1
|
Chan WL, Yun HKB, Cheung EE, Liu M, Hou LY, Lam KO, Wong IYH, Chiu WHK, Law S, Kwong D. Association of sarcopenia with severe chemotherapy toxicities and survival in patients with advanced gastric cancer. Oncologist 2024; 29:e1272-e1279. [PMID: 38885304 PMCID: PMC11449055 DOI: 10.1093/oncolo/oyae123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/01/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Sarcopenia or skeletal muscle depletion is a poor prognostic factor for gastric cancer (GC). However, existing cutoff values of skeletal muscle index (SMI) for defining sarcopenia have been found to have limitations when clinically applied. This study aimed to determine the optimal cutoff for SMI to predict severe toxicities of chemotherapy and overall survival (OS) in patients with advanced GC. METHODS Patients with metastatic gastric adenocarcinoma who received first-line palliative chemotherapy between January 2014 and December 2021 at Queen Mary Hospital, Hong Kong, were included in this study. The SMI was determined via a pre-chemotherapy computed tomography scan. Optimal cutoff points of SMI were identified by recursive partitioning analysis. Univariate and multivariate analyses evaluating risk factors of severe chemotherapy toxicities and OS were also performed. RESULTS A total of 158 patients (male: 108 (68.4%), median age: 65.3) were included. The SMI cutoff to define low SMI was ≤33 cm2/m2 for males and ≤28 cm2/m2 for females; 30 patients (19.0%) had low SMI. Patients with low SMI had a higher incidence of hematological toxicities (63.3% vs 32.0%, P = .001) and non-hematological toxicities (66.7% vs 36.7%, P = .003). Multivariable analysis indicated that low SMI and low serum albumin (≤28 g/L) were independent predictive factors of hematological toxicity, while low SMI and neutrophil-lymphocyte ratio ≥5 were predictive factors of non-hematological toxicity. Moreover, patients with low SMI had a significantly shorter OS (P = .011), lower response rate to chemotherapy (P = .045), and lower utilization of subsequent lines of treatment (P < .001). CONCLUSIONS Using pre-chemotherapy SMI cutoff (≤33 cm2/m2 for males and 28 cm2/m2 for females) one can identify individuals with a higher risk of severe chemotherapy toxicities and worse prognosis.
Collapse
Affiliation(s)
- Wing-Lok Chan
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ho-Kwan Bryan Yun
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Emina Edith Cheung
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Michelle Liu
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Li-Yu Hou
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ka-On Lam
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ian Yu-Hong Wong
- Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Simon Law
- Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Dora Kwong
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
2
|
Baglietto N, Vaquero-Cristóbal R, Albaladejo-Saura M, Mecherques-Carini M, Esparza-Ros F. Assessing skeletal muscle mass and lean body mass: an analysis of the agreement among dual X-ray absorptiometry, anthropometry, and bioelectrical impedance. Front Nutr 2024; 11:1445892. [PMID: 39224178 PMCID: PMC11366593 DOI: 10.3389/fnut.2024.1445892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Methods of body composition estimation such as dual-energy X-ray absorptiometry (DXA), anthropometry, and bioimpedance (BIA) are used for the estimation of skeletal muscle mass (SMM) and lean body mass (LBM). No previous studies have examined whether these methods generate comparable results, or whether they are valid by using DXA as the reference. The aims of the present investigation were: (a) to assess the differences between DXA, anthropometry, and BIA in the estimation of SMM and LBM, taking into consideration the impact of sex and hydration status; and (b) to examine the agreement of anthropometry and BIA as compared to DXA for the estimation of SMM and LBM. Methods A descriptive cross-sectional design was followed with 262 healthy young adults (159 males and 103 females). LBM and SMM were assessed by anthropometry with the formulas from Lee et al. and Kulkarni et al. for LBM; and Kerr (opt a), Kerr (opt b), Lee et al., Poortmans, Matiegka, Martin et al., Drinkwater and Ross, and Heymsfield et al. for SMM; by BIA with the formula reported by the TANITA MC-780-MA software for LBM and SMM; and DXA with the formula reported by the Hologic Horizon software for LBM, and the conversion by Kim et al. for SMM. Results Significant differences were found for both SMM and LBM in kg, and percentages between most methods and formulas for the overall sample (p < 0.001-0.003) and divided by sex (p < 0.001-0.035). Hydration status did not have a significant effect on the differences between methods and formulas (p = 0.058-0.870). Lin's coefficient revealed limited agreement among the majority of formulas and methods (CCC = 0.007-0.880). The Bland-Altman analysis showed significant differences in most methods and formulas, both in the overall sample and divided by sex, when using SMM and LBM with DXA as the reference (p < 0.001-0.030). Conclusion There is a lack of agreement between methods and formulas for assessing SMM and LBM. Sex was found to be a significant factor in this analysis. Furthermore, significant differences were observed between most formulas and methods as compared to DXA, except for the equations to estimate SMM with anthropometry by Poortmans.
Collapse
Affiliation(s)
- Nicolás Baglietto
- International Kinanthropometry Chair, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
- Health Sciences PhD Program, UCAM Universidad Catolica de Murcia, Murcia, Spain
| | - Raquel Vaquero-Cristóbal
- Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport Sciences, Faculty of Sport Sciences, University of Murcia, San Javier, Spain
| | - Mario Albaladejo-Saura
- International Kinanthropometry Chair, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Malek Mecherques-Carini
- International Kinanthropometry Chair, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Francisco Esparza-Ros
- International Kinanthropometry Chair, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
| |
Collapse
|
3
|
Ferrara IR, Sadowsky CL. Muscle Mass as a Biomarker for Health Status and Function in Pediatric Individuals with Neuromuscular Disabilities: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:815. [PMID: 39062264 PMCID: PMC11276588 DOI: 10.3390/children11070815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/22/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.
Collapse
Affiliation(s)
- Isabella R. Ferrara
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
| | - Cristina L. Sadowsky
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| |
Collapse
|
4
|
Vu PT, Chahine C, Chatterjee N, MacLean MT, Swago S, Bhattaru A, Thompson EW, Ikhlas A, Oteng E, Davidson L, Tran R, Hazim M, Raghupathy P, Verma A, Duda J, Gee J, Luks V, Gershuni V, Wu G, Rader D, Sagreiya H, Witschey WR. CT imaging-derived phenotypes for abdominal muscle and their association with age and sex in a medical biobank. Sci Rep 2024; 14:14807. [PMID: 38926479 PMCID: PMC11208425 DOI: 10.1038/s41598-024-64603-6] [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: 05/10/2023] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
The study of muscle mass as an imaging-derived phenotype (IDP) may yield new insights into determining the normal and pathologic variations in muscle mass in the population. This can be done by determining 3D abdominal muscle mass from 12 distinct abdominal muscle regions and groups using computed tomography (CT) in a racially diverse medical biobank. To develop a fully automatic technique for assessment of CT abdominal muscle IDPs and preliminarily determine abdominal muscle IDP variations with age and sex in a clinically and racially diverse medical biobank. This retrospective study was conducted using the Penn Medicine BioBank (PMBB), a research protocol that recruits adult participants during outpatient visits at hospitals in the Penn Medicine network. We developed a deep residual U-Net (ResUNet) to segment 12 abdominal muscle groups including the left and right psoas, quadratus lumborum, erector spinae, gluteus medius, rectus abdominis, and lateral abdominals. 110 CT studies were randomly selected for training, validation, and testing. 44 of the 110 CT studies were selected to enrich the dataset with representative cases of intra-abdominal and abdominal wall pathology. The studies were divided into non-overlapping training, validation and testing sets. Model performance was evaluated using the Sørensen-Dice coefficient. Volumes of individual muscle groups were plotted to distribution curves. To investigate associations between muscle IDPs, age, and sex, deep learning model segmentations were performed on a larger abdominal CT dataset from PMBB consisting of 295 studies. Multivariable models were used to determine relationships between muscle mass, age and sex. The model's performance (Dice scores) on the test data was the following: psoas: 0.85 ± 0.12, quadratus lumborum: 0.72 ± 0.14, erector spinae: 0.92 ± 0.07, gluteus medius: 0.90 ± 0.08, rectus abdominis: 0.85 ± 0.08, lateral abdominals: 0.85 ± 0.09. The average Dice score across all muscle groups was 0.86 ± 0.11. Average total muscle mass for females was 2041 ± 560.7 g with a high of 2256 ± 560.1 g (41-50 year old cohort) and a change of - 0.96 g/year, declining to an average mass of 1579 ± 408.8 g (81-100 year old cohort). Average total muscle mass for males was 3086 ± 769.1 g with a high of 3385 ± 819.3 g (51-60 year old cohort) and a change of - 1.73 g/year, declining to an average mass of 2629 ± 536.7 g (81-100 year old cohort). Quadratus lumborum was most highly correlated with age for both sexes (correlation coefficient of - 0.5). Gluteus medius mass in females was positively correlated with age with a coefficient of 0.22. These preliminary findings show that our CNN can automate detailed abdominal muscle volume measurement. Unlike prior efforts, this technique provides 3D muscle segmentations of individual muscles. This technique will dramatically impact sarcopenia diagnosis and research, elucidating its clinical and public health implications. Our results suggest a peak age range for muscle mass and an expected rate of decline, both of which vary between genders. Future goals are to investigate genetic variants for sarcopenia and malnutrition, while describing genotype-phenotype associations of muscle mass in healthy humans using imaging-derived phenotypes. It is feasible to obtain 3D abdominal muscle IDPs with high accuracy from patients in a medical biobank using fully automated machine learning methods. Abdominal muscle IDPs showed significant variations in lean mass by age and sex. In the future, this tool can be leveraged to perform a genome-wide association study across the medical biobank and determine genetic variants associated with early or accelerated muscle wasting.
Collapse
Affiliation(s)
- Phuong T Vu
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Chantal Chahine
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Neil Chatterjee
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Matthew T MacLean
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sophia Swago
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Abhi Bhattaru
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Elizabeth W Thompson
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Anooshey Ikhlas
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Edith Oteng
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Lauren Davidson
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Richard Tran
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Mohamad Hazim
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Pavan Raghupathy
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Anurag Verma
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey Duda
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - James Gee
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Valerie Luks
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria Gershuni
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gary Wu
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Rader
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hersh Sagreiya
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Walter R Witschey
- Department of Radiology, Perelman School of Medicine, Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| |
Collapse
|
5
|
Li N, Ou J, He H, He J, Zhang L, Peng Z, Zhong J, Jiang N. Exploration of a machine learning approach for diagnosing sarcopenia among Chinese community-dwelling older adults using sEMG-based data. J Neuroeng Rehabil 2024; 21:69. [PMID: 38725065 PMCID: PMC11080130 DOI: 10.1186/s12984-024-01369-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND In the practical application of sarcopenia screening, there is a need for faster, time-saving, and community-friendly detection methods. The primary purpose of this study was to perform sarcopenia screening in community-dwelling older adults and investigate whether surface electromyogram (sEMG) from hand grip could potentially be used to detect sarcopenia using machine learning (ML) methods with reasonable features extracted from sEMG signals. The secondary aim was to provide the interpretability of the obtained ML models using a novel feature importance estimation method. METHODS A total of 158 community-dwelling older residents (≥ 60 years old) were recruited. After screening through the diagnostic criteria of the Asian Working Group for Sarcopenia in 2019 (AWGS 2019) and data quality check, participants were assigned to the healthy group (n = 45) and the sarcopenic group (n = 48). sEMG signals from six forearm muscles were recorded during the hand grip task at 20% maximal voluntary contraction (MVC) and 50% MVC. After filtering recorded signals, nine representative features were extracted, including six time-domain features plus three time-frequency domain features. Then, a voting classifier ensembled by a support vector machine (SVM), a random forest (RF), and a gradient boosting machine (GBM) was implemented to classify healthy versus sarcopenic participants. Finally, the SHapley Additive exPlanations (SHAP) method was utilized to investigate feature importance during classification. RESULTS Seven out of the nine features exhibited statistically significant differences between healthy and sarcopenic participants in both 20% and 50% MVC tests. Using these features, the voting classifier achieved 80% sensitivity and 73% accuracy through a five-fold cross-validation. Such performance was better than each of the SVM, RF, and GBM models alone. Lastly, SHAP results revealed that the wavelength (WL) and the kurtosis of continuous wavelet transform coefficients (CWT_kurtosis) had the highest feature impact scores. CONCLUSION This study proposed a method for community-based sarcopenia screening using sEMG signals of forearm muscles. Using a voting classifier with nine representative features, the accuracy exceeds 70% and the sensitivity exceeds 75%, indicating moderate classification performance. Interpretable results obtained from the SHAP model suggest that motor unit (MU) activation mode may be a key factor affecting sarcopenia.
Collapse
Affiliation(s)
- Na Li
- The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Medical Equipment Innovation Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- The Med-X Center for Manufacturing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jiarui Ou
- College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Haoru He
- The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Medical Equipment Innovation Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- The Med-X Center for Manufacturing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jiayuan He
- The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Medical Equipment Innovation Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- The Med-X Center for Manufacturing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Le Zhang
- College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Zhengchun Peng
- School of Electronic Information and ElectricaEngineering, Shanghaijiao Tong University, Shanghai, 200240, China
| | - Junwen Zhong
- Department of Electromechanical Engineering and Centre for Artificial Intelligence and Robotics, University of Macau, Macau, SAR, 999078, China
| | - Ning Jiang
- The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
- Medical Equipment Innovation Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
- The Med-X Center for Manufacturing, Sichuan University, Chengdu, Sichuan, 610041, China.
| |
Collapse
|
6
|
Chen L, Zhou H, Gong Y, Tang Y, Su H, Jin Z, Chen G, Tong P. How Do Muscle Function and Quality Affect the Progression of KOA? A Narrative Review. Orthop Surg 2024; 16:802-810. [PMID: 38438160 PMCID: PMC10984828 DOI: 10.1111/os.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Knee osteoarthritis (KOA) is widely recognized as a chronic joint disease characterized by degeneration of knee cartilage and subsequent bone hyperplasia. However, it is important to acknowledge the significant role of muscles in the development and progression of KOA. Muscle function (MF) and muscle quality (MQ) are key factors in understanding the involvement of muscles in KOA. Quantitative indices such as muscle mass, muscle strength, muscle cross-sectional area, muscle thickness, and muscle fatigue are crucial in assessing MF and MQ. Despite the growing interest in KOA, there is a scarcity of studies investigating the relationship between muscles and this condition. This review aims to examine the commonly used indices and measurement methods for assessing MF and MQ in clinical settings, while also exploring the association between muscles and KOA. Furthermore, this article highlights the importance of restoring MF and MQ to enhance symptom management and improve the quality of life for patients with KOA.
Collapse
Affiliation(s)
- Lei Chen
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Haojing Zhou
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yichen Gong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yi Tang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Hai Su
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Zhaokai Jin
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Guoqian Chen
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Peijian Tong
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| |
Collapse
|
7
|
Bennett JP, Cataldi D, Liu YE, Kelly NN, Quon BK, Schoeller DA, Kelly T, Heymsfield SB, Shepherd JA. Development and validation of a rapid multicompartment body composition model using 3-dimensional optical imaging and bioelectrical impedance analysis. Clin Nutr 2024; 43:346-356. [PMID: 38142479 DOI: 10.1016/j.clnu.2023.12.009] [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: 05/08/2023] [Revised: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND & AIMS The multicompartment approach to body composition modeling provides a more precise quantification of body compartments in healthy and clinical populations. We sought to develop and validate a simplified and accessible multicompartment body composition model using 3-dimensional optical (3DO) imaging and bioelectrical impedance analysis (BIA). METHODS Samples of adults and collegiate-aged student-athletes were recruited for model calibration. For the criterion multicompartment model (Wang-5C), participants received measures of scale weight, body volume (BV) via air displacement, total body water (TBW) via deuterium dilution, and bone mineral content (BMC) via dual energy x-ray absorptiometry. The candidate model (3DO-5C) used stepwise linear regression to derive surrogate measures of BV using 3DO, TBW using BIA, and BMC using demographics. Test-retest precision of the candidate model was assessed via root mean square error (RMSE). The 3DO-5C model was compared to criterion via mean difference, concordance correlation coefficient (CCC), and Bland-Altman analysis. This model was then validated using a separate dataset of 20 adults. RESULTS 67 (31 female) participants were used to build the 3DO-5C model. Fat-free mass (FFM) estimates from Wang-5C (60.1 ± 13.4 kg) and 3DO-5C (60.3 ± 13.4 kg) showed no significant mean difference (-0.2 ± 2.0 kg; 95 % limits of agreement [LOA] -4.3 to +3.8) and the CCC was 0.99 with a similar effect in fat mass that reflected the difference in FFM measures. In the validation dataset, the 3DO-5C model showed no significant mean difference (0.0 ± 2.5 kg; 95 % LOA -3.6 to +3.7) for FFM with almost perfect equivalence (CCC = 0.99) compared to the criterion Wang-5C. Test-retest precision (RMSE = 0.73 kg FFM) supports the use of this model for more frequent testing in order to monitor body composition change over time. CONCLUSIONS Body composition estimates provided by the 3DO-5C model are precise and accurate to criterion methods when correcting for field calibrations. The 3DO-5C approach offers a rapid, cost-effective, and accessible method of body composition assessment that can be used broadly to guide nutrition and exercise recommendations in athletic settings and clinical practice.
Collapse
Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i at Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Devon Cataldi
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Dale A Schoeller
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI, 53706, USA
| | - Thomas Kelly
- Hologic Inc, 250 Campus Drive, Marlborough, MA, 01752, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i at Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA.
| |
Collapse
|
8
|
Zhong X, Pan Y, Wu K, Wang L, Dou P, Tan P, Zhang P, Li X. A novel nomogram based on body composition and nutritional indicators to predict the prognosis of patients with muscle-invasive bladder cancer undergoing radical cystectomy. Cancer Med 2023; 12:21627-21638. [PMID: 37975152 PMCID: PMC10757150 DOI: 10.1002/cam4.6712] [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: 08/02/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To investigate the prognostic significance of body composition and nutritional indicators in patients undergoing radical cystectomy with muscle-invasive bladder cancer (MIBC) and to develop a novel nomogram that accurately predicts overall survival (OS). METHODS From December 2010 to December 2020, we retrospectively collected clinical and pathological data from 373 MIBC patients who underwent radical cystectomy at our hospital. Preoperative computed tomography (CT) images were used to measure the skeletal muscle index (SMI), subcutaneous adipose index (SAI), visceral adipose index (VAI), skeletal muscle density (SMD), subcutaneous adipose density (SAD), visceral adipose density (VAD), and visceral adipose to subcutaneous adipose area ratio (VSR). The clinicopathological characteristics were evaluated using LASSO regression and multivariate Cox regression, and a nomogram was constructed to predict 1-, 3-, and 5-year overall survival. The concordance index (C-index), time-dependent receiver operating characteristic curves (t-ROC), calibration curve, and decision curve analysis (DCA) were used to assess the discriminative ability, calibration, and clinical practicality of the nomogram. RESULTS Multivariate analyses demonstrated that pT stage, lymph node status, LVI, SMD, and prognostic nutritional index (PNI) are independent prognostic factors for OS. Additionally, a nomogram was created. The nomogram's C-index was 0.714 (95% CI: 0.695-0.733). The area under the t-ROC curve of 1-, 3-, and 5-year survival corresponding to the model was 0.726, 0.788, and 0.785, respectively. The calibration curve demonstrated excellent agreement between the predicted and observed outcomes. The DCA revealed that patients with MIBC could benefit from the nomogram. CONCLUSION Based on body composition and nutritional indicators, we developed a novel nomogram with excellent predictive accuracy and reliability for predicting the prognosis of MIBC patients undergoing RC.
Collapse
Affiliation(s)
- Xin Zhong
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Yunzhe Pan
- Department of UrologyChengdu Second People's HospitalChengduSichuanChina
| | - Kang Wu
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Langkun Wang
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Peng Dou
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Ping Tan
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Peng Zhang
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| | - Xiang Li
- Department of UrologyInstitute of Urology, West China Hospital of Sichuan UniversityChengduSichuanChina
| |
Collapse
|
9
|
Chen M, Liu X, Liu Q, Ding C, Zhao P, Zhang Y, Mao C, Liu C. The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson's disease with sarcopenia: a pilot study. Front Neurosci 2023; 17:1254859. [PMID: 37904815 PMCID: PMC10613525 DOI: 10.3389/fnins.2023.1254859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
Background Patients with Parkinson's disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions. Objective Despite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition. Methods A total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites. Results Parkinson's disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients. Conclusion Biceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.
Collapse
Affiliation(s)
- Minglei Chen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaofang Liu
- Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiuwan Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Changwei Ding
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ping Zhao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yingchun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chengjie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chunfeng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| |
Collapse
|
10
|
Park MW, Park SJ, Chung SG. Relationships Between Skeletal Muscle Mass, Lumbar Lordosis, and Chronic Low Back Pain in the Elderly. Neurospine 2023; 20:959-968. [PMID: 37798990 PMCID: PMC10562244 DOI: 10.14245/ns.2346494.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE Loss of skeletal muscle mass is known to be associated with multiple morbidities. However, there is a dearth of reports on its association with lumbar lordosis and musculoskeletal pain. The aim of this study was to delineate the cross-sectional relationship between loss of skeletal muscle mass, lumbar lordosis, and chronic low back pain (CLBP). METHODS A total of 721 medical records were reviewed, and data from 165 older subjects (over 65 years old; 81 men and 84 women) were retrospectively analyzed. Subjects were categorized into either the CLBP group (back pain for more than 6 months; 35 men and 36 women) or the control group (46 men and 48 women). The modified skeletal muscle mass index (MSMI, appendicular skeletal muscle mass [kg]/weight [kg] × 100), assessed by bioelectrical impedance analysis, and lumbar lordotic angle (LLA) were measured and compared between the CLBP group and the control group. The correlation between MSMI and LLA was investigated. RESULTS The LLA of men and women in the CLBP group was significantly lower than that of the control group (p < 0.05). The MSMI was decreased in the CLBP group compared to the control group (p < 0.05). For both sexes, positive correlations were observed between the MSMI and LLA. CONCLUSION A close cross-sectional relationship was observed between MSMI, LLA, and CLBP. This suggests a potential interaction between the reduction in skeletal muscle mass and altered lumbar spine sagittal alignment, which could lead to CLBP.
Collapse
Affiliation(s)
- Myung Woo Park
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Seoul, Korea
| | | | - Sun Gun Chung
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Rossini-Venturini AC, Veras L, Abdalla PP, Santos APD, Tasinafo-Junior MF, Silva LSLD, Alves TC, Ferriolli E, Romo-Perez V, Garcia-Soidan JL, Mota J, Machado DRL. Multicompartment body composition analysis in older adults: a cross-sectional study. BMC Geriatr 2023; 23:87. [PMID: 36759773 PMCID: PMC9912531 DOI: 10.1186/s12877-023-03752-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/23/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes. METHODS This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable. RESULTS An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R2adj: 0.83 and SEE: 3.16; BMC: R2adj: 0.61 and SEE: 0.30; ALST: R2adj: 0.85 and SEE: 1.65). CONCLUSION The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use.
Collapse
Affiliation(s)
- Ana Claudia Rossini-Venturini
- College of Nursing at Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes nº 3900, University Campus - Monte Alegre, Ribeirão Preto-SP, Brazil. .,Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil.
| | - Lucas Veras
- grid.5808.50000 0001 1503 7226The Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Pedro Pugliesi Abdalla
- grid.11899.380000 0004 1937 0722College of Nursing at Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes nº 3900, University Campus - Monte Alegre, Ribeirão Preto-SP, Brazil ,Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil
| | - André Pereira dos Santos
- grid.11899.380000 0004 1937 0722College of Nursing at Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes nº 3900, University Campus - Monte Alegre, Ribeirão Preto-SP, Brazil ,Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil ,grid.11899.380000 0004 1937 0722School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Márcio Fernando Tasinafo-Junior
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil ,grid.11899.380000 0004 1937 0722School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Leonardo Santos Lopes da Silva
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil ,grid.11899.380000 0004 1937 0722School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Thiago Cândido Alves
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil
| | - Eduardo Ferriolli
- grid.11899.380000 0004 1937 0722Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil ,grid.11899.380000 0004 1937 0722Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Vicente Romo-Perez
- grid.6312.60000 0001 2097 6738Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | - Jose Luis Garcia-Soidan
- grid.6312.60000 0001 2097 6738Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | - Jorge Mota
- grid.5808.50000 0001 1503 7226The Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- grid.11899.380000 0004 1937 0722College of Nursing at Ribeirão Preto, University of São Paulo, Avenue of Bandeirantes nº 3900, University Campus - Monte Alegre, Ribeirão Preto-SP, Brazil ,Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), São Paulo, Brazil ,grid.5808.50000 0001 1503 7226The Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal ,grid.11899.380000 0004 1937 0722School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil ,grid.7157.40000 0000 9693 350XESEC - Universidade do Algarve. , Campus da Penha, Faro, Portugal
| |
Collapse
|
12
|
Dai L, Huang XY, Lu YQ, Liu YY, Song CY, Zhang JW, Li J, Zhang Y, Shan Y, Shi Y. Defining reference values for body composition indices by magnetic resonance imaging in UK Biobank. J Cachexia Sarcopenia Muscle 2023; 14:992-1002. [PMID: 36717370 PMCID: PMC10067500 DOI: 10.1002/jcsm.13181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/06/2022] [Accepted: 01/02/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is the gold standard for evaluating body composition. However, the reference ranges have not been established. METHODS Three lean tissue and seven adipose tissue parameters based on MRI data from the UK Biobank were used in this study. Participants with European ancestry and data on at least one parameter were screened. Age- and sex-specific percentile curves were generated using the lambda-mu-sigma method. Three levels of reference ranges were provided, which were equivalent to the mean ± 1 standard deviation (SD), 2 SDs and 2.5 SDs. RESULTS The final analysis set for each parameter ranged from 4842 to 14 148 participants (53.4%-56.6% women) with a median age of 61. For lean tissue parameters, compared with those at age 45, the median total lean tissue volume and total thigh fat-free muscle volume at age 70 were 2.83 and 1.73 L, and 3.02 and 1.51 L lower in men and women, respectively. The median weight-to-muscle ratios at age 45 were 0.51 and 0.83 kg/L lower compared with those at age 70 in men and women, respectively. Adipose tissue parameters showed inconsistent differences. In men, the median muscle fat infiltration, visceral adipose tissue (VAT) volume, total abdominal adipose tissue index and abdominal fat ratio were 1.48%, 0.32 L, 0.08 L/m2 and 0.4 higher, and the median abdominal subcutaneous adipose tissue (ASAT) volume and total adipose tissue volume were 0.47 and 0.41 L lower, respectively, at age 70 than at age 45. The median total trunk fat volume was approximately 9.53 L at all ages. In women, the median muscle fat infiltration and VAT volume were 1.68% and 0.76 L higher, respectively, at age 70 than at age 45. The median ASAT volume, total adipose tissue volume, total trunk fat volume, total abdominal adipose tissue index and abdominal fat ratio were 0.35 L, 0.78 L, 1.12 L, 0.49 L/m2 and 0.06 higher, respectively, at age 60 than at age 45. The medians of the former three parameters were 0.33 L, 0.14 L and 0.20 L lower, at age 70 than at age 60. The medians of the latter two parameters were approximately 3.64 L/m2 and 0.55 at ages between 60 and 70. CONCLUSIONS We have established reference ranges for MRI-measured body composition parameters in a large community-dwelling population. These findings provide a more accurate assessment of abnormal adipose and muscle conditions.
Collapse
Affiliation(s)
- Liang Dai
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Xiao-Yan Huang
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China.,Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | | | - Yu-Yang Liu
- BGI-Shenzhen, Shenzhen, China.,College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Cong-Ying Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Jing-Wen Zhang
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Jing Li
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China.,Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Yue Zhang
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Ying Shan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| | - Yu Shi
- Department of Ultrasound, Peking University Shenzhen Hospital, Peking University, Shenzhen, Guangdong, China
| |
Collapse
|
13
|
Debs P, Al-Zaghal A, Solnes LB, Alavi A. Sarcopenia and Myositis Revisited. PET Clin 2023; 18:31-38. [DOI: 10.1016/j.cpet.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
Salaffi F, Carotti M, Di Matteo A, Ceccarelli L, Farah S, Villota-Eraso C, Di Carlo M, Giovagnoni A. Ultrasound and magnetic resonance imaging as diagnostic tools for sarcopenia in immune-mediated rheumatic diseases (IMRDs). Radiol Med 2022; 127:1277-1291. [DOI: 10.1007/s11547-022-01560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/12/2022] [Indexed: 01/10/2023]
Abstract
AbstractSarcopenia is characterized by loss of muscle mass, altered muscle composition, fat and fibrous tissue infiltration, and abnormal innervation, especially in older individuals with immune-mediated rheumatic diseases (IMRDs). Several techniques for measuring muscle mass, strength, and performance have emerged in recent decades. The portable dynamometer and gait speed represent the most frequently used tools for the evaluation of muscle strength and physical efficiency, respectively. Aside from dual-energy, X-ray, absorptiometry, and bioelectrical impedance analysis, ultrasound (US) and magnetic resonance imaging (MRI) techniques appear to have a potential role in evaluating muscle mass and composition. US and MRI have been shown to accurately identify sarcopenic biomarkers such as inflammation (edema), fatty infiltration (myosteatosis), alterations in muscle fibers, and muscular atrophy in patients with IMRDs. US is a low-cost, easy-to-use, and safe imaging method for assessing muscle mass, quality, architecture, and biomechanical function. This review summarizes the evidence for using US and MRI to assess sarcopenia.
Collapse
|
15
|
Calf cirfumference as a predictor of skeletal muscle mass in postmenopausal women. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
16
|
Ackermans LL, Rabou J, Basrai M, Schweinlin A, Bischoff S, Cussenot O, Cancel-Tassin G, Renken R, Gómez E, Sánchez-González P, Rainoldi A, Boccia G, Reisinger K, Ten Bosch JA, Blokhuis TJ. Screening, Diagnosis and Monitoring of Sarcopenia: when to use which tool? Clin Nutr ESPEN 2022; 48:36-44. [DOI: 10.1016/j.clnesp.2022.01.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/18/2021] [Accepted: 01/23/2022] [Indexed: 10/19/2022]
|
17
|
Kawano T, Nankaku M, Murao M, Goto K, Kuroda Y, Kawai T, Ikeguchi R, Matsuda S. Functional characteristics associated with hip abductor torque in severe hip osteoarthritis. Musculoskelet Sci Pract 2021; 55:102431. [PMID: 34329871 DOI: 10.1016/j.msksp.2021.102431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/12/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hip abductor weakness due to the progression of hip osteoarthritis (OA) commonly causes poor functional mobility. The hip abductor strength has also been identified as a clinically relevant factor for successful functional outcomes after total hip arthroplasty. OBJECTIVES This study aimed to examine the functional characteristics related to hip abductor torque in patients with hip OA. DESIGN A cross-sectional survey study. METHODS One hundred and eight female patients with severe unilateral hip OA participated in this study. Hip abductor torque and pain were measured. The muscle cross-sectional area (CSA) and skeletal muscle density (SMD) of the gluteal muscles were also measured using computed tomography. To identify the hip parameters associated with hip abductor torque, multiple regression analysis was performed. The healthy model included the CSA and SMD of gluteus maximus, gluteus medius, and gluteus minimus; range of motion in hip abduction; age; and body mass index. The affected model included hip pain in addition to the healthy model. RESULTS In the affected limb, multiple regression analysis identified pain and angle of hip abduction as factors that determine hip abductor torque (Adjusted R2 = 0.39). In contrast, our analysis identified CSA and SMD of the gluteus medius and SMD of the gluteus minimus as the significant variables related to hip abductor torque in the healthy limb (Adjusted R2 = 0.40). CONCLUSION The findings of this study indicated that it is necessary to consider that hip pain may inhibit muscle exertion and contraction while training to improve the hip abductor torque in the affected limb.
Collapse
Affiliation(s)
- Takumi Kawano
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan.
| | - Manabu Nankaku
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Masanobu Murao
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Kawai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Ikeguchi
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan; Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
18
|
The War after War: Volumetric Muscle Loss Incidence, Implication, Current Therapies and Emerging Reconstructive Strategies, a Comprehensive Review. Biomedicines 2021; 9:biomedicines9050564. [PMID: 34069964 PMCID: PMC8157822 DOI: 10.3390/biomedicines9050564] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 04/30/2021] [Accepted: 05/14/2021] [Indexed: 11/25/2022] Open
Abstract
Volumetric muscle loss (VML) is the massive wasting of skeletal muscle tissue due to traumatic events or surgical ablation. This pathological condition exceeds the physiological healing process carried out by the muscle itself, which owns remarkable capacity to restore damages but only when limited in dimensions. Upon VML occurring, the affected area is severely compromised, heavily influencing the affected a person’s quality of life. Overall, this condition is often associated with chronic disability, which makes the return to duty of highly specialized professional figures (e.g., military personnel or athletes) almost impossible. The actual treatment for VML is based on surgical conservative treatment followed by physical exercise; nevertheless, the results, in terms of either lost mass and/or functionality recovery, are still poor. On the other hand, the efforts of the scientific community are focusing on reconstructive therapy aiming at muscular tissue void volume replenishment by exploiting biomimetic matrix or artificial tissue implantation. Reconstructing strategies represent a valid option to build new muscular tissue not only to recover damaged muscles, but also to better socket prosthesis in terms of anchorage surfaces and reinnervation substrates for reconstructed mass.
Collapse
|
19
|
Li GHY, Lee GKY, Au PCM, Chan M, Li HL, Cheung BMY, Wong ICK, Lee VHF, Mok J, Yip BHK, Cheng KKY, Wu CH, Cheung CL. The effect of different measurement modalities in the association of lean mass with mortality: A systematic review and meta-analysis. Osteoporos Sarcopenia 2021; 7:S13-S18. [PMID: 33997304 PMCID: PMC8088995 DOI: 10.1016/j.afos.2021.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/26/2020] [Accepted: 02/24/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Lean mass is commonly measured by 3 modalities, dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and computerized tomography (CT). CT is considered the most accurate, while lean mass measured by DXA and BIA often consists of non-muscle compartment, and hence considered less accurate when compared with CT. It remains unclear if the association of lean mass with mortality would differ using different measurement modalities. METHODS A systematic review and meta-analysis of lean mass and mortality was conducted. The analysis was stratified by different measurement modalities and health conditions. Pooled hazard ratios were estimated using a random effects model. RESULTS This meta-analysis included 188 studies with 98 468 participants. Reduced lean mass measured by BIA, DXA, and CT, was associated with increased risk of mortality with a hazard ratio (HR) of 1.35 (95% CI, 1.21-1.49), 1.18 (95% CI, 1.06-1.30), and 1.44 (95% CI, 1.32-1.57), respectively. Similarly, low lean mass defined by BIA-, DXA-, and CT-measurement was associated with increased risk of mortality, with an HR of 1.81 (95% CI, 1.56-2.10), 1.44 (95% CI, 1.29-1.60), and 1.78 (95% CI, 1.64-1.93). CONCLUSIONS Reduced and low lean mass were robustly associated with increased mortality in studies using different measurement modalities.
Collapse
Affiliation(s)
- Gloria Hoi-Yee Li
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Grace Koon-Yee Lee
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Philip Chun-Ming Au
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marcus Chan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hang-Long Li
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Ian Chi-Kei Wong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Victor Ho-Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Mok
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Benjamin Hon-Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kenneth King-Yip Cheng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chih-Hsing Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
20
|
Cheung CL, Li GHY. Summary of the special issue of the meta-analyses of lean mass with mortality in multiple perspectives. Osteoporos Sarcopenia 2021; 7:S1-S2. [PMID: 33997302 PMCID: PMC8088987 DOI: 10.1016/j.afos.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Gloria Hoi-Yee Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| |
Collapse
|
21
|
Li HL, Au PCM, Lee GKY, Li GHY, Chan M, Cheung BMY, Wong ICK, Lee VHF, Mok J, Yip BHK, Cheng KKY, Wu CH, Cheung CL. Different definition of sarcopenia and mortality in cancer: A meta-analysis. Osteoporos Sarcopenia 2021; 7:S34-S38. [PMID: 33997307 PMCID: PMC8088994 DOI: 10.1016/j.afos.2021.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/25/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Sarcopenia has been an emerging theme in clinical oncology. Various definitions of sarcopenia have been proposed, but their prognostic performance have yet to be evaluated and compared. The aim of this meta-analysis is to comprehensively evaluate the performance of different cutoff definitions of sarcopenia in cancer mortality prognostication. METHODS This is a meta-analysis. Cohort studies on lean mass and mortality published before December 20, 2017 were obtained by systematic search on PubMed, Cochrane Library, and Embase. Inclusion criteria were cohort studies reporting binary lean mass categorized according to clearly defined cutoffs, and with all-cause mortality as study outcome. Studies were stratified according to the cutoff(s) used in defining low lean mass. The cutoff-specific hazard ratios (HRs) and 95% confidence intervals (CIs) of low lean mass on cancer mortality were pooled with a random-effects model and compared. RESULTS Altogether 81 studies that studied binary lean mass were included. The pooled HRs on cancer mortality using the 3 most used definitions were: 1.74 (95% CI, 1.46-2.07) using the definition proposed by International Consensus of Cancer Cachexia, 1.45 (95% CI, 1.21-1.75) using that by Martin, and 1.58 (95% CI, 1.35-1.84) using that by Prado. The associations between sarcopenia and cancer mortality using other definitions were all statistically significant, despite different estimates were observed. CONCLUSIONS The association of low lean mass with increased mortality was consistent across different definitions; this provides further evidence on the poorer survival in cancer patients with sarcopenia. However, further studies evaluating the performance of each definition are warranted.
Collapse
Affiliation(s)
- Hang-Long Li
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Philip Chun-Ming Au
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Grace Koon-Yee Lee
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Gloria Hoi-Yee Li
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marcus Chan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Ian Chi-Kei Wong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| | - Victor Ho-Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Mok
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Benjamin Hon-Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kenneth King-Yip Cheng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chih-Hsing Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
22
|
Esteves CL, Ohara DG, Matos AP, Ferreira VTK, Iosimuta NCR, Pegorari MS. Anthropometric indicators as a discriminator of sarcopenia in community-dwelling older adults of the Amazon region: a cross-sectional study. BMC Geriatr 2020; 20:518. [PMID: 33261567 PMCID: PMC7709449 DOI: 10.1186/s12877-020-01923-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 11/22/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Sarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia. METHODS This was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index - BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05. RESULTS Adjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53-0.76), CC (OR: 0.73; 95%CI: 0.62-0.85), WC (OR: 0.93; 95%CI: 0.90-0.97) and BMI (OR: 0.64; 95%CI: 0.53-0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia. CONCLUSIONS An increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.
Collapse
Affiliation(s)
- Cássio Lima Esteves
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil
| | - Daniela Gonçalves Ohara
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil
| | - Areolino Pena Matos
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil
| | - Vânia T K Ferreira
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil
| | - Natalia C R Iosimuta
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil
| | - Maycon Sousa Pegorari
- Physical Therapy Course, Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km - 02, Jardim Marco Zero, Macapá, Amapá, CEP 68903-419, Brazil.
| |
Collapse
|
23
|
Nankivell BJ, Nankivell LF, Elder GJ, Gruenewald SM. How unmeasured muscle mass affects estimated GFR and diagnostic inaccuracy. EClinicalMedicine 2020; 29-30:100662. [PMID: 33437955 PMCID: PMC7788434 DOI: 10.1016/j.eclinm.2020.100662] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Estimated glomerular filtration (eGFR) results based on serum creatinine are frequently inaccurate with differences against measured GFR (mGFR) often attributed to unmeasured non-functional factors, such as muscle mass. METHODS The influence of muscle mass (measured by dual-energy x-ray absorptiometry, DEXA) on eGFR error (eGFR-mGFR) was evaluated using isotopic mGFR (Tc99m DTPA plasma clearance) in 137 kidney transplant recipients. Serum creatinine was measured by isotopic-calibrated enzymatic analysis, converted to eGFR using Chronic Kidney Disease EPIdemiology (CKD-EPI) formula, then unindexed from body surface area. FINDINGS Unindexed CKD-EPI eGFR error displayed absent fixed bias but modest proportional bias against reference mGFR. eGFR error correlated with total lean mass by DEXA (r=-0·350, P<0·001) and appendicular skeletal muscle index (ASMI), a proxy for muscularity (r=-0·420, P<0·001). eGFR was falsely reduced by -5·9 ± 1·4 mls/min per 10 kg lean mass. Adipose mass and percentage fat had no effect on error. Muscle-associated error varied with each eGFR formula and influenced all CKD stages. Systemic eGFR error was predicted by ASMI, mGFR, recipient age, and trimethoprim use using multivariable regression. Residual plots demonstrated heteroscedasticity and greater imprecision at higher mGFR levels (P<0·001), from increased variance corresponding to higher absolute values and unreliable prediction by serum creatinine of high mGFR. Serum creatinine correlated with ASMI independent of mGFR level (r = 0·416, P<0·001). The diagnostic test performance of CKD-EPI eGFR to predict CKD stage 3 (by mGFR) was weakest in cachexia (sensitivity 68·4%) and muscularity (specificity 47·4%, positive predictive value 54·5% for the highest ASMI quartile). INTERPRETATION Serum creatinine and eGFR are imperfect estimates of true renal function, with systemic errors from muscle mass, tubular secretion, and intrinsic proportional bias; and additional inaccuracy at the extremes of renal function and patient muscularity. Cautious interpretation of eGFR results in the context of body habitus and clinical condition is recommended.
Collapse
Key Words
- ASMI, appendicular skeletal muscle index
- AUC, area under the curve
- BMI, body mass index
- BSA, body surface area
- CG, Cockcroft-Gault (eGFR estimated from creatinine clearance)
- CKD-EPI, Chronic Kidney Disease EPIdemiology (eGFR formula)
- CV, coefficient of variation
- DEXA
- DEXA, dual-energy x-ray absorptiometry
- Diagnostic accuracy
- GFR, glomerular filtration rate
- Kidney transplantation
- MDRD, Modification of Diet in Renal Disease (eGFR formula)
- NPV, negative predictive value
- PPV, positive predictive value
- ROC, receiver operating characteristic
- Tc99m DTPA, Technetium-99 m diethylene-triamine-pentaacetic acid
- eGFR
- eGFR, estimated GFR (implying a creatinine-based formula)
- mGFR, measured GFR (using a reference method)
Collapse
Affiliation(s)
- Brian J. Nankivell
- Departments of Renal Medicine, Westmead Hospital, Westmead, Australia
- Corresponding author.
| | | | - Grahame J. Elder
- Departments of Renal Medicine, Westmead Hospital, Westmead, Australia
- University of Sydney, Australia
| | - Simon M. Gruenewald
- University of Sydney, Australia
- Nuclear Medicine, Westmead Hospital, Westmead, Australia
| |
Collapse
|
24
|
Huber FA, Del Grande F, Rizzo S, Guglielmi G, Guggenberger R. MRI in the assessment of adipose tissues and muscle composition: how to use it. Quant Imaging Med Surg 2020; 10:1636-1649. [PMID: 32742957 DOI: 10.21037/qims.2020.02.06] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Body composition analysis based on the characterization of different tissue compartments is currently experiencing increasing attention by a broad range of medical disciplines for both clinical and research questions. However, body composition profiling (BCP) can be performed utilizing different modalities, which all come along with several technical and diagnostic strengths and limitations, respectively. Magnetic resonance imaging (MRI) demonstrates good soft tissue resolution, high contrast between fat and water, and is free from ionizing radiation. This review article represents an overview of imaging techniques for body composition assessment, focussing on qualitative and quantitative methods of assessing adipose tissue and muscles in MRI.
Collapse
Affiliation(s)
- Florian Alexander Huber
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Filippo Del Grande
- Istituto di imaging della Svizzera Italiana, Regional Hospital of Lugano, Lugano, Switzerland
| | - Stefania Rizzo
- Istituto di imaging della Svizzera Italiana, Regional Hospital of Lugano, Lugano, Switzerland
| | | | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
25
|
Zambone MA, Liberman S, Garcia MLB. Anthropometry, bioimpedance and densitometry: Comparative methods for lean mass body analysis in elderly outpatients from a tertiary hospital. Exp Gerontol 2020; 138:111020. [PMID: 32653450 DOI: 10.1016/j.exger.2020.111020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate lean mass index (LMI) measured by bioimpedance (BIA) and anthropometry compared to densitometry (DXA) in elderly outpatients from a tertiary care hospital. METHODS Participants were over 60-year-old men, presenting no dementia or disability, from a tertiary geriatric ambulatory. LMI obtained by BIA, anthropometry and DXA were submitted to Baumgartner, Janssen and Delmonico calculations respectively. Sarcopenia was calculated as LMI by DXA and handgrip strength. Data were analyzed by T student's test, ANOVA for repeated measures and pos hoc Bonferroni test, Pearson's correlation test, regression equation and Bland Altman analysis, ROC curve and contingency table 2 × 2 for sensitivity, specificity and predictive values. RESULTS A total of 92 participants completed the study. Most of them were married, aged 72.9 ± 6.6, lived a sedentary lifestyle, presented multiple morbidities, and in use of polypharmacy. Appendicular lean mass was lower in sarcopenic participants when compared to that in nonsarcopenic ones (20.2 kg/m2 and 23 kg/m2 respectively, p < 0.0001). BIA sensitivity, specificity and correlation to DXA were 37%, 98% and r = 0.81 (p < 0.001), and for anthropometry 67%, 92% and r = 0.77 (p < 0.0001) respectively. Bland Altman's analysis showed congruence between methods and DXA (anthropometry: bias = -0,05 ± 0,66, limits of agreement (LoA) = -1.37 and 1.26; BIA: bias = 2,2; LoA = 0,7 and 3,7). CONCLUSION Aging and multiple chronic and degenerative morbidities affect LM in vulnerable elderly patients. Both anthropometry and BIA, are accurate to measure LMI independently in this population but Anthropometry presented better agreement to DXA than Bioimpedance and has the advantage of lower price, easier application and cheaper equipment to be applied.
Collapse
Affiliation(s)
- Maria Aquimara Zambone
- Division of Nutrition and Dietetics of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Sami Liberman
- Geriatric Division of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria Lucia Bueno Garcia
- Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
26
|
Gawel SH, Davis GJ, Luo M, Deutz NEP, Wolfe RR, Pereira SL. Serum biomarkers that predict lean mass loss over bed rest in older adults: An exploratory study. Clin Chim Acta 2020; 509:72-78. [PMID: 32505773 DOI: 10.1016/j.cca.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/23/2020] [Accepted: 06/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lean mass (LM) loss during extended bed rest contributes to long term functional decline in older adults. Identifying blood biomarkers that predict a hospitalized individual's risk of losing LM could allow for timely intervention. METHODS LM from 19 healthy subjects (age 60-76 y, 4 males, 15 females), who were confined to 10 days of complete bed rest, was measured pre- and post-bed rest. One hundred eighty-seven biomarkers from pre-bed rest fasted serum samples were obtained from all evaluable subjects (n = 18), analyzed using multiplexed immunoassay array and pooled. Decision tree analysis was used to identify pre-bed rest markers that predict LM loss over bed rest. RESULTS Sixty-three markers were excluded due to being below assay detection limits. One pair of markers, Tissue inhibitor of metalloprotease-1 (TIMP1) and tenascin C (TNC), were found to correlate with percent change in total LM over bed rest: [R2 = 0.71, all subjects; R2 = 0.76, females]. Subjects with pre-bed rest TIMP1 ≥ 141 ng/ml had the highest loss of total LM over bed rest, whereas subjects with pre-bed rest TIMP1 < 141 and TNC ≥ 461 ng/ml maintained total LM over bed rest. An additional marker set was found to correlate with percent change in leg LM loss over bed rest: matrix metalloprotease-3 (MMP3) and apolipoprotein A2 (APOA2) [R2 = 0.59, females]. Females with pre-bed rest MMP3 < 6.93 ng/ml had the highest loss of leg LM over bed rest. Whereas females with pre-bed rest MMP3 ≥ 6.93 and ApoA2 < 276 ng/ml, maintained leg lean mass at the end of bed rest. CONCLUSIONS Panels of blood biomarkers associated with the muscle extracellular matrix may predict the likelihood for LM loss over extended bed rest.
Collapse
Affiliation(s)
- Susan H Gawel
- Abbott Diagnostics Division, Abbott Laboratories, 100 Abbott Park Road, Abbott Park, IL 60064, USA
| | - Gerard J Davis
- Abbott Diagnostics Division, Abbott Laboratories, 100 Abbott Park Road, Abbott Park, IL 60064, USA
| | - Menghua Luo
- Abbott Nutrition Division, Abbott Laboratories, 3300 Stelzer Road, Columbus, OH 43219, USA
| | - Nicolaas E P Deutz
- Texas A&M University, Department of Health & Kinesiology, 675 John Kimbrough Blvd, College Station, TX 77843-4253, USA
| | - Robert R Wolfe
- University of Arkansas Medical Sciences, UAMS Centers on Aging, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Suzette L Pereira
- Abbott Nutrition Division, Abbott Laboratories, 3300 Stelzer Road, Columbus, OH 43219, USA.
| |
Collapse
|
27
|
Marzuca-Nassr GN, SanMartín-Calísto Y, Guerra-Vega P, Artigas-Arias M, Alegría A, Curi R. Skeletal Muscle Aging Atrophy: Assessment and Exercise-Based Treatment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:123-158. [PMID: 32304033 DOI: 10.1007/978-3-030-42667-5_6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In the ordinary course of aging, individuals change their body composition, mainly reducing their skeletal muscle mass and increasing their fat mass. In association, muscle strength and functionality also decrease. The geriatric assessment allows knowing the baseline situation of the patients, determines the impact of diseases, and defines specific treatments. There are various tools to evaluate the health condition of older people. These tools include the assessment scales of necessary Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), physical and functional assessment scales, and instruments that assess the cognitive state of the person. There are several strategies that have been proposed to combat skeletal muscle atrophy due to aging, such as physical exercise, nutritional supplements, or drugs. Some researchers have highlighted the efficacy of the combination of the mentioned strategies. In this chapter, we will focus only on physical exercise as a strategy to reduce skeletal muscle loss during aging.
Collapse
Affiliation(s)
- Gabriel Nasri Marzuca-Nassr
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile. .,Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
| | - Yuri SanMartín-Calísto
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Pablo Guerra-Vega
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.,Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Puerto Montt, Chile
| | - Macarena Artigas-Arias
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Andrea Alegría
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
| |
Collapse
|
28
|
Equation models developed with bioelectric impedance analysis tools to assess muscle mass: A systematic review. Clin Nutr ESPEN 2019; 35:47-62. [PMID: 31987121 DOI: 10.1016/j.clnesp.2019.09.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/06/2019] [Accepted: 09/21/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS This systematic review aims to systematically assess and summarize the equation models developed to estimate muscle mass with bioelectric impedance analysis (BIA) instruments against a reference instrument (DXA, MRI, CT-scan, Ultrasonography), in order to help researchers and clinicians choose the most adapted equation, depending on the device and the population in question. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was followed. Medline (via Ovid) and Scopus were searched in January 2019 for observational (transversal, longitudinal, retrospective) studies developing an equation prediction model to validate BIA against another reference method for the assessment of muscle mass. Study selection and data extraction was performed independently by two researchers. Methodological quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS 25 studies matched the inclusion criteria and were included in the present systematic review. Among them, 10 studies proposed an equation for subjects aged 65 years and older, 9 for adults, 4 for infants and 2 did not report the age of the population. A large heterogeneity was observed regarding the brand and type of BIA as well as the administration protocol (mode, frequency, number of electrodes, administration position and empty bladder/stomach or not). Most of the studies used DXA as the reference instrument, except 4 that used MRI. In each of the included papers authors provided, through simple or multiple regression, a predictive equation for muscle mass. BIA resistance index, sex, weight, age, BIA reactance and height were most frequently included as predictive variables. The majority of the equations developed explained more than 80% of the variance between both instruments. Out of the 25 equations available, only 9 were also validated in another population within the same paper. CONCLUSION This systematic review of the literature offers clinicians and researchers the opportunity to verify the existence of a prediction equation when using a BIA device for estimating muscle mass. This will help them to obtain a valid estimation of muscle mass in a specific population and with a specific instrument. If the equation exists and has been validated by a study free of high risk of bias, it's use is recommended because the development of a new equation in the same context seems redundant and undesirable. If a validation has not been carried out for a specific brand of BIA, reference method or population, we recommend the development and cross-validation of a new equation.
Collapse
|
29
|
Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH, Kim KW. Recent Issues on Body Composition Imaging for Sarcopenia Evaluation. Korean J Radiol 2019; 20:205-217. [PMID: 30672160 PMCID: PMC6342757 DOI: 10.3348/kjr.2018.0479] [Citation(s) in RCA: 196] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/15/2018] [Indexed: 02/07/2023] Open
Abstract
Recently, sarcopenia has garnered renewed interest. Sarcopenia is a disease characterized by decreased skeletal muscle mass and strength/function, which can impair the quality of life and increase physical disability, adverse metabolic effects, and mortality. Imaging tools for evaluating and diagnosing sarcopenia have developed rapidly. Radiologists should be aware of sarcopenia and its clinical implications. We review current knowledge about sarcopenia, its pathophysiological impact, and advantages and disadvantages of methods for evaluation of sarcopenia focusing on body composition imaging modalities such as whole-body dual-energy X-ray absorptiometry, CT, and MRI. Controversial issues are discussed, including the lack of consensus and standardization of the disease definition, imaging modality, measurement methods, and diagnostic cutoff points.
Collapse
Affiliation(s)
- Koeun Lee
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yongbin Shin
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimi Huh
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, Suwon, Korea.
| | - Yu Sub Sung
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kwon Ha Yoon
- Department of Radiology, Wonkwang University College of Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Kyung Won Kim
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
30
|
Sanfilippo J, Krueger D, Heiderscheit B, Binkley N. Dual-Energy X-Ray Absorptiometry Body Composition in NCAA Division I Athletes: Exploration of Mass Distribution. Sports Health 2019; 11:453-460. [PMID: 31348720 PMCID: PMC6745817 DOI: 10.1177/1941738119861572] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Body composition assessment is frequently used in sports medicine and athletic performance environments to assess change in response to strength training and nutrition programs. However, to effectively do so requires knowledge regarding expected body composition values relative to sport and sex. Dual-energy x-ray absorptiometry (DXA) is widely used to evaluate body composition, although its utility in relationship to specific sports, performance, or rehabilitation is not clearly defined. HYPOTHESIS Body composition metrics and distribution of National Collegiate Athletic Association Division I collegiate athletes will vary based on sport and sex. LEVEL OF EVIDENCE Level 4. STUDY DESIGN Cross-sectional study. METHODS A convenience sample of 337 athletes (229 men and 108 women) participating in football, wrestling, soccer, hockey, basketball, golf, softball, or volleyball was evaluated. DXA-measured total body composition, including bone mineral density (BMD), % lean mass, % fat, and regional distribution, were compared by sex, sport, and with an age-matched National Health and Nutrition Examination Survey (NHANES) population. RESULTS Men had higher BMD, lower % fat (16.4% vs 25.2%) and higher % lean mass (79.2% vs 70.6%) (P < 0.001). Regional composition varied by sport and sex, with women having a greater proportion of lean mass at the trunk and men in their arms (P < 0.0001). Leg lean mass was distributed similarly between sexes (35%). Overall, the normative group (NHANES) had lower BMD and higher percentage fat. CONCLUSION DXA-measured body composition and lean mass distribution varies by sport and sex in Division I athletes. The observed difference to the NHANES population emphasizes challenges in identifying appropriate comparison populations, reinforcing the need to compare athletes with their own baseline. CLINICAL RELEVANCE These findings establish a framework to investigate the relevance of these variances and determine the utility of body composition analysis in elite athletes.
Collapse
Affiliation(s)
- Jennifer Sanfilippo
- University of Wisconsin Badger Athletic
Performance Program, Madison, Wisconsin
| | - Diane Krueger
- University of Wisconsin Osteoporosis
Clinical Research Program, Madison, Wisconsin
| | - Bryan Heiderscheit
- University of Wisconsin Badger Athletic
Performance Program, Madison, Wisconsin
- University of Wisconsin Orthopedics and
Rehabilitation, Madison, Wisconsin
| | - Neil Binkley
- University of Wisconsin Badger Athletic
Performance Program, Madison, Wisconsin
- University of Wisconsin Osteoporosis
Clinical Research Program, Madison, Wisconsin
| |
Collapse
|
31
|
Abstract
Sarcopenia is the progressive loss of skeletal mass and strength, particularly in older adults, with consequent reduction in function and independence. Changing population demographics, have resulted in increased prevalence of sarcopenia and this is associated with a considerable economic burden. Whilst simple, effective, non-intrusive management of this condition exists, no routine diagnosis takes place either in the UK or in many other countries, partly due to an absence of pragmatic clinical diagnostic tools to support the early identification of the syndrome. This position paper aims to provide a short overview proposing the potential case for developing ultrasound as a new and alternative diagnostic tool for identifying sarcopenia.
Collapse
Affiliation(s)
- H J Stringer
- Howard Stringer, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT,
| | | |
Collapse
|
32
|
Verreijen AM, Engberink MF, Houston DK, Brouwer IA, Cawthon PM, Newman AB, Tylavsky FA, Harris TB, Weijs PJM, Visser M. Dietary protein intake is not associated with 5-y change in mid-thigh muscle cross-sectional area by computed tomography in older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2019; 109:535-543. [PMID: 30850837 PMCID: PMC6408207 DOI: 10.1093/ajcn/nqy341] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/06/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A higher protein intake is suggested to preserve muscle mass during aging and may therefore reduce the risk of sarcopenia. OBJECTIVES We explored whether the amount and type (animal or vegetable) of protein intake were associated with 5-y change in mid-thigh muscle cross-sectional area (CSA) in older adults (n = 1561). METHODS Protein intake was assessed at year 2 by a Block food-frequency questionnaire in participants (aged 70-79 y) of the Health, Aging, and Body Composition (Health ABC) Study, a prospective cohort study. At year 1 and year 6 mid-thigh muscle CSA in square centimeters was measured by computed tomography. Multiple linear regression analysis was used to examine the association between energy-adjusted protein residuals in grams per day (total, animal, and vegetable protein) and muscle CSA at year 6, adjusted for muscle CSA at year 1 and potential confounders including prevalent health conditions, physical activity, and 5-y change in fat mass. RESULTS Mean (95% CI) protein intake was 0.90 (0.88, 0.92) g · kg-1 · d-1 and mean (95% CI) 5-y change in muscle CSA was -9.8 (-10.6, -8.9) cm2. No association was observed between energy-adjusted total (β = -0.00; 95% CI: -0.06, 0.06 cm2; P = 0.982), animal (β = -0.00; 95% CI: -0.06, 0.05 cm2; P = 0.923), or plant (β = +0.07; 95% CI: -0.06, 0.21 cm2; P = 0.276) protein intake and muscle CSA at year 6, adjusted for baseline mid-thigh muscle CSA and potential confounders. CONCLUSIONS This study suggests that a higher total, animal, or vegetable protein intake is not associated with 5-y change in mid-thigh muscle CSA in older adults. This conclusion contradicts some, but not all, previous research. This trial was registered at www.trialregister.nl as NTR6930.
Collapse
Affiliation(s)
- Amely M Verreijen
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Mariëlle F Engberink
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Denise K Houston
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Ann B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Frances A Tylavsky
- Health Science Center, Preventive Medicine, University of Tennessee, Memphis, TN
| | | | - Peter J M Weijs
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Nutrition and Dietetics, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| |
Collapse
|
33
|
Combination of DXA and BIS body composition measurements is highly correlated with physical function-an approach to improve muscle mass assessment. Arch Osteoporos 2018; 13:97. [PMID: 30218261 DOI: 10.1007/s11657-018-0508-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023]
Abstract
RATIONALE Fluid volume estimates may help predict functional status and thereby improve sarcopenia diagnosis. MAIN RESULT Bioimpedance-derived fluid volume, combined with DXA, improves identification of jump power over traditional measures. SIGNIFICANCE DXA-measured lean mass should be corrected for fluid distribution in older populations; this may be a surrogate of muscle quality. PURPOSE Sarcopenia, the age-related loss of muscle mass and function, negatively impacts functional status, quality of life, and mortality. We aimed to determine if bioimpedance spectroscopy (BIS)-derived estimates of body water compartments can be used in conjunction with dual-energy X-ray absorptiometry (DXA) measures to aid in the prediction of functional status and thereby, ultimately, improve the diagnosis of sarcopenia. METHODS Participants (≥ 70 years) had physical and muscle function tests, DXA, and BIS performed. Using a BMI correction method, intracellular water (ICWc), extracellular water (ECWc), and ECWc to ICWc (E/Ic) ratio was estimated from standard BIS measures. Jump power was assessed using jump mechanography. RESULTS The traditional measure used to diagnose sarcopenia, DXA-derived appendicular lean mass (ALM) corrected for height (ALM/ht2), was the least predictive measure explaining jump power variability (r2 = 0.31, p < 0.0001). The best measure for explaining jump power was a novel variable combining DXA ALM and BIS-derived E/Ic ratio (ALM/(E/Ic); r2 = 0.70, p < 0.0001). ALM/(E/Ic) and ICWc had the highest correlation with jump power and grip strength, specifically jump power (r = 0.84 and r = 0.80, respectively; p < 0.0001). CONCLUSIONS The creation of a novel variable (ALM/(E/Ic)) improved the ability of DXA to predict jump power in an older population. ALM/(E/Ic) substantially outperformed traditional lean mass measures of sarcopenia and could well be an improved diagnostic approach to predict functional status. DXA-measured ALM should be corrected for fluid distribution, i.e., ALM/(E/Ic); this correction may be considered a surrogate of muscle quality.
Collapse
|
34
|
McPhee JS, Cameron J, Maden-Wilkinson T, Piasecki M, Yap MH, Jones DA, Degens H. The Contributions of Fiber Atrophy, Fiber Loss, In Situ Specific Force, and Voluntary Activation to Weakness in Sarcopenia. J Gerontol A Biol Sci Med Sci 2018; 73:1287-1294. [PMID: 29529132 PMCID: PMC6132117 DOI: 10.1093/gerona/gly040] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/24/2018] [Indexed: 12/25/2022] Open
Abstract
The contributions of fiber atrophy, fiber loss, in situ specific force, and voluntary activation to weakness in sarcopenia remain unclear. To investigate, 40 older (20 women; age 72 ± 4 years) and 31 younger adults (15 women, age 22 ± 3 years) completed measurements. The knee extensor maximal voluntary torque (MVC) was measured as well as voluntary activation, patella tendon moment arm length, muscle volume, and fascicle architecture to estimate in situ specific force. Fiber cross-sectional area (FCSA), fiber numbers, and connective tissue contents were also estimated from vastus lateralis biopsies. The MVC, quadriceps volume, and specific force were 39%, 28%, and 17% lower, respectively, in old compared with young, but voluntary activation was not different. The difference in muscle size was due in almost equal proportions to lower type II FCSA and fewer fibers. Five years later (n = 23) the MVC, muscle volume and voluntary activation in old decreased an additional 12%, 6%, and 4%, respectively, but there was no further change in specific force. In situ specific force declines relatively early in older age and reduced voluntary activation occurs later, but the overall weakness in sarcopenia is mainly related to loss of both type I and II fibers and type II fiber atrophy.
Collapse
Affiliation(s)
- Jamie S McPhee
- School of Healthcare Science, Manchester Metropolitan University, UK
| | - James Cameron
- School of Healthcare Science, Manchester Metropolitan University, UK
| | | | - Mathew Piasecki
- School of Healthcare Science, Manchester Metropolitan University, UK
| | - Moi Hoon Yap
- School of Mathematics, Computing and Digital Technology, Manchester Metropolitan University, UK
| | - David A Jones
- School of Healthcare Science, Manchester Metropolitan University, UK
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, UK
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas
| |
Collapse
|
35
|
Recio-Boiles A, Galeas JN, Goldwasser B, Sanchez K, Man LMW, Gentzler RD, Gildersleeve J, Hollen PJ, Gralla RJ. Enhancing evaluation of sarcopenia in patients with non-small cell lung cancer (NSCLC) by assessing skeletal muscle index (SMI) at the first lumbar (L1) level on routine chest computed tomography (CT). Support Care Cancer 2018; 26:2353-2359. [PMID: 29417293 PMCID: PMC5984123 DOI: 10.1007/s00520-018-4051-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 01/15/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE Ongoing cancer cachexia trials evaluate sarcopenia by skeletal muscle index (SMI) at the L3 vertebrae level, commonly used as a standard. Routine chest CT institutional protocols widely differ in including L3. We investigated whether SMI at L1 assessment, rather than L3, would be reliable and more practicable for non-small cell lung cancer (NSCLC). METHODS NSCLC patients with routine CT chest had SMI measurements performed at L1 using Slice-O-Matic software. Accuracy of including L1 level, imaging quality, and ability to detect sarcopenia was collected and correlation of L1 SMI with body mass index (BMI) was performed. RESULTS Thirty-seven patients with NSCLC (73 CT assessments) were enlisted at three institutions. Characteristics: 47% female; medians: age 59, KPS 80%; BMI 25.49, weight 72.97 kg, SMI 59.24. Sarcopenia was detected in 14.7% of patients; 20% had sarcopenic obesity. Of the 73 CTs, 94.5% included L1 (95% CI 86.6-98.5%). Three images (4%) were difficult to evaluate. Inclusion of L1 was similar among the three participating institutions (90.4 to 96.7% inclusion). BMI correlation with SMI was weak (r = 0.329). CONCLUSIONS SMI assessment at L1 is achievable in patients with NSCLC receiving routine chest CT, with 96% having acceptable quality evaluations. Similar to results previously reported at L3, BMI showed poor correlation and low sensitivity to detect muscle mass loss. The use of CT at L1 is reliable and presents the opportunity for easier patient evaluation of sarcopenia in patients with lung cancer without the need for additional testing or radiation exposure.
Collapse
Affiliation(s)
| | - Jose N Galeas
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Bernard Goldwasser
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Karla Sanchez
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | | | | | | | | | - Richard J Gralla
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
| |
Collapse
|
36
|
Easton JF, Stephens CR, Román-Sicilia H, Cesari M, Pérez-Zepeda MU. Anthropometric measurements and mortality in frail older adults. Exp Gerontol 2018; 110:61-66. [PMID: 29775746 DOI: 10.1016/j.exger.2018.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 03/09/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND As the number of older adults increases, so does the number of frail older adults. Although anthropometry has been widely used as a way to stratify the overall mortality risk of a person, the significance of these measurements becomes blurred in the case of frail older adults who have changes in body composition. Therefore, the aim of this study is to determine the association of anthropometric measurements (body mass index, knee-adjusted height body mass index, waist-to-hip ratio and calf circumference) with mortality risk in a group of older Mexican adults. METHODS This is a longitudinal analysis of the Mexican Health and Aging sub-sample (with biomarkers, n = 2573) from the first wave in 2001, followed-up to the last available wave in 2015. Only frail 50-year or older adults (Frailty Index with a cut-off value of 0.21 or higher, was used) were considered for this analysis (n = 1298). A survival analysis was performed with Kaplan-Meier curves and Cox regression models (unadjusted and adjusted for confounding). Socio-demographic, health risks, physical activity and comorbidities were variables used for adjusting the multivariate models. RESULTS From the total sample of 1298 older adults, 32.5% (n = 422) died during follow-up. The highest hazard ratio in the adjusted model was for calf circumference 1.31 (95% confidence interval 1.02-1.69, p = 0.034). Other measurements were not significant. CONCLUSIONS Anthropometric measurements have different significance in frail older adults, and these differences could have implications on adverse outcomes. Calf circumference has a potential value in predicting negative health outcomes.
Collapse
Affiliation(s)
- Jonathan F Easton
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad de México, Mexico; Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Christopher R Stephens
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad de México, Mexico; Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Heriberto Román-Sicilia
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community, University of Milan, Milan, Italy
| | - Mario Ulises Pérez-Zepeda
- Geriatric Epidemiologic Research Department, Instituto Nacional de Geriatría, Mexico; Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
| |
Collapse
|
37
|
Buckinx F, Landi F, Cesari M, Fielding RA, Visser M, Engelke K, Maggi S, Dennison E, Al-Daghri NM, Allepaerts S, Bauer J, Bautmans I, Brandi ML, Bruyère O, Cederholm T, Cerreta F, Cherubini A, Cooper C, Cruz-Jentoft A, McCloskey E, Dawson-Hughes B, Kaufman JM, Laslop A, Petermans J, Reginster JY, Rizzoli R, Robinson S, Rolland Y, Rueda R, Vellas B, Kanis JA. Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle 2018; 9:269-278. [PMID: 29349935 PMCID: PMC5879987 DOI: 10.1002/jcsm.12268] [Citation(s) in RCA: 466] [Impact Index Per Article: 77.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/05/2017] [Accepted: 10/12/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND All proposed definitions of sarcopenia include the measurement of muscle mass, but the techniques and threshold values used vary. Indeed, the literature does not establish consensus on the best technique for measuring lean body mass. Thus, the objective measurement of sarcopenia is hampered by limitations intrinsic to assessment tools. The aim of this study was to review the methods to assess muscle mass and to reach consensus on the development of a reference standard. METHODS Literature reviews were performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis working group on frailty and sarcopenia. Face-to-face meetings were organized for the whole group to make amendments and discuss further recommendations. RESULTS A wide range of techniques can be used to assess muscle mass. Cost, availability, and ease of use can determine whether the techniques are better suited to clinical practice or are more useful for research. No one technique subserves all requirements but dual energy X-ray absorptiometry could be considered as a reference standard (but not a gold standard) for measuring muscle lean body mass. CONCLUSIONS Based on the feasibility, accuracy, safety, and low cost, dual energy X-ray absorptiometry can be considered as the reference standard for measuring muscle mass.
Collapse
Affiliation(s)
- Fanny Buckinx
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart Rome, Milan, Italy
| | - Matteo Cesari
- Gérontopôle, University Hospital of Toulouse, Toulouse, France.,INSERM UMR1027, University of Toulouse III Paul Sabatier, Toulouse, France
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, 02111, USA
| | - Marjolein Visser
- Department of Health Sciences, VU University Amsterdam, Amsterdam, Netherlands.,Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - Klaus Engelke
- Institute of Medical Physics, University of Erlangen, Erlangen, Germany
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England, UK
| | - Nasser M Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | | | - Jurgen Bauer
- Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Oldenburg, Germany
| | - Ivan Bautmans
- Gerontology and Frailty in Ageing Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, viale Pieraccini 6, 59139, Florence, Italy
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Human Medicines Research and Development Support Division, Scientific Advice, London, UK
| | - Francesca Cerreta
- Human Medicines Research and Development Support Division, Scientific Advice, London, UK
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England, UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Alphonso Cruz-Jentoft
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), Madrid, Spain
| | - Eugene McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.,MRC and Arthritis Research UK Centre for Integrated research in Musculoskeletal Ageing (CIMA), London, UK
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Jean-Marc Kaufman
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Andrea Laslop
- Scientific Office, Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton NHS Foundation Trust, Southampton, UK
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse); UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | | | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse); UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, UK and Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia
| |
Collapse
|
38
|
Inose H, Yamada T, Hirai T, Yoshii T, Abe Y, Okawa A. The impact of sarcopenia on the results of lumbar spinal surgery. Osteoporos Sarcopenia 2018; 4:33-36. [PMID: 30775539 PMCID: PMC6362951 DOI: 10.1016/j.afos.2018.02.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/21/2018] [Accepted: 02/28/2018] [Indexed: 12/25/2022] Open
Abstract
Objectives As the population ages, the number of lumbar spinal surgeries performed on sarcopenic patients will increase. The purpose of this study was to investigate the prevalence of sarcopenia and evaluated its impact on the results of lumbar spinal surgery. Methods This study included 2 groups: One group consisted of patients who underwent whole-body dual-energy X-ray absorptiometry (DXA) scanning before the option of undergoing surgery for lumbar spinal disease (LSD group) and a second group consisted of patients underwent DXA scanning for osteoporosis screening under hospital watch at the geriatric medicine department (control group). In order to evaluate the impact of sarcopenia on the clinical outcome of lumbar spinal surgery, the Japanese Orthopedic Association (JOA) score, the recovery rate based on the JOA score, and visual analogue scale (VAS) scores for lower back pain, lower extremity pain, and lower extremity numbness were compared within the LSD group. Results The prevalence of sarcopenia showed no statistical difference between groups (control group, 50.7%; LSD group, 46.5%). In the LSD group, while the changes in VAS scores showed no statistical difference between the nonsarcopenia subgroup and sarcopenia subgroup, the sarcopenia subgroup demonstrated inferior JOA scores and recovery rates at the final follow-up when compared with the nonsarcopenia subgroup (P < 0.05). Conclusions This study demonstrated a high prevalence of sarcopenia among the elderly populations in Japan and a negative impact of sarcopenia on clinical outcomes after lumbar spinal surgery.
Collapse
Affiliation(s)
- Hiroyuki Inose
- Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Yamada
- Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Hirai
- Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuko Abe
- Department of Geriatric Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
39
|
Bartley JM, Studenski SA. Muscle Ultrasound As a Link to Muscle Quality and Frailty in the Clinic. J Am Geriatr Soc 2017; 65:2562-2563. [DOI: 10.1111/jgs.15075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Jenna M. Bartley
- Center on Aging; Department of Immunology; University of Connecticut Health Center; Farmington CT
| | - Stephanie A. Studenski
- Translational Gerontology Branch; Longitudinal Studies Section; National Institute on Aging; Baltimore MD
| |
Collapse
|
40
|
Clark RV, Walker AC, Miller RR, O'Connor-Semmes RL, Ravussin E, Cefalu WT. Creatine ( methyl-d 3) dilution in urine for estimation of total body skeletal muscle mass: accuracy and variability vs. MRI and DXA. J Appl Physiol (1985) 2017; 124:1-9. [PMID: 28860169 DOI: 10.1152/japplphysiol.00455.2016] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A noninvasive method to estimate muscle mass based on creatine ( methyl-d3) (D3-creatine) dilution using fasting morning urine was evaluated for accuracy and variability over a 3- to 4-mo period. Healthy older (67- to 80-yr-old) subjects ( n = 14) with muscle wasting secondary to aging and four patients with chronic disease (58-76 yr old) fasted overnight and then received an oral 30-mg dose of D3-creatine at 8 AM ( day 1). Urine was collected during 4 h of continued fasting and then at consecutive 4- to 8-h intervals through day 5. Assessment was repeated 3-4 mo later in 13 healthy subjects and 1 patient with congestive heart failure. Deuterated and unlabeled creatine and creatinine were measured using liquid chromatography-tandem mass spectrometry. Total body creatine pool size and muscle mass were calculated from D3-creatinine enrichment in urine. Muscle mass was also measured by whole body MRI and 24-h urine creatinine, and lean body mass (LBM) was measured by dual-energy X-ray absorptiometry (DXA). D3-creatinine urinary enrichment from day 5 provided muscle mass estimates that correlated with MRI for all subjects ( r = 0.88, P < 0.0001), with less bias [difference from MRI = -3.00 ± 2.75 (SD) kg] than total LBM assessment by DXA, which overestimated muscle mass vs. MRI (+22.5 ± 3.7 kg). However, intraindividual variability was high with the D3-creatine dilution method, with intrasubject SD for estimated muscle mass of 2.5 kg vs. MRI (0.5 kg) and DXA (0.8 kg). This study supports further clinical validation of the D3-creatine method for estimating muscle mass. NEW & NOTEWORTHY Measurement of creatine ( methyl-d3) (D3-creatine) and D3-creatinine excretion in fasted morning urine samples may be a simple, less costly alternative to MRI or dual-energy X-ray absorptiometry (DXA) to calculate total body muscle mass. The D3-creatine enrichment method provides estimates of muscle mass that correlate well with MRI, and with less bias than DXA. However, intraindividual variability is high with the D3-creatine method. Studies to refine the spot urine sample method for estimation of muscle mass may be warranted.
Collapse
Affiliation(s)
- Richard V Clark
- Muscle Metabolism Discovery Performance Unit, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Ann C Walker
- Muscle Metabolism Discovery Performance Unit, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Ram R Miller
- Muscle Metabolism Discovery Performance Unit, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Robin L O'Connor-Semmes
- Muscle Metabolism Discovery Performance Unit, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Eric Ravussin
- Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | | |
Collapse
|
41
|
Imboden MT, Swartz AM, Finch HW, Harber MP, Kaminsky LA. Reference standards for lean mass measures using GE dual energy x-ray absorptiometry in Caucasian adults. PLoS One 2017; 12:e0176161. [PMID: 28426779 PMCID: PMC5398591 DOI: 10.1371/journal.pone.0176161] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/06/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To develop reference values by age and sex for LM measures using GE-Healthcare DXA systems. METHODS A de-identified sample was obtained from Ball State University's Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee's Physical Activity & Health Research Laboratory. DXA scans of 2,076 women and 1,251 men were completed using a GE Lunar Prodigy or iDXA. Percentiles (%ile) were calculated for all variables of interest (LM, LMI, %LM, and ALMI) and a factorial ANOVA was used to assess differences for each variable between 10-year age groups and sex, as well as the interaction between age and sex. RESULTS Men had higher mean total LM, %LM, LMI, and ALMI than women (p<0.01), across all age groups. All LM variables decreased significantly over the 5 decades in men, however in women only total LM, %LM, and ALMI decreased from the youngest to oldest age groups (p<0.01). CONCLUSION These reference values provide for a more accurate interpretation of GE-Healthcare DXA-derived LM measurements offering clinicians and researchers with an initial resource to aid in the early detection and assessment of LM deficits.
Collapse
Affiliation(s)
- Mary T. Imboden
- Ball State University, Muncie, Indiana, United States of America
- * E-mail:
| | - Ann M. Swartz
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Holmes W. Finch
- Ball State University, Muncie, Indiana, United States of America
| | | | | |
Collapse
|
42
|
Godoy K, Sávio KEDO, Akutsu RDC, Gubert MB, Botelho RBA. Food insecurity and nutritional status of individuals in a socially vulnerable situation in Brazil. CIENCIA & SAUDE COLETIVA 2017. [DOI: 10.1590/1413-81232017222.17132016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The objective was to investigate the association between food insecurity (FI) and anthropometric indicators among beneficiaries of a Brazilian social program called Community Canteens (CCs). This was a cross-sectional study. The associations were analyzed by chi-square test and Poisson regression. The subjects were 1,232 patrons of Brazil’s CCs. Men with severe FI had a lower mean BMI (-1.53 kg/m2) and a lower body fat percentage (-3.83 percentage points). Men that had a fat percentage classified as “risk of diseases associated with malnutrition” had a 2.34 times greater chance of experiencing severe FI, as did those who had low weight (PR: 2.64). However, these results were no longer significant after Poisson regression. With respect to women, there were no significant associations between the variables studied and FI. The high prevalence of overweight and body fat in the population at all of the FI levels and for both sexes are an indication of the complexity of the Brazilian scenario regarding the aspect of nutrition and excess weight in poor communities.
Collapse
|
43
|
Tosato M, Marzetti E, Cesari M, Savera G, Miller RR, Bernabei R, Landi F, Calvani R. Measurement of muscle mass in sarcopenia: from imaging to biochemical markers. Aging Clin Exp Res 2017; 29:19-27. [PMID: 28176249 DOI: 10.1007/s40520-016-0717-0] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 10/10/2016] [Indexed: 12/18/2022]
Abstract
Sarcopenia encompasses the loss of muscle mass and strength/function during aging. Several methods are available for the estimation of muscle or lean body mass. Popular assessment tools include body imaging techniques (e.g., magnetic resonance imaging, computed tomography, dual X-ray absorptiometry, ultrasonography), bioelectric impedance analysis, anthropometric parameters (e.g., calf circumference, mid-arm muscle circumference), and biochemical markers (total or partial body potassium, serum and urinary creatinine, deuterated creatine dilution method). The heterogeneity of the populations to be evaluated as well as the setting in which sarcopenia is investigated impacts the definition of "gold standard" assessment techniques. The aim of this article is to critically review available methods for muscle mass estimation, highlighting strengths and weaknesses of each of them as well as their proposed field of application.
Collapse
|
44
|
Krueger D, Siglinsky E, Buehring B, Binkley N. Total Body Less Head Measurement Is Most Appropriate for Lean Mass Assessment in Adults. J Clin Densitom 2017; 20:128-129. [PMID: 27773537 DOI: 10.1016/j.jocd.2016.08.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Diane Krueger
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| | - Ellen Siglinsky
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| | - Bjoern Buehring
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| | - Neil Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
45
|
Multi-frequency bioelectrical impedance analysis (BIA) compared to magnetic resonance imaging (MRI) for estimation of fat-free mass in colorectal cancer patients treated with chemotherapy. Clin Nutr ESPEN 2016; 16:8-15. [DOI: 10.1016/j.clnesp.2016.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 11/19/2022]
|
46
|
Smith S, Madden AM. Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques. J Hum Nutr Diet 2016; 29:714-732. [PMID: 27137882 DOI: 10.1111/jhn.12372] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice.
Collapse
Affiliation(s)
- S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| |
Collapse
|
47
|
Sergi G, Trevisan C, Veronese N, Lucato P, Manzato E. Imaging of sarcopenia. Eur J Radiol 2016; 85:1519-24. [PMID: 27117135 DOI: 10.1016/j.ejrad.2016.04.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/13/2016] [Accepted: 04/13/2016] [Indexed: 12/25/2022]
Abstract
Sarcopenia is currently considered a geriatric syndrome increasing in older people. The consequences of sarcopenia - in terms of impaired mobility, limited self-sufficiency and disability - have been amply demonstrated, increasing the need to develop methods to identify muscle mass loss as early as possible. Although sarcopenia involves a reduction in both muscle mass and function, loss of muscle mass remains the essential criterion for diagnosing this condition in daily practice. Computed tomography and magnetic resonance imaging represent the gold standard for studying body composition, and can identify quantitative and qualitative changes in muscle mass. These techniques are costly, time-consuming and complex, however, so their applicability is limited to the research field. Sonography, on the other hand, has the advantage of being a relatively quick and inexpensive method for detecting loss of muscle fibers and fat infiltration by analyzing muscle thickness and echo intensity. To the best of our knowledge, however, only few studies have compared the results of ultrasound with those obtained by other methods in order to establish its reliability in this setting. Dual X-ray absorptiometry thus remains the most often used technology for studying body composition, detecting quantitative changes in muscle mass with the advantages of a low radiation dose, a simple technology and a rapid assessment.
Collapse
Affiliation(s)
- Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, Padova, Italy.
| | - Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, Padova, Italy
| | - Nicola Veronese
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, Padova, Italy
| | - Paola Lucato
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, Padova, Italy
| | - Enzo Manzato
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, Padova, Italy; National Research Council, Institute of Neuroscience, Aging Branch, Via Giustiniani 2, Padova, Italy
| |
Collapse
|
48
|
Paula JAD, Wamser EL, Gomes ARS, Valderramas SR, Cardoso Neto J, Schieferdecker MEM. Análise de métodos para detectar sarcopenia em idosas independentes da comunidade. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.140233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Resumo Introdução: O envelhecimento impõe modificações na composição corporal dos indivíduos. Uma das características mais marcantes desse período é a perda progressiva de massa, força e função musculares, conhecida como sarcopenia. Objetivos: Verificar a presença de sarcopenia em idosas hígidas da comunidade utilizando combinações de diferentes métodos para avaliar massa muscular (MM) e desempenho físico, bem como se há concordância entre as combinações para diagnóstico da sarcopenia. Método: Estudo transversal com 37 idosas da Universidade Aberta da Maturidade. Os parâmetros para avaliar a MM foram: circunferência da panturrilha (CP) e massa muscular esquelética (MME) por meio da impedância bioelétrica (BIA) e índice de músculo esquelético (IME). Quanto à performance física, realizou-se a força de preensão palmar (FPP) com dinamômetro manual, velocidade de marcha (VM) em 10 metros e o timed up and go (TUG) para mobilidade funcional. Para comparar os métodos diagnósticos de sarcopenia foram empregadas quatro combinações distintas: C1= IME+FPP+VM; C2= IME+FPP+TUG; C3= CP+FPP+VM e C4= CP+FPP+TUG, de acordo com o proposto pelo consenso europeu. Para verificação da diferença entre os métodos foram aplicados os testes de Kruskal-Wallis e as comparações múltiplas para dados não pareados; e o coeficiente Kappa ponderado para avaliação do grau de concordância. Resultados: As combinações C1 e C2 identificaram pré-sarcopenia, sarcopenia e sarcopenia grave. Entre C1 e C2, evidenciou-se alta concordância (0,92), já C3 e C4 não identificaram presença de sarcopenia nas idosas. Conclusão: A CP, para avaliar a MM, pode não detectar a sarcopenia em idosas com excesso de peso. Porém, a alta concordância entre as duas combinações que utilizaram o IME e VM ou TUG, indicam a aplicação de ambas na prática clínica.
Collapse
|
49
|
The role of computed tomography in evaluating body composition and the influence of reduced muscle mass on clinical outcome in abdominal malignancy: a systematic review. Eur J Clin Nutr 2015; 69:1079-86. [PMID: 25782424 DOI: 10.1038/ejcn.2015.32] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/13/2015] [Accepted: 02/02/2015] [Indexed: 12/21/2022]
Abstract
It is estimated that there were 3.45 million new cases and 1.75 million deaths from cancer in Europe in 2012. Colorectal cancer was one of the most common cancers, accounting for 13% of new cases and 12.2% of all deaths. Conditions causing reduced muscle mass, such as sarcopenia, can increase the morbidity and mortality of people with cancer. Computed tomography (CT) scans can provide accurate, high-quality information on body composition, including muscle mass. To date, there has been no systematic review on the role of CT scans in identifying sarcopenia in abdominal cancer. This review aimed to examine the role of CT scans in determining the influence of reduced muscle mass on clinical outcome in abdominal cancer. A systematic review of English-language articles published in 2000 or later was conducted. Articles included cohort, randomised controlled trials and validation studies. Participants were people diagnosed with abdominal cancer who had undergone a CT scan. Data extraction and critical appraisal were undertaken. Ten cohort studies met the inclusion criteria. Seven studies demonstrated that low muscle mass was significantly associated with poor clinical outcome, with six specifically demonstrating reduced survival rates. Eight studies demonstrated that a greater number of patients (27.3-66.7%) were identified as sarcopenic using CT scans compared with numbers identified as malnourished using body mass index. CT scans can identify reduced muscle mass and predict negative cancer outcomes in people with abdominal malignancies, where traditional methods of assessment are less effective.
Collapse
|
50
|
Funghetto SS, de Oliveira Silva A, de Sousa NMF, Stival MM, Tibana RA, Pereira LC, Antunes MLC, de Lima LR, Prestes J, Oliveira RJ, Dutra MT, Souza VC, da Cunha Nascimento D, de Oliveira Karnikowski MG. Comparison of percentage body fat and body mass index for the prediction of inflammatory and atherogenic lipid risk profiles in elderly women. Clin Interv Aging 2015; 10:247-53. [PMID: 25609936 PMCID: PMC4298285 DOI: 10.2147/cia.s69711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To compare the clinical classification of the body mass index (BMI) and percentage body fat (PBF) for the prediction of inflammatory and atherogenic lipid profile risk in older women. METHOD Cross-sectional analytical study with 277 elderly women from a local community in the Federal District, Brazil. PBF and fat-free mass (FFM) were determined by dual energy X-ray absorptiometry. The investigated inflammatory parameters were interleukin 6 and C-reactive protein. RESULTS Twenty-five percent of the elderly women were classified as normal weight, 50% overweight, and 25% obese by the BMI. The obese group had higher levels of triglycerides and very low-density lipoproteins than did the normal weight group (P≤0.05) and lower levels of high-density lipoproteins (HDL) than did the overweight group (P≤0.05). According to the PBF, 49% of the elderly women were classified as eutrophic, 28% overweight, and 23% obese. In the binomial logistic regression analyses including age, FFM, and lipid profile, only FFM (odds ratio [OR]=0.809, 95% confidence interval [CI]: 0.739-0.886; P<0.0005) proved to be a predictor of reaching the eutrophic state by the BMI. When the cutoff points of PBF were used for the classification, FFM (OR=0.903, CI=0.884-0.965; P=0.003) and the total cholesterol/HDL ratio (OR=0.113, CI=0.023-0.546; P=0.007) proved to be predictors of reaching the eutrophic state. CONCLUSION Accurate identification of obesity, systemic inflammation, and atherogenic lipid profile is key to assessing the risk of cardiometabolic diseases. Classification based on dual energy X-ray absorptiometry measures, along with biochemical and inflammatory parameters, seems to have a great clinical importance, since it allows the lipid profile eutrophic distinction in elderly overweight women.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Vinícius Carolino Souza
- University of Brasília (UnB), Brasília, DF, Brazil
- Catholic University of Brasília, Brasília, DF, Brazil
| | | | | |
Collapse
|