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Durelle C, Delmont E, Michel C, Trabelsi A, Hostin MA, Ogier A, Bendahan D, Attarian S. Quantification of muscle involvement in familial amyloid polyneuropathy using MRI. Eur J Neurol 2023; 30:3286-3295. [PMID: 37422895 DOI: 10.1111/ene.15970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/09/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND PURPOSE Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a rare genetic disease with autosomal-dominant inheritance. In this study, we aimed to quantify fatty infiltration (fat fraction [FF]) and magnetization transfer ratio (MTR) in individual muscles of patients with symptomatic and asymptomatic TTR-FAP using magnetic resonance imaging. Secondarily, we aimed to assess correlations with clinical and electrophysiological variables. METHODS A total of 39 patients with a confirmed mutation in the TTR gene (25 symptomatic and 14 asymptomatic) and 14 healthy volunteers were included. A total of 16 muscles were manually delineated in the nondominant lower limb from T1-weighted anatomical images. The corresponding masks were propagated on the MTR and FF maps. Detailed neurological and electrophysiological examinations were conducted in each group. RESULTS The MTR was decreased (42.6 AU; p = 0.001) and FF was elevated (14%; p = 0.003) in the lower limbs of the symptomatic group, with preferential posterior and lateral involvement. In the asymptomatic group, elevated FF was quantified in the gastrocnemius lateralis muscle (11%; p = 0.021). FF was significantly correlated with disease duration (r = 0.49, p = 0.015), neuropathy impairment score for the lower limb (r = 0.42, p = 0.041), Overall Neuropathy Limitations Scale score (r = 0.49, p = 0.013), polyneuropathy disability score (r = 0.57, p = 0.03) and the sum of compound muscle action potential (r = 0.52, p = 0.009). MTR was strongly correlated to FF (r = 0.78, p < 0.0001), and a few muscles with an FF within the normal range had a reduced MTR. CONCLUSION These observations suggest that FF and MTR could be interesting biomarkers in TTR-FAP. In asymptomatic patients, FF in the gastrocnemius lateralis muscle could be a good indicator of the transition from an asymptomatic to a symptomatic form of the disease. MTR could be an early biomarker of muscle alterations.
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Affiliation(s)
- Clémence Durelle
- Centre de référence des maladies neuromusculaires et de la SLA, hôpitaux universitaires de Marseille, Marseille, France
| | - Emilien Delmont
- Centre de référence des maladies neuromusculaires et de la SLA, hôpitaux universitaires de Marseille, Marseille, France
| | - Constance Michel
- Centre de résonance magnétique biologique et médicale (Crmbm), Marseille, France
| | - Amira Trabelsi
- Aix-Marseille Univ, CNRS, Centrale Marseille, Institute Fresnel, Marseille, France
| | - Marc-Adrien Hostin
- Centre de résonance magnétique biologique et médicale (Crmbm), Marseille, France
| | - Augustin Ogier
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - David Bendahan
- Centre de résonance magnétique biologique et médicale (Crmbm), Marseille, France
| | - Shahram Attarian
- Centre de référence des maladies neuromusculaires et de la SLA, hôpitaux universitaires de Marseille, Marseille, France
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Fahrner A, Alchus Laiferová N, Ukropcová B, Ukropec J, Krützfeldt J. Activation of PDGF Signaling in the Adult Muscle Stem Cell Niche in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab 2023; 108:2052-2064. [PMID: 36702759 PMCID: PMC10348470 DOI: 10.1210/clinem/dgad041] [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: 07/09/2022] [Revised: 01/07/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
CONTEXT Type 2 diabetes mellitus (T2D) negatively affects muscle mass and function throughout life. Whether adult muscle stem cells contribute to the decrease in muscle health is not clear and insights into the stem cell niche are difficult to obtain. OBJECTIVE To establish the upstream signaling pathway of microRNA (miR)-501, a marker of activated myogenic progenitor cells, and interrogate this pathway in muscle biopsies from patients with T2D. METHODS Analysis of primary muscle cell cultures from mice and 4 normoglycemic humans and muscle biopsies from 7 patients with T2D and 7 normoglycemic controls using gene expression, information on histone methylation, peptide screening, and promoter assays. RESULTS miR-501 shares the promoter of its host gene, isoform 2 of chloride voltage-gated channel 5 (CLCN5-2), and miR-501 expression increases during muscle cell differentiation. We identify platelet-derived growth factor (PDGF) as an upstream regulator of CLCN5-2 and miR-501 via Janus kinase/signal transducer and activator of transcription. Skeletal muscle biopsies from patients with T2D revealed upregulation of PDGF (1.62-fold, P = .002), CLCN5-2 (2.85-fold, P = .03), and miR-501 (1.73-fold, P = .02) compared with normoglycemic controls. In addition, we observed a positive correlation of PDGF and miR-501 in human skeletal muscle (r = 0.542, P = .045, n = 14). CONCLUSIONS We conclude that paracrine signaling in the adult muscle stem cells niche is activated in T2D. Expression analysis of the PDGF-miR-501 signaling pathway could represent a powerful tool to classify patients in clinical trials that aim to improve muscle health and glucose homeostasis in patients with diabetes.
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Affiliation(s)
- Alexandra Fahrner
- Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, 8091 Zurich, Switzerland
- Life Science Zurich Graduate School, Biomedicine, University of Zurich, 8057 Zurich, Switzerland
| | - Nikoleta Alchus Laiferová
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
| | - Barbara Ukropcová
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia
| | - Jozef Ukropec
- Department of Metabolic Disease Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
| | - Jan Krützfeldt
- Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Zurich, 8091 Zurich, Switzerland
- Life Science Zurich Graduate School, Biomedicine, University of Zurich, 8057 Zurich, Switzerland
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3
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Sacco ICN, Trombini-Souza F, Suda EY. Impact of biomechanics on therapeutic interventions and rehabilitation for major chronic musculoskeletal conditions: A 50-year perspective. J Biomech 2023; 154:111604. [PMID: 37159980 DOI: 10.1016/j.jbiomech.2023.111604] [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: 01/26/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
The pivotal role of biomechanics in the past 50 years in consolidating the basic knowledge that underpins prevention and rehabilitation measures has made this area a great spotlight for health practitioners. In clinical practice, biomechanics analysis of spatiotemporal, kinematic, kinetic, and electromyographic data in various chronic conditions serves to directly enhance deeper understanding of locomotion and the consequences of musculoskeletal dysfunctions in terms of motion and motor control. It also serves to propose straightforward and tailored interventions. The importance of this approach is supported by myriad biomechanical outcomes in clinical trials and by the development of new interventions clearly grounded on biomechanical principles. Over the past five decades, therapeutic interventions have been transformed from fundamentally passive in essence, such as orthoses and footwear, to emphasizing active prevention, including exercise approaches, such as bottom-up and top-down strengthening programs for runners and people with osteoarthritis. These approaches may be far more effective inreducing pain, dysfunction, and, ideally, incidence if they are based on the biomechanical status of the affected person. In this review, we demonstrate evidence of the impact of biomechanics and motion analysis as a foundation for physical therapy/rehabilitation and preventive strategies for three chronic conditions of high worldwide prevalence: diabetes and peripheral neuropathy, knee osteoarthritis, and running-related injuries. We conclude with a summary of recommendations for future studies needed to address current research gaps.
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Affiliation(s)
- Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Eneida Yuri Suda
- Postgraduate Program in Physiotherapy, Universidade Ibirapuera, São Paulo, Brazil
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Le Corre A, Caron N, Turpin NA, Dalleau G. Mechanisms underlying altered neuromuscular function in people with DPN. Eur J Appl Physiol 2023:10.1007/s00421-023-05150-2. [PMID: 36763123 DOI: 10.1007/s00421-023-05150-2] [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: 08/05/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
Diabetes alters numerous physiological functions and can lead to disastrous consequences in the long term. Neuromuscular function is particularly affected and is impacted early, offering an opportunity to detect the onset of diabetes-related dysfunctions and follow the advancement of the disease. The role of physical training for counteracting the deleterious effects of diabetes is well accepted but at the same time, it appears difficult to reliably assess the effects of exercise on functional capacity in patients with diabetic peripheral neuropathy (DPN). In this paper, we will review the specific characteristics of various neuromuscular dysfunctions associated with diabetes according to the DPN presence or not, and their changes over time. We present several propositions regarding the onset of neuromuscular alterations in people with diabetes compared to people with DPN. It appears that motor unit loss and neuromuscular transmission impairment are among the main mechanisms explaining the considerable degradation of neuromuscular function in the transition from a diabetic to neuropathic state. Rate of force development and contractile properties could start to decrease with the onset of preferential type II fiber atrophy, commonly reported in people with DPN. Finally, Mmax amplitude could decrease with neuromuscular fatigue only in people with DPN, reflecting the fatigue-related neuromuscular transmission impairment reported in people with DPN. In this review, we show that the different neuromuscular parameters are altered at different stages of diabetes, according to the presence of DPN or not. The precise evaluation of these parameters might participate in adapting the physical training prescription.
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Affiliation(s)
- Antonin Le Corre
- IRISSE (EA 4075), UFR SHE, University of La Réunion, 117 Rue du Général Ailleret, 97430, Le Tampon, France.
| | - Nathan Caron
- IRISSE (EA 4075), UFR SHE, University of La Réunion, 117 Rue du Général Ailleret, 97430, Le Tampon, France
| | - Nicolas A Turpin
- IRISSE (EA 4075), UFR SHE, University of La Réunion, 117 Rue du Général Ailleret, 97430, Le Tampon, France
| | - Georges Dalleau
- IRISSE (EA 4075), UFR SHE, University of La Réunion, 117 Rue du Général Ailleret, 97430, Le Tampon, France
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Favretto MA, Andreis FR, Cossul S, Negro F, Oliveira AS, Marques JLB. Differences in motor unit behavior during isometric contractions in patients with diabetic peripheral neuropathy at various disease severities. J Electromyogr Kinesiol 2023; 68:102725. [PMID: 36436278 DOI: 10.1016/j.jelekin.2022.102725] [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: 12/29/2021] [Revised: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to determine whether HD-sEMG is sensitive to detecting changes in motor unit behavior amongst healthy adults and type 2 diabetes mellitus (T2DM) patients presenting diabetic peripheral neuropathy (DPN) at different levels. Healthy control subjects (CON, n = 8) and T2DM patients presenting no DPN symptoms (ABS, n = 8), moderate DPN (MOD, n = 18), and severe DPN (SEV, n = 12) performed isometric ankle dorsiflexion at 30 % maximum voluntary contraction while high-density surface EMG (HD-sEMG) was recorded from the tibialis anterior muscle. HD-sEMG signals were decomposed, providing estimates of discharge rate, motor unit conduction velocity (MUCV), and motor unit territory area (MUTA). As a result, the ABS group presented reduced MUCV compared to CON. The groups with diabetes presented significantly larger MUTA compared to the CON group (p < 0.01), and the SEV group presented a significantly lower discharge rate compared to CON and ABS (p < 0.01). In addition, the SEV group presented significantly higher CoVforce compared to CON and MOD. These results support the use of HD-SEMG as a method to detect peripheral and central changes related to DPN.
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Affiliation(s)
- Mateus André Favretto
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
| | - Felipe Rettore Andreis
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Sandra Cossul
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Francesco Negro
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
| | | | - Jefferson Luiz Brum Marques
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Tan Y, Liu X, Yang Y, Li B, Yu F, Zhao W, Fu C, Yu X, Han Z, Cheng M. Metabolomics analysis reveals serum biomarkers in patients with diabetic sarcopenia. Front Endocrinol (Lausanne) 2023; 14:1119782. [PMID: 37033246 PMCID: PMC10073735 DOI: 10.3389/fendo.2023.1119782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION Diabetic sarcopenia (DS) is characterized by muscle atrophy, slower nerve conduction, reduced maximum tension generated by skeletal muscle contraction, and slower contraction rate. Hence, DS can cause limb movement degeneration, slow movement, reduced balance, reduced metabolic rate, falls, fractures, etc. Moreover, the relevant early biological metabolites and their pathophysiological mechanism have yet to be characterized. METHOD The current cross-sectional study employed serum metabolomics analysis to screen potential noninvasive biomarkers in patients with diabetic sarcopenia. A total of 280 diabetic patients were enrolled in the study (n = 39 sarcopenia [DS], n = 241 without sarcopenia [DM]). Ten patients were randomly selected from both groups. Non-targeted metabolomic analysis was performed by ultra-high-performance liquid chromatography-electrospray ionization tandem mass spectrometry. RESULTS A total of 632 differential metabolites were identified, including 82 that were significantly differentially abundant (P < 0.05, VIP > 1, FC > 1.2 or FC < 0.8). Compared with the DM group, the contents of pentadecanoic acid, 5'-methylthioadenosine (5'-MTA), N,N-dimethylarginine (asymmetric dimethylarginine, ADMA), and glutamine in the DS group were significantly increased, while that of isoxanthohumol was decreased. DISCUSSION Based on receiver operating characteristic curve analysis, pentadecanoic acid, 5'-MTA, ADMA, and glutamine may serve as potential biomarkers of DS. Moreover, ATP-binding cassette (ABC) transporters and the mammalian target of the rapamycin signaling pathway were found to potentially have important regulatory roles in the occurrence and development of DS (P < 0.05). Collectively, the differential metabolites identified in this study provide new insights into the underlying pathophysiology of DS and serve as a basis for therapeutic interventions.
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Affiliation(s)
- Yuwei Tan
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Xiaosong Liu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Yinping Yang
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Baoying Li
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Aixinzhuoer Medical Laboratory, Jinan, China
| | - Fei Yu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Wenqian Zhao
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Chunli Fu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Xin Yu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Zhenxia Han
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
| | - Mei Cheng
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Jinan Clinical Research Center for Geriatric Medicine (202132001), Jinan, China
- *Correspondence: Mei Cheng,
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Mohapatra S, Ramachandran M, Behera KK, Priyadarsini N, Nanda P, Devi S. Association of peripheral neuropathy with skeletal muscle mass and function in type two diabetes mellitus patients: A cross-sectional study. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Association of peripheral neuropathy with skeletal muscle mass and function in type two diabetes mellitus patients: A cross-sectional study. ENDOCRINOLOGIA, DIABETES Y NUTRICION 2022; 69:591-599. [PMID: 36446485 DOI: 10.1016/j.endien.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND & OBJECTIVE Diabetic peripheral neuropathy (DPN) is considered to be a risk factor for development of sarcopenia. Therefore, our study aimed to detect the association between peripheral neuropathy with skeletal muscle mass and function in type two diabetes mellitus (T2DM) patients. METHODS A total of 176 participants, ≥45 years were included in the study. Out of 176, 60 were healthy volunteers, 60 had T2DM without neuropathy, 56 had T2DM with neuropathy. In all the participants peripheral nerve function was assessed by nerve conduction studies (Common peroneal and Sural nerve) and sarcopenia parameters were evaluated according to the Asian Working Group for Sarcopenia (AWGS) criteria. RESULTS The present study suggested that diabetic peripheral neuropathy (DPN) was associated with decline in muscle mass, which was found only in men. Our study showed a positive correlation between appendicular skeletal muscle index (ASMI) and common peroneal nerve amplitude and sural nerve amplitude with r=0.527, p<0.05; r=0.847, p<0.001 respectively. Furthermore, in multiple linear regression analyses, we found a positive relationship between ASMI and sural nerve amplitude after adjustment for confounders like age, duration of diabetes, and HbA1C (B=0.739; p<0.001). CONCLUSION As DPN patients are more prone to developing sarcopenia, and periodic assessment of skeletal muscle mass and function is warranted to initiate early lifestyle interventions in these patients, which will improve their quality of life.
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Wannarong T, Sukpornchairak P, Naweera W, Geiger CD, Ungprasert P. Association between diabetic peripheral neuropathy and sarcopenia: A systematic review and meta‐analysis. Geriatr Gerontol Int 2022; 22:785-789. [DOI: 10.1111/ggi.14462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Thapat Wannarong
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
- Neuromuscular Division, Department of Neurology Duke University Hospital Durham North Carolina USA
| | - Persen Sukpornchairak
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
| | - Weerakit Naweera
- Nephrology Division, Department of Internal Medicine King Narai Hospital Lopburi Thailand
| | - Christopher D. Geiger
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
| | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases Cleveland Clinic Foundation Cleveland Ohio USA
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Bidirectional roles of skeletal muscle fibro-adipogenic progenitors in homeostasis and disease. Ageing Res Rev 2022; 80:101682. [PMID: 35809776 DOI: 10.1016/j.arr.2022.101682] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/09/2022] [Accepted: 07/04/2022] [Indexed: 02/07/2023]
Abstract
Sarcopenia and myopathies cause progressive muscle weakness and degeneration, which are closely associated with fat infiltration and fibrosis in muscle. Recently, experimental research has shed light on fibro-adipogenic progenitors (FAPs), also known as muscle-resident mesenchymal progenitors with multiple differentiation potential for adipogenesis, fibrosis, osteogenesis and chondrogenesis. They are considered key regulators of muscle homeostasis and integrity. They play supportive roles in muscle development and repair by orchestrating the regulatory interplay between muscle stem cells (MuSCs) and immune cells. Interestingly, FAPs also contribute to intramuscular fat infiltration, fibrosis and other pathologies when the functional integrity of the network is compromised. In this review, we summarize recent insights into the roles of FAPs in maintenance of skeletal muscle homeostasis, and discuss the underlying mechanisms regulating FAPs behavior and fate, highlighting their roles in participating in efficient muscle repair and fat infiltrated muscle degeneration as well as during muscle atrophy. We suggest that controlling and predicting FAPs differentiation may become a promising strategy to improve muscle function and prevent irreparable muscle damage.
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Orlando G, Balducci S, Boulton AJM, Degens H, Reeves ND. Neuromuscular dysfunction and exercise training in people with diabetic peripheral neuropathy: A narrative review. Diabetes Res Clin Pract 2022; 183:109183. [PMID: 34929255 DOI: 10.1016/j.diabres.2021.109183] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 11/21/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is a common condition that is associated with neuromuscular dysfunction and peripheral sensory impairment. These deficits predispose patients to sensory and motor system limitations, foot ulcers and a high risk of falls. Exercise training has been proposed as an effective tool to alleviate neural deficits and improve whole-body function. Here we review the effects of DPN on neuromuscular function, the mechanisms underlying this impairment, and the neural and muscular adaptations to exercise training. Muscle dysfunction is an early hallmark of DPN. Deficits in muscle strength, power, mass and a greater fatigability are particularly severe in the lower extremity muscles. Non-enzymatic glycation of motor proteins, impaired excitation-contraction coupling and loss of motor units have been indicated as the main factors underlying muscular dysfunction. Among the exercise-based solutions, aerobic training improves neural structure and function and ameliorates neuropathic signs and symptoms. Resistance training induces marked improvement of muscle performance and may alleviate neuropathic pain. A combination of aerobic and resistance training (i.e., combined training) restores small sensory nerve damage, reduces symptoms, and improves muscle function. The evidence so far suggests that exercise training is highly beneficial and should be included in the standard care for DPN patients.
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Affiliation(s)
- Giorgio Orlando
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.
| | | | - Andrew J M Boulton
- Department of Medicine, Manchester Royal Infirmary, Manchester, UK; Diabetes Research Institute, University of Miami, Miami, FL, USA
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK; Lithuanian Sport University, Kaunas, Lithuania
| | - Neil D Reeves
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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Wang Z, Peng S, Zhang H, Sun H, Hu J. Gait Parameters and Peripheral Neuropathy in Patients With Diabetes: A Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:891356. [PMID: 35721708 PMCID: PMC9199374 DOI: 10.3389/fendo.2022.891356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate the relationship between diabetic peripheral neuropathy (DPN) and gait abnormality in diabetic patients. METHODS Related research concerning the gait of diabetic patients with and without DPN was collected and analyzed by searching PubMed, Embase, and Web of Science. Statistical analysis was performed by using RevMan 5.3 software. RESULTS Twenty-one studies were included in this meta-analysis, consisting of 499 diabetic neuropathy patients and 467 diabetes controls without neuropathy. Meta-analysis results showed lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment in the DPN group, compared with their counterparts. CONCLUSION Among diabetic patients, those complicated with DPN possess lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment.
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Affiliation(s)
- Zhenchao Wang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Si Peng
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Endocrinology, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Honghong Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Sun
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Hong Sun, ; Ji Hu,
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Hong Sun, ; Ji Hu,
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Farup J, Just J, de Paoli F, Lin L, Jensen JB, Billeskov T, Roman IS, Cömert C, Møller AB, Madaro L, Groppa E, Fred RG, Kampmann U, Gormsen LC, Pedersen SB, Bross P, Stevnsner T, Eldrup N, Pers TH, Rossi FMV, Puri PL, Jessen N. Human skeletal muscle CD90 + fibro-adipogenic progenitors are associated with muscle degeneration in type 2 diabetic patients. Cell Metab 2021; 33:2201-2214.e11. [PMID: 34678202 PMCID: PMC9165662 DOI: 10.1016/j.cmet.2021.10.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/29/2021] [Accepted: 10/01/2021] [Indexed: 01/12/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with impaired skeletal muscle function and degeneration of the skeletal muscles. However, the mechanisms underlying the degeneration are not well described in human skeletal muscle. Here we show that skeletal muscle of T2DM patients exhibit degenerative remodeling of the extracellular matrix that is associated with a selective increase of a subpopulation of fibro-adipogenic progenitors (FAPs) marked by expression of THY1 (CD90)-the FAPCD90+. We identify platelet-derived growth factor (PDGF) as a key FAP regulator, as it promotes proliferation and collagen production at the expense of adipogenesis. FAPsCD90+ display a PDGF-mimetic phenotype, with high proliferative activity, clonogenicity, and production of extracellular matrix. FAPCD90+ proliferation was reduced by in vitro treatment with metformin. Furthermore, metformin treatment reduced FAP content in T2DM patients. These data identify a PDGF-driven conversion of a subpopulation of FAPs as a key event in the fibrosis development in T2DM muscle.
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Affiliation(s)
- Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark.
| | - Jesper Just
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus 8200, Denmark; Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark
| | - Frank de Paoli
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Lin Lin
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Jonas Brorson Jensen
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Tine Billeskov
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark; Diabetes and Hormonal Diseases, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Ines Sanchez Roman
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus 8000, Denmark; Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid 28670, Spain
| | - Cagla Cömert
- Molecular Research Unit, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark
| | - Andreas Buch Møller
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Luca Madaro
- Department of AHFMO, University of Rome "la Sapienza," Rome 00185, Italy
| | - Elena Groppa
- The University of British Columbia, Vancouver BC CA V6T, Canada
| | - Rikard Göran Fred
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen 2200, Denmark
| | - Ulla Kampmann
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Lars C Gormsen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Steen B Pedersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark; Diabetes and Hormonal Diseases, Aarhus University Hospital, Aarhus 8200, Denmark
| | - Peter Bross
- Molecular Research Unit, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark
| | - Tinna Stevnsner
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus 8000, Denmark
| | - Nikolaj Eldrup
- Department of Vascular Surgery, Rigshospitalet, Copenhagen 2100, Denmark
| | - Tune H Pers
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen 2200, Denmark
| | - Fabio M V Rossi
- The University of British Columbia, Vancouver BC CA V6T, Canada
| | - Pier Lorenzo Puri
- Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Niels Jessen
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus 8200, Denmark; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus 8200, Denmark.
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Reeves ND, Orlando G, Brown SJ. Sensory-Motor Mechanisms Increasing Falls Risk in Diabetic Peripheral Neuropathy. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57050457. [PMID: 34066681 PMCID: PMC8150714 DOI: 10.3390/medicina57050457] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/16/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is associated with peripheral sensory and motor nerve damage that affects up to half of diabetes patients and is an independent risk factor for falls. Clinical implications of DPN-related falls include injury, psychological distress and physical activity curtailment. This review describes how the sensory and motor deficits associated with DPN underpin biomechanical alterations to the pattern of walking (gait), which contribute to balance impairments underpinning falls. Changes to gait with diabetes occur even before the onset of measurable DPN, but changes become much more marked with DPN. Gait impairments with diabetes and DPN include alterations to walking speed, step length, step width and joint ranges of motion. These alterations also impact the rotational forces around joints known as joint moments, which are reduced as part of a natural strategy to lower the muscular demands of gait to compensate for lower strength capacities due to diabetes and DPN. Muscle weakness and atrophy are most striking in patients with DPN, but also present in non-neuropathic diabetes patients, affecting not only distal muscles of the foot and ankle, but also proximal thigh muscles. Insensate feet with DPN cause a delayed neuromuscular response immediately following foot–ground contact during gait and this is a major factor contributing to increased falls risk. Pronounced balance impairments measured in the gait laboratory are only seen in DPN patients and not non-neuropathic diabetes patients. Self-perception of unsteadiness matches gait laboratory measures and can distinguish between patients with and without DPN. Diabetic foot ulcers and their associated risk factors including insensate feet with DPN and offloading devices further increase falls risk. Falls prevention strategies based on sensory and motor mechanisms should target those most at risk of falls with DPN, with further research needed to optimise interventions.
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Sneag DB, Tan ET. Can Quantitative MRI Be Used to Differentiate Physiologic Changes Behind Muscle Weakness in Type 2 Diabetes Mellitus? Radiology 2020; 297:620-621. [PMID: 33064035 PMCID: PMC7706872 DOI: 10.1148/radiol.2020203768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Darryl B. Sneag
- From the MRI Laboratory, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021
| | - Ek T. Tan
- From the MRI Laboratory, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021
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Stouge A, Khan KS, Kristensen AG, Tankisi H, Schlaffke L, Froeling M, Væggemose M, Andersen H. MRI of Skeletal Muscles in Participants with Type 2 Diabetes with or without Diabetic Polyneuropathy. Radiology 2020; 297:608-619. [PMID: 33048033 DOI: 10.1148/radiol.2020192647] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundDiabetic polyneuropathy (DPN) is associated with loss of muscle strength. MRI including diffusion-tensor imaging (DTI) may enable detection of muscle abnormalities related to type 2 diabetes mellitus (DM2) and DPN.PurposeTo assess skeletal muscle abnormalities in participants with DM2 with or without DPN by using MRI.Materials and MethodsThis prospective cross-sectional study included participants with DM2 and DPN (DPN positive), participants with DM2 without DPN (DPN negative), and healthy control (HC) participants enrolled between August 2017 and June 2018. Muscle strength at the knee and ankle was determined with isokinetic dynamometry. MRI of the lower extremities included the Dixon sequence, multicomponent T2 mapping, and DTI calculated fat fractions (FFs), T2 relaxation of muscle (T2water), fractional anisotropy (FA), and diffusivity (mean, axial, and radial). One-way analysis of variance and Tukey honestly significant difference were applied for comparison between groups, and multivariate regression models were used for association between MRI parameters, nerve conduction, strength, and body mass index (BMI).ResultsTwenty participants with DPN (mean age, 65 years ± 9 [standard deviation]; 70% men; mean BMI, 34 kg/m2 ± 5), 20 participants without DPN (mean age, 64 years ± 9; 55% men; mean BMI, 30 kg/m2 ± 6), and 20 HC participants (mean age, 61 years ± 10; 55% men; mean BMI, 27 kg/m2 ± 5) were enrolled in this study. Muscle strength adjusted for age, sex, and BMI was lower in participants with DPN than in DPN-negative and HC participants in the upper and lower leg (plantar flexors [PF], 62% vs 78% vs 89%; P < .001; knee extensors [KE], 73% vs 95% vs 93%; P < .001). FF was higher in leg muscle groups of participants with DPN than in DPN-negative and HC participants (PF, 20% vs 10% vs 8%; P < .001; KE, 13% vs 8% vs 6%; P < .001). T2water was prolonged in leg muscle groups of participants with DPN when compared with HC participants (PF, 33 msec vs 31 msec; P < .001; KE, 32 msec vs 31 msec; P = .002) and in the lower leg when compared with participants without DPN (PF, 33 msec vs 32 msec; P = .03). In multivariate regression models, strength was associated with FA (b = -0.0004), T2water (b = -0.03 msec), and FF (b = -0.1%) at thigh level (P < .001). Furthermore, FA (b = -0.007), T2water (b = -0.53 msec), and FF (b = -4.0%) were associated with nerve conduction at calf level (P < .001).ConclusionMRI of leg muscle groups revealed fat accumulation, differences in water composition, and structural changes in participants with type 2 diabetes mellitus and neuropathy. Abnormalities were most pronounced in the plantar flexors.© RSNA, 2020Online supplemental material is available for this article.See also the editorial by Sneag and Tan in this issue.
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Affiliation(s)
- Anders Stouge
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Karolina S Khan
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Alexander G Kristensen
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Hatice Tankisi
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Lara Schlaffke
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Martijn Froeling
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Michael Væggemose
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Henning Andersen
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
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Wu R, Zhang Y, Bai JJ, Sun J, Bao ZJ, Wang Z. Impact of lower limb muscle strength on walking function beyond aging and diabetes. J Int Med Res 2020; 48:300060520928826. [PMID: 32589863 PMCID: PMC7436777 DOI: 10.1177/0300060520928826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective This study was performed to investigate the influence of lower limb muscle strength on the walking function of advanced-age patients with diabetes. Methods In this cross-sectional descriptive study, data were collected from 202 advanced-age patients with diabetes. All patients completed questionnaires, the one-leg stance test, the timed up-and-go test, the 30-s sit-to-stand test, and plantar pressure platform measurements. The patients were divided in two groups according to their lower limb muscle strength: those with declining muscle strength and those with normal muscle strength. Results Walking function was significantly abnormal in the patients with declining lower limb muscle strength. The gait trajectories were abnormal, mainly with respect to a shortage of driving force. Conclusion The lower limb muscle strength can affect the static balance and dynamic balance in advanced-age patients with declining lower limb muscle strength.
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Affiliation(s)
- Ran Wu
- Department of Nursing, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yan Zhang
- Clinical Key Laboratory of Geriatric Medicine, Shanghai, China.,Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiao-Jiao Bai
- Department of Nursing, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiao Sun
- Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Zhi-Jun Bao
- Clinical Key Laboratory of Geriatric Medicine, Shanghai, China.,Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Zheng Wang
- Department of Nursing, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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Huang L, Zhang Y, Wang Y, Shen X, Yan S. Diabetic Peripheral Neuropathy Is Associated With Higher Systolic Blood Pressure in Adults With Type 2 Diabetes With and Without Hypertension in the Chinese Han Population. Can J Diabetes 2019; 44:615-623. [PMID: 32276832 DOI: 10.1016/j.jcjd.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Our aim in this study was to investigate the association between diabetic peripheral neuropathy (DPN) and above-normal blood pressure in nonhypertensive adult patients with type 2 diabetes mellitus (T2DM). We also compared achievement of clinical targets for DPN and non-DPN with T2DM. METHODS A retrospective survey was administered to 3,810 patients with T2DM. Cases were grouped according to the Toronto Clinical Scoring System as follows: non-DPN, mild DPN, moderate DPN and severe DPN. A total of 1,835 patients (hypertensive, 1,247; nonhypertensive, 588) also underwent nerve conduction velocity testing, and then was divided into quartile groups. RESULTS Irrespective of hypertension, systolic blood pressure (SBP) and glycated hemoglobin levels in the DPN group were higher than those in the non-DPN group (p<0.001). In hypertensive patients, blood pressure goal achievement was lower in the DPN group compared with the non-DPN group (31.1% vs 40.5%, p<0.05). Compared with the nerve conduction velocity Q1 (<P25%) group, optimal SBP of the Q2 (P25% to P50%), Q3 (P50% to P75%) and Q4 (>P75%) groups decreased by 62.2%, 68.2% and 78.0%, respectively. In the nonhypertensive patients, detection of optimal SBP was lower in the DPN group than in the non-DPN group (p<0.05). After adjusting for age, sex and diabetes duration (model 2), a 3-point higher DPN score on the Toronto Clinical Scoring System was associated with an SBP level of 4.2 mmHg higher (95% confidence interval, 0.01 to 0.17; p<0.01) in nonhypertensive patients with diabetes. CONCLUSIONS DPN is associated with difficulty in hypertension management in T2DM. It is also associated with elevated systolic blood hypertension, even in nonhypertensive patients with diabetes. Elevated SBP in nonhypertensive T2DM may be also worthy of further attention.
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Affiliation(s)
- Lingning Huang
- Endocrinology Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yongze Zhang
- Endocrinology Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yunmin Wang
- Endocrinology Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Ximei Shen
- Endocrinology Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Sunjie Yan
- Endocrinology Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Diabetes Research Institute of Fujian Province, Fuzhou, Fujian, China.
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Yasemin Ö, Seydahmet A, Özcan K. Relationship between diabetic neuropathy and sarcopenia. Prim Care Diabetes 2019; 13:521-528. [PMID: 31126745 DOI: 10.1016/j.pcd.2019.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The present study was designed to examine the prevalence of sarcopenia in patients who have Diabetic Neuropathy (DN); and to determine the relation between DN and sarcopenia. MATERIAL AND METHODS A total of 602 diabetic patients (mean age 60.2 ± 10.6 years; 40.5% male) were included in the study, which was designed as a cross-sectional study. The body composition was measured with the bioimpedance analysis method, and the muscle strength was measured by evaluating the hand grip strength. Those who showed only reduced handgrip strength were categorized in the s-presarcopenia group, whereas patients with only muscle volume loss were categorized in the v-presarcopenia group, those who had them together were defined as sarcopenia; and sarcopenia that was accompanied by obesity was defined as sarcopenic obesity. DN consisted of Diabetic Sensorimotor Polyneuropathy (DSPN) and Diabetic Autonomic Neuropathies (DAN) as two large groups. DAN consisted of its sub-groups of Cardiovascular Autonomic Neuropathy (CV-AN), Gastrointestinal Autonomic Neuropathy (GI-AN), Genitourinary Autonomic Neuropathy (GU-AN), Sudomotor Autonomic Neuropathy (SM-AN), which were identified with their own methods. Logistic regression analyzes were carried out to determine the relations of DN and its subgroups with sarcopenia and its components. RESULTS The DN prevalence was determined to be 85% in the entire patient population; and it was 80.2% in those who had normal muscle mass and strength, 84.4% in s-presarcopenic patients, 82.1% in v-presarcopenic patients, and 94.1% in sarcopenic patients. On the other hand, DN prevalence was 89.2% in non-obese sarcopenics; however, it was determined as 95,9% in sarcopenic obese patients. Similarly, the DN prevalence of non-sarcopenic patients was determined to be 76.7% in non-obese patients; and 88.5% in those who were obese. The sarcopenia incidence in patients who had DN was higher at a significant level than in those without DN (24.7%-8.9%). In the multivariate logistic regression analyzes, DN was determined to be associated with sarcopenia, independently from age and gender, even from accompanying concomitant diseases, BMI, Ha1c and GFR levels (OR: 2.38, 95% CI: 1.02-5.54). CONCLUSIONS The present study revealed the relation of sarcopenia with DN, especially with GI-AN and GU-AN.
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Affiliation(s)
- Özgür Yasemin
- University of Health Sciences, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Departmant of Internal Medicine, Diabetes Center, Istanbul, Turkey.
| | - Akın Seydahmet
- University of Health Sciences, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Departmant of Internal Medicine, Diabetes Center, Istanbul, Turkey
| | - Keskin Özcan
- University of Health Sciences, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Departmant of Internal Medicine, Diabetes Center, Istanbul, Turkey
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Gilmore KJ, Fanous J, Doherty TJ, Kimpinski K, Rice CL. Nerve dysfunction leads to muscle morphological abnormalities in chronic inflammatory demyelinating polyneuropathy assessed by MRI. Clin Anat 2019; 33:77-84. [DOI: 10.1002/ca.23473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/05/2019] [Accepted: 09/15/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology, Faculty of Health Science London Ontario Canada
| | - Jacob Fanous
- School of Kinesiology, Faculty of Health Science London Ontario Canada
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
- Department of Physical Medicine and Rehabilitation Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
| | - Kurt Kimpinski
- School of Kinesiology, Faculty of Health Science London Ontario Canada
- Department of Clinical Neurological Sciences Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology, Faculty of Health Science London Ontario Canada
- Department of Anatomy and Cell Biology Schulich School of Medicine and Dentistry, The University of Western Ontario London Ontario Canada
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Long-Chain Fatty Acids and Inflammatory Markers Coaccumulate in the Skeletal Muscle of Sarcopenic Old Rats. DISEASE MARKERS 2019; 2019:9140789. [PMID: 31354893 PMCID: PMC6636585 DOI: 10.1155/2019/9140789] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/09/2019] [Accepted: 05/09/2019] [Indexed: 01/16/2023]
Abstract
Obesity and inflammation are reportedly associated with the pathogenesis of sarcopenia, which is characterized by age-related loss of skeletal muscle mass. Intramuscular fat deposits have been found to compromise muscle integrity; however, the relevant fat compounds and their roles as mediators of muscular inflammation are not known. The aim of this study was to identify potential correlations between inflammation markers and lipid compounds that accumulate in the quadriceps muscle of previously described Sprague-Dawley (SD) rat model for high-fat diet- (HFD-) induced muscle loss. Six-month-old SD rats were continuously fed a control (CD) or HFD until the age of 21 months. Magnetic resonance imaging (MRI) revealed a significant decline in muscle cross-sectional area in male SD rats as a result of HFD, but not in female rats. Here, we developed a new procedure to quantitatively identify and classify the fatty acid methyl esters (FAMEs) in rats' quadriceps muscles from our former study using gas chromatography-mass spectrometry (GC-MS). Fatty acid analysis revealed accumulation of octadecadienoic (linoleic acid), octadecanoic (stearic acid), and octadecenoic (vaccenic acid) acids exclusively in the quadriceps muscles of male rats. The designated fatty acids were mainly incorporated into triacylglycerols (TAGs) or free fatty acids (FFAs), and their proportions were significantly elevated by consumption of a HFD. Furthermore, the number of resident immune cells and the levels of the chemokines RANTES, MCP-1, and MIP-2 were significantly increased in quadriceps muscle tissue of HFD-fed male, but not female rats. Together, HFD-induced muscle loss in aged male SD rats is associated with greater deposits of long-chain fatty acid esters and increased levels of the inflammatory markers RANTES, MCP-1, and MIP-2 in skeletal muscle tissue. This trend is further reinforced by long-term consumption of a HFD, which may provoke synergistic crosstalk between long-chain fatty acids and inflammatory pathways in sarcopenic muscle.
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Xu D, Jiang Z, Sun Z, Wang L, Zhao G, Hassan HM, Fan S, Zhou W, Han S, Zhang L, Wang T. Mitochondrial dysfunction and inhibition of myoblast differentiation in mice with high-fat-diet-induced pre-diabetes. J Cell Physiol 2018; 234:7510-7523. [PMID: 30362548 DOI: 10.1002/jcp.27512] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/10/2018] [Indexed: 01/18/2023]
Abstract
Pre-diabetes is characterized by impaired glucose tolerance (IGT) and/or impaired fasting glucose. Impairment of skeletal muscle function is closely associated with the progression of diabetes. However, the entire pathological characteristics and mechanisms of pre-diabetes in skeletal muscle remain fully unknown. Here, we established a mouse model of pre-diabetes, in which 6-week-old male C57BL6/J mice were fed either normal diet or high-fat diet (HFD) for 8 or 16 weeks. Both non-fasting and fasting glucose levels and the results of glucose and insulin tolerance tests showed that mice fed an 8-week HFD developed pre-diabetes with IGT; whereas mice fed a 16-week HFD presented with impaired fasting glucose and impaired glucose tolerance (IFG-IGT). Mice at both stages of pre-diabetes displayed decreased numbers of mitochondria in skeletal muscle. Moreover, IFG-IGT mice exhibited decreased mitochondrial membrane potential and ATP production in skeletal muscle and muscle degeneration characterized by a shift in muscle fibers from predominantly oxidative type I to glycolytic type II. Western blotting and histological analysis confirmed that myoblast differentiation was only inhibited in IFG-IGT mice. For primary skeletal muscle satellite cells, inhibition of differentiation was observed in palmitic acid-induced insulin resistance model. Moreover, enhanced myoblast differentiation increased glucose uptake and insulin sensitivity. These findings indicate that pre-diabetes result in mitochondrial dysfunction and inhibition of myoblast differentiation in skeletal muscle. Therefore, interventions that enhance myoblast differentiation may improve insulin resistance of diabetes at the earlier stage.
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Affiliation(s)
- Dengqiu Xu
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Zhenzhou Jiang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China.,Key Laboratory of Drug Quality Control and Pharmacovigilance China Pharmaceutical University, Nanjing, China
| | - Zeren Sun
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Lu Wang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Guolin Zhao
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Hozeifa M Hassan
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Sisi Fan
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Wang Zhou
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Shuangshuang Han
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China
| | - Luyong Zhang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China.,Key Laboratory of Drug Quality Control and Pharmacovigilance China Pharmaceutical University, Nanjing, China.,Center for Drug Screening and Pharmacodynamics Evaluation, School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Tao Wang
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing, China.,Jiangsu Center for Pharmacodynamics Research and Evaluation, China Pharmaceutical University, Nanjing, China
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23
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Gilmore KJ, Doherty TJ, Kimpinski K, Rice CL. Reductions in muscle quality and quantity in chronic inflammatory demyelinating polyneuropathy patients assessed by magnetic resonance imaging. Muscle Nerve 2018; 58:396-401. [DOI: 10.1002/mus.26159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 05/01/2018] [Accepted: 05/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Kevin J. Gilmore
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
| | - Timothy J. Doherty
- Department of Clinical Neurological Sciences; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
| | - Kurt Kimpinski
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology; The University of Western Ontario; London Ontario Canada
- Department of Anatomy and Cell Biology; Schulich School of Medicine and Dentistry, The University of Western Ontario; London Ontario Canada
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24
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Parasoglou P, Rao S, Slade JM. Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy. Clin Ther 2017; 39:1085-1103. [PMID: 28571613 PMCID: PMC5503477 DOI: 10.1016/j.clinthera.2017.05.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The present review highlights current concepts regarding the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. It discusses the lack of effective pharmacologic treatments and the role of physical exercise intervention in limb protection and symptom reversal. It also highlights the importance of magnetic resonance imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. METHODS This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of patients with diabetes. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. FINDINGS Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This finding is an important concern for patients with DPN because their falls are likely to be injurious and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate-intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and partially reverse some of the symptoms of DPN. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. IMPLICATIONS Noninvasive exercise intervention is particularly valuable in DPN because of its safety, low cost, and potential to augment pharmacologic interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed.
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Affiliation(s)
- Prodromos Parasoglou
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, New York.
| | - Smita Rao
- Department of Physical Therapy, New York University, New York, New York
| | - Jill M Slade
- Department of Radiology, Michigan State University, East Lansing, Michigan; Biomedical Imaging Research Center, Michigan State University, East Lansing, Michigan
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25
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Zanuso S, Sacchetti M, Sundberg CJ, Orlando G, Benvenuti P, Balducci S. Exercise in type 2 diabetes: genetic, metabolic and neuromuscular adaptations. A review of the evidence. Br J Sports Med 2017; 51:1533-1538. [DOI: 10.1136/bjsports-2016-096724] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/18/2022]
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26
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Fukuda T, Bouchi R, Takeuchi T, Nakano Y, Murakami M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y. Association of diabetic retinopathy with both sarcopenia and muscle quality in patients with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2017; 5:e000404. [PMID: 28761661 PMCID: PMC5530250 DOI: 10.1136/bmjdrc-2017-000404] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/29/2017] [Accepted: 04/26/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To examine whether the existence and severity of diabetic retinopathy (DR) could be associated with the prevalent sarcopenia and muscle quality in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This is a cross-sectional study of 316 patients with type 2 diabetes (mean age 65±12 years; 38% female). Body compositions were measured by the dual-energy X-ray absorptiometry. Patients were divided into three groups: patients without DR (NDR), with non-proliferative DR (NPDR) and proliferative DR (PDR). Sarcopenia was diagnosed according to the criteria for Asians, using both skeletal muscle index (SMI) and grip strength (kg). Muscle quality was also determined by the grip strength divided by SMI. Logistic regression analyses were carried out to assess the cross-sectional association of the severity of DR with sarcopenia. In addition, linear regression analyses were performed to determine the associations between DR and muscle quality. Selection of covariates in the multivariate logistic and linear regression analyses was done by a stepwise procedure. RESULTS Among the patients examined, NDR, NPDR and PDR were diagnosed in 261, 38 and 17 patients, respectively. The prevalence of sarcopenia significantly increased along with the progression of DR. Multivariate logistic regression analysis showed that PDR is significantly associated with sarcopenia (OR 7.78, 95% CI 1.52 to 39.81, p=0.014) and low muscle strength (OR 6.25, 95% CI 1.15 to 33.96, p=0.034). Multivariate linear regression analysis additionally showed that the existence of DR was significantly associated with the muscle quality (standardized β -0.136, p=0.005 for NPDR, standardized β -0.146, p=0.003 for PDR). CONCLUSIONS This study provides evidence that PDR is significantly associated with sarcopenia, and the existence of DR increases the risk for low muscle quality in patients with type 2 diabetes.
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Affiliation(s)
- Tatsuya Fukuda
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryotaro Bouchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takato Takeuchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yujiro Nakano
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanori Murakami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Isao Minami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Izumiyama
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koshi Hashimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takanobu Yoshimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- CREST, Japan Agency for Medical Research and Development, Tokyo, Japan
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