Assessment of lipids in skeletal muscle by LCModel and AMARES

Efficacy of high-intensity interval training versus continuous training on serum myonectin and lipid outcomes in adults with metabolic syndrome: A post-hoc analysis of a clinical trial

BACKGROUND

Myonectin is a myokine with potential effects on the lipid metabolism; however, its regulation by exercise in humans remains unclear. We aimed to compare the efficacy of high-intensity interval training low-volume (HIIT) versus moderate-intensity continuous training (MICT) on serum myonectin, serum lipids, appendicular fat and lean mass, and intramuscular lipids in humans.

METHODS

Secondary analysis of a controlled, randomized, clinical trial in adults of both sexes with metabolic syndrome, who underwent a supervised, three-times/week, 12-week treadmill program. HIIT (n = 29) consisted of six intervals with one-minute, high-intensity phases at 90% of peak oxygen consumption (VO2peak) for a total of 22 min. MICT (n = 31) trained at 60% of VO2peak for 36 min. Serum myonectin was measured using a human enzyme-linked immunosorbent assay. Lipid profile was determined by enzymatic methods and free fatty acids (FFA) were measured by gas chromatography. Fat and lean mass were assessed by dual-energy X-ray absorptiometry. Intramuscular lipids were measured through proton magnetic resonance spectroscopy.

RESULTS

Subjects had a mean age of 50.8±6.0 years and body mass index of 30.6±4.0 kg/m2. Compared to MICT, HIIT was not superior at increasing serum myonectin (p = 0.661) or linoleic acid (p = 0.263), reducing palmitic (p = 0.286) or stearic acid (p = 0.350), or improving lipid profile (all p>0.05), appendicular fat mass index -AFMI- (p = 0.713) or appendicular lean mass percentage -ALM- (p = 0.810). Compared to baseline, only HIIT significantly increased myonectin (p = 0.042), with a large effect size, although both interventions reduced AFMI and increased ALM with a large effect size. Lipid profile, FFA and intramuscular lipids did not change in any intervention group (p>0.05).

CONCLUSIONS

Compared to MICT, HIIT low volume did not demonstrate superiority in improving serum lipids. The fact that both training types reduced AFMI without paralleled significant changes in serum myonectin suggests that this myokine may have a minor effect on short-middle-term exercise-induced fat mobilization.

Quantification of Extramyocellular Lipids and Intramuscular Fat from Muscle Echo Intensity in Lower Limb Muscles: A Comparison of Four Ultrasound Devices against Magnetic Resonance Spectroscopy

This study aimed to compare different ultrasound devices with magnetic resonance spectroscopy (MRS) to quantify muscle lipid content from echo intensity (EI). Four different ultrasound devices were used to measure muscle EI and subcutaneous fat thickness in four lower-limb muscles. Intramuscular fat (IMF), intramyocellular (IMCL) and extramyocellular lipids (EMCL) were measured using MRS. Linear regression was used to compare raw and subcutaneous fat thickness-corrected EI values to IMCL, EMCL and IMF. IMCL had a poor correlation with muscle EI (r = 0.17-0.32, NS), while EMCL (r = 0.41-0.84, p < 0.05-p < 0.001) and IMF (r = 0.49-0.84, p < 0.01-p < 0.001) had moderate to strong correlation with raw EI. All relationships were improved when considering the effect of subcutaneous fat thickness on muscle EI measurements. The slopes of the relationships were similar across devices, but there were some differences in the y-intercepts when raw EI values were used. These differences disappeared when subcutaneous fat thickness-corrected EI values were considered, allowing for the creation of generic prediction equations (r = 0.41-0.68, p < 0.001). These equations can be used to quantify IMF and EMCL within lower limb muscles from corrected-EI values in non-obese subjects, regardless of the ultrasound device used.

Serum Levels of Myonectin Are Lower in Adults with Metabolic Syndrome and Are Negatively Correlated with Android Fat Mass

Myonectin has shown beneficial effects on lipid regulation in murine models; therefore, it may have implications in the pathophysiology of metabolic syndrome (MS). We evaluated the relationship between serum myonectin and serum lipids, global and regional fat mass, intramuscular lipid content, and insulin resistance (IR) in adults with metabolic risk factors. This was a cross-sectional study in sedentary adults who were diagnosed with MS or without MS (NMS). Serum myonectin was quantified by enzyme-linked immunosorbent assay, lipid profile by conventional techniques, and free fatty acids (FFA) by gas chromatography. Body composition was assessed by dual-energy X-ray absorptiometry and intramuscular lipid content through proton nuclear magnetic resonance spectroscopy in the right vastus lateralis muscle. IR was estimated with the homeostatic model assessment (HOMA-IR). The MS (n = 61) and NMS (n = 29) groups were comparable in age (median (interquartile range): 51.0 (46.0-56.0) vs. 53.0 (45.5-57.5) years, p > 0.05) and sex (70.5% men vs. 72.4% women). MS subjects had lower serum levels of myonectin than NMS subjects (1.08 (0.87-1.35) vs. 1.09 (0.93-4.05) ng·mL^-1, p < 0.05). Multiple linear regression models adjusted for age, sex, fat mass index and lean mass index showed that serum myonectin was negatively correlated with the android/gynoid fat mass ratio (R² = 0.48, p < 0.01), but not with the lipid profile, FFA, intramuscular lipid content or HOMA-IR. In conclusion, serum myonectin is lower in subjects with MS. Myonectin negatively correlates with a component relevant to the pathophysiology of MS, such as the android/gynoid fat mass ratio, but not with other components such as FFA, intramuscular fat or IR.

Importance of skeletal muscle lipid levels for muscle function and physical function in older individuals

The skeletal muscle contains lipids inside (intramyocellular lipids, IMCL) or outside (extramyocellular lipids, EMCL) its cells. The muscle lipid content increases with age; however, the characteristics of IMCL and EMCL in older individuals are not well known. We aimed to examine the characteristics of skeletal muscle lipids by investigating their relationship with muscle function and physical functions. Seven elderly men and 16 elderly women participated. The skeletal muscle lipid content, including IMCL and EMCL, was measured in the vastus lateralis by proton magnetic resonance spectroscopy. Isometric knee extension with maximal voluntary contraction (MVC) and time-to-task failure for knee extension with 50% MVC were measured as muscle functions. The participants performed six physical function tests: preferred gait speed, maximal gait speed, Timed Up and Go, chair sit-to-stand, handgrip strength, and stand from the floor. The time to knee extension task failure had a significant relationship with the IMCL (r_s = -0.43, P < 0.05), but not with the EMCL content. Significant relationships were confirmed in the EMCL content with the sit-to-stand (r_s = -0.48, P < 0.05) and stand-from-the-floor (r_s = 0.53, P < 0.05) tests. These findings indicated that muscle lipids are associated with muscle and physical functional performances in older individuals. Novelty: No relationship was confirmed between IMCL and EMCL in older individuals. Muscle endurance performance had a relationship with IMCL, but not with EMCL. Relationships between EMCL and physical functional tests (e.g., sit-to-stand and stand from the floor) were confirmed.

Sex-Specific Differences in Lower Body Fat Distribution and Association with Physical Performance among Healthy Community-Dwelling Older Adults: A Pilot Study

This study aims to examine sex-specific differences in body composition and lower extremity fat distribution and their association with physical performance among healthy older adults. The pilot study comprises 40 subjects (20 men and 20 women) matched by age and body mass index. The participants undergo dual-energy X-ray absorptiometry, magnetic resonance imaging, and proton magnetic resonance spectroscopy (¹H-MRS) to assess body composition and lower extremity fat distribution. ¹H-MRS is used to measure the extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) contents of the lower leg muscles (soleus and tibialis anterior) at the maximum circumference of the calf after overnight fasting. The tibialis anterior IMCL, as assessed by ¹H-MRS, is negatively associated with the five-times sit-to-stand test scores (r_s = 0.518, p = 0.023) in men, while the soleus IMCL content is negatively associated with the timed up-and-go test scores (r_s = 0.472, p = 0.048) in women. However, the soleus EMCL content is positively associated with the five-times sit-to-stand test scores (r_s = −0.488, p = 0.040) in women, but this association is not statistically significant in men. This study shows an inverse correlation between IMCL content and physical performance in healthy older individuals and lower leg muscle-specific IMCL based on sex differences. Furthermore, our results suggest that greater EMCL content in the soleus and calf subcutaneous fat might affect physical performance positively in women but not men.

Contribution of skeletal muscle and serum lipids to muscle contraction induced by neuromuscular electrical stimulation in older individuals

Intramyocellular lipids (IMCL) stored in droplets in muscle cells and free fatty acids (FFA) from fat cells in the blood are the main substrates of adenosine triphosphate during continuous muscle contractions of relatively lower intensity. Although it is known that the lipid oxidative capacity decreases with aging, the effect of IMCL and FFA on muscle contraction in older individuals remains unclear. The purpose of this study was to investigate the contribution of skeletal muscle lipids and blood lipids as energy sources for muscle contraction in older individuals. Eighteen older individuals (mean age: 70.4 ± 3.5 years) underwent muscle contraction intervention induced by intermittent neuromuscular electrical stimulation (NMES) to the vastus lateralis for 30 min. Fasting blood samples were obtained and proton magnetic resonance spectroscopy (1 H-MRS) was performed before and after NMES, and the parameters (including IMCL and extramyocellular lipid [EMCL]) from 1 H-MRS, along with FFA and adiponectin levels, were analyzed using the blood samples of all participants. Levels of IMCL and EMCL did not change (p > 0.05); however, FFA and adiponectin levels decreased from 1.1 ± 0.5 mEq/L to 0.8 ± 0.2 mEq/L and 12.0 ± 5.3 μg/ml to 11.4 ± 5.0 μg/ml, after NMES (p < 0.05), respectively. These findings indicate that serum lipids, but not skeletal muscle lipids, are the energy substrate utilized during involuntary muscle contraction in older individuals.

Quantitative evaluation of bone marrow fat content and unsaturated fatty index in young male soccer players using proton magnetic resonance spectroscopy (1H-MRS): a preliminary study

Background

Marrow fat exists as a distinct adipose tissue and plays a critical role in affecting both the quantity and quality of bone. However, the effect of soccer training on marrow fat has been rarely reported. This study aims to evaluate and characterize the marrow fat content and composition in different bone areas of soccer players and age-matched healthy subjects using proton magnetic resonance spectroscopy (¹H-MRS).

Methods

Between May 2020 and June 2020, 20 professional soccer players (20.7±0.9 years) and 20 age-matched healthy subjects (21.2±0.8 years) were enrolled in this cross-sectional study. The ¹H-MRS were acquired from the 3^rd lumbar vertebrae, bilateral femoral necks, and distal tibias of all subjects using a single-voxel point-resolved spatially localized spectroscopy (PRESS) sequence. Four soccer players underwent a second magnetic resonance (MR) examination within a 30-minute interval after the initial scan to evaluate test-retest reproducibility. Inter- and intra-observer measurement reliabilities were assessed using 10 randomly selected spectra from the soccer players group. All spectra were processed using the jMRUI software package (http://www.jmrui.eu/). Quantified water and lipid signals were used to calculate fat content (FC) and the unsaturated fatty index (UI).

Results

Compared with healthy subjects, we found that soccer players had a lower FC in L3 and bilateral femoral necks and higher UI in the left femoral neck (P<0.05). All FC and UI values of the bilateral distal tibias showed no significant differences between the two groups (P>0.05). The UI values of the right femoral neck or distal tibia were markedly higher than the left side in both inactive subjects and soccer players (P<0.05, except for the femoral neck in players), and there were notable ΔUI differences in the lower limbs between the soccer players and the healthy subjects (P<0.05).

Conclusions

Soccer practice can be considered a positive sport that contributes to decreasing FC in lumbar vertebrae and femoral necks and increasing the UI in femoral necks. Quantitative MRS provides an ideal modality to predict marrow fat metabolism caused by mechanical stimulation.

Effect of electromyostimulation on intramyocellular lipids of the vastus lateralis in older adults: a randomized controlled trial

BACKGROUND

Excessive intramyocellular lipid (IMCL) accumulation is a primary cause of skeletal muscle insulin resistance, especially in older adults, and interventions that reduce IMCL contents are important to improve insulin sensitivity. Electromyostimulation (EMS)-induced changes in IMCL content in older adults remain unknown. The purpose of this study was to clarify the effects of a single bout of EMS on the IMCL content of the vastus lateralis muscle in older adults.

METHODS

Twenty-two physically active, non-obese older men and women were randomly assigned to an EMS intervention group (69.0 ± 5.2 years, n = 12) or a control group (68.4 ± 3.5 years, n = 10). EMS was applied to the vastus lateralis (7 s on and 7 s off) for 30 min; control participants sat quietly for 30 min. IMCL content within the vastus lateralis was quantified with ¹H-magnetic resonance spectroscopy (n = 7 per group). Fasting plasma glucose and insulin values were determined from blood samples collected before and after the EMS intervention.

RESULTS

EMS induced a significant reduction in plasma glucose (93.1 ± 9.6 to 89.5 ± 9.1 mg/dL, p < 0.01), but not IMCL content (15.7 ± 15.7 to 15.8 ± 13.1 mmol/kg wet weight, p = 0.49) or insulin (5.4 ± 2.4 to 4.7 ± 2.7 μIU/mL, p = 0.18). In the control group, no changes in IMCL content in the vastus lateralis was observed after prolonged quiet sitting.

CONCLUSION

EMS intervention for 30 min induces changes in plasma glucose, but no changes in IMCL content in older adults.

TRIAL REGISTRATION

University hospital Medical Information Network (UMIN) Center ID: UMIN000020126 . Retrospectively registered on December 222,015. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023242.

Magnetic Resonance Spectroscopic Analysis of Multifidus Muscle Lipid Contents and Association with Nociceptive Pain in Chronic Low Back Pain

Study Design

Cross-sectional study.

Purpose

This study aimed to analyze the differences in the lipid contents in chronic low back pain (CLBP) patients with nociceptive pain (NocP) and neuropathic pain (NeP) using magnetic resonance spectroscopy (MRS) of the multifidus muscle (Mm).

Overview of Literature

Early identification of the pain characteristics with CLBP is important because specific treatment approaches are required, depending on NocP and NeP.

Methods

The participants were 50 patients with CLBP (23 men and 27 women; mean age, 63.1±17.8 years; range, 41–79 years). We compared the Visual Analog Scale (VAS) scores, intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) of the Mm in NocP and NeP groups, as evaluated with the Japanese NeP screening questionnaire.

Results

The patients were categorized into the NocP (n=32) and NeP (n=18) groups. The mean VAS score of the NocP group was 59.3±3.1 mm and that of the NeP group was 73.6±4.6 mm. The mean VAS score was significantly higher in the NeP group as compared to that in the NocP group (p<0.01). As per the analysis of covariance for the VAS score, the mean IMCL levels of the Mm in the NocP and NeP groups were 722.3 mmol/L (95% confidence interval [CI], 611.4–833.1) and 484.8 mmol/L (95% CI, 381.1–588.5), respectively. The mean IMCL level was significantly higher in the NocP group than in the NeP group (p<0.05). The mean EMCL levels of the Mm for the NocP and NeP groups were 6,022.9 mmol/L (95% CI, 4,510.6–7,535.2) and 5,558.1 mmol/L (95% CI, 4,298.3–6,817.9), respectively; however, the difference was not significant (p=0.72).

Conclusions

The results indicated an association between the IMCL level of the Mm and NocP. Our results suggest that MRS of the Mm might be beneficial for the assessment of CLBP as well as appropriate targeted analgesic therapies.

Clinical and molecular evidence of accelerated ageing following very preterm birth

BACKGROUND

The mechanisms responsible for the associations between very preterm birth and a higher risk of poor cardiovascular and metabolic health in adult life are unknown.

METHODS

Here, we compare the clinical and molecular phenotypes of healthy, normal-weight young adults (18-27 years), born very preterm (<33 weeks gestational age (GA)) and at full-term (37-42 weeks GA). Outcomes included whole-body MRI, hepatic and muscle ¹H MRS, blood pressure measurements and telomere length.

RESULTS

We recruited 156 volunteers, 69 preterm (45 women; 24 men) and 87 born at full-term (45 women; 42 men). Preterm individuals had a significantly altered blood pressure profile, including higher systolic blood pressure (SBP mmHg: preterm men 133.4 ± 10.1, term men 23.0 ± 6.9; preterm women 124.3 ± 7.1, term women 118.4 ± 8.0, p < 0.01 for all). Furthermore, preterm men had fewer long telomeres (145-48.5 kb: preterm men 14.1 ± 0.9%, term men 17.8 ± 1.1%, p < 0.05; 48.5-8.6 kb: preterm men 28.2 ± 2.6, term men 37.0 ± 2.4%, p < 0.001) and a higher proportion of shorter telomeres (4.2-1.3 kb: preterm men 40.4 ± 3.5%, term men 29.9 ± 3.2%, p < 0.01).

CONCLUSION

Our data indicate that healthy young adults born very preterm manifest clinical and molecular evidence of accelerated ageing.

Proton MR spectroscopy of human pancreas allografts

OBJECTIVE

To estimate pancreas graft relaxation times and concentrations of total fat, and the intracellular lipids of non-adipose pancreatic cells (NAPC) using proton (¹H) magnetic resonance spectroscopy (MRS) during cold preservation.

MATERIALS AND METHODS

Grafts from 11 human donors were investigated. Each pancreas was perfused in situ with histidine-tryptophan-ketoglutarate (HTK) or with University of Wisconsin solution and placed into a transport container. Temperature of the grafts was maintained at 4 ± 2 °C during transport to our hospital and MR scanning. A 1.5 T clinical scanner was used for the measurements. Single-voxel PRESS spectra were acquired using transmit-receiver head coil.

RESULTS

Relaxation times were measured for lipid (-CH₂-)_n (T₁, 287 ± 60 ms; T₂, 27 ± 4 ms), and tissue water (T₁, 670 ± 69 ms; T₂, 77 ± 17 ms). Average total fat, and intracellular lipids of NAPC concentrations were 79.2 ± 100.8 (range 2.4-304.4), and 2.9 ± 1.2 mmol/kg ww, respectively.

CONCLUSION

We have shown that ¹H-MRS is a useful tool for the estimation of pancreas graft lipid concentrations. Total pancreatic fat and especially content of intracellular lipids of NAPC are valuable measures for inspection of graft quality prior to transplantation or islet of Langerhans isolation.

Effects of muscle fiber orientation to main magnetic field on muscle metabolite profiles for magnetic resonance spectroscopy acquisition

BACKGROUND

Proton magnetic resonance spectroscopy (¹H MRS) is a technique widely used for investigating metabolites in humans. Lipids are stored outside the muscle cell are called extramyocellular lipids (EMCL), and lipids stored on the inside of muscle cells are called intramyocellular lipids (IMCL). The relationship between metabolic syndrome and IMCL has been extensively studied.

AIM

To determine the effects of muscle fiber orientations on muscle metabolites using ¹H MRS.

METHODS

Chicken muscles were used as the subject in this study. MRS spectra were performed on a 1.5T Magnetic resonance imaging machine (1.5 Tesla Philips Achieva). A single voxel (8 mm × 8 mm × 20 mm) was placed on the chicken extensor iliotibialis lateralis muscle with the muscle fiber oriented at 0°, 30°, 60°, and 90° to the main magnetic field. ¹H MRS spectra were acquired using a point-resolved spectroscopy, TR = 2000 ms, TE = 30 ms, and NSA = 256. Metabolites of interest from each orientation to the main magnetic field were compared using Wilcoxon signed-rank test. Differences less than 0.05 were considered to be statistically significant with 95%CI.

RESULTS

The metabolite profiles were different for each orientation of muscle fibers to the main magnetic field. The orientation at 90° was the most different compared to other orientations. The quantity of IMCL and EMCL exhibited statistically significantly changes with impacts at 30°, 60°, and 90° when compared with muscles aligned at 0° to the main magnetic field. Statistical analysis showed statistically significant IMCL (CH₃), EMCL (CH₃), and IMCL (CH₂) at 30°, 60°, and 90° (P = 0.017, 0.018, and 0.018, respectively) and EMCL (CH₂) at 30° and 60° (P = 0.017 and 0.042, respectively). EMCL (CH₂) at 90° was unable to be measured in this study. The muscle lipids quantified at 30°, 60°, and 90° tended to be lower when compared to 0°.

CONCLUSION

Careful positioning is one of the most important factors to consider when studying ¹H MRS metabolites in muscles to ensure reproducibility and uniformity of muscle metabolite spectra.

Relationship between physical activity and intramyocellular lipid content is different between young and older adults

PURPOSE

Intramyocellular lipid (IMCL) is influenced by physical exercise; however, whether the habitual level of physical activity affects resting IMCL content remains unclear. The purpose of this study was to determine the relationship between physical activity levels and resting IMCL content in young and older adults.

METHODS

In total, 15 nonobese young adults (21.0 ± 0.0 years) and 15 older adults (70.7 ± 3.8 years) were recruited. Time spent performing physical activities for 10 days was assessed using a three-dimensional ambulatory accelerometer, and intensity was categorized as light [< 3.0 metabolic equivalents (METs)], moderate (3.0-6.0 METs), or vigorous (> 6.0 METs). Physical activity level was calculated as the product of METs and time spent performing physical activities (MET h) at each intensity level. The IMCL content in the vastus lateralis was determined using ¹H-magnetic resonance spectroscopy after overnight fasting.

RESULTS

No significant differences in IMCL content were observed between young and older adults. Vigorous intensity physical activity (time and MET h) was significantly lower in older than young adults (p < 0.01); this difference was not observed for light and moderate intensity physical activity. Light intensity physical activity (time and MET h) was significantly and inversely correlated with IMCL content in young adults (r = - 0.59 and r = - 0.58; both p < 0.05), but not in older adults.

CONCLUSIONS

These results suggest that daily light intensity physical activity reduces resting IMCL content in young adults, whereas no significant relationship was seen between daily physical activity and resting IMCL content in older adults.

Chemical shift-encoded MRI for assessment of bone marrow adipose tissue fat composition: Pilot study in premenopausal versus postmenopausal women

OBJECT

To quantify and compare subregional proximal femur bone marrow fat composition in premenopausal and postmenopausal women using chemical shift-encoded-MRI (CSE-MRI).

MATERIALS AND METHODS

A multi gradient-echo sequence at 3 T was used to scan both hips of premenopausal (n = 9) and postmenopausal (n = 18) women. Subregional fat composition (saturation, poly-unsaturation, mono-unsaturation) was quantitatively assessed in the femoral head, femoral neck, Ward's triangle, greater trochanter, and proximal shaft in bone marrow adipose tissue and separately within red and yellow marrow adipose tissue.

RESULTS

Significant differences in fat composition in postmenopausal compared to premenopausal women, which varied depending on the subregion analyzed, were found. Within both whole and yellow marrow adipose tissue, postmenopausal women demonstrated higher saturation (+14.7% to +43.3%), lower mono- (-11.4% to -33%) and polyunsaturation (-52 to -83%) (p < 0.05). Within red marrow adipose tissue, postmenopausal women demonstrated lower fat quantity (-16% to -24%) and decreased polyunsaturation (-80 to -120%) in the femoral neck, greater trochanter, and Ward's triangle (p < 0.05).

CONCLUSION

CSE-MRI can be used to detect subregional differences in proximal femur marrow adipose tissue composition between pre- and post-menopausal women in clinically feasible scan times.

Analysis of intra and extramyocellular lipids in the multifidus muscle in patients with chronic low back pain using MR spectroscopy

OBJECTIVE

To analyse the intra- (IMCL) and extramyocellular lipids (EMCL) concentration in the multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with low back pain (LBP), and to evaluate the correlation between those lipid concentrations and age, obesity, atrophy of the Mm and LBP intensity.

METHODS

60 LBP patients underwent routine diagnostic MRI of the lumbar spine before undergoing imaging for the study. Body mass index, as an indicator of obesity and visual analogue scale, as an indicator of LBP were also measured. Proton MRS was acquired with a single-voxel point-resolved spectroscopy sequence. Furthermore, the MRS volume of interest for measuring the IMCL and EMCL concentration at L4/5 for the right Mm was determined, and we measured the cross-sectional area of Mm as an indicator of muscle atrophy.

RESULTS

Age showed correlation with EMCL concentration (r = 0.314, p = 0.008). The body mass index showed correlation with EMCL concentration (r = 0.358, p = 0.005). The cross-sectional area of Mm showed correlation with EMCL concentration (r = -0.543, p < 0.001). Moreover, the LBP visual analogue scale showed correlation with IMCL concentration (r = 0.367, p = 0.004).

CONCLUSION

There were correlations between age, obesity, muscle atrophy, and EMCL concentration in Mm. IMCL concentration in Mm showed a correlation with LBP intensity. This may suggest that IMCL concentration could become an effective objective indicator of chronic LBP intensity. Advances in knowledge: We investigated the characteristics of fat content in Mm with LBP patients. This study was demonstrated the association of the IMCL and EMCL concentration in Mm with various patient parameters.

The influence of leg positioning on the appearance and quantification of 1H magnetic resonance muscle spectra obtained from calf muscle

PURPOSE

To study proton magnetic resonance spectra (¹H-MRS) of the muscle metabolite of a leg muscle in neutral (NEU), internal rotation (INT), and external rotation (EXT) leg positioning.

MATERIAL AND METHODS

The volunteers were selected for this study. The tibialis anterior (TA), soleus (SOL), and gastrocnemius (GAS) muscles of a non-dominate leg were determined by using single-voxel spectroscopy 8 × 8 × 20 mm³ in size. ¹H-MRS measurements were performed on a 1.5-Tesla magnetic resonance imaging (MRI) scanner.

RESULTS

The results showed that metabolite spectrum of muscle in each NEU, INT, and EXT of leg positioning were not similar. Additionally, the quantification of IMCL (CH₃) and EMCL (CH₃) is significantly different in SOL.

CONCLUSIONS

Our study showed that leg positioning influences the appearance and quantification of ¹H-MRS in the calf muscle. Hence, it is necessary to pay close attention to positioning because it interferes with spectral fitting and quantification.

1 H-MRS processing parameters affect metabolite quantification: The urgent need for uniform and transparent standardization

Proton magnetic resonance spectroscopy (¹ H-MRS) can be used to quantify in vivo metabolite levels, such as lactate, γ-aminobutyric acid (GABA) and glutamate (Glu). However, there are considerable analysis choices which can alter the accuracy or precision of ¹ H-MRS metabolite quantification. It is currently unknown to what extent variations in the analysis pipeline used to quantify ¹ H-MRS data affect outcomes. The purpose of this study was to evaluate whether the quantification of identical ¹ H-MRS scans across independent and experienced research groups would yield comparable results. We investigated the influence of model parameters and spectral quantification software on fitted metabolite concentration values. Sixty spectra in 30 individuals (repeated measures) were acquired using a 7-T MRI scanner. Data were processed by four independent research groups with the freedom to choose their own individualized and optimal parameter settings using LCModel software. Data were processed a second time in one group using an independent software package (NMRWizard) for an additional comparison with a different post-processing platform. Correlations across research groups of the ratio between the highest and, arguably, the most relevant resonances for neurotransmission [N-acetyl aspartate (NAA), N-acetyl aspartyl glutamate (NAAG) and Glu] over the total creatine [creatine (Cr) + phosphocreatine (PCr)] concentration, using Pearson's product-moment correlation coefficient (r), were calculated. Mean inter-group correlations using LCModel software were 0.87, 0.88 and 0.77 for NAA/Cr + PCr, NAA + NAAG/Cr + PCr and Glu/Cr + PCr, respectively. The mean correlations when comparing NMRWizard results with LCModel fitting results at University Medical Center Utrecht (UMCU) were 0.87, 0.89 and 0.71 for NAA/Cr + PCr, NAA + NAAG/Cr + PCr and Glu/Cr + PCr, respectively. Metabolite quantification using identical ¹ H-MRS data was influenced by processing parameters, basis sets and software choice. Locally preferred processing choices affected metabolite quantification, even when using identical software. Our results reinforce the notion that standard practices should be established to regularize outcomes of ¹ H-MRS studies, and that basis sets used for processing should be made available to the scientific community.

Effects of habitual aerobic exercise on the relationship between intramyocellular or extramyocellular lipid content and arterial stiffness

The accumulation of intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) is associated with arterial stiffness in middle-aged and older adults. Habitual aerobic exercise induces the improvement of arterial stiffness with reduction in fat accumulation. However, the relationship between aerobic exercise-induced changes in muscular lipids and arterial stiffness remains unclear. The purpose of this study was to investigate whether habitual aerobic exercise-induced changes in IMCL and EMCL content would lead to an improvement of arterial stiffness. First, in a cross-sectional study, we investigated whether cardiorespiratory fitness level affects the association between IMCL or EMCL content and arterial stiffness in 60 middle-aged and older subjects (61.0±1.3 years). Second, in an intervention study, we examined whether aerobic exercise training-induced changes in IMCL and EMCL content are associated with a reduction in arterial stiffness in 18 middle-aged and older subjects (67.0±1.7 years). In the cross-sectional study, IMCL content was negatively correlated with brachial-ankle pulse wave velocity (baPWV) (r=-0.47, P<0.05), whereas EMCL content was positively correlated with baPWV (r=0.48, P<0.05) in the low-fitness group, but was not correlated in the high-fitness group. Furthermore, 8-week aerobic exercise training in older adults increased IMCL content and reduced EMCL content. The training-induced change in baPWV was negatively correlated with training-induced changes in IMCL but was positively correlated with training-induced changes in EMCL. These findings suggest that aerobic exercise training-induced changes in IMCL and EMCL content may be related to a reduction in arterial stiffness in middle-aged and older adults.

Intramuscular adipose tissue determined by T1-weighted MRI at 3T primarily reflects extramyocellular lipids

PURPOSE

The purpose of this study was to assess relationships between intramuscular adipose tissue (IntraMAT) content determined by MRI and intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) determined by (1)H magnetic resonance spectroscopy ((1)H MRS) or echo intensity determined by B-mode ultrasonography of human skeletal muscles.

METHODS

Thirty young and elderly men and women were included. T1-weighted MRI was taken from the right mid-thigh to measure IntraMAT content of the vastus lateralis (VL) and biceps femoris (BF) using a histogram shape-based thresholding technique. IMCL and EMCL were measured from the VL and BF at the right mid-thigh using (1)H MRS. Ultrasonographic images were taken from the VL and BF of the right mid-thigh to measure echo intensity based on gray-scale level for quantitative analysis.

RESULTS

There was a significant correlation between IntraMAT content by MRI and EMCL of the VL and BF (VL, r=0.506, P<0.01; BF, r=0.591, P<0.001) and between echo intensity and EMCL of the VL and BF (VL, r=0.485, P<0.05; BF, r=0.648, P<0.01). IntraMAT content was also significantly correlated with echo intensity of the VL and BF (VL, r=0.404, P<0.05; BF, r=0.493, P<0.01).

CONCLUSION

Our study suggests that IntraMAT content determined by T1-weighted MRI at 3T primarily reflects extramyocellular lipids, not intramyocellular lipids, in human skeletal muscles.

In vivo high-resolution magic angle spinning magnetic and electron paramagnetic resonance spectroscopic analysis of mitochondria-targeted peptide in Drosophila melanogaster with trauma-induced thoracic injury

Trauma is the most common cause of mortality among individuals aged between 1 and 44 years and the third leading cause of mortality overall in the US. In this study, we examined the effects of trauma on the expression of genes in Drosophila melanogaster, a useful model for investigating genetics and physiology. After trauma was induced by a non-lethal needle puncture of the thorax, we observed the differential expression of genes encoding for mitochondrial uncoupling proteins, as well as those encoding for apoptosis-related and insulin signaling-related proteins, thus indicating muscle functional dysregulation. These results prompted us to examine the link between insulin signaling and mitochondrial dysfunction using in vivo nuclear magnetic resonance (NMR) with complementary electron paramagnetic resonance (EPR) spectroscopy. Trauma significantly increased insulin resistance biomarkers, and the NMR spectral profile of the aged flies with trauma-induced thoracic injury resembled that of insulin-resistant chico mutant flies. In addition, the mitochondrial redox status, as measured by EPR, was significantly altered following trauma, indicating mitochondrial uncoupling. A mitochondria-targeted compound, Szeto-Schiller (SS)-31 that promotes adenosine triphosphate (ATP) synthesis normalized the NMR spectral profile, as well as the mitochondrial redox status of the flies with trauma-induced thoracic injury, as assessed by EPR. Based on these findings, we propose a molecular mechanism responsible for trauma-related mortality and also propose that trauma sequelae in aging are linked to insulin signaling and mitochondrial dysfunction. Our findings further suggest that SS-31 attenuates trauma-associated pathological changes.

A 3-day high-fat/low-carbohydrate diet does not alter exercise-induced growth hormone response in healthy males

OBJECTIVE

The purpose of the present study was to examine the effects of 3 days isoenergetic high-fat/low-carbohydrate diet (HF-LC) relative to low-fat/high-carbohydrate diet (LF-HC) on the exercise-induced growth hormone (GH) response in healthy male subjects.

DESIGN

Ten healthy young males participated in this study. Each subject consumed the HF-LC (18±1% protein, 61±2% fat, 21±1% carbohydrate, 2720 kcal per day) for 3 consecutive days after consuming the LF-HC (18±1% protein, 20±1% fat, 62±1% carbohydrate, 2755 kcal per day) for 3 consecutive days. After each dietary intervention period, the hormonal and metabolic responses to an acute exercise (30 min of continuous pedaling at 60% of V˙O2max) were compared. The intramyocellular lipid (IMCL) contents in the vastus lateralis, soleus, and tibialis anterior were evaluated by proton magnetic resonance spectroscopy.

RESULTS

Serum GH concentrations increased significantly during the exercise after both the HF-LC and LF-HC periods (P<0.05). However, the exercise-induced GH response was not significantly different between the two periods. Fat utilization and lipolytic responses during the exercise were enhanced significantly after the HF-LC period compared with the LF-HC period. IMCL content did not differ significantly in any portion of muscle after the dietary interventions.

CONCLUSIONS

We could not show that short-term HF-LC consumption changed significantly exercise-induced GH response or IMCL content in healthy young males.

Intramyocellular and Extramyocellular Lipids Are Associated With Arterial Stiffness

BACKGROUND

Obese and overweight patients are at increased risk of arterial stiffness, and visceral, epicardial and hepatic fat accumulation is associated with cardiovascular disease risk. In general, muscular lipids are stored either in interstitial adipose tissue (extramyocellular lipid (EMCL)) or in lipid droplets within muscle cells (intramyocellular lipid (IMCL)). However, the association between IMCL or EMCL content and arterial stiffness remains unclear. This cross-sectional study aimed to clarify this association.

METHODS

A total of 237 subjects (18-81 years) were enrolled in this study. The IMCL and EMCL contents of the right vastus lateralis muscle were evaluated by proton magnetic resonance spectroscopy. Arterial stiffness was estimated using brachial-ankle pulse wave velocity (baPWV).

RESULTS

There were significant correlations between baPWV and the contents of both IMCL (R = -0.23, P < 0.001) and EMCL (R = 0.53, P < 0.001) in all subjects. The baPWV negatively correlated with IMCL content (R = -0.45, P < 0.001) in females only. In contrast, significant positive correlations were observed between baPWV and EMCL content in both males (R = 0.59, P < 0.001) and females (R = 0.55, P < 0.001). IMCL and EMCL contents contributed independently to baPWV variation after adjustment for age, sex, body mass index, visceral and subcutaneous abdominal fat, upper and lower limb fat, blood pressure, heart rate, and lipid profiles.

CONCLUSION

These results suggest that IMCL and EMCL contents may be a risk factor for arterial stiffness, and this association differed with gender and age.

Chronic reduction of plasma free fatty acid improves mitochondrial function and whole-body insulin sensitivity in obese and type 2 diabetic individuals

Insulin resistance and dysregulation of free fatty acid (FFA) metabolism are core defects in type 2 diabetic (T2DM) and obese normal glucose tolerant (NGT) individuals. Impaired muscle mitochondrial function (reduced ATP synthesis) also has been described in insulin-resistant T2DM and obese subjects. We examined whether reduction in plasma FFA concentration with acipimox improved ATP synthesis rate and altered reactive oxygen species (ROS) production. Eleven NGT obese and 11 T2DM subjects received 1) OGTT, 2) euglycemic insulin clamp with muscle biopsy, and 3) (1)H-magnetic resonance spectroscopy of tibialis anterior muscle before and after acipimox (250 mg every 6 h for 12 days). ATP synthesis rate and ROS generation were measured in mitochondria isolated from muscle tissue ex vivo with chemoluminescence and fluorescence techniques, respectively. Acipimox 1) markedly reduced the fasting plasma FFA concentration and enhanced suppression of plasma FFA during oral glucose tolerance tests and insulin clamp in obese NGT and T2DM subjects and 2) enhanced insulin-mediated muscle glucose disposal and suppression of hepatic glucose production. The improvement in insulin sensitivity was closely correlated with the decrease in plasma FFA in obese NGT (r = 0.81) and T2DM (r = 0.76) subjects (both P < 0.001). Mitochondrial ATP synthesis rate increased by >50% in both obese NGT and T2DM subjects and was strongly correlated with the decrease in plasma FFA and increase in insulin-mediated glucose disposal (both r > 0.70, P < 0.001). Production of ROS did not change after acipimox. Reduction in plasma FFA in obese NGT and T2DM individuals improves mitochondrial ATP synthesis rate, indicating that the mitochondrial defect in insulin-resistant individuals is, at least in part, reversible.

4 weeks of high-intensity interval training does not alter the exercise-induced growth hormone response in sedentary men

This study determined the effects of high-intensity interval training on the exercise-induced growth hormone (GH) responses, whole body and regional fat content. Twenty-four sedentary males were randomized to either a high-intensity interval training (HIT) group or a low-intensity continuous training (LT) group. The HIT group performed intermittent exercises at 85% of , whereas the LT group performed continuous exercise for 22 min at 45% of . Before and after 4 weeks of training, hormonal and metabolic responses to acute exercise were determined. Acute exercise significantly increased GH concentrations in both groups (p < 0.05). However, the responses did not change after training period in either group. Furthermore, the training did not significantly affect intramyocellular or intrahepatic lipid content in either group. The present study indicates that 4 weeks of high-intensity interval training does not alter the exercise-induced GH responses, whole body fat mass or intramyocellular and intrahepatic lipid content in sedentary males.

Different quantification algorithms may lead to different results: a comparison using proton MRS lipid signals

Proton magnetic resonance spectroscopy (MRS) is a sensitive method for investigating the biochemical compounds in a tissue. The interpretation of the data relies on the quantification algorithms applied to MR spectra. Each of these algorithms has certain underlying assumptions and may allow one to incorporate prior knowledge, which could influence the quality of the fit. The most commonly considered types of prior knowledge include the line-shape model (Lorentzian, Gaussian, Voigt), knowledge of the resonating frequencies, modeling of the baseline, constraints on the damping factors and phase, etc. In this article, we study whether the statistical outcome of a biological investigation can be influenced by the quantification method used. We chose to study lipid signals because of their emerging role in the investigation of metabolic disorders. Lipid spectra, in particular, are characterized by peaks that are in most cases not Lorentzian, because measurements are often performed in difficult body locations, e.g. in visceral fats close to peristaltic movements in humans or very small areas close to different tissues in animals. This leads to spectra with several peak distortions. Linear combination of Model spectra (LCModel), Advanced Method for Accurate Robust and Efficient Spectral fitting (AMARES), quantitation based on QUantum ESTimation (QUEST), Automated Quantification of Short Echo-time MRS (AQSES)-Lineshape and Integration were applied to simulated spectra, and area under the curve (AUC) values, which are proportional to the quantity of the resonating molecules in the tissue, were compared with true values. A comparison between techniques was also carried out on lipid signals from obese and lean Zucker rats, for which the polyunsaturation value expressed in white adipose tissue should be statistically different, as confirmed by high-resolution NMR measurements (considered the gold standard) on the same animals. LCModel, AQSES-Lineshape, QUEST and Integration gave the best results in at least one of the considered groups of simulated or in vivo lipid signals. These outcomes highlight the fact that quantification methods can influence the final result and its statistical significance.

jSIPRO - analysis tool for magnetic resonance spectroscopic imaging

Magnetic resonance spectroscopic imaging (MRSI) involves a huge number of spectra to be processed and analyzed. Several tools enabling MRSI data processing have been developed and widely used. However, the processing programs primarily focus on sophisticated spectra processing and offer limited support for the analysis of the calculated spectroscopic maps. In this paper the jSIPRO (java Spectroscopic Imaging PROcessing) program is presented, which is a java-based graphical interface enabling post-processing, viewing, analysis and result reporting of MRSI data. Interactive graphical processing as well as protocol controlled batch processing are available in jSIPRO. jSIPRO does not contain a built-in fitting program. Instead, it makes use of fitting programs from third parties and manages the data flows. Currently, automatic spectra processing using LCModel, TARQUIN and jMRUI programs are supported. Concentration and error values, fitted spectra, metabolite images and various parametric maps can be viewed for each calculated dataset. Metabolite images can be exported in the DICOM format either for archiving purposes or for the use in neurosurgery navigation systems.

Whole body, regional fat accumulation, and appetite-related hormonal response after hypoxic training

The present study was conducted to determine change in regional fat accumulation and appetite-related hormonal response following hypoxic training. Twenty sedentary subjects underwent hypoxic (n = 9, HYPO, FiO(2) = 15%) or normoxic training (n = 11, NOR, FiO(2) = 20·9%) during a 4-week period (3 days per week). They performed a 4-week training at 55% of maximal oxygen uptake (V·O(2max)) for each condition. Before and after the training period, V·O(2max), whole body fat mass, abdominal fat area, intramyocellular lipid content (IMCL), fasting and postprandial appetite-related hormonal responses were determined. Both groups showed a significant increase in V·O(2max) following training (P<0·05). Whole body and segmental fat mass, abdominal fat area, IMCL did not change in either group. Fasting glucose and insulin concentrations significantly reduced in both groups (P<0·05). Although area under the curve for the postprandial blood glucose concentrations significantly decreased in both groups (P<0·05), the change was significantly greater in the HYPO group than in the NOR group (P<0·05). Changes in postprandial plasma ghrelin were similar in both groups. A significant reduction of postprandial leptin response was observed in both groups (P<0·05), while postprandial glucagon-like peptide-1 (GLP-1) concentrations increased significantly in the NOR group only (P<0·05). In conclusion, hypoxic training for 4 weeks resulted in greater improvement in glucose tolerance without loss of whole body fat mass, abdominal fat area or IMCL. However, hypoxic training did not have synergistic effect on the regulation of appetite-related hormones.

Influence of foot orientation on the appearance and quantification of 1H magnetic resonance muscle spectra obtained from the soleus and the vastus lateralis

Muscle (1)H magnetic resonance spectroscopy noninvasively measures intramyocellular lipid levels, which correlate with obesity, insulin resistance, and type 2 diabetes. The appearance of muscle magnetic resonance spectra is influenced by bulk magnetic susceptibility and residual dipolar couplings which depend on the angle between the muscle fibers and the main magnetic field. This study used a 4 T magnet to examine the influence of foot orientation on the appearance and quantification of muscle magnetic resonance spectra from the soleus and the vastus lateralis. For each individual, intramyocellular lipid, extramyocellular lipid, and creatine concentrations were quantified in the soleus and the vastus lateralis during one session. Foot orientation was found to influence the appearance of muscle spectra from the soleus but not from the vastus lateralis. It was concluded that quantifying intramyocellular lipid by the standard LCModel using a water reference may be more appropriate than using a creatine reference in the presence of residual dipolar couplings.

Comparison of 3.0 T proton magnetic resonance spectroscopy short and long echo-time measures of intramyocellular lipids in obese and normal-weight women

PURPOSE

To compare correlations of intramyocellular lipids (IMCL) measured by short and long echo-time proton magnetic resonance spectroscopy (1H-MRS) with indices of body composition and insulin resistance in obese and normal-weight women.

MATERIALS AND METHODS

We quantified IMCL of tibialis anterior (TA) and soleus (SOL) muscles in 52 premenopausal women (37 obese and 15 normal weight) using single-voxel 1H-MRS PRESS at 3.0 T with short (30 msec) and long (144 msec) echo times. Statistical analyses were performed to determine correlations of IMCL with body composition as determined by computed tomography (CT) and insulin resistance indices and to compare correlation coefficients from short and long echo-time data. Signal-to-noise ratio (SNR), linewidth, and coefficients of variation (CV) of short and long echo-time spectra were calculated.

RESULTS

Short and long echo-time IMCL from TA and SOL significantly correlated with body mass index (BMI) and abdominal fat depots (r = 0.32 to 0.70, P = <0.05), liver density (r = -0.39 to -0.50, P < 0.05), and glucose area under the curve as a measure of insulin resistance (r = 0.47 to 0.49, P < 0.05). There was no significant difference between correlation coefficients of short and long echo-time spectra (P > 0.5). Short echo-time IMCL in both muscles showed significantly higher SNR (P < 0.0001) and lower CVs when compared to long echo-time acquisitions. Linewidth measures were not significantly different between groups.

CONCLUSION

IMCL quantification using short and long echo-time 1H-MRS at 3.0 T is useful to detect differences in muscle lipid content in obese and normal-weight subjects. In addition, IMCL correlates with body composition and markers of insulin resistance in this population with no significant difference in correlations between short and long echo-times. Short echo-time IMCL quantification of TA and SOL muscles at 3.0 T was superior to long echo-time due to better SNR and better reproducibility.

In vivo high-resolution magic angle spinning magnetic resonance spectroscopy of Drosophila melanogaster at 14.1 T shows trauma in aging and in innate immune-deficiency is linked to reduced insulin signaling

In vivo magnetic resonance spectroscopy (MRS), a non-destructive biochemical tool for investigating live organisms, has yet to be used in the fruit fly Drosophila melanogaster, a useful model organism for investigating genetics and physiology. We developed and implemented a high-resolution magic-angle-spinning (HRMAS) MRS method to investigate live Drosophila at 14.1 T. We demonstrated, for the first time, the feasibility of using HRMAS MRS for molecular characterization of Drosophila with a conventional MR spectrometer equipped with an HRMAS probe. We showed that the metabolic HRMAS MRS profiles of injured, aged wild-type (wt) flies and of immune deficient (imd) flies were more similar to chico flies mutated at the chico gene in the insulin signaling pathway, which is analogous to insulin receptor substrate1-4 (IRS1-4) in mammals and less to those of adipokinetic hormone receptor (akhr) mutant flies, which have an obese phenotype. We thus provide evidence for the hypothesis that trauma in aging and in innate immune-deficiency is linked to insulin signaling. This link may explain the mitochondrial dysfunction that accompanies insulin resistance and muscle wasting that occurs in trauma, aging and immune system deficiencies, leading to higher susceptibility to infection. Our approach advances the development of novel in vivo non-destructive research approaches in Drosophila, suggests biomarkers for investigation of biomedical paradigms, and thus may contribute to novel therapeutic development.