) and incident type 2 diabetes in a retrospective longitudinal cohort of Chinese men and women. MATERIALS AND METHODS We enrolled Chinese adults without diabetes at baseline from WATCH (West chinA adulT health CoHort), a large health check-up-based database. We calculated pSMI to estimate skeletal muscular mass, and measured blood glucose variables and assessed self-reported history to identify new-onset diabetes. The nonlinear association between pSMI and incident type 2 diabetes was modelled using the penalized spline method. The piecewise association was estimated using segmented linear splines in weighted Cox proportional hazards regression models. RESULTS Of 47 885 adults (53.2% women) with a median age of 40 years, 1836 developed type 2 diabetes after a 5-year median follow-up. In women, higher pSMI was associated with a lower risk of incident type 2 diabetes (Pnonlinearity = 0.09, hazard ratio [HR] per standard deviation increment in pSMI: 0.79 [95% confidence interval {CI} 0.68, 0.91]). A nonlinear association of pSMI with incident type 2 diabetes was detected in men (Pnonlinearity < 0.001). In men with pSMI lower than 8.1, higher pSMI was associated with a lower risk of incident type 2 diabetes (HR 0.58 [95% CI 0.40, 0.84]), whereas pSMI was not significantly associated with incident diabetes in men with pSMI equal to or greater than 8.1 (HR 1.08 [95% CI 0.93, 1.25]). CONCLUSIONS In females, a larger muscular mass is associated with a lower risk of type 2 diabetes. For males, this association is significant only among those with diminished muscle mass.
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Affiliation(s)
- Dan Liu
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Nan Li
- Department of Informatics, West China Hospital, Sichuan University, Chengdu, China
| | - Yiling Zhou
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Miye Wang
- Department of Informatics, West China Hospital, Sichuan University, Chengdu, China
| | - Peige Song
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Qingyang Shi
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Chen
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Kaixin Zhou
- College of Life Sciences, University of the Chinese Academy of Sciences, Beijing, China
- College of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huan Wang
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Tao Li
- Department of Anesthesiology, Laboratory of Mitochondria and Metabolism, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
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10
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María de los Angeles MM, del Socorro CRE, Hugo MZ, José de Jesús GG. Glucose metabolism in gestational diabetes and their relationship with fat mass / muscle mass index. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100274. [PMID: 38292823 PMCID: PMC10824678 DOI: 10.1016/j.eurox.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction During pregnancy, women experience metabolic changes that may induce insulin resistance, which can be traced to the blood glucose levels A number of factors may intervene in the metabolism of glucose in pregnant women; one of them is body composition. This factor is useful for studying metabolic diseases, for which the identification of the fat mass/muscle mass index (FMMMI) considered an especially relevant factor. Owing to their nature, techniques such as bioimpedance have been sparsely used for analysis during pregnancy. Aim This study aimed to identify the relationship between fat mass / muscle mass index and glucose metabolism in pregnant women. Methods This descriptive cross-sectional study included 231 women between the ages of 18 and 35 years and 24-28 weeks of gestation, who attended a state hospital for regular check-ups and exhibited risk factors for the development of gestational diabetes (GD) according to the Current Practice Guidelines in Primary Care. The participants underwent a physical examination, anthropometric measurements bio impedance were obtained, and oral glucose tolerance curves were constructed. FMMMI was calculated. Results The prevalence of gestational diabetes was observed to be 13.4%. Women with a GD diagnosis had a significantly higher FMMMI than in those with no GD (0.746 ± 0.168 vs 0.567 ± 0.167;p < 0.005). The assessment of the FMMMI tertiles revealed that GD prevalence was higher in tertile 3 than in tertiles 1 and 2 (tertile 1: 2.6%; tertile 2: 9.1%; tertile 3: 24%). Conclusion FMMMI is associated with glucose tolerance test response in pregnant women and a higher prevalence of GD.
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Affiliation(s)
| | | | - Mendieta Zerón Hugo
- School of Medicine, Universidad Autónoma del Estado de México (UAEMex), Toluca, Mexico
- Cipres Grupo Médico, S.C, Toluca, Mexico
- Mónica Pretelini Saénz5 Maternal Perinatal Hospital, Toluca, Mexico
| | - Garduño García José de Jesús
- School of Medicine, Universidad Autónoma del Estado de México (UAEMex), Toluca, Mexico
- Regional General Hospital 251, Instituto Mexicano del Seguro Social (IMSS), Metepec, Mexico
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11
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Kee YK, Lee J, Nam BY, Joo YS, Kang SW, Huh KH, Park JT. Donor fat-to-muscle ratio and kidney transplant outcomes: A proposition of metabolic memory. Diabetes Metab Res Rev 2024; 40:e3781. [PMID: 38367259 DOI: 10.1002/dmrr.3781] [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: 10/11/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 02/19/2024]
Abstract
AIMS The impact of donor abdominal fat-to-muscle ratio (FMR) on kidney transplant (KT) outcomes was assessed. Given the transient nature of the donor's metabolic environment in transplant recipients, this study investigated the capacity of body composition to induce metabolic memory effects. MATERIALS AND METHODS KT patients (n = 895) who received allografts from living donors (2003-2013) were included. Donor fat and muscle were quantified using pre-KT abdominal computed tomography scans. Patients were categorised into donor FMR tertiles and followed up for graft outcomes. Additionally, genome-wide DNA methylation analysis was performed on 28 kidney graft samples from KT patients in the low- and high-FMR groups. RESULTS Mean recipient age was 42.9 ± 11.4 years and 60.9% were males. Donor FMR averaged 1.67 ± 0.79. Over a median of 120.9 ± 42.5 months, graft failure (n = 127) and death-censored graft failure (n = 109) were more frequent in the higher FMR tertiles. Adjusted hazard ratios for the highest versus lowest FMR tertile were 1.71 (95% CI, 1.06-2.75) for overall graft failure and 1.90 (95% CI, 1.13-3.20) for death-censored graft failure. Genome-wide DNA methylation analysis identified 58 differentially methylated regions (p < 0.05, |Δβ| > 0.2) and 35 genes showed differential methylation between the high- (FMR >1.91) and low-FMR (FMR <1.27) groups. CONCLUSIONS Donors with increased fat and reduced muscle composition may negatively impact kidney allograft survival in recipients, possibly through the transmission of epigenetic changes, implying a body-composition-related metabolic memory effect.
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Affiliation(s)
- Youn Kyung Kee
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Juhan Lee
- Department of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, South Korea
| | - Bo Young Nam
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Young Su Joo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Kyu Ha Huh
- Department of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
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12
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Huang F, Ji X, Wang Z, Yin Y, Fan L, Li J, Zhou Z, Li X. Fat-to-muscle ratio is associated with insulin resistance and cardiometabolic disorders in adults with type 1 diabetes mellitus. Diabetes Obes Metab 2023; 25:3181-3191. [PMID: 37455673 DOI: 10.1111/dom.15212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
AIMS This study aimed to investigate the correlation of the fat-to-muscle ratio (FMR) with insulin resistance (IR) and cardiometabolic disorders (CMD) in patients with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS We retrospectively recruited 420 adults with T1DM [52.6% men, median age 32.4 (24.5, 43.0) years]. Body composition was assessed by bioelectrical impedance analysis and FMR was calculated. The characteristics of the overall participants were compared between tertiles of FMR. Logistic regression analyses were performed to assess the association of FMR tertiles with IR and cardiometabolic risk factors. RESULTS Median age and median haemoglobin A1c of all participants were 32.4 (24.5, 43.0) years and 7.4 (6.5, 8.7)%, respectively. The prevalence of IR and CMD was 18% and 38.6%. The FMR significantly differed between men and women [0.39 (0.31, 0.53) vs. 0.74 (0.63, 0.92), respectively, p < .001]. The proportion of IR and CMD gradually increased as the FMR increased. The multivariable-adjusted odd ratios for IR and CMD in FMR tertile 3 compared with tertile 1 were 4.8 [95% confidence interval (CI): (1.9, 12.1)] and 9.7 (95% CI: 4.2, 22.3), respectively, in men. For women, the corresponding odd ratios were 4.0 (95% CI: 1.2, 12.9) for IR and 5.8 (95% CI: 2.4, 13.6) for CMD. CONCLUSIONS FMR is associated with IR and CMD in adults with T1DM and could be used as a promising parameter for targeting treatment in T1DM.
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Affiliation(s)
- Fansu Huang
- Department of Nutrition, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaolin Ji
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhen Wang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yixuan Yin
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Fan
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Juan Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xia Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
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13
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Chen Y, Wen W, Mai Z, Wang M, Chen H, Sun J. The serum creatinine to cystatin C to waist circumference ratios predicts risk for type 2 diabetes: A Chinese cohort study. J Diabetes 2023; 15:808-816. [PMID: 37408146 PMCID: PMC10590677 DOI: 10.1111/1753-0407.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/11/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND There is a lack of research regarding the relationship between creatinine to cystatin C to waist circumference ratio (CCR/WC ratios) and the development of type 2 diabetes mellitus (T2DM). We aimed to evaluate the association between CCR/WC ratios and incident T2DM in Chinese adults. METHODS This prospective study was from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). The participants were divided into three groups by tertiaries of the CCR/WC ratios. Cox proportional-hazards models were used to identify the relationship between CCR/WC and T2DM. RESULTS Overall, 5938 participants were included for analysis, 766 of whom developed T2DM between 2011 and 2018. Risk of incident T2DM was decreased with tertiaries 2, 3 versus tertiary 1 of the CCR/WC index (adjusted hazard ratio [HR] 0.772 [95% confidence interval 0.647-0.921] and 0.724 [0.596-0.880], p for trend = .001 across tertiaries of the CCR/WC index). The results were consistent excluding participants with T2DM in the first 2 years. CONCLUSIONS This study demonstrated that CCR/WC was negatively correlated with the risk of T2DM in Chinese adults. Early detection is necessary to control the development of T2DM in Chinese with low CCR/WC levels.
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Affiliation(s)
- Yinfei Chen
- Department of Endocrinology, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
- Present address:
Shangyu People's Hospital of ShaoxingShaoxingChina
| | - Weiheng Wen
- Department of Endocrinology, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Zhiliang Mai
- Department of Digestive Medicine, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Ming Wang
- Department of Traditional Chinese Medicine, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Hong Chen
- Department of Endocrinology, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Jia Sun
- Department of Endocrinology, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
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14
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Zhou R, Chen H, Lin Y, Li F, Zhong Q, Huang Y, Wu X. Total and Regional Fat/Muscle Mass Ratio and Risks of Incident Cardiovascular Disease and Mortality. J Am Heart Assoc 2023; 12:e030101. [PMID: 37642038 PMCID: PMC10547339 DOI: 10.1161/jaha.123.030101] [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: 03/07/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Background To evaluate the sex-specific associations of total and regional fat/muscle mass ratio (FMR) with cardiovascular disease (CVD) incidence and mortality, and to explore the underlying mechanisms driven by cardiometabolites and inflammatory cells. We compared the predictive value of FMRs to body mass index. Methods and Results This population-based, prospective cohort study included 468 885 UK Biobank participants free of CVD at baseline. Fat mass and muscle mass were estimated using a bioelectrical impedance assessment device. FMR was calculated as fat mass divided by muscle mass in corresponding body parts (total body, trunk, arm, and leg). Multivariable Cox proportional hazards models and mediation analyses were used. During 12.5 years of follow-up, we documented 49 936 CVD cases and 4158 CVD deaths. Higher total FMR was associated with an increased risk of incident CVD (hazard ratios [HRs] were 1.63 and 1.83 for men and women, respectively), ischemic heart disease (men: HR, 1.61; women: HR, 1.81), myocardial infarction (men: HR, 1.72; women: HR, 1.49), and congestive heart failure (men: HR, 2.25; women: HR, 2.57). The positive associations of FMRs with mortality from total CVD or its subtypes were significant mainly in trunk and arm for male patients (P for trend <0.05). We also identified 8 cardiometabolites and 5 inflammatory cells that partially mediated FMR-CVD associations. FMRs were modestly better at discriminating cardiovascular mortality risk. Conclusions Higher total and regional FMRs were associated with an increased risk of CVD and mortality, partly mediated through cardiometabolites and inflammatory cells. Early monitoring of FMR should be considered to alleviate CVD risk. FMRs were superior to body mass index in predicting CVD mortality.
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Affiliation(s)
- Rui Zhou
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Hao‐Wen Chen
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Yang Lin
- Center for Disease Control and Prevention of Chaoyang District of BeijingBeijingChina
| | - Fu‐Rong Li
- School of MedicineSouthern University of Science and TechnologyShenzhenChina
| | - Qi Zhong
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Yi‐Ning Huang
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Xian‐Bo Wu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
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15
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He H, Pan L, Wang D, Liu F, Du J, Pa L, Wang X, Cui Z, Ren X, Wang H, Peng X, Zhao J, Shan G. The association between muscle-to-fat ratio and cardiometabolic risks: The China National Health Survey. Exp Gerontol 2023; 175:112155. [PMID: 36940562 DOI: 10.1016/j.exger.2023.112155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/25/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND The relationship between muscle mass and fat mass might be an indicator to assess the cardiometabolic risk independently from overweight/obesity, but evidence from a representative general Chinese population is lacking. OBJECTIVE To understand the age- and sex-specific associations between muscle-to-fat ratio (MFR) and cardiometabolic risks in Chinese population. METHODS 31,178 (12,526 men and 18,652 women) subjects from the China National Health Survey were included. Muscle mass and fat mass were assessed by a bioelectrical impedance device. MFR was calculated as muscle mass divided by fat mass. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum lipids, fasting plasma glucose and serum uric acid were measured. General linear regressions, quantile regressions and restricted cubic-spline (RCS) regressions were applied to assess the effect of MFR on cardiometabolic profiles. RESULTS Per unit increase of MFR was associated with a 0.631 (0.759-0.502) mmHg SBP decrease in men, 2.648 (3.073-2.223) in women; 0.480 (0.568-0.392) mmHg DBP decrease in men, 2.049 (2.325-1.774) in women; a 0.054 (0.062-0.046) mmol/L total cholesterol decrease in men, 0.147 (0.172-0.122) in women; 0.084 (0.098-0.070) mmol/L triglycerides decrease in men, 0.225 (0.256-0.194) in women; a 0.045 (0.054-0.037) mmol/L low-density lipoprotein decrease in men, 0.183 (0.209-0.157) in women; a 2.870 (2.235-3.506) μmol/L serum uric acid decrease in men, 13.352 (14.967-11.737) in women; and a 0.027 (0.020-0.033) mmol/L high-density lipoprotein increase in men, 0.112 (0.098-0.126) mmol/L in women. The effect in overweight/obese people was much significant than in under/normal weight counterparts. The RCS curves revealed both linear and non-linear relationships between increased MFR and lower cardiometabolic risk. CONCLUSIONS Muscle-to-fat ratio is independently associated with multiple cardiometabolic parameters among Chinese adults. Higher MFR is related with better cardiometabolic health, and the effect is much significant in overweight/obese people and women.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Xianghua Wang
- Integrated Office, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Peking Union Medical College, Tianjin, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Hohhot, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Jingbo Zhao
- Department of Epidemiology and Statistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
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Manzano-Carrasco S, Garcia-Unanue J, Haapala EA, Felipe JL, Gallardo L, Lopez-Fernandez J. Relationships of BMI, muscle-to-fat ratio, and handgrip strength-to-BMI ratio to physical fitness in Spanish children and adolescents. Eur J Pediatr 2023; 182:2345-2357. [PMID: 36881145 PMCID: PMC9989582 DOI: 10.1007/s00431-023-04887-4] [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: 09/20/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 03/08/2023]
Abstract
This study aimed to determine the relationship of body mass index (BMI), muscle-to-fat ratio (MFR), and handgrip strength-to-BMI ratio to physical fitness parameters in an active young population according to sex across four different time points. A total of 2256 Spanish children and adolescents (aged 5-18) from rural areas participating in an extracurricular sport in different municipal sports schools participated in this study. Participants were divided into children (5-10 years) and adolescents (11-18 years), boys and girls, and across four different time points (2018, 2019, 2020, 2021). Data on anthropometric measures (BMI, MFR, appendicular skeletal muscle mass) and physical fitness (handgrip strength, cardiorespiratory fitness, and vertical jump) were collected. Boys who were overweight, but especially boys with obesity, had higher absolute handgrip strength in children and adolescents than their normal weight counterparts in 2020 and 2021. Boys and girls with normal weight presented higher cardiorespiratory fitness and vertical jump than their overweight and obese peers over the years. The MFR was directly correlated with the cardiorespiratory fitness and vertical jump variables, but not with handgrip strength, in boys and girls. The handgrip strength-to-BMI ratio in both sexes was positively correlated to the different physical fitness parameters. Conclusion: BMI, MFR, and handgrip strength-to-BMI can be used as health and physical fitness indicators in this population. What is Known: • BMI is the main indicator commonly used as a proxy for obesity for many years. Nevertheless, it cannot differentiate between fat mass and fat-free mass. • There are other indicators such as MFR and handgrip strength-to-BMI that might be more accurate and can serve to monitor the health and fitness of children and adolescents. What is New: • MFR showed a positive and significant correlation with cardiorespiratory fitness and vertical jump in both sexes. On the other hand, the handgrip strength-to-BMI presented a positive correlation with cardiorespiratory fitness, vertical jump, and handgrip strength. • The use of these indicators obtained through different parameters of body composition and physical fitness can serve as a tool to identify the relationships of the paediatric population with physical fitness.
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Affiliation(s)
- Samuel Manzano-Carrasco
- IGOID Research Group, Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Jorge Garcia-Unanue
- IGOID Research Group, Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, Universidad de Castilla-La Mancha, Toledo, Spain.
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jose Luis Felipe
- IGOID Research Group, Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Leonor Gallardo
- IGOID Research Group, Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
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Yu B, Sun Y, Du X, Zhang H, Chen C, Tan X, Yang Z, Lu Y, Wang N. Age-specific and sex-specific associations of visceral adipose tissue mass and fat-to-muscle mass ratio with risk of mortality. J Cachexia Sarcopenia Muscle 2023; 14:406-417. [PMID: 36447372 PMCID: PMC9891960 DOI: 10.1002/jcsm.13142] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Limited studies have explored the association between visceral adipose tissue (VAT) mass and fat-to-muscle mass ratio (FMR) and mortality. We aimed to evaluate the sex-specific association of VAT and FMR with all-cause and cause-specific mortality by age. METHODS A total of 438 896 participants (49.8% men, mean age ± standard deviation: 57 ± 8 years for men; 56 ± 8 years for women) were included from the UK Biobank cohort. The nature of VAT was predictive, as obtained by sex-stratified, non-linear prediction models. Fat and muscle mass were estimated using a bioelectrical impedance assessment device. FMR was calculated as the fat mass divided by the muscle mass in the whole body. VAT and FMRs were divided into quintiles in ascending order, and the 3rd quintile was used as the reference. Cox regression analyses were used to estimate the associations between VAT, FMR and mortality. RESULTS During a median of 12.4 years of follow-up, we documented 29 903 deaths. After adjusting for various covariates, the individuals in the highest quintiles of VAT and FMR had the highest hazard ratios (HRs) of all-cause mortality [1.24 (95% confidence interval: 1.17-1.33) for VAT and 1.24 (1.17-1.31) for FMR in men; and 1.11 (1.03-1.21) for VAT in women], except that the 1st quintile of FMR in women had the greatest HR [1.18 (1.09-1.27)]. Significant interactions were observed in both sexes according to age category (P for interaction < 0.05). Among men <50 years, participants in the 1st and 5th quintiles of VAT and FMR had significantly higher risks of mortality [1.30 (1.02-1.66) and 1.67 (1.27-2.19) in VAT; 1.25 (0.99-1.56) and 1.41 (1.11-1.79) in FMR, respectively]; in women, this phenomenon was observed in the ≥60 age group [1.16 (1.06-1.27) and 1.19 (1.08-1.31) in VAT; 1.18 (1.08-1.29) and 1.11 (1.01-1.22) in FMR, respectively]. VAT showed a linear positive association with mortality in women <60 years and a J-shaped association from respiratory disease in both sexes ≥60 years. FMR showed a linear positive association with mortality from cancer in men <60 years and a J-shaped association with mortality from cause-specific mortality in both sexes ≥60 years, except for mortality from cardiovascular disease in men. CONCLUSIONS Most associations of VAT and FMR with all-cause mortality were J-shaped and were significantly modified by age status (<50, 50-59 and ≥60 years). The clinical implication is that regarding body composition and VAT mass, different health strategies may be adopted for people of different sexes and ages.
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Affiliation(s)
- Bowei Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xinyue Du
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Haojie Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiao Tan
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,School of Public Health, Zhejiang University, Hangzhou, China
| | - Zhongyi Yang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Kouda K, Fujita Y, Nakama C, Ohara K, Tachiki T, Tamaki J, Yura A, Moon JS, Kajita E, Imai N, Uenishi K, Iki M. Association between trunk-to-peripheral fat ratio and renal function in elderly Japanese men: baseline data from the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study. Environ Health Prev Med 2023; 28:30. [PMID: 37183008 DOI: 10.1265/ehpm.22-00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Central obesity as measured by waist-to-hip circumference ratio (WHR) has been reported to be associated with renal hemodynamics and function. However, the adipose component of WHR, which is a composite measure of fat mass and fat-free mass, is small, particularly in nonobese subjects. Trunk-to-peripheral fat ratio as measured using dual-energy absorptiometry (DXA) is a more precise method for evaluating central fat distribution than WHR. The present study investigated the cross-sectional association between DXA-measured trunk-to-peripheral fat ratio and estimated glomerular filtration rate (eGFR) in community-dwelling elderly Japanese men. METHODS Participants were 575 men aged ≥65 years at the time of the baseline survey of the second Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) cohort study. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat. RESULTS eGFR values significantly decreased from the lowest to the highest quintile of TAR/TLR. After adjusting for potential confounding factors including whole-body fat, the highest quintile of both TAR and TLR showed statistically significant odds ratios for the risk of eGFR <60 ml/min/1.73 m2, relative to the lowest quintile. In addition, a significant decreasing trend was observed for eGFR values from the lowest to the highest quintile of TAR/TLR after adjusting for confounding factors including whole-body fat. CONCLUSION Elderly men with a large trunk-to-peripheral fat ratio tended to have a lower eGFR. This association occurred independently of that between whole-body fat and eGFR.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University
| | - Yuki Fujita
- Center for Medical Education, Kindai University Faculty of Medicine
| | - Chikako Nakama
- Department of Hygiene and Public Health, Kansai Medical University
| | - Kumiko Ohara
- Department of Hygiene and Public Health, Kansai Medical University
| | | | - Junko Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Akiko Yura
- Department of Public Health, Kindai University Faculty of Medicine
| | | | | | - Nami Imai
- Department of Pharmaceutical and Medical Business Sciences, Nihon Pharmaceutical University
| | - Kazuhiro Uenishi
- Laboratory of Physiological Nutrition, Kagawa Nutrition University
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine
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19
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Salvatore T, Galiero R, Caturano A, Rinaldi L, Criscuolo L, Di Martino A, Albanese G, Vetrano E, Catalini C, Sardu C, Docimo G, Marfella R, Sasso FC. Current Knowledge on the Pathophysiology of Lean/Normal-Weight Type 2 Diabetes. Int J Mol Sci 2022; 24:ijms24010658. [PMID: 36614099 PMCID: PMC9820420 DOI: 10.3390/ijms24010658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Since early times, being overweight and obesity have been associated with impaired glucose metabolism and type 2 diabetes (T2D). Similarly, a less frequent adult-onset diabetes in low body mass index (BMI) people has been known for many decades. This form is mainly found in developing countries, whereby the largest increase in diabetes incidence is expected in coming years. The number of non-obese patients with T2D is also on the rise among non-white ethnic minorities living in high-income Western countries due to growing migratory flows. A great deal of energy has been spent on understanding the mechanisms that bind obesity to T2D. Conversely, the pathophysiologic features and factors driving the risk of T2D development in non-obese people are still much debated. To reduce the global burden of diabetes, we need to understand why not all obese people develop T2D and not all those with T2D are obese. Moreover, through both an effective prevention and the implementation of an individualized clinical management in all people with diabetes, it is hoped that this will help to reduce this global burden. The purpose of this review is to take stock of current knowledge about the pathophysiology of diabetes not associated to obesity and to highlight which aspects are worthy of future studies.
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Affiliation(s)
- Teresa Salvatore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Livio Criscuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Anna Di Martino
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Gaetana Albanese
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Christian Catalini
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Giovanni Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Mediterrannea Cardiocentro, I–80122 Napoli, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Correspondence:
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20
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He H, Pan L, Wang D, Liu F, Du J, Pa L, Wang X, Cui Z, Ren X, Wang H, Peng X, Zhao J, Shan G. Fat-to-Muscle Ratio Is Independently Associated with Hyperuricemia and a Reduced Estimated Glomerular Filtration Rate in Chinese Adults: The China National Health Survey. Nutrients 2022; 14:4193. [PMID: 36235845 PMCID: PMC9573307 DOI: 10.3390/nu14194193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The effects of the fat-to-muscle ratio (FMR) on hyperuricemia and a reduction in the estimated glomerular filtration rate (eGFR) are still unclear. METHODS Data from the China National Health Survey were used to explore the associations of the FMR with hyperuricemia and reduced eGFR. The fat mass and muscle mass were measured through bioelectrical impedance analysis. Mediation analysis was used to estimate the mediated effect of hyperuricemia on the association between the FMR and reduced eGFR. RESULTS A total of 31171 participants were included. For hyperuricemia, compared with the Q1 of the FMR, the ORs (95% CI) of Q2, Q3 and Q4 were 1.60 (1.32-1.95), 2.31 (1.91-2.80) and 2.71 (2.15-3.43) in men and 1.91 (1.56-2.34), 2.67 (2.12-3.36) and 4.47 (3.40-5.89) in women. For the reduced eGFR, the ORs (95% CI) of Q2, Q3 and Q4 of the FMR were 1.48 (1.18-1.87), 1.38 (1.05-1.82) and 1.45 (1.04-2.04) in men aged 40-59, but no positive association was found in younger men or in women. Hyperuricemia mediated the association between the FMR and reduced eGFR in men. The OR (95% CI) of the indirect effect was 1.08 (1.05-1.10), accounting for 35.11% of the total effect. CONCLUSIONS The FMR was associated with hyperuricemia and reduced eGFR, and the associations varied based on sex and age. The effect of the FMR on the reduced eGFR was significantly mediated by hyperuricemia in men.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Dingming Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Feng Liu
- Department of Chronic and Noncommunicable Disease Prevention and Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an 710054, China
| | - Jianwei Du
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hainan Provincial Center for Disease Control and Prevention, Haikou 570203, China
| | - Lize Pa
- Department of Chronic and Noncommunicable Disease Prevention and Control, Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi 830001, China
| | - Xianghua Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin 300192, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050000, China
| | - Xiaolan Ren
- Department of Chronic and Noncommunicable Disease Prevention and Control, Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Hailing Wang
- Department of Chronic and Noncommunicable Disease Prevention and Control, Inner Mongolia Autonomous Region Center for Disease Control and Prevention, Baotou 014000, China
| | - Xia Peng
- Department of Chronic and Noncommunicable Disease Prevention and Control, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - Jingbo Zhao
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
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21
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Wang W, Luo Y, Zhuang Z, Song Z, Huang N, Li Y, Dong X, Xiao W, Zhao Y, Huang T. Total and regional fat-to-muscle mass ratio and risks of incident all-cause dementia, Alzheimer's disease, and vascular dementia. J Cachexia Sarcopenia Muscle 2022; 13:2447-2455. [PMID: 35856185 PMCID: PMC9530585 DOI: 10.1002/jcsm.13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/24/2022] [Accepted: 06/25/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The fat-to-muscle mass ratio (FMR), which integrates the antagonistic effects of fat and muscle mass, has been proposed as a useful indicator to assess disease risk independent of overall obesity. However, little is known about the association between FMR and dementia risk. We aimed to prospectively investigate the sex-specific associations between total and regional FMR and incident dementia. METHODS A total of 491 420 participants (223 581 men and 267 839 women; mean age 56.7 ± 8.2 and 56.3 ± 8.0 years old, respectively) free of dementia at baseline from the UK Biobank were included. Fat mass and muscle mass were measured using a bioelectrical impedance assessment device. Cox regression analyses were used to examine the associations of total and regional FMR with incident all-cause dementia, Alzheimer's disease (AD) and vascular dementia (VD). The shape of the associations of the continuous scale of FMR and incident dementia were examined using restricted cubic spline analysis. RESULTS During a median 8.65 years of follow-up, we documented 2 225 incident all-cause dementia cases, including 836 AD and 468 VD cases. There was an L-shaped association between whole body FMR and all-cause dementia risk in both sexes after adjusting body mass index (BMI) and other covariates (P for non-linear <0.001 in men and women), where all-cause dementia risk decreased steeply with increasing FMR and levelled off at around the medians (0.35 in men, 0.61 in women) with a hazard ratio (HR) of 0.78 (95% CI: 0.64, 0.96; P = 0.019) and 0.60 (0.47, 0.77; <0.001) per 1 standard deviation (SD) increase in men and women, respectively. Compared with other body parts, FMR of the leg showed the strongest inverse associations [HR (95% CI; P) per 1 SD below the medians: 0.60 (0.48, 0.75; <0.001); 0.61 (0.47, 0.79; <0.001) in men and women, respectively]. Specifically, the inverse associations of whole body FMR on all-cause dementia risk were significant only among participants over the age of 60 (P for trend <0.001). Multivariable adjusted Cox models showed inverse associations of whole body FMR with AD in men only (P for trend = 0.003), whereas no statistically significant decrease was detected in VD among men and women. CONCLUSIONS Our analyses provide strong evidence for L-shaped associations of total and regional FMR with the development of dementia among participants aged 60 years or older independent of overall obesity.
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Affiliation(s)
- Wenxiu Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yongchun Luo
- Department of Neurosurgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zimin Song
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ninghao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yueying Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xue Dong
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wendi Xiao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yimin Zhao
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.,Center for Intelligent Public Health, Academy for Artificial Intelligence, Peking University, Beijing, China
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22
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Zhao S, Tang J, Zhao Y, Xu C, Xu Y, Yu S, Zhang Y. The impact of body composition and fat distribution on blood pressure in young and middle-aged adults. Front Nutr 2022; 9:979042. [PMID: 36118739 PMCID: PMC9478411 DOI: 10.3389/fnut.2022.979042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background The relative contributions of each component of body composition to blood pressure (BP) remain unclear. Objective We aimed to comprehensively investigate the impact of body composition and fat distribution on BP and quantify their relative contributions to BP in a large cohort with young and middle-aged adults. Methods 14,412 participants with available data on whole-body DXA measurement from the National Health and Nutrition Examination Survey were included. Multiple stepwise linear regressions of BP on components of body composition and fat distribution were built. Then, relative importance analysis was performed to quantify the contributions of each component to BP. Results The median age of participants was 36 years and there were 50.7% women. Linear regression with mutual adjustment showed that total fat mass, total muscle mass, and trunk fat mass significantly and positively associated with BP; however, arm and leg fat mass significantly and negatively associated with BP. In men, after further adjusted for potential covariates, SBP were significantly determined by trunk fat mass (β = 0.33, P < 0.001), leg fat mass (β = − 0.12, P < 0.001), and total muscle mass (β = 0.10, P < 0.001); and DBP were significantly determined by trunk fat mass (β = 0.52, P < 0.001), leg fat mass (β = −0.15, P < 0.001), arm fat mass (β = −0.23, P < 0.001), and total muscle mass (β = 0.06, P < 0.001). Similar results were observed in women. Relative importance analysis showed that trunk fat mass was the major contributor (38–61%) to both SBP and DBP; meanwhile, total muscle mass also made relatively great contribution (35–43%) to SBP. Conclusion Both fat mass and muscle mass independently associated with and substantially contributed to SBP in both men and women. After full adjustment, trunk fat mass positively associated with both SBP and DBP, and was the most dominant contributor to BP; however, leg fat mass negatively associated with both SBP and DBP.
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Xu C, Zhao S, Yu S, Tang J, Zhang H, Xu B, Xu Y, Zhang Y. Short Sleep Duration Was Associated with Increased Regional Body Fat in US Adults: The NHANES from 2011 to 2018. Nutrients 2022; 14:2840. [PMID: 35889797 PMCID: PMC9322167 DOI: 10.3390/nu14142840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The relationship between sleep duration and different regional fat is unclear. We aimed to investigate the association between sleep duration and different regional fat mass (FM) among a population of US adults. Methods: 9413 participants were included from the National Health and Nutrition Examination Survey (NHANES), from 2011 to 2018. The sleep duration was divided into short sleep (<7 h/day), normal sleep (7−9 h/day) and long sleep (>9 h/day). Different regional FM was measured by dual-energy X-ray absorptiometry, including trunk FM, arms FM and legs FM. Fat mass index (FMI) was obtained by dividing FM (kg) by the square of body height (m2). Multiple linear regression was used to evaluate the relationship between sleep duration and regional FMI. Results: The mean sleep duration was 7.1 ± 1.5 h/day. After adjusting for socio-demographic, lifestyle information, comorbid diseases and medications, short sleepers had higher trunk FMI (β = 0.134, 95% confidence interval (CI): 0.051−0.216, p = 0.001), arms FMI (β = 0.038, 95% CI: 0.016−0.06, p < 0.001) and legs FMI (β = 0.101, 95% CI: 0.044−0.158, p < 0.001) compared to normal sleepers, whereas no significant difference was found in long sleepers. The similar results were also observed in men, while short sleepers only had higher arms FM in women (all p < 0.01). In addition, compared to normal sleepers, short sleepers had higher arms FMI and legs FMI in the obese group (all p < 0.05), while no relationship was observed in non-obese group. Conclusions: Short sleep duration, but not long sleep duration, was independently related to the increased different regional body fat in US adults, especially in men and those with obesity.
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Affiliation(s)
- Chong Xu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
| | - Song Zhao
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
| | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
| | - Han Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China;
| | - Bei Xu
- Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; (C.X.); (S.Z.); (S.Y.); (J.T.)
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Cai M, Li H, Wu Y, Zhang S, Wang X, Zhang Z, Lin H. Ambient Air Pollution Associated with Body Fat Percentages at Different Body Compartments: A Cohort Study of UK Biobank Participants. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:67702. [PMID: 35767013 PMCID: PMC9241977 DOI: 10.1289/ehp10920] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 06/01/2023]
Affiliation(s)
- Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen, Guangdong, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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Bioelectrical Impedance Analysis for the Assessment of Body Composition in Sarcopenia and Type 2 Diabetes. Nutrients 2022; 14:nu14091864. [PMID: 35565832 PMCID: PMC9099885 DOI: 10.3390/nu14091864] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
Sarcopenia is emerging as a severe complication in type 2 diabetes (T2DM). On the other hand, it has been documented that nutritional aspects, such as insufficient protein or total energy intake, increase sarcopenia risk. The analysis of body composition is a relevant approach to assess nutritional status, and different techniques are available. Among such techniques, bioelectrical impedance analysis (BIA) is particularly interesting, since it is non-invasive, simple, and less expensive than the other techniques. Therefore, we conducted a review study to analyze the studies using BIA for body composition analysis in T2DM patients with sarcopenia or at risk of catching it. Revised studies have provided important information concerning relationships between body composition parameters (mainly muscle mass) and other aspects of T2DM patients’ conditions, including different comorbidities, and information on how to avoid muscle mass deterioration. Such relevant findings suggest that BIA can be considered appropriate for body composition analysis in T2DM complicated by sarcopenia/muscle loss. The wide size of the patients’ cohort in many studies confirms that BIA is convenient for clinical applications. However, studies with a specific focus on the validation of BIA, in the peculiar population of patients with T2DM complicated by sarcopenia, should be considered.
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Qiu S, Cai X, Yuan Y, Xie B, Sun Z, Wang D, Wu T. Muscle strength and prediabetes progression and regression in middle-aged and older adults: a prospective cohort study. J Cachexia Sarcopenia Muscle 2022; 13:909-918. [PMID: 35068089 PMCID: PMC8978008 DOI: 10.1002/jcsm.12905] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Prediabetes progression is associated with increased mortality while its regression decreases it. It is unclear whether muscle strength is related to prediabetes progression or regression. This study investigated the associations of muscle strength, assessed by grip strength and chair-rising time, with prediabetes progression and regression based on the China Health and Retirement Longitudinal Study (CHARLS) enrolling middle-aged and older adults. METHODS We included 2623 participants with prediabetes from CHARLS, who were followed up 4 years later with blood samples collected for measuring fasting plasma glucose and haemoglobin A1c. Grip strength (normalized by body weight) and chair-rising time were assessed at baseline and categorized into tertiles (low, middle, and high groups). Prediabetes at baseline and follow-up was defined primarily using the American Diabetes Association (ADA) criteria and secondarily using the World Health Organization (WHO) and International Expert Committee (IEC) criteria. Multinomial logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The mean age of included participants was 59.0 ± 8.6 years, and 46.6% of them were males. During follow-up, 1646 participants remained as prediabetes, 379 progressed to diabetes, and 598 regressed to normoglycaemia based on ADA criteria. Participants who progressed to diabetes had lower normalized grip strength than those who remained as prediabetes (0.49 ± 0.15 vs. 0.53 ± 0.15, P < 0.001), but participants who regressed to normoglycaemia showed the opposite (0.55 ± 0.16 vs. 0.53 ± 0.15, P = 0.003). However, chair-rising time was comparable across different groups (Poverall = 0.17). Compared with participants in low normalized grip strength or high chair-rising time group, those in high normalized grip strength or low chair-rising time group had decreased odds of progression to diabetes (OR 0.62, 95% CI 0.44 to 0.87; and OR 0.69, 95% CI 0.51 to 0.93, respectively) after multivariable adjustment. However, both were unrelated to the odds of regression to normoglycaemia (OR 0.94, 95% CI 0.71 to 1.25; and OR 0.84, 95% CI 0.65 to 1.07, respectively). These outcomes remained generally comparable when prediabetes was defined by WHO or IEC criteria. Higher normalized grip strength but not lower chair-rising time was prospectively associated with lower blood pressure, better glycaemic condition, and lower inflammation (all P ≤ 0.04). CONCLUSIONS High muscle strength is associated with reduced odds of progression to diabetes but does not predict regression to normoglycaemia in prediabetes. Future studies are warranted to assess whether increases in muscle strength promote prediabetes regression.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.,Department of Endocrinology, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University), Shenzhen, China
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.,Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Bo Xie
- Department of General Practice, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Zilin Sun
- Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.,Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, SA, Australia
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Xintong L, Dongmei X, Li Z, Ruimin C, Yide H, Lingling C, Tingting C, Yingying G, Jiaxin L. Correlation of body composition in early pregnancy on gestational diabetes mellitus under different body weights before pregnancy. Front Endocrinol (Lausanne) 2022; 13:916883. [PMID: 36387861 PMCID: PMC9649916 DOI: 10.3389/fendo.2022.916883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The prediction of gestational diabetes mellitus (GDM) by body composition-related indicators in the first trimester was analyzed under different body mass index (BMI) values before pregnancy. METHODS This was a retrospective analysis of pregnant women who were treated, had documented data, and received regular perinatal care at the Third Affiliated Hospital of Zhengzhou University from January 1, 2021, to December 31, 2021. Women with singleton pregnancies who did not have diabetes before pregnancy were included. In the first trimester (before the 14th week of pregnancy), bioelectric impedance assessment (BIA) was used to analyze body composition-related indicators such as protein levels, mineral levels, fat volume, and the waist-hip fat ratio. The Pearman's correlation coefficient was used to evaluate the linear relationship between the continuous variables and pre-pregnancy body mass index (BMI). In the univariate body composition analysis, the association with the risk of developing GDM was included in a multivariate analysis using the relative risk and 95% confidence interval obtained from logarithmic binomial regression, and generalized linear regression was used for multivariate regression analysis. Furthermore, the area under the curve (AUC) was calculated by receiver operating characteristic (ROC) curves. The optimal cutoff value of each risk factor was calculated according to the Youden Index. RESULTS In a retrospective study consisting of 6698 pregnant women, we collected 1109 cases of gestational diabetes. Total body water (TBW), protein levels, mineral levels, bone mineral content (BMC), body fat mass (BFM), soft lean mass (SLM), fat-free mass (FMM), skeletal muscle mass (SMM), percent body fat (PBF), the waist-hip ratio (WHR), the visceral fat level (VFL), and the basal metabolic rate (BMR) were significantly higher in the GDM group than in the normal group (P<0.05). Under the pre-pregnancy BMI groupings, out of 4157 pregnant women with a BMI <24 kg/m2, 456 (10.97%) were diagnosed with GDM, and out of 2541 pregnant women with a BMI ≥24 kg/m2, 653 (25.70%) were diagnosed with GDM. In the generalized linear regression model, it was found that in all groups of pregnant women, pre-pregnancy BMI, age, gestational weight gain (GWG) in the first trimester, and weight at the time of the BIA had a certain risk for the onset of GDM. In Model 1, without adjusting for confounders, the body composition indicators were all positively correlated with the risk of GDM. In Model 3, total body water, protein levels, mineral levels, bone mineral content, soft lean mass, fat-free mass, skeletal muscle mass, and the basal metabolic rate were protective factors for GDM. After Model 4 was adjusted for confounders, only the waist-hip ratio was positively associated with GDM onset. Among pregnant women with a pre-pregnancy BMI <24 kg/m2, the body composition-related indicators in Model 2 were all related to the onset of GDM. In Model 3, total body water, soft lean mass, fat-free mass, and the basal metabolic rate were negatively correlated with GDM onset. In the body composition analysis of among women with a pre-pregnancy BMI ≥ 24 kg/m2, only Model 1 and Model 2 were found to show positive associations with GDM onset. In the prediction model, in the basic data of pregnant women, the area under the receiver operating characteristic curve predicted by gestational weight gain for GDM was the largest (0.795), and its cutoff value was 1.415 kg. In the body composition results, the area under the receiver operating characteristic curve of body fat mass for predicting GDM risk was larger (0.663) in all pregnant women. CONCLUSIONS Through this retrospective study, it was found that the body composition-related indicators were independently associated with the onset of GDM in both the pre-pregnancy BMI <24 kg/m2 and pre-pregnancy BMI ≥24 kg/m2 groups. Body fat mass, the visceral fat level, and the waist-hip ratio had a higher correlation with pre-pregnancy BMI. Total body water, protein levels, mineral levels, bone mineral content, soft lean mass, fat-free mass, skeletal muscle mass, and the basal metabolic rate were protective factors for GDM after adjusting for some confounders. In all pregnant women, the waist-hip ratio was found to be up to 4.562 times the risk of GDM development, and gestational weight gain had the best predictive power for GDM. Gestational weight gain in early pregnancy, body fat mass, and the waist-hip ratio can assess the risk of GDM in pregnant women, which can allow clinicians to predict the occurrence of GDM in pregnant women as early as possible and implement interventions to reduce adverse perinatal outcomes.
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Affiliation(s)
- Li Xintong
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xu Dongmei
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Perinatal Health, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Xu Dongmei,
| | - Zhang Li
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cao Ruimin
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Yide
- Anesthesiology, Xinxiang Medical University, Xinxiang, China
| | - Cui Lingling
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chen Tingting
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guo Yingying
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Li Jiaxin
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
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