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Giacona JM, Afridi A, Bezan Petric U, Johnson T, Pastor J, Ren J, Sandon L, Malloy C, Pandey A, Shah A, Berry JD, Moe OW, Vongpatanasin W. Association between dietary phosphate intake and skeletal muscle energetics in adults without cardiovascular disease. J Appl Physiol (1985) 2024; 136:1007-1014. [PMID: 38482570 DOI: 10.1152/japplphysiol.00818.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/05/2024] [Accepted: 02/24/2024] [Indexed: 04/17/2024] Open
Abstract
Highly bioavailable inorganic phosphate (Pi) is present in large quantities in the typical Western diet and represents a large fraction of total phosphate intake. Dietary Pi excess induces exercise intolerance and skeletal muscle mitochondrial dysfunction in normal mice. However, the relevance of this to humans remains unknown. The study was conducted on 13 individuals without a history of cardiopulmonary disease (46% female, 15% Black participants) enrolled in the pilot-phase of the Dallas Heart and Mind Study. Total dietary phosphate was estimated from 24-h dietary recall (ASA24). Muscle ATP synthesis was measured at rest, and phosphocreatinine (PCr) dynamics was measured during plantar flexion exercise using 7-T 31P magnetic resonance (MR) spectroscopy in the calf muscle. Correlation was assessed between dietary phosphate intake normalized to total caloric intake, resting ATP synthesis, and PCr depletion during exercise. Higher dietary phosphate intake was associated with lower resting ATP synthesis (r = -0.62, P = 0.03), and with higher levels of PCr depletion during plantar flexion exercise relative to the resting period (r = -0.72; P = 0.004). These associations remain significant after adjustment for age and estimated glomerular filtration rate (both P < 0.05). High dietary phosphate intake was also associated with lower serum Klotho levels, and Klotho levels are in turn associated with PCr depletion and higher ADP accumulation post exercise. Our study suggests that higher dietary phosphate is associated with reduced skeletal muscle mitochondrial function at rest and exercise in humans providing new insight into potential mechanisms linking the Western diet to impaired energy metabolism.NEW & NOTEWORTHY This is the first translational research study directly demonstrating the adverse effects of dietary phosphate on muscle energy metabolism in humans. Importantly, our data show that dietary phosphate is associated with impaired muscle ATP synthesis at rest and during exercise, independent of age and renal function. This is a new biologic paradigm with significant clinical dietary implications.
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Affiliation(s)
- John M Giacona
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Areeb Afridi
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Ursa Bezan Petric
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Talon Johnson
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Johanne Pastor
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Lona Sandon
- Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Craig Malloy
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Ambarish Pandey
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Amil Shah
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jarett D Berry
- Department of Internal Medicine, University of Texas Health Science Center at Tyler, Tyler, Texas, United States
| | - Orson W Moe
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Wanpen Vongpatanasin
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
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Ren J, Rodriguez L, Johnson T, Henning A, Dhaher YY. 17β-Estradiol Effects in Skeletal Muscle: A 31P MR Spectroscopic Imaging (MRSI) Study of Young Females during Early Follicular (EF) and Peri-Ovulation (PO) Phases. Diagnostics (Basel) 2024; 14:235. [PMID: 38337751 PMCID: PMC10854839 DOI: 10.3390/diagnostics14030235] [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: 12/17/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
The natural variation in estrogen secretion throughout the female menstrual cycle impacts various organs, including estrogen receptor (ER)-expressed skeletal muscle. Many women commonly experience increased fatigue or reduced energy levels in the days leading up to and during menstruation, when blood estrogen levels decline. Yet, it remains unclear whether endogenous 17β-estradiol, a major estrogen component, directly affects the energy metabolism in skeletal muscle due to the intricate and fluctuating nature of female hormones. In this study, we employed 2D 31P FID-MRSI at 7T to investigate phosphoryl metabolites in the soleus muscle of a cohort of young females (average age: 28 ± 6 years, n = 7) during the early follicular (EF) and peri-ovulation (PO) phases, when their blood 17β-estradiol levels differ significantly (EF: 28 ± 18 pg/mL vs. PO: 71 ± 30 pg/mL, p < 0.05), while the levels of other potentially interfering hormones remain relatively invariant. Our findings reveal a reduction in ATP-referenced phosphocreatine (PCr) levels in the EF phase compared to the PO phase for all participants (5.4 ± 4.3%). Furthermore, we observe a linear correlation between muscle PCr levels and blood 17β-estradiol concentrations (r = 0.64, p = 0.014). Conversely, inorganic phosphate Pi and phospholipid metabolite GPC levels remain independent of 17β-estradiol but display a high correlation between the EF and PO phases (p = 0.015 for Pi and p = 0.0008 for GPC). The robust association we have identified between ATP-referenced PCr and 17β-estradiol suggests that 17β-estradiol plays a modulatory role in the energy metabolism of skeletal muscle.
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Affiliation(s)
- Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Luis Rodriguez
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA;
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Talon Johnson
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Anke Henning
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Yasin Y. Dhaher
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA;
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Vongpatanasin W, Giacona JM, Pittman D, Murillo A, Khan G, Wang J, Johnson T, Ren J, Moe OW, Pak CCY. Potassium Magnesium Citrate Is Superior to Potassium Chloride in Reversing Metabolic Side Effects of Chlorthalidone. Hypertension 2023; 80:2611-2620. [PMID: 37846572 PMCID: PMC10843503 DOI: 10.1161/hypertensionaha.123.21932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Thiazide diuretics (TD) are the first-line treatment of hypertension because of its consistent benefit in lowering blood pressure and cardiovascular risk. TD is also known to cause an excess risk of diabetes, which may limit long-term use. Although potassium (K) depletion was thought to be the main mechanism of TD-induced hyperglycemia, TD also triggers magnesium (Mg) depletion. However, the role of Mg supplementation in modulating metabolic side effects of TD has not been investigated. Therefore, we aim to determine the effect of potassium magnesium citrate (KMgCit) on fasting plasma glucose and liver fat by magnetic resonance imaging during TD therapy. METHODS Accordingly, we conducted a double-blinded RCT in 60 nondiabetic hypertension patients to compare the effects of KCl versus KMgCit during chlorthalidone treatment. Each patient received chlorthalidone alone for 3 weeks before randomization. Primary end point was the change in fasting plasma glucose after 16 weeks of KCl or KMgCit supplementation from chlorthalidone alone. RESULTS The mean age of subjects was 59±11 years (30% Black participants). Chlorthalidone alone induced a significant rise in fasting plasma glucose, and a significant fall in serum K, serum Mg, and 24-hour urinary citrate excretion (all P<0.05). KMgCit attenuated the rise in fasting plasma glucose by 7.9 mg/dL versus KCl (P<0.05), which was not observed with KCl. There were no significant differences in liver fat between the 2 groups. CONCLUSIONS KMgCit is superior to KCl, the common form of K supplement used in clinical practice, in preventing TD-induced hyperglycemia. This action may improve tolerability and cardiovascular safety in patients with hypertension treated with this drug class.
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Affiliation(s)
- Wanpen Vongpatanasin
- Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research (W.V., O.W.M., C.C.Y.P.), University of Texas Southwestern Medical Center, Dallas
| | - John M Giacona
- Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas
- Department of Applied Clinical Research (J.M.G., J.W.), University of Texas Southwestern Medical Center, Dallas
| | - Danielle Pittman
- Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas
| | - Ashley Murillo
- Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas
| | - Ghazi Khan
- Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas
| | - Jijia Wang
- Department of Applied Clinical Research (J.M.G., J.W.), University of Texas Southwestern Medical Center, Dallas
| | - Talon Johnson
- Advanced Imaging Research Center (T.J., J.R.), University of Texas Southwestern Medical Center, Dallas
| | - Jimin Ren
- Advanced Imaging Research Center (T.J., J.R.), University of Texas Southwestern Medical Center, Dallas
| | - Orson W Moe
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research (W.V., O.W.M., C.C.Y.P.), University of Texas Southwestern Medical Center, Dallas
- Department of Internal Medicine, Division of Nephrology (O.W.M.), University of Texas Southwestern Medical Center, Dallas
- Department of Physiology (O.W.M.), University of Texas Southwestern Medical Center, Dallas
| | - Charles C Y Pak
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research (W.V., O.W.M., C.C.Y.P.), University of Texas Southwestern Medical Center, Dallas
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Widmaier M, Lim SI, Wenz D, Xin L. Fast in vivo assay of creatine kinase activity in the human brain by 31 P magnetic resonance fingerprinting. NMR IN BIOMEDICINE 2023; 36:e4998. [PMID: 37424110 DOI: 10.1002/nbm.4998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 05/15/2023] [Accepted: 06/12/2023] [Indexed: 07/11/2023]
Abstract
A new and efficient magnetisation transfer 31 P magnetic resonance fingerprinting (MT-31 P-MRF) approach is introduced to measure the creatine kinase metabolic ratek CK between phosphocreatine (PCr) and adenosine triphosphate (ATP) in human brain. The MRF framework is extended to overcome challenges in conventional 31 P measurement methods in the human brain, enabling reduced acquisition time and specific absorption rate (SAR). To address the challenge of creating and matching large multiparametric dictionaries in an MRF scheme, a nested iteration interpolation method (NIIM) is introduced. As the number of parameters to estimate increases, the size of the dictionary grows exponentially. NIIM can reduce the computational load by breaking dictionary matching into subsolutions of linear computational order. MT-31 P-MRF combined with NIIM providesT 1 PCr ,T 1 ATP andk CK estimates in good agreement with those obtained by the exchange kinetics by band inversion transfer (EBIT) method and literature values. Furthermore, the test-retest reproducibility results showed that MT-31 P-MRF achieves a similar or better coefficient of variation (<12%) forT 1 ATP andk CK measurements in 4 min 15 s, than EBIT with 17 min 4 s scan time, enabling a fourfold reduction in scan time. We conclude that MT-31 P-MRF in combination with NIIM is a fast, accurate, and reproducible approach for in vivok CK assays in the human brain, which enables the potential to investigate energy metabolism in a clinical setting.
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Affiliation(s)
- Mark Widmaier
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Laboratory for Functional and Metabolic Imaging, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
- Animal Imaging and Technology, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Song-I Lim
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Laboratory for Functional and Metabolic Imaging, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
- Animal Imaging and Technology, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Daniel Wenz
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Animal Imaging and Technology, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Lijing Xin
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Animal Imaging and Technology, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
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Carrell T, Gu M, Bosshard JC, Sun C, McDougall MP, Wright SM. Assessing the Feasibility of Dynamic 31P Spectroscopy for Metabolic Studies with a 1.0T Extremity Scanner. IEEE Trans Biomed Eng 2021; 69:1975-1982. [PMID: 34855583 DOI: 10.1109/tbme.2021.3132252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: The feasibility of conducting in vivo non-localized 31P Magnetic Resonance Spectroscopy (MRS) with a 1.0T extremity scanner and the potential to increase accessibility of this important diagnostic tool for low cost applications is revisited. Methods: This work presents a custom transmit-only quadrature birdcage, four-element receive coil array, and spectrometer interfaced to a commercial ONI 1.0T magnet for enabling multi-channel, non-1H frequency capabilities. A custom, magnetic resonance compatible plantar flexion-extension exercise device was also developed to enable exercise protocols. The coils were assessed with bench measurements and 31P phantom studies before an in vivo demonstration. Results: In pulse and acquire spectroscopy of a phantom, the array was found to improve the signal-to-noise ratio (SNR) by a factor of 1.31 and reduce the linewidth by 13.9% when compared to a large loop coil of the same overall size. In vivo testing results show that two averages and a four second repetition time for a temporal resolution of eight seconds was sufficient to obtain phosphocreatine recovery values and baseline pH levels aligned with expected literature values. Conclusion: Initial in vivo human skeletal muscle 31P MRS allowed successful monitoring of metabolic changes during an 18-minute exercise protocol. Significance: Adding an array coil and multinuclear capability to a commercial low-cost 1.0T extremity scanner enabled the observation of characteristic 31P metabolic information, such as the phosphocreatine recovery rate and underlying baseline pH.
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Meyerspeer M, Boesch C, Cameron D, Dezortová M, Forbes SC, Heerschap A, Jeneson JA, Kan HE, Kent J, Layec G, Prompers JJ, Reyngoudt H, Sleigh A, Valkovič L, Kemp GJ. 31 P magnetic resonance spectroscopy in skeletal muscle: Experts' consensus recommendations. NMR IN BIOMEDICINE 2020; 34:e4246. [PMID: 32037688 PMCID: PMC8243949 DOI: 10.1002/nbm.4246] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 05/07/2023]
Abstract
Skeletal muscle phosphorus-31 31 P MRS is the oldest MRS methodology to be applied to in vivo metabolic research. The technical requirements of 31 P MRS in skeletal muscle depend on the research question, and to assess those questions requires understanding both the relevant muscle physiology, and how 31 P MRS methods can probe it. Here we consider basic signal-acquisition parameters related to radio frequency excitation, TR, TE, spectral resolution, shim and localisation. We make specific recommendations for studies of resting and exercising muscle, including magnetisation transfer, and for data processing. We summarise the metabolic information that can be quantitatively assessed with 31 P MRS, either measured directly or derived by calculations that depend on particular metabolic models, and we give advice on potential problems of interpretation. We give expected values and tolerable ranges for some measured quantities, and minimum requirements for reporting acquisition parameters and experimental results in publications. Reliable examination depends on a reproducible setup, standardised preconditioning of the subject, and careful control of potential difficulties, and we summarise some important considerations and potential confounders. Our recommendations include the quantification and standardisation of contraction intensity, and how best to account for heterogeneous muscle recruitment. We highlight some pitfalls in the assessment of mitochondrial function by analysis of phosphocreatine (PCr) recovery kinetics. Finally, we outline how complementary techniques (near-infrared spectroscopy, arterial spin labelling, BOLD and various other MRI and 1 H MRS measurements) can help in the physiological/metabolic interpretation of 31 P MRS studies by providing information about blood flow and oxygen delivery/utilisation. Our recommendations will assist in achieving the fullest possible reliable picture of muscle physiology and pathophysiology.
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Affiliation(s)
- Martin Meyerspeer
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
- High Field MR CenterMedical University of ViennaViennaAustria
| | - Chris Boesch
- DBMR and DIPRUniversity and InselspitalBernSwitzerland
| | - Donnie Cameron
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
| | - Monika Dezortová
- MR‐Unit, Department of Diagnostic and Interventional RadiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Sean C. Forbes
- Department of Physical TherapyUniversity of FloridaGainesvilleFloridaUSA
| | - Arend Heerschap
- Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | - Jeroen A.L. Jeneson
- Department of RadiologyAmsterdam University Medical Center|site AMCAmsterdamthe Netherlands
- Cognitive Neuroscience CenterUniversity Medical Center GroningenGroningenthe Netherlands
- Center for Child Development and Exercise, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Hermien E. Kan
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
- Duchenne CenterThe Netherlands
| | - Jane Kent
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
| | - Gwenaël Layec
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
- Institute for Applied Life SciencesUniversity of MassachusettsAmherstMAUSA
| | | | - Harmen Reyngoudt
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of Myology AIM‐CEAParisFrance
| | - Alison Sleigh
- Wolfson Brain Imaging CentreUniversity of CambridgeCambridgeUK
- Wellcome Trust‐MRC Institute of Metabolic ScienceUniversity of CambridgeCambridgeUK
- NIHR/Wellcome Trust Clinical Research FacilityCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Ladislav Valkovič
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), RDM Cardiovascular Medicine, BHF Centre of Research ExcellenceUniversity of OxfordOxfordUK
- Department of Imaging MethodsInstitute of Measurement Science, Slovak Academy of SciencesBratislavaSlovakia
| | - Graham J. Kemp
- Department of Musculoskeletal Biology and Liverpool Magnetic Resonance Imaging Centre (LiMRIC)University of LiverpoolLiverpoolUK
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