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Bennett JP, Wong MC, Liu YE, Quon BK, Kelly NN, Garber AK, Heymsfield SB, Shepherd JA. Trunk-to-leg volume and appendicular lean mass from a commercial 3-dimensional optical body scanner for disease risk identification. Clin Nutr 2024; 43:2430-2437. [PMID: 39305753 PMCID: PMC11439580 DOI: 10.1016/j.clnu.2024.09.028] [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: 07/03/2024] [Revised: 08/24/2024] [Accepted: 09/12/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND & AIMS Body shape expressed as the trunk-to-leg volume ratio is associated with diabetes and mortality due to the associations between higher adiposity and lower lean mass with Metabolic Syndrome (MetS) risk. Reduced appendicular muscle mass is associated with malnutrition risk and age-related frailty, and is a risk factor for poor treatment outcomes related to MetS and other clinical conditions (e.g.; cancer). These measures are traditionally assessed by dual-energy X-ray absorptiometry (DXA), which can be difficult to access in clinical settings. The Shape Up! Adults trial (SUA) demonstrated the accuracy and precision of 3-dimensional optical imaging (3DO) for body composition as compared to DXA and other criterion measures. Here we assessed whether trunk-to-leg volume estimates derived from 3DO are associated with MetS risk in a similar way as when measured by DXA. We further explored if estimations of appendicular lean mass (ALM) could be made using 3DO to further improve the accessibility of measuring this important frailty and disease risk factor. METHODS SUA recruited participants across sex, age (18-40, 40-60, >60 years), BMI (under, normal, overweight, obese), and race/ethnicity (non-Hispanic [NH] Black, NH White, Hispanic, Asian, Native Hawaiian/Pacific Islander) categories. Each participant had whole-body DXA and 3DO scans, and measures of cardiovascular health. The 3DO measures of trunk and leg volumes were calibrated to DXA to express equivalent trunk-to-leg volume ratios. We expressed each blood measure and overall MetS risk in quartile gradations of trunk-to-leg volume previously defined by National Health and Nutrition Examination Survey (NHANES). Finally, we utilized 3DO measures to estimate DXA ALM using ten-fold cross-validation of the entire dataset. RESULTS Participants were 502 (273 female) adults, mean age = 46.0 ± 16.5y, BMI = 27.6 ± 7.1 kg/m2 and a mean DXA trunk-to-leg volume ratio of 1.47 ± 0.22 (females: 1.43 ± 0.23; males: 1.52 ± 0.20). After adjustments for age and sex, each standard deviation increase in trunk-to-leg volume by 3DO was associated with a 3.3 (95% odds ratio [OR] = 2.4-4.2) times greater risk of MetS, with individuals in the highest quartile of trunk-to-leg at 27.4 (95% CI: 9.0-53.1) times greater risk of MetS compared to the lowest quartile. Risks of elevated blood biomarkers as related to high 3DO trunk-to-leg volume ratios were similar to previously published comparisons using DXA trunk-to-leg volume ratios. Estimated ALM by 3DO was correlated to DXA (r2 = 0.96, root mean square error = 1.5 kg) using ten-fold cross-validation. CONCLUSION Using thresholds of trunk-to-leg associated with MetS developed on a sample of US-representative adults, trunk-to-leg ratio by 3DO after adjustments for offsets showed significant associations to blood parameters and MetS risk. 3DO scans provide a precise and accurate estimation of ALM across the range of body sizes included in the study sample. The development of these additional measures improves the clinical utility of 3DO for the assessment of MetS risk as well as the identification of low muscle mass associated with poor cardiometabolic and functional health.
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Affiliation(s)
- Jonathan P Bennett
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA.
| | - Michael C Wong
- 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
| | - Brandon K Quon
- 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
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
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Locatelli JC, Costa JG, Haynes A, Naylor LH, Fegan PG, Yeap BB, Green DJ. Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition? Diabetes Care 2024; 47:1718-1730. [PMID: 38687506 DOI: 10.2337/dci23-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
This narrative review highlights the degree to which new antiobesity medications based on gut-derived nutrient-stimulated hormones (incretins) cause loss of lean mass, and the importance of resistance exercise to preserve muscle. Glucagon-like peptide 1 receptor agonists (GLP-1RA) induce substantial weight loss in randomized trials, effects that may be enhanced in combination with glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Liraglutide and semaglutide (GLP-1RA), tirzepatide (GLP-1 and GIP receptor dual agonist), and retatrutide (GLP-1, GIP, and glucagon receptor triple agonist) are peptides with incretin agonist activity that induce ∼15-24% weight loss in adults with overweight and obesity, alongside beneficial impacts on blood pressure, cholesterol, blood glucose, and insulin. However, these agents also cause rapid and significant loss of lean mass (∼10% or ∼6 kg), comparable to a decade or more of aging. Maintaining muscle mass and function as humans age is crucial to avoiding sarcopenia and frailty, which are strongly linked to morbidity and mortality. Studies indicate that supervised resistance exercise training interventions with a duration >10 weeks can elicit large increases in lean mass (∼3 kg) and strength (∼25%) in men and women. After a low-calorie diet, combining aerobic exercise with liraglutide improved weight loss maintenance compared with either alone. Retaining lean mass during incretin therapy could blunt body weight (and fat) regain on cessation of weight loss pharmacotherapy. We propose that tailored resistance exercise training be recommended as an adjunct to incretin therapy to optimize changes in body composition by preserving lean mass while achieving fat loss.
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Affiliation(s)
- João Carlos Locatelli
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Juliene Gonçalves Costa
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Andrew Haynes
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - P Gerry Fegan
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
- Medical School, Curtin University, Perth, Australia
| | - Bu B Yeap
- Medical School, Curtin University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
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Kim YE, Kim D, Kim J, Yun M, Kang ES. Association between appendicular skeletal muscle mass and myocardial glucose uptake measured by 18F-FDG PET. ESC Heart Fail 2024. [PMID: 39344859 DOI: 10.1002/ehf2.15086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/18/2024] [Accepted: 09/05/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Low muscle mass is associated with high insulin resistance and an increased risk of cardiovascular disease. This study aims to determine whether low muscle mass affects the alterations in myocardial substrate metabolism that are associated with the development of cardiovascular disease. METHOD The study included 299 individuals (182 men and 117 women) who underwent examination at the Severance Health Check-up Center between January 2018 and February 2019. Myocardial glucose uptake was assessed using [18F]-fluorodeoxyglucose-positron emission tomography (18F-FDG PET/CT) scanning. Direct segmental bioimpedance analysis was used to measure appendicular skeletal muscle mass (ASM). RESULTS We analysed men and women separately owing to sex-related body composition differences. ASM/Ht2 was significantly positively correlated with myocardial glucose uptake measured by 18F-FDG PET/CT [ln (SUVheart/liver)] only in men (r = 0.154, P = 0.038 in men; r = -0.042, P = 0.652 in women, respectively). In men, myocardial glucose uptake was significantly associated with ASM/Ht2 even after adjusting for multiple confounders in a multivariable linear regression model (standardized β = 0.397, P = 0.004, in men; β = - 0.051, P = 0.698, in women). In women, age (β = -0.424 P = 0.029) was independent determinants of myocardial glucose uptake. CONCLUSIONS In men, ASM was strongly associated with myocardial glucose uptake as measured by 18F-FDG PET/CT. In women, age was significantly correlated with myocardial substrate utilization, but not with ASM.
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Affiliation(s)
- Young-Eun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dongwoo Kim
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiwon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Gholami F, Hajiheidari A, Barkhidarian B, Soveid N, Yekaninejad MS, Karimi Z, Bahrampour N, Keshavarz SA, Javdan G, Mirzaei K. A comparison of principal component analysis, reduced-rank regression, and partial least-squares in the identification of dietary patterns associated with cardiometabolic risk factors in Iranian overweight and obese women. BMC Med Res Methodol 2024; 24:215. [PMID: 39333898 PMCID: PMC11428567 DOI: 10.1186/s12874-024-02298-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/25/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND According to epidemiological studies, unhealthy dietary patterns and lifestyle lead to rising obesity and cardiometabolic diseases in Iran. Hybrid techniques were used to identify a dietary pattern characterized by fiber, folic acid, and carotenoid intake due to their association with cardiometabolic risk factors such as anthropometric measurements, blood pressure, lipid profile, C-Reactive Protein (CRP), Plasminogen Activator Inhibitor (PAI), Homeostatic Model Assessment Index (HOMA Index), cardiometabolic index (CMI), and monocyte chemoattractant protein (MCP-1). So, the objective of the recent study is to compare the reduced-rank regression (RRR) and partial least-squares (PLS) approaches to principal component analysis (PCA) for estimating diet-cardiometabolic risk factor correlations in Iranian obese women. METHODS Data on dietary intake was gathered from 376 healthy overweight and obese females aged 18 to 65 years using a 147-item food frequency questionnaire (FFQ). In this cross-sectional study, participants were referred to health centers of Tehran. Dietary patterns were developed using PCA, PLS, and RRR, and their outputs were assessed to identify reasonable patterns connected to cardiometabolic risk factors. The response variables for PLS and RRR were fiber, folic acid, and carotenoid intake. RESULTS In this study, 3 dietary patterns were identified by the PCA method, 2 dietary patterns by the PLS method, and one dietary pattern by the RRR method. High adherence to the plant-based dietary pattern identified by all methods were associated with higher fat free mass index (FFMI) (P < 0.05). Women in the highest tertile of the plant-based dietary pattern identified by PLS had 0.06 mmol/L (95% CI: 0.007,0.66, P = 0.02), 0.36 mmHg (95% CI: 0.14,0.88, P = 0.02), and 0.46 mg/l (95% CI: 0.25,0.82, P < 0.001), lower FBS, DBP, and CRP respectively than women in the first tertile. Also, PLS and RRR-derived patterns explained greater variance in the outcome (PCA: 1.05%; PLS: 11.62%; RRR: 25.28%), while the PCA dietary patterns explained greater variance in the food groups (PCA: 22.81%; PLS: 14.54%; RRR: 1.59%). CONCLUSION PLS was found to be more appropriate in determining dietary patterns associated with cardiometabolic-related risk factors. Nevertheless, the advantage of PLS over PCA and RRR must be confirmed in future longitudinal studies with extended follow-up in different settings, population groups, and response variables.
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Affiliation(s)
- Fatemeh Gholami
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, 14155, Tehran, Iran.
| | | | - Bahareh Barkhidarian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, 14155, Tehran, Iran
| | - Neda Soveid
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, 14155, Tehran, Iran
| | - Mir Saeid Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Zahra Karimi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Niki Bahrampour
- Department of Nutrition, Science and Research Branch, Islamic Azad University (SRBIAU), Tehran, Iran
| | - Seyed Ali Keshavarz
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamali Javdan
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar 'Abbas, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, 14155, Tehran, Iran.
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Tuccinardi D, Watanabe M, Masi D, Monte L, Meffe LB, Cavallari I, Nusca A, Maddaloni E, Gnessi L, Napoli N, Manfrini S, Grigioni F. Rethinking weight loss treatments as cardiovascular medicine in obesity, a comprehensive review. Eur J Prev Cardiol 2024; 31:1260-1273. [PMID: 38833329 DOI: 10.1093/eurjpc/zwae171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/27/2024] [Accepted: 05/08/2024] [Indexed: 06/06/2024]
Abstract
The global escalation of obesity has made it a worldwide health concern, notably as a leading risk factor for cardiovascular disease (CVD). Extensive evidence corroborates its association with a range of cardiac complications, including coronary artery disease, heart failure, and heightened vulnerability to sudden cardiac events. Additionally, obesity contributes to the emergence of other cardiovascular risk factors including dyslipidaemia, type 2 diabetes, hypertension, and sleep disorders, further amplifying the predisposition to CVD. To adequately address CVD in patients with obesity, it is crucial to first understand the pathophysiology underlying this link. We herein explore these intricate mechanisms, including adipose tissue dysfunction, chronic inflammation, immune system dysregulation, and alterations in the gut microbiome.Recent guidelines from the European Society of Cardiology underscore the pivotal role of diagnosing and treating obesity to prevent CVD. However, the intricate relationship between obesity and CVD poses significant challenges in clinical practice: the presence of obesity can impede accurate CVD diagnosis while optimizing the effectiveness of pharmacological treatments or cardiac procedures requires meticulous adjustment, and it is crucial that cardiologists acknowledge the implications of excessive weight while striving to enhance outcomes for the vulnerable population affected by obesity. We, therefore, sought to overcome controversial aspects in the clinical management of heart disease in patients with overweight/obesity and present evidence on cardiometabolic outcomes associated with currently available weight management interventions, with the objective of equipping clinicians with an evidence-based approach to recognize and address CVD risks associated with obesity.
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Affiliation(s)
- Dario Tuccinardi
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Endocrinology and Diabetology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Mikiko Watanabe
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Davide Masi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lavinia Monte
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Endocrinology and Diabetology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Luigi Bonifazi Meffe
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Endocrinology and Diabetology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Ilaria Cavallari
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Cardiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Annunziata Nusca
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Cardiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Ernesto Maddaloni
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Nicola Napoli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Endocrinology and Diabetology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Silvia Manfrini
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Endocrinology and Diabetology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Francesco Grigioni
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Research Unit of Cardiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
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Zhang K, Li X, Guo Q, Ding W, Niu J, Zhao J, Zhang L, Qi H, Zhang S, Yu C. Lower extremity function and cardiovascular disease risk in hemodialysis patients: A multicenter cross-sectional study. Physiol Rep 2024; 12:e70014. [PMID: 39164207 PMCID: PMC11335428 DOI: 10.14814/phy2.70014] [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: 10/19/2023] [Revised: 07/23/2024] [Accepted: 08/08/2024] [Indexed: 08/22/2024] Open
Abstract
Physical performance in hemodialysis patients declines and serves as a cardiovascular disease (CVD) incidence and mortality predictor. However, lower extremity function's role remains unclear. This study aimed to quantify the association between lower extremity function and CVD risk in hemodialysis patients. This was a multicenter cross-sectional study enrolling 868 participants (532 males, 336 females) from seven hemodialysis centers in Shanghai, China. Patients were divided into three groups per lower extremity function, evaluated by short physical performance battery (SPPB) scores: 0-6, 7-9, and 10-12. Upper extremity function was quantified through grip strength assessment. CVD risk was assessed using the Framingham Risk Score. Approximately 35% of hemodialysis patients had impaired lower extremity function (SPPB score < 10). Participants with high SPPB scores had stronger handgrip and lower Framingham CVD risk scores than those with low and moderate SPPB scores (p < 0.05). After adjusting clinical confounders, SPPB was independently associated with CVD risk, as a categorized variable (odds ratio: 0.577, 95% confidence interval [CI]: 0.388-0.857, p = 0.006) and as a continuous variable (odds ratio: 0.858, 95% CI: 0.772-0.953, p = 0.004). An SPPB score < 10 predicted an increased CVD risk (area under curve: 0.649, 95% CI: 0.599-0.699, p < 0.001). Causality between physical performance and CVD risk was not considered. Some upper limb results may not be generalizable to peritoneal dialysis and kidney transplant patients. Lower extremity function was significantly associated with CVD risk in hemodialysis patients. Further studies are needed to explore the long-term relationship between lower extremity function and CVD risk.
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Affiliation(s)
- Kun Zhang
- Department of Nephrology, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Xin Li
- Department of Nephrology, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Qi Guo
- Department of Rehabilitation MedicineShanghai University of Medicine and Health Sciences Affiliated Zhoupu HospitalShanghaiChina
| | - Wei Ding
- Department of Nephrology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jianying Niu
- Department of Nephrology, The Fifth People's Hospital of ShanghaiFudan UniversityShanghaiChina
| | - Junli Zhao
- Department of NephrologyShanghai University of Medicine and Health Sciences Affiliated Zhoupu HospitalShanghaiChina
| | - Liming Zhang
- Department of NephrologyZhabei Central Hospital of JingAn District of ShanghaiShanghaiChina
| | - Hualin Qi
- Department of NephrologyShanghai Pudong New Area People's HospitalShanghaiChina
| | - Suhua Zhang
- Department of NephrologySuzhou Kowloon Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
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Park D, Rho J, Kim E, Kim Y. Comparison of Absolute and Relative Grip Strength to Predict Incidence of Diabetes Mellitus in Korea: A Prospective Cohort Study. Metab Syndr Relat Disord 2024; 22:463-470. [PMID: 38634825 DOI: 10.1089/met.2024.0006] [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] [Indexed: 04/19/2024] Open
Abstract
Background: This study aimed to investigate the association between absolute grip strength (AGS), relative grip strength (RGS) levels, and the risk of developing diabetes in middle-aged adults, utilizing longitudinal data. Methods: A total of 1935 participants, 51-81 years of age, were engaged in surveys both in 2017-2018 and during the subsequent follow-up survey in 2019-2020. Diabetes diagnosis and treatment were the criteria for categorizing individuals as "diabetic." Grip strength was measured using the JAMA-5030J1 equipment (SAEHAN, Korea), and AGS and RGS were also categorized into tertiles by gender. A proportional hazards Cox regression model was used to evaluate the relationship among AGS, RGS, and the risk of developing diabetes. Subsequently, we computed the hazard ratio (HR) and 95% confidence interval (95% CI) for the risk of developing diabetes. Results: After adjusting for various confounding variables, a significant reduction in diabetes risk was observed in the high grip strength group, adjusted for body mass index (RGS1) and body weight (RGS2), compared with the low RGS1 and RGS2 groups (RGS1 HR = 0.54, 95% CI = 0.36-0.80; RGS2 HR = 0.50, 95% CI = 0.34-0.73). However, there were no significant associations between AGS and diabetes risk. Furthermore, significant differences in the relationship among AGS, RGS levels, and the risk of developing diabetes were found across gender and insulin resistance levels. Conclusion: This study underscores the importance of RGS levels in predicting the incidence of diabetes, with AGS, RGS1, and RGS2 emerging as significant predictive indicators for assessing diabetes risk.
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Affiliation(s)
- DooYong Park
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
| | - JinWon Rho
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
| | - Eunkyung Kim
- Department of Physical Education, College of Education, Chonnam National University, Gwangju, Korea
| | - YeonSoo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
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8
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Ji JJ, Zhao MJ, Xiao ML, Zhang HE, Tan Q, Cheng YR, Lu F. Association between relative muscle strength and cardiovascular disease among middle-aged and older adults in China. BMC Public Health 2024; 24:1928. [PMID: 39026227 PMCID: PMC11256373 DOI: 10.1186/s12889-024-19473-y] [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: 03/02/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The association between sarcopenia and cardiovascular disease (CVD) is well known. However, the clinical diagnosis of sarcopenia is complex and not suitable for early clinical identification and prevention of CVD. Relative muscle strength (RMS) is a relatively quantitative and straightforward indicator, but its association with CVD remains unclear. Hence, the objective of this research was to investigate the correlation between RMS and CVD incidence. METHODS This was a cross-sectional study, using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011. CVD events were assessed through self-reported physician diagnoses. The RMS was determined by dividing the maximum grip strength by the appendicular skeletal muscle mass (ASM). This study used multivariate logistic regression and restricted cubic spline (RCS) curves to explore the correlation between RMS and CVD incidence. Additionally, we conducted subgroup analyses to provide additional evidence supporting the association between the two variables. RESULTS A total of 8,733 people were included in our study, with 1,152 (13.19%) CVD patients and 7,581 (86.81%) non-CVD patients. When the data were grouped according to quartiles (Q) of RMS, the inverse association between CVD and RMS remained statistically significant even after controlling for all potential confounding factors. Compared with participants in Q1 of RMS, the ORs (95% CIs) of CVD among those in Q2-Q4 were 0.99 (0.83, 1.17), 0.81 (0.67, 0.98), and 0.70 (0.57, 0.85), respectively. Moreover, the RCS results showed a negative linear correlation between the RMS and CVD incidence (P for nonlinearity = 0.555). Subgroup analysis revealed no significant interaction in any of the groups except for the sex group (P for interaction = 0.046). CONCLUSION Our study indicated a stable negative correlation between RMS and CVD incidence. RMS is helpful for the early identification and prevention of CVD.
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Affiliation(s)
- Jin-Jin Ji
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Meng-Jie Zhao
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Meng-Li Xiao
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Hui-E Zhang
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Qin Tan
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Yu-Rong Cheng
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China
| | - Fang Lu
- China Academy of Chinese Medicine Sciences, Xiyuan Hospital, Beijing, 100091, China.
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, 100091, China.
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, 100091, China.
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Oguntade AS, Taylor H, Lacey B, Lewington S. Adiposity, fat-free mass and incident heart failure in 500 000 individuals. Open Heart 2024; 11:e002711. [PMID: 38964877 PMCID: PMC11227841 DOI: 10.1136/openhrt-2024-002711] [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: 04/14/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND AND AIMS The independent role of body fat distribution and fat-free mass in heart failure (HF) risk is unclear. We investigated the role of different body composition compartments in risk of HF. METHODS Present analyses include 428 087 participants (mean age 55.9 years, 44% male) from the UK Biobank. Associations of long-term average levels of body composition measures with incident HF were determined using adjusted Cox proportional hazards regression models. RESULTS Over a median follow-up of 13.8 years, there were 10 455 first-ever incident HF events. Overall, HF risk was more strongly associated with central adiposity (waist circumference (WC) adjusted for body mass index (BMI); HR 1.38, 95% CI 1.32 to 1.45) than general adiposity (BMI adjusted for WC; HR 1.22, 95% CI 1.16 to 1.27). Although dual X-ray absorptiometry-derived body fat remained positively related to HF after adjustment for fat-free mass (HR 1.37, 95% CI 1.18 to 1.59), the association of fat-free mass with HF was substantially attenuated by fat mass (HR 1.12, 95% CI 1.01 to 1.26) while visceral fat (VAT) remained associated with HF independent of subcutaneous fat (HR 1.20, 95% CI 1.09 to 1.33). In analyses of HF subtypes, HF with preserved ejection fraction was independently associated with all fat measures (eg, VAT: HR 1.23, 95% CI 1.12 to 1.35; body fat: HR 1.36, 95% CI 1.17 to 1.57) while HF with reduced ejection fraction was not independently associated with fat measures (eg, VAT: HR 1.29, 95% CI 0.98 to 1.68; body fat: HR 1.29, 95% CI 0.80 to 2.07). CONCLUSIONS This large-scale study shows that excess adiposity and fat mass are associated with higher HF risk while the association of fat-free mass with HF could be explained largely by its correlation with fat mass. The study also describes the independent relevance of body fat distribution to HF subtypes, suggesting different mechanisms may be driving their aetiopathogenesis.
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Affiliation(s)
- Ayodipupo S Oguntade
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Hannah Taylor
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ben Lacey
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank, Stockport, UK
| | - Sarah Lewington
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
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Tarabeih N, Kalinkovich A, Ashkenazi S, Cherny SS, Shalata A, Livshits G. Analysis of the Associations of Measurements of Body Composition and Inflammatory Factors with Cardiovascular Disease and Its Comorbidities in a Community-Based Study. Biomedicines 2024; 12:1066. [PMID: 38791028 PMCID: PMC11117926 DOI: 10.3390/biomedicines12051066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
The associations of cardiovascular disease (CVD) with comorbidities and biochemical and body composition measurements are repeatedly described but have not been studied simultaneously. In the present cross-sectional study, information on CVD and comorbidities [type 2 diabetes mellitus (T2DM), hypertension (HTN), and hyperlipidemia (HDL)], body composition, levels of soluble markers, and other measures were collected from 1079 individuals. When we examined the association of each comorbidity and CVD, controlling for other comorbidities, we observed a clear pattern of the comorbidity-related specific associations with tested covariates. For example, T2DM was significantly associated with GDF-15 levels and the leptin/adiponectin (L/A) ratio independently of two other comorbidities; HTN, similarly, was independently associated with extracellular water (ECW) levels, L/A ratio, and age; and HDL was independently related to age only. CVD showed very strong independent associations with each of the comorbidities, being associated most strongly with HTN (OR = 10.89, 6.46-18.38) but also with HDL (2.49, 1.43-4.33) and T2DM (1.93, 1.12-3.33). An additive Bayesian network analysis suggests that all three comorbidities, particularly HTN, GDF-15 levels, and ECW content, likely have a main role in the risk of CVD development. Other factors, L/A ratio, lymphocyte count, and the systemic inflammation response index, are likely indirectly related to CVD, acting through the comorbidities and ECW.
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Affiliation(s)
- Nader Tarabeih
- Department of Morphological Sciences, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (N.T.); (S.A.)
| | - Alexander Kalinkovich
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (A.K.); (S.S.C.)
| | - Shai Ashkenazi
- Department of Morphological Sciences, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (N.T.); (S.A.)
| | - Stacey S. Cherny
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (A.K.); (S.S.C.)
| | - Adel Shalata
- The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 32000, Israel;
| | - Gregory Livshits
- Department of Morphological Sciences, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (N.T.); (S.A.)
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; (A.K.); (S.S.C.)
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11
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Wang L, Ding H, Deng Y, Huang J, Lao X, Wong MCS. Associations of obesity indices change with cardiovascular outcomes: a dose-response meta-analysis. Int J Obes (Lond) 2024; 48:635-645. [PMID: 38336864 DOI: 10.1038/s41366-024-01485-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Little is known about the degrees and shapes of associations of changes in obesity indices with cardiovascular disease (CVD) and mortality risks. We aimed to conduct a dose-response meta-analysis for the associations of changes in weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and waist-to-height ratio with CVD events, CVD-specific deaths, and all-cause mortality. METHODS We searched MEDLINE via OvidSP, Embase via OvidSP, Web of Science, CINAHL, and Scopus for articles published before January 8th, 2023. Dose-response relationships were modeled using the one-stage mixed-effects meta-analysis. Random-effects models were used to pool the relative risk (RR) and 95% confidence interval (CI). RESULTS We included 122 articles. Weight change was negatively associated with deaths from CVD and any cause, while WC change elevated CVD-specific mortality. Non-linear relationships also confirmed the adverse effects of increased WC on CVD-specific mortality. Additionally, gains of 5 kg in weight and 1 kg/m2 in BMI or more were associated with elevated CVD events, especially among young adults and individuals without CVD. Conversely, reductions of 5 kg in weight and 1 kg/m2 in BMI or more were associated with higher CVD-specific and all-cause deaths than increased counterparts, particularly among old adults and individuals with CVD. Similar non-linear relationships between relative changes in weight and BMI and deaths from CVD and any cause were observed. CONCLUSIONS The effects of changes in weight and BMI on CVD outcomes were affected by age and cardiovascular health. Tailored weight management and avoidance of increased WC should be recommended.
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Affiliation(s)
- Lyu Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hanyue Ding
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunyang Deng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiangqian Lao
- Department of Biomedical Science, City University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China.
- School of Public Health, Peking University, Beijing, China.
- Centre for Health Education and Health Promotion, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China.
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12
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Booker R, Wong M, Bancks MP, Carnethon MR, Chow LS, Lewis CE, Schreiner PJ, Alexandria SJ. The longitudinal association of adipose-to-lean ratio with incident cardiometabolic morbidity: The CARDIA study. J Diabetes Complications 2024; 38:108725. [PMID: 38520820 PMCID: PMC11058009 DOI: 10.1016/j.jdiacomp.2024.108725] [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: 10/25/2023] [Revised: 03/01/2024] [Accepted: 03/16/2024] [Indexed: 03/25/2024]
Abstract
AIM To assess the association of adipose-to-lean ratio (ALR) with incident type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia in middle adulthood. METHOD Black and White Coronary Artery Risk Development in Young Adults participants without T2DM, hypertension, or dyslipidemia in 2005-06 (baseline) were included. Baseline adipose and lean mass were assessed via dual-energy X-ray absorptiometry. ALR was calculated as adipose divided by lean mass and then standardized within sex strata. Single time-point incident morbidity was assessed every five years from baseline through 2016. Cox proportional hazards regression was used to estimate hazard ratios (HR) for morbidity over 10 years per 1-SD increment in ALR adjusted for cardiovascular risk factors. RESULT The cumulative incidence of T2DM was 7.9 % (129 events/N = 1643; 16,301 person-years), 26.7 % (485 events/N = 1819; 17,895 person-years) for hypertension, and 49.1 % (435 events/N = 855, 8089 person-years) for dyslipidemia. In the adjusted models, ALR was positively associated with a risk of T2DM (HR [95 % CI]; 1.69 [1.31, 2.19]) and hypertension (1.23 [1.08, 1.40]). There was no significant interaction between ALR and sex for any morbidity. CONCLUSION ALR in middle adulthood is associated with incident T2DM and hypertension. The extent to which localized body composition measures might inform morbidity risk merits further investigation.
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Affiliation(s)
- Robert Booker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Mandy Wong
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael P Bancks
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lisa S Chow
- University of Minnesota, Minneapolis, MN, USA
| | - Cora E Lewis
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Shaina J Alexandria
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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13
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Haidar A, Srikanthan P, Watson K, Allison M, Kronmal R, Horwich T. Associations Between Visceral Fat, Abdominal Muscle, and Coronary Artery Calcification: A Cross-Sectional Analysis of the Multi-Ethnic Study of Atherosclerosis. Am J Cardiol 2024; 217:77-85. [PMID: 38432335 PMCID: PMC11005919 DOI: 10.1016/j.amjcard.2024.02.030] [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: 12/11/2023] [Revised: 02/07/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
The associations of body composition components, including muscle and adipose tissue, and markers of subclinical coronary artery disease are unclear. We examined the relation between abdominal computed tomography (CT)-derived measures of the area and density of fat and muscle with coronary artery calcification (CAC), using data from the Multi-Ethnic Study of Atherosclerosis (MESA). A total of 1,974 randomly selected MESA participants free of coronary heart disease underwent abdominal CT scans at examinations 2 or 3, with the resulting images interrogated for abdominal body composition. Using 6 cross-sectional slices spanning L2 to L5, the Medical Imaging Processing Analysis and Visualization software was used to determine abdominal muscle and fat composition using appropriate Hounsfield units ranges. CT chest scans were used to obtain CAC scores, calculated using the Agatston method and spatially weighted calcium score. Multivariable linear and logistic regression analyses were performed to assess the relation between abdominal visceral fat and muscle area and density to prevalent CAC. A total of 1,089 participants had a CAC >0, with an average CAC score of 310. In the fully adjusted model, for every 10-cm2 increase in visceral fat area, the likelihood of having a CAC greater than 0 increased by 0.60% (p <0.001). In the minimally adjusted model, abdominal muscle area was significantly associated with CAC >0, which became nonsignificant in the fully adjusted model. For the density of visceral fat, every 1-Hounsfield unit increase (less lipid-dense fat tissue), the likelihood of having a CAC score >0 decreased by 0.29% (p <0.05). No significant relation was observed between density of abdominal muscle and CAC >0. A greater area and higher lipid density of abdominal visceral fat were associated with an increased likelihood of having CAC, whereas there was no significant relation between abdominal muscle area or density and CAC. The quantity and the quality of fat have associations, with an important marker of subclinical atherosclerosis, CAC, and their significance with respect to cardiovascular outcomes, require further evaluation.
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Affiliation(s)
- Amier Haidar
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Preethi Srikanthan
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Karol Watson
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Richard Kronmal
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Tamara Horwich
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
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14
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Horn J. The dichotomy between health and drug abuse in bodybuilding. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:212-225. [PMID: 38645972 PMCID: PMC11027851 DOI: 10.1177/14550725231206011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/21/2023] [Indexed: 04/23/2024] Open
Abstract
Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.
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15
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Kim D, Kim HJ, Song TJ. Association of body composition indices with cardiovascular outcomes: a nationwide cohort study. Am J Clin Nutr 2024; 119:876-884. [PMID: 38408726 DOI: 10.1016/j.ajcnut.2024.02.015] [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: 05/05/2023] [Revised: 02/03/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Previous studies regarding BMI (kg/m2) and associated cardiovascular outcomes yield inconsistent results. OBJECTIVES We aimed to investigate the association between body composition and cardiovascular outcomes according to BMI categories in the Korean general population. METHODS A total of 2,604,401 participants were enrolled in this nationwide cohort study using the National Health Insurance Service-Health Checkup data set. Predicted lean BMI (pLBMI), body fat mass index (pBFMI), and appendicular skeletal muscle mass index (pASMMI) were calculated using validated anthropometric prediction equations. A multivariable time-dependent Cox regression analysis was conducted to assess the association with cardiovascular outcomes. The results were presented with adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), considering BMI categories (BMI < 18.5, BMI 18.5-24.9, BMI 25-29.9, and BMI ≥ 30). RESULTS Higher pLBMI and pASMMI were correlated with a reduced risk of composite cardiovascular outcomes. For pLBMI, HR was 0.910 (95% CI: 0.908, 0.913, P < 0.001) for males and 0.905 (95% CI: 0.899, 0.910, P < 0.001) for females. For pASMMI, HR was 0.825 (95% CI: 0.820, 0.829, P < 0.001) for males and 0.788 (95% CI: 0.777, 0.800, P < 0.001) for females. Conversely, a higher pBFMI was associated with an increased risk, with HR of 1.082 (95% CI: 1.071, 1.093, P < 0.001) for males and 1.181 (95% CI: 1.170, 1.192, P < 0.001) for females. Subgroup analysis based on BMI categories revealed no significant risk association for pBFMI in the BMI < 18.5 group. In the group with BMI ≥ 30, neither pLBMI nor pASMMI demonstrated a significant risk association. CONCLUSIONS Our results highlight the value of pLBMI, pBFMI, and pASMMI as variables for assessing risk of composite cardiovascular outcomes. The significance of indicators may vary depending on BMI categories.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Kim
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
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16
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Suthahar N, Zwartkruis V, Geelhoed B, Withaar C, Meems LMG, Bakker SJL, Gansevoort RT, van Veldhuisen DJ, Rienstra M, de Boer RA. Associations of relative fat mass and BMI with all-cause mortality: Confounding effect of muscle mass. Obesity (Silver Spring) 2024; 32:603-611. [PMID: 38200704 DOI: 10.1002/oby.23953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE The study objective was to examine associations of relative fat mass (RFM) and BMI with all-cause mortality in the Dutch general population and to investigate whether additional adjustment for muscle mass strengthened these associations. METHODS A total of 8433 community-dwelling adults from the PREVEND general population cohort (1997-1998) were included. Linear regression models were used to examine associations of RFM and BMI with 24-h urinary creatinine excretion, a marker of total muscle mass. Cox regression models were used to examine associations of RFM and BMI with all-cause mortality. RESULTS The mean age of the cohort was 49.8 years (range: 28.8-75.7 years), and 49.9% (n = 4209) were women. In age- and sex-adjusted models, both RFM and BMI were associated with total muscle mass (24-h urinary creatinine excretion), and these associations were stronger with BMI (standardized beta [Sβ]RFM : 0.29; 95% CI: 0.27-0.31 vs. SβBMI : 0.38; 95% CI: 0.36-0.40; pdifference < 0.001). During a median follow-up period of 18.4 years, 1640 deaths (19.4%) occurred. In age- and sex-adjusted models, RFM was significantly associated with all-cause mortality (hazard ratio per 1-SD [HRRFM ]: 1.16; 95% CI: 1.09-1.24), whereas BMI was not (HRBMI : 1.04; 95% CI: 0.99-1.10). After additional adjustment for muscle mass, associations of both RFM and BMI with all-cause mortality increased in magnitude (HRRFM : 1.24; 95% CI: 1.16-1.32 and HRBMI : 1.12; 95% CI: 1.06-1.19). Results were broadly similar in multivariable adjusted models. CONCLUSIONS In the general population, a higher RFM was significantly associated with mortality risk, whereas a higher BMI was not. Adjusting for total muscle mass increased the strength of associations of both RFM and BMI with all-cause mortality.
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Affiliation(s)
- Navin Suthahar
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Victor Zwartkruis
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bastiaan Geelhoed
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Coenraad Withaar
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Laura M G Meems
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Nephrology Division, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, Nephrology Division, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Dirk Jan van Veldhuisen
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Kirwan R, Mazidi M, Butler T, Perez de Heredia F, Lip GYH, Davies IG. The association of appendicular lean mass and grip strength with low-density lipoprotein, very low-density lipoprotein, and high-density lipoprotein particle diameter: a Mendelian randomization study of the UK Biobank cohort. EUROPEAN HEART JOURNAL OPEN 2024; 4:oeae019. [PMID: 38595990 PMCID: PMC11003544 DOI: 10.1093/ehjopen/oeae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/11/2024]
Abstract
Aims Reduced muscle mass and reduced strength are frequently associated with both alterations in blood lipids and poorer cardiometabolic outcomes in epidemiological studies; however, a causal association cannot be determined from such observations. Two-sample Mendelian randomization (MR) was applied to assess the association of genetically determined appendicular lean mass (ALM) and handgrip strength (HGS) with serum lipid particle diameter. Methods and results Mendelian randomization was implemented using summary-level data from the largest genome-wide association studies on ALM (n = 450 243), HGS (n = 223 315), and lipoprotein [low-density lipoprotein (LDL), very LDL (VLDL), and high-density lipoprotein (HDL)] particle diameters (n = 115 078). Inverse variance-weighted (IVW) method was used to calculate the causal estimates. Weighted median-based method, MR-Egger, and leave-one-out method were applied as sensitivity analysis. Greater ALM had a statistically significant positive effect on HDL particle diameter (MR-Egger: β = 0.055, SE = 0.031, P = 0.081; IVW: β = 0.068, SE = 0.014, P < 0.001) and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β = -0.114, SE = 0.039, P = 0.003; IVW: β = -0.081, SE = 0.017, P < 0.001). Similarly, greater HGS had a statistically significant positive effect on HDL particle diameter (MR-Egger: β = 0.433, SE = 0.184, P = 0.019; IVW: β = 0.121, SE = 0.052, P = 0.021) and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β = -0.416, SE = 0.163, P = 0.011; IVW: β = -0.122, SE = 0.046, P = 0.009). There was no statistically significant effect of either ALM or HGS on LDL particle diameter. Conclusion There were potentially causal associations between both increasing ALM and HGS and increasing HDL particle size and decreasing VLDL particle size. These causal associations may offer possibilities for interventions aimed at improving cardiovascular disease risk profile.
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Affiliation(s)
- Richard Kirwan
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Mohsen Mazidi
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK
- Clinical Trial Service Unit, Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Roosevelt Dr., Doll Bldg, Oxford, OX3 7LF, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Tom Butler
- School of Applied Health and Social Care and Social Work, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK
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Coelho-Júnior HJ, Calvani R, Álvarez-Bustos A, Tosato M, Russo A, Landi F, Picca A, Marzetti E. Physical performance and negative events in very old adults: a longitudinal study examining the ilSIRENTE cohort. Aging Clin Exp Res 2024; 36:33. [PMID: 38345698 PMCID: PMC10861604 DOI: 10.1007/s40520-024-02693-y] [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: 10/16/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Declining physical performance in old age is associated with a wide range of negative health-related outcomes. However, it is unclear which physical capabilities should be prioritized to obtain prognostic information in older adults. AIMS To examine the associations between the performance on several physical function tests and falls, disability, and death in a well-characterized sample of very old Italian adults. METHODS This was a prospective cohort study of older adults who lived in the mountain community of the Sirente geographic area in Central Italy. Physical performance was assessed using isometric handgrip strength (IHG), walking speed (WS) at a usual and fast pace, 5-time sit-to-stand test (5STS), and sit-to-stand power measures. Appendicular skeletal muscle mass was estimated from calf circumference using a validated equation. History of falls, incident falls, and disability status according to basic Activities of Daily Living (ADLs) were recorded over two years. Survival status was obtained from the participants' general practitioners and was confirmed by the National Death Registry over 10 years from enrolment. Linear, binary, and Cox regressions were performed to evaluate the association between physical performance measures and health outcomes. RESULTS The mean age of the 255 participants was 84.2 ± 5.1 years, and 161 (63.1%) were women. Logistic regression indicated that IHG was significantly associated with incident ADL disability, whereas specific sit-to-stand muscle power was an independent predictor of death. No significant associations were observed between physical function and falls. CONCLUSIONS Our findings indicate selective associations between physical function tests and the occurrence of negative events in very old adults, with poor IHG predicting disability and specific sit-to-stand muscle power being longitudinally associated with death.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
| | - Riccardo Calvani
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Alejandro Álvarez-Bustos
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Av. Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Matteo Tosato
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Andrea Russo
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
- Department of Medicine and Surgery, LUM University, Str. Statale 100 Km 18, 70100, Casamassima, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
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19
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Madlala HP, Myer L, Geffen H, Meyer D, Mendham AE, Goedecke JH, Bengtson AM, Jao J, Dugas LR. Measurement of body composition in postpartum South African women living with and without HIV infection. Front Nutr 2024; 11:1280425. [PMID: 38385007 PMCID: PMC10879415 DOI: 10.3389/fnut.2024.1280425] [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: 08/20/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Background While several methodologies are available to measure adiposity, few have been validated in sub-Saharan African (SSA) and none in postpartum African women living with HIV (WLHIV). We compared bioelectrical impendence analysis (BIA) and air displacement plethysmography (ADP) against dual x-ray absorptiometry (DXA) in South African women and examined differences by HIV and body mass index (BMI) status. Methods Lin's concordance correlation coefficient (CCC) test was used to examine fat mass (FM), fat free mass (FFM), and total body fat percent (%BF) difference between BIA vs. DXA, and ADP vs. DXA in women living with HIV (n = 57) and without HIV (n = 25). The Bland Altman test was used to assess mean differences and the direction of bias. Results The median age was 31 years (IQR, 26-35) and months postpartum were 11 (IQR, 7-16), 44% of the women had obesity. Lin's CCC for BIA and ADP vs. DXA were both 0.80 for %BF and 0.97 for FM, and 0.86 and 0.80 for FFM, respectively. Mean differences (DXA-BIA and ADP estimates) were 0.22 ± 4.54% (p = 0.54) and 3.35 ± 3.27% (p < 0.01) for %BF, -0.82 ± 3.56 kg (p = 0.06) and 1.43 ± 2.68 kg (p = 0.01) for FM, -1.38 ± 3.61 kg (p = 0.01) and - 3.34 ± 2.37 kg (p < 0.01) for FFM, respectively. BIA overestimated %BF in WLHIV and underestimated it in women with obesity. Conclusion Body composition measurements using BIA and ADP correlated well with DXA, thereby providing alternative, safe tools for measuring postpartum FM and FFM in SSA women, including WLHIV.
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Affiliation(s)
- Hlengiwe P. Madlala
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Hayli Geffen
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Demi Meyer
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Amy E. Mendham
- Riverland Academy of Clinical Excellence (RACE), Riverland Mallee Coorong Local Health Network, South Australia Health, Berri, SA, Australia
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), FIMS International Collaborating Centre of Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Julia H. Goedecke
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), FIMS International Collaborating Centre of Sports Medicine, University of Cape Town, Cape Town, South Africa
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
| | - Angela M. Bengtson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Jennifer Jao
- Division of Infectious Diseases, Department of Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lara R. Dugas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, United States
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20
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Wei L, Zeng J, Fan M, Chen B, Li X, Li Y, Xu S. Associations between handgrip strength and skeletal muscle mass with all-cause mortality and cardiovascular mortality in people with type 2 diabetes: A prospective cohort study of the UK Biobank. J Diabetes 2024; 16:e13464. [PMID: 37608605 PMCID: PMC10809293 DOI: 10.1111/1753-0407.13464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
AIMS To explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all-cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients. MATERIALS AND METHODS Data were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex-specific analyses were conducted. RESULTS A total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow-up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all-cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles (p trend <.05). A 1 SD decrease in HGS was found to both increase the all-cause risk (HR: 1.31 [95% CI: 1.24-1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22-1.50]) for men, and all-cause risk (HR: 1.26 [95% CI: 1.11-1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09-1.89]) for women. There was no statistically significant trend association between SMM/height2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height2 showed a U-shaped nonlinear relationship (pnonlinear <.05). CONCLUSIONS Grip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U-shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.
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Affiliation(s)
- Lingqi Wei
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Jingjing Zeng
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Menglin Fan
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Bo Chen
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Xiaying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Ying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Shaoyong Xu
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
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Mogi M, Tanaka A, Node K, Tomitani N, Hoshide S, Narita K, Nozato Y, Katsurada K, Maruhashi T, Higashi Y, Matsumoto C, Bokuda K, Yoshida Y, Shibata H, Toba A, Masuda T, Nagata D, Nagai M, Shinohara K, Kitada K, Kuwabara M, Kodama T, Kario K. 2023 update and perspectives. Hypertens Res 2024; 47:6-32. [PMID: 37710033 DOI: 10.1038/s41440-023-01398-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/30/2023] [Indexed: 09/16/2023]
Abstract
Total 276 manuscripts were published in Hypertension Research in 2022. Here our editorial members picked up the excellent papers, summarized the current topics from the published papers and discussed future perspectives in the sixteen fields. We hope you enjoy our special feature, 2023 update and perspectives in Hypertension Research.
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Affiliation(s)
- Masaki Mogi
- Deparment of Pharmacology, Ehime University Graduate School of Medicine, 454 Shitsukawa Tohon, Ehime, 791-0295, Japan.
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, Saga, 849-8501, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, Saga, 849-8501, Japan
| | - Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yoichi Nozato
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Kenichi Katsurada
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University School of Medicine, 3311-1, Shimotsuke, Tochigi, 329-0498, Japan
| | - Tatsuya Maruhashi
- Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yukihito Higashi
- Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Divivsion of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Chisa Matsumoto
- Center for Health Surveillance & Preventive Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
- Department of Cardiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Kanako Bokuda
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu city, Oita, 879-5593, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu city, Oita, 879-5593, Japan
| | - Ayumi Toba
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Takahiro Masuda
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Michiaki Nagai
- Cardiovascular Section, Department of Internal Medicine, Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 800 SL Young Blvd, COM 5400, Oklahoma City, OK, 73104, USA
- Department of Cardiology, Hiroshima City Asa Hospital, 1-2-1 Kameyamaminami Asakita-ku, Hiroshima, 731-0293, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kento Kitada
- Department of Pharmacology, Faculty of Medicine, Kagawa University, 1750-1 Miki, Kita, Kagawa, 761-0793, Japan
| | - Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Takahide Kodama
- Department of Cardiology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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22
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Luengo-Pérez LM, Fernández-Bueso M, Ambrojo A, Guijarro M, Ferreira AC, Pereira-da-Silva L, Moreira-Rosário A, Faria A, Calhau C, Daly A, MacDonald A, Rocha JC. Body Composition Evaluation and Clinical Markers of Cardiometabolic Risk in Patients with Phenylketonuria. Nutrients 2023; 15:5133. [PMID: 38140392 PMCID: PMC10745907 DOI: 10.3390/nu15245133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Cardiovascular diseases are the main cause of mortality worldwide. Patients with phenylketonuria (PKU) may be at increased cardiovascular risk. This review provides an overview of clinical and metabolic cardiovascular risk factors, explores the connections between body composition (including fat mass and ectopic fat) and cardiovascular risk, and examines various methods for evaluating body composition. It particularly focuses on nutritional ultrasound, given its emerging availability and practical utility in clinical settings. Possible causes of increased cardiometabolic risk in PKU are also explored, including an increased intake of carbohydrates, chronic exposure to amino acids, and characteristics of microbiota. It is important to evaluate cardiovascular risk factors and body composition in patients with PKU. We suggest systematic monitoring of body composition to develop nutritional management and hydration strategies to optimize performance within the limits of nutritional therapy.
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Affiliation(s)
- Luis M. Luengo-Pérez
- Biomedical Sciences Department, University of Extremadura, 06008 Badajoz, Spain
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Mercedes Fernández-Bueso
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Ana Ambrojo
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Marta Guijarro
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Ana Cristina Ferreira
- Reference Centre of Inherited Metabolic Diseases, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal; (A.C.F.); or (J.C.R.)
| | - Luís Pereira-da-Silva
- CHRC—Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal; (L.P.-d.-S.); (A.F.)
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
| | - André Moreira-Rosário
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Ana Faria
- CHRC—Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal; (L.P.-d.-S.); (A.F.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Conceição Calhau
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Anne Daly
- Birmingham Children’s Hospital, Birmingham B4 6NH, UK; (A.D.); (A.M.)
| | - Anita MacDonald
- Birmingham Children’s Hospital, Birmingham B4 6NH, UK; (A.D.); (A.M.)
| | - Júlio César Rocha
- Reference Centre of Inherited Metabolic Diseases, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal; (A.C.F.); or (J.C.R.)
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
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23
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Choi KY, Kim TY, Chon YE, Kim MN, Lee JH, Hwang SG, Lee J, Kwak MK, Hong E, Choi YM, Ha Y. Impact of anthropometric parameters on outcomes in Asians with metabolic dysfunction-associated fatty liver disease. J Cachexia Sarcopenia Muscle 2023; 14:2747-2756. [PMID: 37881112 PMCID: PMC10751424 DOI: 10.1002/jcsm.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND We examined the incidence and predictors of clinical outcomes in metabolic dysfunction-associated fatty liver disease (MAFLD), focusing on anthropometric parameters. METHODS Adult patients with MAFLD were identified in nationwide databases and a hospital cohort. Primary endpoints were atherosclerotic cardiovascular disease (ASCVD) and advanced fibrosis. Logistic and Cox regression analyses were used to analyse the association between anthropometric parameters and endpoints. RESULTS In total, 4407 of 15 256 (28.9%) and 6274 of 25 784 subjects (24.3%) had MAFLD in the nationwide database; of these, 403 (9.2%) and 437 (7.0%) subjects were of lean/normal weight, respectively. Compared to the overweight/obese group, the lean/normal weight group had a significantly lower muscle mass (15.0 vs. 18.9 kg) and handgrip strength (31.9 vs. 35.1 kg) and had a higher ASCVD risk (9.0% vs. 6.3% and 15.9% vs. 8.5%; Ps < 0.001). Sarcopenia (odds ratio [OR], 6.66; 95% confidence interval [CI], 1.79-24.80) and handgrip strength (OR, 0.92; 95% CI, 0.86-0.97; Ps = 0.005) were associated with the ASCVD risk in the lean/normal weight group. In a hospital cohort (n = 1363), the ASCVD risk was significantly higher in the lean/normal weight group than in the overweight/obese group (median follow-up, 39.1 months). Muscle mass was inversely correlated with the ASCVD risk (hazard ratio [HR], 0.72; 95% CI, 0.56-0.94), while visceral adiposity was associated with advanced fibrosis (HR, 1.36; 95% CI, 1.10-1.69; Ps < 0.05). CONCLUSIONS Muscle mass/strength was significantly associated with the ASCVD risk in patients with MAFLD. Visceral adiposity was an independent predictor of advanced fibrosis.
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Affiliation(s)
- Kyu Yeon Choi
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
| | - Tae Yeon Kim
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
| | - Young Eun Chon
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
| | - Mi Na Kim
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
| | - Joo Ho Lee
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
| | - Seong Gyu Hwang
- Department of Gastroenterology, CHA Gumi Medical CenterCHA UniversityGumiSouth Korea
| | - Jiwoo Lee
- Department of Endocrinology and Metabolism, Hallym University Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseongSouth Korea
| | - Mi Kyung Kwak
- Department of Endocrinology and Metabolism, Hallym University Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseongSouth Korea
| | - Eun‐Gyoung Hong
- Department of Endocrinology and Metabolism, Hallym University Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseongSouth Korea
| | - Yun Mi Choi
- Department of Endocrinology and Metabolism, Hallym University Dongtan Sacred Heart HospitalHallym University College of MedicineHwaseongSouth Korea
| | - Yeonjung Ha
- Department of Gastroenterology, CHA Bundang Medical CenterCHA UniversitySeongnamSouth Korea
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24
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Jang SY, Kim HJ, Chang JY. Association of changes in body mass index and waist circumference with cardiovascular risk in non-alcoholic fatty liver disease: A nationwide study. Dig Liver Dis 2023; 55:1509-1514. [PMID: 37419727 DOI: 10.1016/j.dld.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND We investigated whether changes in body mass index (BMI) and waist circumference (WC) are associated with cardiovascular risk in patients with NAFLD using a nationwide dataset. METHODS Using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) data in Korea, a total of 19,057 subjects who underwent two consecutive medical check-ups (2009-2010 and 2011-2012) and who had a fatty-liver index (FLI) value of ≥ 60 were included in the analysis. Cardiovascular events were defined as the occurrence of stroke or transient ischemic attack, coronary heart disease, and cardiovascular death. RESULTS After multivariable adjustment, the risk of cardiovascular events was significantly lower in subjects with decreases in both BMI and WC (HR, 0.83; 95% CI, 0.69-0.99) and those with increased BMI and decreased WC (HR, 0.74; 95% CI, 0.59-0.94) when compared with those who showed increases in both BMI and WC. The effect of cardiovascular risk reduction among the group with increased BMI but decreased WC was particulary pronounced among those who had metabolic syndrome during the second check-up (HR, 0.63; 95% CI 0.43-0.93, p for interaction 0.02). CONCLUSIONS Changes in BMI and WC were significantly associated with cardiovascular risk in NAFLD patients. NAFLD patients with increased BMI and decreased WC had the lowest cardiometabolic risk.
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Affiliation(s)
- Se Young Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Kwaśny A, Łokieć K, Uchmanowicz B, Młynarska A, Smereka J, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in acute coronary syndrome: A retrospective cohort study. Nutr Metab Cardiovasc Dis 2023; 33:2242-2250. [PMID: 37516641 DOI: 10.1016/j.numecd.2023.06.010] [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: 04/04/2023] [Revised: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND AIMS In patients with some cardiovascular disease conditions the result of Nutritional Risk Screening 2002 (NRS-2002) and body mass index (BMI) is related to the in-hospital mortality. The aim of this study was to assess the prognostic impact of BMI and NRS 2002 on in-hospital mortality among patients with acute myocardial infarction (AMI) in relation to sex. METHODS AND RESULTS The study was based on a retrospective analysis of 945 medical records of AMI patients admitted to the Cardiology Department between 2017 and 2019. Patients with a score NRS2002 ≥ 3 are considered to be nutritionally at risk. The WHO BMI criteria were used. The endpoint was in-hospital mortality. Logistic regression was used to analyse the impact of quantitative variables on dichotomous outcome. Odds ratios (OR) with 95% confidence intervals were reported. Female patients were significantly older than male patients (73.24 ± 11.81 vs 67 ± 11.81). In an unadjusted model, the risk of malnutrition was a significant predictor of the odds of in-hospital mortality only in female patients (OR = 7.51, p = 0.001). In a multivariate model adjusted by all variables, heart failure (HF) (OR = 8.408, p = 0.003) and the risk of malnutrition (OR = 6.555, p = 0.007) were independent predictors of the odds of in-hospital mortality in female patients. The only significant independent predictor of the odds of in-hospital mortality in male patients was HF (OR = 3.789 p = 0.006). CONCLUSIONS Only in the case of female patients with AMI, the risk of malnutrition was independently associated with the odds of in-hospital mortality. There was no effect of BMI on in-hospital mortality in both sexes.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, Academy of Business Administration and Health Sciences, Lodz, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, Lodz, Poland
| | - Bartosz Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
| | - Michał Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland; Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
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26
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Chong HW, Son J, Chae C, Jae C. The relationship between skeletal muscle mass and the KOSHA cardiovascular risk in obese male workers. Ann Occup Environ Med 2023; 35:e40. [PMID: 38029272 PMCID: PMC10654537 DOI: 10.35371/aoem.2023.35.e40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/08/2023] [Accepted: 09/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Efforts for the prevention and management of cardiovascular diseases (CVDs) in workers have been actively pursued. Obesity is one of the important risk factors related to CVDs. Obesity has various metabolic characteristics, and some individuals can be metabolically healthy. Body composition including skeletal muscle mass is known to have protective effect in obesity. The study aims to investigate the association between skeletal muscle mass and Korea Occupational Safety and Health Agency (KOSHA) CVD risk among obese male manufacturing workers in Korea and to identify appropriate indicators of skeletal muscle mass for predicting risk of CVDs. Methods The study was conducted on 2,007 obese male workers at a manufacturing industry aged more than 19 years. Skeletal muscle mass, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) and skeletal muscle to body fat ratio (MFR) were used to evaluate body composition and these indicators were divided into quartiles. The odds ratios (ORs) and 95% confidence intervals (CIs) for the KOSHA CVD risk groups according to quartiles of skeletal muscle mass indicators were estimated using ordinal logistic regression analysis. Results The OR for the KOSHA CVD risk groups in the highest quartile of SMI was 1.67 (95% CI: 1.42-1.92), while the ORs for the KOSHA CVD risk groups in the highest quartiles of SMM%, SMM/body mass index (BMI), and MFR were 0.47 (95% CI: 0.22-0.72), 0.51 (95% CI: 0.05-0.76), and 0.48 (95% CI: 0.23-0.74), respectively. Conclusions We found that high SMI increase the likelihood of high risk of CVDs, while high SMM%, SMM/BMI, and MFR lower the likelihood of high risk of CVDs. Accurate evaluation of skeletal muscle mass can help assess the cardiovascular risk in obese male workers.
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Affiliation(s)
- Hyo Won Chong
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - JunSeok Son
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Changho Chae
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Changho Jae
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Kobayashi Y, Long J, Dan S, Johannsen NM, Talamoa R, Raghuram S, Chung S, Kent K, Basina M, Lamendola C, Haddad F, Leonard MB, Church TS, Palaniappan L. Strength training is more effective than aerobic exercise for improving glycaemic control and body composition in people with normal-weight type 2 diabetes: a randomised controlled trial. Diabetologia 2023; 66:1897-1907. [PMID: 37493759 PMCID: PMC10527535 DOI: 10.1007/s00125-023-05958-9] [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: 12/14/2022] [Accepted: 04/27/2023] [Indexed: 07/27/2023]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes in people in the healthy weight BMI category (<25 kg/m2), herein defined as 'normal-weight type 2 diabetes', is associated with sarcopenia (low muscle mass). Given this unique body composition, the optimal exercise regimen for this population is unknown. METHODS We conducted a parallel-group RCT in individuals with type 2 diabetes (age 18-80 years, HbA1c 47.5-118.56 mmol/mol [6.5-13.0%]) and BMI <25 kg/m2). Participants were recruited in outpatient clinics or through advertisements and randomly assigned to a 9 month exercise programme of strength training alone (ST), aerobic training alone (AER) or both interventions combined (COMB). We used stratified block randomisation with a randomly selected block size. Researchers and caregivers were blinded to participants' treatment group; however, participants themselves were not. Exercise interventions were conducted at community-based fitness centres. The primary outcome was absolute change in HbA1c level within and across the three groups at 3, 6 and 9 months. Secondary outcomes included changes in body composition at 9 months. Per adherence to recommended exercise protocol (PP) analysis included participants who completed at least 50% of the sessions. RESULTS Among 186 individuals (ST, n=63; AER, n=58; COMB, n=65) analysed, the median (IQR) age was 59 (53-66) years, 60% were men and 83% were Asian. The mean (SD) HbA1c level at baseline was 59.6 (13.1) mmol/mol (7.6% [1.2%]). In intention-to-treat analysis, the ST group showed a significant decrease in HbA1c levels (mean [95% CI] -0.44 percentage points [-0.78, -0.12], p=0.002), while no significant change was observed in either the COMB group (-0.35 percentage points, p=0.13) or the AER group (-0.24 percentage points, p=0.10). The ST group had a greater improvement in HbA1c levels than the AER group (p=0.01). Appendicular lean mass relative to fat mass increased only in the ST group (p=0.0008), which was an independent predictor of HbA1c change (beta coefficient -7.16, p=0.01). Similar results were observed in PP analysis. Only one adverse event, in the COMB group, was considered to be possibly associated with the exercise intervention. CONCLUSIONS/INTERPRETATION In normal-weight type 2 diabetes, strength training was superior to aerobic training alone, while no significant difference was observed between strength training and combination training for HbA1c reduction. Increased lean mass relative to decreased fat mass was an independent predictor of reduction in HbA1c level. TRIAL REGISTRATION ClinicalTrials.gov NCT02448498. FUNDING This study was funded by the National Institutes of Health (NIH; R01DK081371).
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Affiliation(s)
- Yukari Kobayashi
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Stanford Cardiovascular Institute, Stanford, CA, USA.
| | - Jin Long
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Shozen Dan
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, USA
| | - Neil M Johannsen
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Louisiana State University, Baton Rouge, LA, USA
| | - Ruth Talamoa
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Sonia Raghuram
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Sukyung Chung
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Kyla Kent
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Marina Basina
- Division of Endocrinology, Gerontology, and Metabolism, Stanford University School of Medicine, Stanford, CA, USA
| | - Cynthia Lamendola
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Francois Haddad
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford, CA, USA
| | - Mary B Leonard
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Timothy S Church
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Louisiana State University, Baton Rouge, LA, USA
- Wondr Health, Dallas, TX, USA
| | - Latha Palaniappan
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Salinas-Mandujano RG, Reynoso-Camacho R, Salgado LM, Ramos-Gomez M, Pérez-Ramírez IF, Aguilar-Galarza A, Moreno-Celis U, Anaya-Loyola MA. A New Approach Using BMI and FMI as Predictors of Cardio-Vascular Risk Factors among Mexican Young Adults. Eur J Investig Health Psychol Educ 2023; 13:2063-2081. [PMID: 37887147 PMCID: PMC10606082 DOI: 10.3390/ejihpe13100146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
The study aimed to identify accurate cut-off points for waist circumference (WC), body fat percentage (BF%), body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI), and to determine their effective accuracy to predict cardiovascular risk factors (CVRFs) among Mexican young adults. A cross-sectional study was conducted among 1730 Mexican young adults. Adiposity measures and CVRFs were assessed under fasting conditions. The optimal cut-off points were assessed using the receiver operating characteristic curve (ROC). Age-adjusted odds ratios (OR) were used to assess the associations between anthropometric measurements and CVRFs. The cut-off values found, in females and males, respectively, for high WC (≥72.3 and ≥84.9), high BF% (≥30 and ≥22.6), high BMI (≥23.7 and ≥24.4), high FMI (≥7.1 and ≥5.5), and low FFMI (≤16 and ≤18.9) differ from those set by current guidelines. High BMI in women, and high FMI in men, assessed by the 50th percentile, had the best discriminatory power in detecting CVRFs, especially high triglycerides (OR: 3.07, CI: 2.21-4.27 and OR: 3.05, CI: 2.28-4.08, respectively). Therefore, these results suggest that BMI and FMI measures should be used to improve the screening of CVRFs in Mexican young adults.
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Affiliation(s)
- Rocío Guadalupe Salinas-Mandujano
- Department of Food Science, School of Chemistry, Autonomous University of Queretaro, C. U., Cerro de las Campanas, S/N, Queretaro 76010, Mexico; (R.G.S.-M.)
| | - Rosalía Reynoso-Camacho
- Department of Food Science, School of Chemistry, Autonomous University of Queretaro, C. U., Cerro de las Campanas, S/N, Queretaro 76010, Mexico; (R.G.S.-M.)
| | - Luis Miguel Salgado
- Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada, Instituto Politécnico Nacional, Queretaro 76090, Mexico
| | - Minerva Ramos-Gomez
- Department of Food Science, School of Chemistry, Autonomous University of Queretaro, C. U., Cerro de las Campanas, S/N, Queretaro 76010, Mexico; (R.G.S.-M.)
| | - Iza F. Pérez-Ramírez
- Department of Food Science, School of Chemistry, Autonomous University of Queretaro, C. U., Cerro de las Campanas, S/N, Queretaro 76010, Mexico; (R.G.S.-M.)
| | - Adriana Aguilar-Galarza
- Department of Studies in Human Nutrition, School of Natural Science, Autonomous University of Queretaro, Av. de las Ciencias, S/N., Juriquilla, Delegación Santa Rosa Jauregui, Queretaro 76230, Mexico
| | - Ulisses Moreno-Celis
- Department of Studies in Human Nutrition, School of Natural Science, Autonomous University of Queretaro, Av. de las Ciencias, S/N., Juriquilla, Delegación Santa Rosa Jauregui, Queretaro 76230, Mexico
| | - Miriam Aracely Anaya-Loyola
- Department of Studies in Human Nutrition, School of Natural Science, Autonomous University of Queretaro, Av. de las Ciencias, S/N., Juriquilla, Delegación Santa Rosa Jauregui, Queretaro 76230, Mexico
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29
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Zhou R, Chen H, Lin Y, Li F, Zhong Q, Huang Y, Wu X. Total and Regional Fat/Muscle Mass Ratio and Risks of Incident Cardiovascular Disease and Mortality. J Am Heart Assoc 2023; 12:e030101. [PMID: 37642038 PMCID: PMC10547339 DOI: 10.1161/jaha.123.030101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Background To evaluate the sex-specific associations of total and regional fat/muscle mass ratio (FMR) with cardiovascular disease (CVD) incidence and mortality, and to explore the underlying mechanisms driven by cardiometabolites and inflammatory cells. We compared the predictive value of FMRs to body mass index. Methods and Results This population-based, prospective cohort study included 468 885 UK Biobank participants free of CVD at baseline. Fat mass and muscle mass were estimated using a bioelectrical impedance assessment device. FMR was calculated as fat mass divided by muscle mass in corresponding body parts (total body, trunk, arm, and leg). Multivariable Cox proportional hazards models and mediation analyses were used. During 12.5 years of follow-up, we documented 49 936 CVD cases and 4158 CVD deaths. Higher total FMR was associated with an increased risk of incident CVD (hazard ratios [HRs] were 1.63 and 1.83 for men and women, respectively), ischemic heart disease (men: HR, 1.61; women: HR, 1.81), myocardial infarction (men: HR, 1.72; women: HR, 1.49), and congestive heart failure (men: HR, 2.25; women: HR, 2.57). The positive associations of FMRs with mortality from total CVD or its subtypes were significant mainly in trunk and arm for male patients (P for trend <0.05). We also identified 8 cardiometabolites and 5 inflammatory cells that partially mediated FMR-CVD associations. FMRs were modestly better at discriminating cardiovascular mortality risk. Conclusions Higher total and regional FMRs were associated with an increased risk of CVD and mortality, partly mediated through cardiometabolites and inflammatory cells. Early monitoring of FMR should be considered to alleviate CVD risk. FMRs were superior to body mass index in predicting CVD mortality.
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Affiliation(s)
- Rui Zhou
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Hao‐Wen Chen
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Yang Lin
- Center for Disease Control and Prevention of Chaoyang District of BeijingBeijingChina
| | - Fu‐Rong Li
- School of MedicineSouthern University of Science and TechnologyShenzhenChina
| | - Qi Zhong
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Yi‐Ning Huang
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
| | - Xian‐Bo Wu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research)Southern Medical UniversityGuangzhouChina
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Liu J, Jin X, Feng Z, Huang J. The association of central and extremity circumference with all-cause mortality and cardiovascular mortality: a cohort study. Front Cardiovasc Med 2023; 10:1251619. [PMID: 37719982 PMCID: PMC10501716 DOI: 10.3389/fcvm.2023.1251619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background Central obesity increases the risk of several diseases, including diabetes, cardiovascular disease (CVD), and cancer. However, the association between extremity obesity and mortality has not been extensively evaluated. The objective of this study was to investigate the quantitative effects of waist circumference (WC), arm circumference (AC), calf circumference (CC), and thigh circumference (TC) on all-cause mortality and CVD mortality. Methods The study used data from the National Health and Nutrition Examination Survey (NHANES) sample survey from 1999 to 2006. A total of 19,735 participants were included in the study. We divided the participants into four groups (Q1-Q4) and used Q1 as a reference to compare the risk of all-cause mortality and CVD mortality in Q2-Q4. COX proportional hazard regression model was used to analyze the relationship between WC, AC, CC and TC on all-cause and CVD mortality. In addition, we conducted a stratified analysis of gender. Results After a mean follow-up of 11.8 years, we observed a total of 3,446 deaths, of which 591 were due to cardiovascular disease. The results showed that for both men and women, compared to the first group, the risk of all-cause mortality was significantly higher in the other three groups of WC and significantly lower in the other three groups of AC, CC, and TC. Similar results were observed after adjusting for confounding factors such as demographics. Conclusions Our results show that all-cause and CVD mortality are positively associated with measures of central obesity and negatively associated with measures of extremity obesity, and that AC, CC, and TC can be used as potential tools to measure prognosis in the general population.
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Affiliation(s)
- Jiajun Liu
- Department of Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xueshan Jin
- Nephropathy Center, The Affiliated Jiangmen TCM Hospital, Jinan University, Jiangmen, China
| | - Ziyi Feng
- Department of Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jieming Huang
- Department of Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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Kang D, Park J, Eun SD. Protocol for Community-Based Exercise Training after Discharge from Hospital-Based Stroke Rehabilitation: A Multicenter, Randomized, Parallel-Group, Double-Blind Controlled Pilot and Feasibility Trial. Healthcare (Basel) 2023; 11:2275. [PMID: 37628473 PMCID: PMC10454670 DOI: 10.3390/healthcare11162275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Exercise training participation of patients with stroke in the community after discharge from the hospital has many benefits for physical, social, and psychological rehabilitation and improves their quality of life. However, in the Republic of Korea, studies on stroke survivors who can participate in an exercise training program have not been conducted. This trial aims to investigate the effectiveness of exercise training programs after patients with stroke are discharged from the hospital with a doctor's note and referred to a community exercise center, as there is a lack of studies on this population. This multicenter, randomized, parallel-group, double-blind controlled pilot and feasibility trial will randomly assign 120 patients with stroke to either 8 weeks of a community-based exercise training program (experimental group) or activities of daily living (control group). The primary outcomes will be muscle strength, cardiorespiratory fitness, body composition, physical performance, and gait. The secondary outcomes will be quality of life and activities of daily living. This study's results may add new insights into the effectiveness of community-based exercise training programs after patients with stroke are discharged from the hospital with a doctor's note and referred to a community exercise center. The success of the new exercise training approach could offer valuable information for developing more inclusive protocols for patients with stroke in the future if it proves to be efficacious.
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Affiliation(s)
| | - Jiyoung Park
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea;
| | - Seon-Deok Eun
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea;
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32
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Nora CL, Zhang L, Castro RJ, Marx A, Carman HB, Lum T, Tsimikas S, Hong MY. Effects of mixed nut consumption on LDL cholesterol, lipoprotein(a), and other cardiometabolic risk factors in overweight and obese adults. Nutr Metab Cardiovasc Dis 2023; 33:1529-1538. [PMID: 37263914 DOI: 10.1016/j.numecd.2023.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND AIMS Elevated LDL-C, lipoprotein(a) [Lp(a)], and inflammation are associated with greater risk for atherosclerotic cardiovascular events. Consumption of individual nut types decreases these risk factors but knowledge about the effect of mixed nuts on Lp(a) is limited. The objective of this study was to determine the effects of consuming 42.5 g/day of mixed nuts on LDL-C, Lp(a), and inflammatory markers in individuals with overweight or obesity. METHODS AND RESULTS In a 16-week randomized control trial, 29 participants with overweight or obesity (BMI 25-40 kg/m2) consumed either 42.5 g/day of mixed nuts (cashews, almonds, macadamia nuts, Brazil nuts, pecans, pistachios, walnuts, and peanuts) or 69 g/day isocaloric pretzels. Blood samples were collected at baseline, week 8, and week 16 for analysis on total cholesterol (TC), LDL-C, Lp(a), inflammation markers, glucose, insulin, adiponectin and liver function enzymes. No significant differences were seen in TC, LDL-C, HDL-C, Lp(a), or liver function enzymes between the two groups. Participants consuming mixed nuts had significantly lower body fat percentage and diastolic blood pressure, and higher adiponectin (all P ≤ 0.05). C-reactive protein (CRP) and 8-oxo-deoxyguanosis (8-oxodG) showed non-significant decreasing trends and total antioxidant capacity (TAC) had a non-significant increasing trend in the mixed nut group. CONCLUSION Consumption of mixed nuts had no evidence of an effect on LDL-C or Lp(a) throughout the intervention. Notably, mixed nut consumption lowered body fat percentage without significant changes in body weight or BMI. Future studies with larger sample sizes investigating the changing trends of CRP, 8-oxodG, and TAC are warranted. CLINICAL TRIAL REGISTER NCT03375866.
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Affiliation(s)
- Chelsea L Nora
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Liyue Zhang
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Robert J Castro
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Amanda Marx
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Hannah B Carman
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Tiffany Lum
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Sotirios Tsimikas
- School of Medicine, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Mee Young Hong
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA.
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Zabaleta-Korta A, Fernández-Peña E, Torres-Unda J, Francés M, Zubillaga A, Santos-Concejero J. Regional Hypertrophy: The Effect of Exercises at Long and Short Muscle Lengths in Recreationally Trained Women. J Hum Kinet 2023; 87:259-270. [PMID: 37559762 PMCID: PMC10407320 DOI: 10.5114/jhk/163561] [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: 12/18/2022] [Accepted: 04/03/2023] [Indexed: 08/11/2023] Open
Abstract
The aim of the present study was to analyse the role of exercises' resistance profile in regional hypertrophy. Thirty-eight healthy women completed a 9-week resistance training program consisting of either 4 sets of 12 repetitions to volitional failure of inclined bicep curls (INC group) or preacher curls (PREA group), three times per week. Pre- and post-intervention muscle thickness was measured using B-mode ultrasound imaging with a linear-array transducer. Scan acquisition sites were determined by measuring 50%, 60% and 70% of the distance between the posterior crest of the acromion and the olecranon. Statistical significance was set at p < 0.05. No region of the INC group grew when comparing pre- to post-intervention. The 70% region of the PREA group grew significantly (muscle thickness increased from 2.7 ± 0.43 cm to 2.94 ± 0.44 cm). We found no growth differences between regions when analysing per group (p = 0.274), region (p = 0.571) or group*region (p = 0.367). Our results show that the distal region of the arm grows in response to the preacher curl that places the highest amount of strain in the range of motion in which the arm muscles are more elongated.
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Affiliation(s)
- Aitor Zabaleta-Korta
- Sports and Education Department, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Eneko Fernández-Peña
- Sports and Education Department, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Jon Torres-Unda
- Physiotherapy Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Maider Francés
- Physiotherapy Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Asier Zubillaga
- Sports and Education Department, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Jordan Santos-Concejero
- Sports and Education Department, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
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Damigou E, Kouvari M, Panagiotakos D. The role of skeletal muscle mass on cardiovascular disease risk: an emerging role on modulating lipid profile. Curr Opin Cardiol 2023; 38:352-357. [PMID: 36928171 DOI: 10.1097/hco.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review was to present updated evidence on the role of skeletal muscle mass on cardiometabolic health. RECENT FINDINGS Increased lean, and especially skeletal, muscle mass has been associated with better cardiometabolic health in various epidemiological studies, even in younger age groups. In addition, the link between skeletal muscle mass and adult lipid profile is of interest. A preliminary analysis using the data from the ATTICA prospective cohort study (2002-2022) supports this association. SUMMARY Skeletal muscle mass has many metabolic functions (i.e., glucose, insulin and protein metabolism, mitochondrial function, arterial stiffness, inflammation, oxidative stress, brain function, hormone status). Given its associations with the lipid profile and overall cardiometabolic risk, skeletal muscle mass stands among the emerging risk factors for cardiovascular diseases. In addition to only using body mass index or fat distribution, more studies should evaluate lean mass and its prognostic and predictive ability regarding chronic diseases.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, Liu K, Shirai K, Sheerah HA, Cao J. Association between android fat mass, gynoid fat mass and cardiovascular and all-cause mortality in adults: NHANES 2003-2007. Front Cardiovasc Med 2023; 10:1055223. [PMID: 37273879 PMCID: PMC10233278 DOI: 10.3389/fcvm.2023.1055223] [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: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives Evidence of the relationship between android fat mass and gynoid fat mass with the mortality prediction is still limited. Current study analyzed the NHANES database to investigate the relationship between android fat mass, gynoid fat mass and CVD, with all-cause mortality. Method The study subjects were NHANES participants over 20 years old, two indicators of regional body composition, android fat and gynoid fat were measured by Dual Energy x-ray Absorptiometry (DEXA). The other various covariates data obtained from the NHANES questionnaire and laboratory measurements, including age, gender, education, race/ethnicity, uric acid, total serum cholesterol, albumin, Vitamin C, folate, alcohol drinking, smoking status, history of diabetes, and hypertension. Mortality status was ascertained from a linked mortality file prepared by the National Center for Health Statistics. The study population was divided quartiles based on the distribution of android fat mass and gynoid fat mass. The relationship between these two indicators with cardiovascular and all-cause mortality was investigated by using Cox regression. The covariates age, gender, smoking status, drinking status, history of diabetes, and history of hypertension were stratified. Results In the fully adjusted model, Q3 had the lowest HR in android fat mass and gynoid fat mass. When examining the relationship between android fat mass and CVD mortality, current smokers and drinkers had the lowest CVD risk in Q2 [smoking: 0.21 (0.08, 0.52), drinking: 0.14 (0.04, 0.50)]. In diabetic patients, compared with Q1, other groups with increased android fat mass can significantly reduce the risk of CVD [Q4: 0.17 (0.04, 0.75), Q3: 0.18 (0.03, 1.09), Q2: 0.27 (0.09, 0.83)]. In ≥60 years old and female, the greater the gynoid fat mass, the smaller the HR of all-cause mortality [Q4 for ≥60 years old: 0.57 (0.33, 0.96), Q4 for female: 0.37 (0.23, 0.58)]. People <60 years old had a lower risk of all-cause mortality with gynoid fat mass in Q3 than those ≥60 years old [<60 years: 0.50 (0.27, 0.91), ≥60 years: 0.65 (0.45, 0.95)]. Among subjects without hypertension, the group with the largest android fat mass had the lowest risk of CVD mortality, and the group with the largest gynoid fat mass had the lowest risk of all-cause mortality [Android fat mass: 0.36 (0.16, 0.81), gynoid fat mass: 0.57 (0.39, 0.85)]. Conclusion Moderate android fat mass and gynoid fat mass (Q3) had the most protective effect. Smokers and drinkers need to control their body fat. Being too thin is harmful to people with diabetes. Increased gynoid fat mass is a protective factor for all-cause mortality in older adults and females. Young people's gynoid fat mass is more protective in the moderate range than older people's. If no high blood pressure exists, people with more android and gynoid fat mass have a lower risk of CVD or all-cause mortality.
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Affiliation(s)
- Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan, China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyi Yu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macao, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Nian Huang
- School of Public Health, Wuhan University, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Japan
| | - Haytham A. Sheerah
- Assistant Deputyship for International Collaborations, Ministry of Health, Riyadh, Saudi Arabia
| | - Jinhong Cao
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
- Research Center for the Development of Chinese Medicine, Hubei Province Project of Key Research Institute of Humanities and Social Sciences at Universities, Wuhan, China
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Weakley J, Schoenfeld BJ, Ljungberg J, Halson SL, Phillips SM. Physiological Responses and Adaptations to Lower Load Resistance Training: Implications for Health and Performance. SPORTS MEDICINE - OPEN 2023; 9:28. [PMID: 37171517 PMCID: PMC10182225 DOI: 10.1186/s40798-023-00578-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Abstract
Resistance training is a method of enhancing strength, gait speed, mobility, and health. However, the external load required to induce these benefits is a contentious issue. A growing body of evidence suggests that when lower load resistance training [i.e., loads < 50% of one-repetition maximum (1RM)] is completed within close proximity to concentric failure, it can serve as an effective alternative to traditional higher load (i.e., loads > 70% of 1RM) training and in many cases can promote similar or even superior physiological adaptations. Such findings are important given that confidence with external loads and access to training facilities and equipment are commonly cited barriers to regular resistance training. Here, we review some of the mechanisms and physiological changes in response to lower load resistance training. We also consider the evidence for applying lower loads for those at risk of cardiovascular and metabolic diseases and those with reduced mobility. Finally, we provide practical recommendations, specifically that to maximize the benefits of lower load resistance training, high levels of effort and training in close proximity to concentric failure are required. Additionally, using lower loads 2-3 times per week with 3-4 sets per exercise, and loads no lower than 30% of 1RM can enhance muscle hypertrophy and strength adaptations. Consequently, implementing lower load resistance training can be a beneficial and viable resistance training method for a wide range of fitness- and health-related goals.
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Affiliation(s)
- Jonathon Weakley
- School of Behavioural and Health Sciences, Australian Catholic University, 211.1.26, Brisbane, QLD, Australia.
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, QLD, Australia.
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
| | | | - Johanna Ljungberg
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, 211.1.26, Brisbane, QLD, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, QLD, Australia
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
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Christen T, de Mutsert R, Smit RA, Willems van Dijk K, Lamb HJ, Rosendaal FR, Jukema JW, Trompet S. The association between leptin and subclinical cardiovascular disease explained by body fat: Observational and Mendelian randomization analyses. Nutr Metab Cardiovasc Dis 2023; 33:1077-1086. [PMID: 36958975 DOI: 10.1016/j.numecd.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND AIMS Leptin has been associated with adverse effects on cardiovascular disease, but the effect of confounding by body fat in these associations remains unclear. To investigate associations between leptin and heart function and subclinical cardiovascular disease adjusted for total body fat, and to investigate the causal relation between leptin and cardiovascular disease using Mendelian randomisation. METHODS AND RESULTS Leptin concentrations, total body fat and diverse measures of subclinical cardiovascular disease were determined in participants of the Netherlands Epidemiology of Obesity study. Linear regression between leptin concentration and measures of heart function, ECG measures, and carotid intima media thickness as a measure of subclinical atherosclerosis was adjusted for potential confounding factors, and additionally including total body fat. We analysed the combined effects of genetic variants from a GWAS on leptin concentrations in publicly-available summary statistics of coronary heart disease GWAS (CARDIoGRAMplusC4D, n = 184,305). As many as 6107 men and women, mean (SD) age 56 (6) years, BMI 26 (4) kg/m2, and median leptin concentration 12.1 μg (IQR: 6.7-22.6) were included. In observational analyses, leptin was weakly associated with heart function and subclinical cardiovascular disease, but these associations attenuated when adjusting for total body fat. A doubling of genetically-determined leptin concentration was associated with an odds ratio of cardiovascular disease of 0.69 (0.37, 1.27). CONCLUSION Observational associations between leptin and subclinical measures of cardiovascular disease were largely explained by differences in total body fat. Results of analyses of genetically-determined leptin and coronary heart disease risk were inconclusive due to a large confidence interval.
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Affiliation(s)
- Tim Christen
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Roelof Aj Smit
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Ko Willems van Dijk
- Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, the Netherlands; Department of Human Genetics, LUMC, Leiden, the Netherlands; Internal Medicine, Division of Endocrinology, LUMC, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, LUMC, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | | - Stella Trompet
- Department of Gerontology and Geriatrics, LUMC, Leiden, the Netherlands.
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Green ES, Williams ER, Feito Y, Jenkins NT. Physiological and Anthropometric Differences Among Endurance, Strength, and High-Intensity Functional Training Participants: A Cross-Sectional Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:131-142. [PMID: 35302436 DOI: 10.1080/02701367.2021.1947468] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/10/2021] [Indexed: 06/14/2023]
Abstract
Purpose: We compared aerobic capacity (V˙O2max), mitochondrial capacity (mV˙O2), anaerobic power, strength, and muscle endurance in healthy, active men from strength (STR), endurance (END) and high-intensity functional training (HIFT) backgrounds. Methods: Twenty-four men (n = 8/group) completed a cycle ergometer test to determine V˙O2max, followed by a 3-min all-out test to determine peak (PP) and end power (EP), and to estimate anaerobic [work done above EP (WEP)] and aerobic work capacity. Strength was determined by knee extensor maximal voluntary contraction at various flexion angles. The endurance index (EI) of the vastus lateralis (VL) was assessed by measuring muscle contraction acceleration during electrical twitch mechanomyography. mV˙O2max of the VL was assessed using near-infrared spectroscopy to estimate muscle oxygen consumption during transient femoral artery occlusions. Results: V˙O2max was significantly different among groups (p < .05). PP was significantly higher in HIFT and STR versus END (p < .05). EP was significantly higher in HIFT and END compared to STR (p < .05). WEP was significantly higher in STR compared to END (p < .05), whereas total work done was significantly higher in HIFT and END compared to STR (p < .05). mV˙O2max and EI were comparable between HIFT and END but significantly lower in STR versus END (p < .05). Torque production was significantly lower in END compared to STR and HIFT at all flexion angles (p < .05), with no difference between STR and HIFT. Conclusion: HIFT participants can exert similar power outputs and absolute strength compared to strength focused participants but exhibit fatigue resistance and mitochondrial capacity comparable to those who train for endurance.
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Higher Muscle Mass and Higher Serum Prealbumin Levels Are Associated with Better Survival in Hemodialysis Patients during a Five-Year Observation Period. Nutrients 2023; 15:nu15051237. [PMID: 36904235 PMCID: PMC10005672 DOI: 10.3390/nu15051237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Dialysis is the most commonly used renal replacement therapy in patients with end-stage renal disease. The mortality rate of hemodialysis patients is 15-20%, with cardiovascular complications being the most common. There is an association between the severity of atherosclerosis and both the development of protein-calorie malnutrition and inflammatory mediators. The aim of this study was to assess the relationship between biochemical markers of nutritional status, body composition and survival in hemodialysis patients. METHODS Fifty-three hemodialysis patients were included in the study. Serum albumin, prealbumin, and IL-6 levels were measured, as well as body weight, body mass index, fat content and muscle mass. The five-year survival of patients was calculated using Kaplan-Meier estimators. The long-rank test was used for univariate comparison of survival curves, and the Cox proportional hazards model was used for multivariate analysis of survival predictors. RESULTS There were 47 deaths, 34 of which were due to cardiovascular disease. The hazard ratio (HR) for age in the middle-aged group (55-65 years) was 1.28 (confidence interval [CI] 0.58, 2.79) and 5.43 (CI 2.1, 14.07; statistically significant) for the oldest age group (over 65 years). A prealbumin level above 30 mg/dl was associated with an HR of 0.45 (CI 0.24, 0.84). Serum prealbumin (odds ratio [OR] = 5.23; CI 1.41, 19.43; p = 0.013) and muscle mass (OR = 7.5; CI 1.31, 43.03; p = 0.024) were significant predictors of all-cause mortality. CONCLUSIONS Prealbumin level and muscle mass were associated with increased mortality risk. Identification of these factors may improve the survival of hemodialysis patients.
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Liu CA, Liu T, Ge YZ, Song MM, Ruan GT, Lin SQ, Xie HL, Shi JY, Zheng X, Chen Y, Shen L, Deng L, Shi HP. Muscle distribution in relation to all-cause and cause-specific mortality in young and middle-aged adults. J Transl Med 2023; 21:154. [PMID: 36841788 PMCID: PMC9960213 DOI: 10.1186/s12967-023-04008-7] [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: 01/13/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The relationship between muscle and prognosis, especially that between muscle distribution across different body parts, and the related prognosis is not well established. OBJECTIVE To investigate the relationship between muscle distribution and all-cause and cause-specific mortality and their potential modifiers. DESIGN Longitudinal cohort study. C-index, IDI, and NRI were used to determine the best indicator of prognosis. COX regression analysis was performed to explore the relationship between variables and outcomes. Interaction and subgroup analyses were applied to identify the potential modifiers. PARTICIPANTS A total of 5052 participants (weighted: 124,841,420) extracted from the NHANES 2003-2006 of median age 45 years and constituting 50.3% men were assessed. For validation, we included 3040 patients from the INSCOC cohort in China. MAIN MEASURES Muscle mass and distribution. KEY RESULTS: COX regression analysis revealed that upper limbs (HR = 0.41, 95% CI 0.33-0.51), lower limbs (HR = 0.54, 95% CI 0.47-0.64), trunk (HR = 0.71, 95% CI, 0.59-0.85), gynoid (HR = 0.47, 95% CI 0.38-0.58), and total lean mass (HR = 0.55, 95% CI 0.45-0.66) were all associated with the better survival of participants (P trend < 0.001). The changes in the lean mass ratio of the upper and lower limbs and the lean mass ratio of the android and gynoid attenuated the protective effect of lean mass. Age and sex acted as potential modifiers, and the relationship between lean mass and the prognosis was more significant in men and middle-aged participants when compared to that in other age groups. Sensitive analyses depicted that despite lean mass having a long-term impact on prognosis (15 years), it has a more substantial effect on near-term survival (5 years). CONCLUSION Muscle mass and its distribution affect the prognosis with a more significant impact on the near-term than that on the long-term prognosis. Age and sex acted as vital modifiers.
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Affiliation(s)
- Chen-An Liu
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Tong Liu
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Shi-Qi Lin
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Jin-Yu Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Xin Zheng
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Yue Chen
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Liuyi Shen
- Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Li Deng
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.
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Relationship of Functional Outcome With Sarcopenia and Objectively Measured Physical Activity in Patients With Stroke Undergoing Rehabilitation. J Aging Phys Act 2023; 31:1-6. [PMID: 35461188 DOI: 10.1123/japa.2022-0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/08/2023]
Abstract
This study aimed to investigate the relationship of Functional Independence Measure for motor function (FIM-M) with sarcopenia, and physical activity in patients with stroke undergoing rehabilitation. This cross-sectional study included patients with stroke at a single convalescent rehabilitation hospital. Sarcopenia was diagnosed based on the Asia Working Group for Sarcopenia 2019 criteria. Physical activity was measured as the duration of light-intensity physical activity and moderate to vigorous physical activity using a triaxial accelerometer. Of 80 patients (median age: 72.0 years), 46 (57.5%) were diagnosed with sarcopenia. In multivariate linear regression analysis, FIM-M score was significantly associated with sarcopenia (β = -0.15, p = .043) and light-intensity physical activity (β = 0.55, p < .001). In another model, FIM-M score was significantly associated with moderate to vigorous physical activity (β = 0.27, p = .002) but not with sarcopenia. This study demonstrated that FIM-M was partially associated with sarcopenia and associated with physical activity regardless of intensity in patients with stroke.
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Spain DR, Andrews AM, Crews SA, Khan JM. Males With Traumatic Lower Limb Loss Differ in Body Fat Distribution Compared to Those Without Limb Loss. Mil Med 2023; 188:e140-e144. [PMID: 34143209 DOI: 10.1093/milmed/usab237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 06/04/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The primary objective was to examine body fat composition in males with traumatic lower limb loss and a comparison group without limb loss. A secondary objective was to determine if there are differences in body fat composition by traumatic limb loss level. RESEARCH METHODS AND PROCEDURES Cross-sectional analyses of baseline in-person intake data was completed at a large military medical center. Data were collected from 2011 to 2020, and analysis was conducted in 2020. Participants (n = 89) included males who sustained traumatic lower limb loss (n = 50) and an age-matched comparison group without limb loss (n = 39). Mean age of participants was 36.0 ± 13.2 years. Main outcomes measured included age, height, body mass index, weight, body fat mass and percent, android fat mass and percent, gynoid fat mass and percent, and android/gynoid percent fat ratio. Differences between groups were assessed using t-tests or Mann-Whitney U tests. Differences between limb loss levels were assessed using one-way ANOVA or Wilcoxon signed-rank test. RESULTS Body fat percent (P = .001), gynoid fat percent (P = .010), android fat mass (P = .01), and percent (P = .02) were higher in the group with limb loss. There were no differences in body fat composition between limb loss levels (P > .05). CONCLUSION Males with traumatic lower limb loss had a higher body fat percent compared to those without limb loss. Given higher body fat composition in individuals with limb loss and the relationship between body fat composition and cardiovascular disease risk, including body composition analysis with clinical screening could identify changes and allow for early intervention.
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Affiliation(s)
- David R Spain
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Care Division, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Anne M Andrews
- Research Protections Office, National Institute of Standards and Technology, Gaithersburg, MD 20889, USA.,Department of Orthopaedics and Rehabilitation, and US Military-Baylor Graduate Program in Nutrition, Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Sara A Crews
- U.S. Military-Baylor, Graduate Program of Nutrition, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.,Nutrition Services Department, Darnall Army Medical Center, Fort Hood, TX 76544, USA
| | - Joetta M Khan
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
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Nishio R, Dohi T, Fukase T, Takeuchi M, Takahashi N, Endo H, Doi S, Okai I, Iwata H, Okazaki S, Miyauchi K, Daida H, Minamino T. Impact of simple equation for estimating appendicular skeletal muscle mass in patients with stable coronary artery disease undergoing percutaneous coronary intervention. IJC HEART & VASCULATURE 2022; 44:101163. [PMID: 36545275 PMCID: PMC9762183 DOI: 10.1016/j.ijcha.2022.101163] [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: 08/24/2022] [Revised: 11/24/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Background Sarcopenia, which is evaluated based on appendicular skeletal muscle mass (ASM) using dual-energy X-ray absorptiometry and bioelectrical impedance analysis, is a prognostic predictor for adverse outcomes in patients with coronary artery disease (CAD). However, a simple equation for estimating ASM is yet to be validated in clinical practice. Methods We enrolled 2211 patients with CAD who underwent percutaneous coronary intervention at our hospital between 2010 and 2017. The mean age was 68 years and 81.5 % were men. Patients were divided into 2 groups based on each ASM index (ASMI): low; male < 7.3 and female < 5.0 and high; male ≥ 7.3 and female ≥ 5.0. ASM was calculated using the following equation: 0.193 × bodyweight + 0.107 × height - 4.157 × gender - 0.037 × age - 2.631. Primary endpoints were major adverse cardiac events (MACE, which includes cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for heart failure), and all-cause mortality. Results During the median follow-up period of 4.8 years, cumulative incidence of events were significantly higher in the low ASMI group. Cox proportional hazards model revealed that the low ASMI group had a significantly higher risk of primary endpoints than the high ASMI group (all-cause mortality; hazard ratio (HR): 2.13, 95 % confidence interval [CI]: 1.40-3.22, p < 0.001 and 4-point MACE; HR: 1.72, 95 % CI: 1.12-2.62, p = 0.01). Similar trends were observed after stratification by age of 65 years. Conclusion Low ASMI, evaluated using the aforementioned equation, is an independent predictor of MACE and all-cause mortality in patients with CAD.
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Key Words
- ASM, appendicular skeletal muscle mass
- ASMI, appendicular skeletal muscle mass index
- AWGS, Asian Working Group for Sarcopenia
- Appendicular skeletal mass index
- BIA, bioelectrical impedance analysis
- CAD, coronary artery disease
- CI, confidence interval
- CKD, chronic kidney disease
- CVD, cardiovascular deaths
- Coronary artery disease
- DXA, dual-energy X-ray absorptiometry
- HR, hazard ratio
- LVEF, left ventricular ejection fraction
- MACE, major adverse cardiac events
- PCI, percutaneous coronary intervention
- Percutaneous coronary intervention
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Affiliation(s)
- Ryota Nishio
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan,Corresponding author at: Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Tatsuya Fukase
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuhiro Takeuchi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Norihito Takahashi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirohisa Endo
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinichiro Doi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Iwao Okai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Iwata
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinya Okazaki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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44
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Fan Y, Liu J, Jin L, Liu Z, Han L, Wang Y, Zhang Y, Shen P, Li Z. Impacts of metabolic disorders on short- and long-term mortality after coronary artery surgery in the elderly. BMC Cardiovasc Disord 2022; 22:504. [PMID: 36434496 PMCID: PMC9700925 DOI: 10.1186/s12872-022-02954-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Elderly patients undergoing cardiac operation often suffer various metabolic comorbidities, such as diabetes mellitus (DM) and obesity. The metabolic disorders in these individuals are widely considered to be possible predisposing factors for unfavourable prognosis. This retrospective study was aimed to determine the association of metabolic diseases with the mortality of elderly patients after coronary artery bypass grafting (CABG) and to identify the protective or risk factors related to their short- and long-term survival. METHODS Totally 684 patients aged 75 years or above undergoing isolated CABG were evaluated retrospectively. There were two groups depending on the body mass index (BMI): an overweight and obesity group (n = 354) and a normal weight and lean group (n = 330). Propensity score matching (PSM) was performed to adjust baseline clinical characteristics, which reduced confounding bias. The short-term postoperative mortality was tested via logistic regression. Kaplan-Meier and Cox regression analyses were done to compute the overall survival in each group and to identify relevant variables associated with all-cause mortality, respectively. RESULTS The prevalence rates of metabolic comorbidities in the total cohort were: diabetes mellitus (32.5%), overweight or obesity (51.8%) and hypertension (72.8%). The 30-day postoperative mortality was 5.1% and the long-term mortality was 15.25% at a median 46.2-month follow-up (1.0-178.6 months). The 30-day postoperative mortality was relevant to DM, diseased coronary arteries, New York Heart Association class, intra-aortic balloon pump and emergency surgery. The long-term mortality was negatively associated with overweight and obesity. Univariate and multivariate logistic regression recognized DM as an adverse factor related with 30-day postoperative mortality whether before or after PSM. The long-term mortality was not significantly relevant with DM (HR = 0.753, 95% CI 0.402-1.411). Overweight or obesity was not the risk factor of 30-day postoperative mortality (OR = 1.284, 95% CI 0.426-3.868), but was the protective factor of long-term survival (HR = 0.512, 95% CI 0.279-0.939). CONCLUSIONS The "obesity paradox" exists regarding the prognosis of individuals aged ≥ 75, which was presented as lower long-term mortality no matter from all cause or cardio-cerebrovascular cause in patients with BMI ≥ 24. Trial registration ChiCTR2200061869 (05/07/2022).
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Affiliation(s)
- Yuhong Fan
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai, 200030, China
| | - Jingjing Liu
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Lei Jin
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai, 200030, China
| | - Zhonghe Liu
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai, 200030, China
| | - Lixiang Han
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yue Wang
- Outpatient Clinic, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai, 200030, China.
| | - Peiming Shen
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai, 200030, China.
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Bragança MLBM, Coelho CCNDS, de Oliveira BR, Bogea EG, Confortin SC, da Silva AAM. The Frequency of Daily Consumption of Sugar-Sweetened Beverages Is Associated with Reduced Muscle Mass Index in Adolescents. Nutrients 2022; 14:4917. [PMID: 36432603 PMCID: PMC9699446 DOI: 10.3390/nu14224917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
The consumption of sugar-sweetened beverages (SSBs) has increased in recent years and has become a cause of concern because these beverages pose a risk to human health. Thus, we evaluated the association between SSBs consumption and muscle mass index (MMI) in adolescents. This cross-sectional study evaluated 2393 adolescents (18/19-years-old). Consumption of SSBs was analyzed based on the frequency of daily consumption and energy contribution categorized into tertiles. MMI was examined using the ratio of muscle mass (kilograms) to height (meters squared). The highest tertile of the frequency of daily SSB intake was associated with a reduced MMI in men (β = -0.31; 95%CI: -0.60, -0.01) and women (β = -0.24; 95%CI: -0.45, -0.02). However, these associations were not observed after adjusting for sugar contained in SSBs in men (β = -0.26; 95%CI: -0.69, 0.17) and for carbohydrate, lipid, and protein intake in women (β = -0.19; 95%CI: -0.42, 0.04). The highest energy contribution tertile of SSBs was associated with a reduced MMI in male adolescents (β = -0.34; 95%CI: -0.64, -0.04). This association was not observed after adjusting for intake of sugar in SSBs (β = -0.38; 95%CI: -0.75, 0.01). The frequency of daily consumption of SSBs was considered a risk factor for decreased MMI in both sexes, and the energy contribution of these drinks was a risk factor for MMI reduced only in male adolescents.
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Seo J, Li W, Safiriyu I, Kharawala A, Nagraj S, Tahir A, Doundoulakis I, Koliastasis L, Rios S, Palaiodimos L, Kokkinidis DG. A Meta-Analysis on the Impact of High BMI in Patients Undergoing Transcatheter Aortic Valve Replacement. J Cardiovasc Dev Dis 2022; 9:386. [PMID: 36354785 PMCID: PMC9695436 DOI: 10.3390/jcdd9110386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/22/2022] [Accepted: 11/01/2022] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND A paradoxical association of obesity with lower risk of transcatheter aortic valve replacement (TAVR) outcomes has been reported. We aimed to systematically review the literature and compare TAVR-related morbidity and mortality among individuals with overweight or obesity and their peers with normal body mass index (BMI). METHODS PubMed and Embase databases were systematically searched for studies reporting TAVR outcomes in different BMI groups. Separate meta-analyses were conducted for studies reporting hazard ratios (HR) and odds ratios/relative risks. Short- and mid-/long-term outcomes were examined. RESULTS 26 studies with a total of 74,163 patients were included in our study. Overweight was associated with lower risk of short-term mortality (HR: 0.77; 95% CI: 0.60-0.98) and mid-/long-term mortality (HR: 0.79; 95% CI: 0.70-0.89). Obesity was associated with lower risk for mid-/long-term mortality (HR: 0.79; 95% CI: 0.73-0.86), but no difference was observed in short-term mortality, although a trend was noted (HR: 0.87l 95% CI: 0.74-1.01). Individuals with obesity demonstrated an association with higher odds of major vascular complications (OR: 1.33; 95% CI: 1.05-1.68). Both overweight (OR: 1.16; 95% CI: 1.03-1.30) and obesity (OR: 1.26; 95% CI: 1.06-1.50) were associated with higher likelihood for receiving permanent pacemakers after TAVR. CONCLUSION Individuals with overweight and obesity were associated with lower mortality risk compared to those with normal BMI but with higher likelihood of major vascular complications and permanent pacemaker implantation after TAVR.
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Affiliation(s)
- Jiyoung Seo
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Weijia Li
- AdventHealth Orlando, Orlando, FL 32803, USA
| | - Israel Safiriyu
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Amrin Kharawala
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Sanjana Nagraj
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Arooj Tahir
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Ioannis Doundoulakis
- Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Leonidas Koliastasis
- Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Saul Rios
- Montefiore Einstein Center for Heart & Vascular Care, Albert Einstein College of Medicine, Montefiore Medical Center, The Bronx, NY 10467, USA
| | - Leonidas Palaiodimos
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA
| | - Damianos G. Kokkinidis
- Section of Cardiovascular Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT 06510, USA
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Biomarkers extracted by fully automated body composition analysis from chest CT correlate with SARS-CoV-2 outcome severity. Sci Rep 2022; 12:16411. [PMID: 36180519 PMCID: PMC9524347 DOI: 10.1038/s41598-022-20419-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
The complex process of manual biomarker extraction from body composition analysis (BCA) has far restricted the analysis of SARS-CoV-2 outcomes to small patient cohorts and a limited number of tissue types. We investigate the association of two BCA-based biomarkers with the development of severe SARS-CoV-2 infections for 918 patients (354 female, 564 male) regarding disease severity and mortality (186 deceased). Multiple tissues, such as muscle, bone, or adipose tissue are used and acquired with a deep-learning-based, fully-automated BCA from computed tomography images of the chest. The BCA features and markers were univariately analyzed with a Shapiro–Wilk and two-sided Mann–Whitney-U test. In a multivariate approach, obtained markers were adjusted by a defined set of laboratory parameters promoted by other studies. Subsequently, the relationship between the markers and two endpoints, namely severity and mortality, was investigated with regard to statistical significance. The univariate approach showed that the muscle volume was significant for female (pseverity ≤ 0.001, pmortality ≤ 0.0001) and male patients (pseverity = 0.018, pmortality ≤ 0.0001) regarding the severity and mortality endpoints. For male patients, the intra- and intermuscular adipose tissue (IMAT) (p ≤ 0.0001), epicardial adipose tissue (EAT) (p ≤ 0.001) and pericardial adipose tissue (PAT) (p ≤ 0.0001) were significant regarding the severity outcome. With the mortality outcome, muscle (p ≤ 0.0001), IMAT (p ≤ 0.001), EAT (p = 0.011) and PAT (p = 0.003) remained significant. For female patients, bone (p ≤ 0.001), IMAT (p = 0.032) and PAT (p = 0.047) were significant in univariate analyses regarding the severity and bone (p = 0.005) regarding the mortality. Furthermore, the defined sarcopenia marker (p ≤ 0.0001, for female and male) was significant for both endpoints. The cardiac marker was significant for severity (pfemale = 0.014, pmale ≤ 0.0001) and for mortality (pfemale ≤ 0.0001, pmale ≤ 0.0001) endpoint for both genders. The multivariate logistic regression showed that the sarcopenia marker was significant (pseverity = 0.006, pmortality = 0.002) for both endpoints (ORseverity = 0.42, 95% CIseverity: 0.23–0.78, ORmortality = 0.34, 95% CImortality: 0.17–0.67). The cardiac marker showed significance (p = 0.018) only for the severity endpoint (OR = 1.42, 95% CI 1.06–1.90). The association between BCA-based sarcopenia and cardiac biomarkers and disease severity and mortality suggests that these biomarkers can contribute to the risk stratification of SARS-CoV-2 patients. Patients with a higher cardiac marker and a lower sarcopenia marker are at risk for a severe course or death. Whether those biomarkers hold similar importance for other pneumonia-related diseases requires further investigation.
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Ahmad SR. Plant-based diet for obesity treatment. Front Nutr 2022; 9:952553. [PMID: 36159462 PMCID: PMC9493195 DOI: 10.3389/fnut.2022.952553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity rates continue to rise, resulting in a global epidemic that shows no sign of slowing down. Our understanding of this complex disease is also constantly evolving, requiring healthcare providers to stay up to date with best practices. The application of plant-based diets (PBDs) may hold the key to a successful weight-control strategy. PBD refers to any dietary pattern that emphasizes the consumption of plant foods while excluding the consumption of most or all animal products. The purpose of this mini-review is to report on the application of PBDs as a potential treatment for obesity. PBDs have also been shown to be beneficial in the treatment of other non-communicable diseases, such as the prevention and treatment of type 2 diabetes. Many of the reported RCTs were of short duration. Longer-term studies, as well as studies focusing on strict adherence to the PBD regime, are needed. PBD is a beneficial approach to improving health, particularly in obese patients. Benefits include weight loss, improved cardiovascular health, lower blood pressure, and improved glucose metabolism.
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Shailendra P, Baldock KL, Li LSK, Bennie JA, Boyle T. Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. Am J Prev Med 2022; 63:277-285. [PMID: 35599175 DOI: 10.1016/j.amepre.2022.03.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study aimed to systematically review and meta-analyze the relationship between resistance training and all-cause, cardiovascular disease, and cancer mortality. METHODS Systematic review and meta-analysis following PRISMA guidelines (International Prospective Register of Systematic Reviews Registration Number CRD42019136654) was conducted. MEDLINE (OVID), Embase, Emcare, SPORTDiscus, The Cochrane Library, and SCOPUS were searched from inception to June 6, 2021. Included studies reported resistance training as the exposure and all-cause mortality, cardiovascular disease‒specific mortality, and/or cancer-specific mortality as outcome/s. Only studies conducted among nonclinical adult populations (aged ≥18 years) and written in English were included. RESULTS A total of 10 studies were included in the meta-analyses. Compared with undertaking no resistance training, undertaking any amount of resistance training reduced the risk of all-cause mortality by 15% (RR of 6 studies=0.85; 95% CI=0.77, 0.93), cardiovascular disease mortality by 19% (RR of 4 studies=0.81; 95% CI=0.66, 1.00), and cancer mortality by 14% (RR of 5 studies=0.86; 95% CI=0.78, 0.95). A dose-response meta-analysis of 4 studies suggested a nonlinear relationship between resistance training and the risk of all-cause mortality. A maximum risk reduction of 27% was observed at around 60 minutes per week of resistance training (RR=0.74; 95% CI=0.64, 0.86). Mortality risk reductions diminished at higher volumes. DISCUSSION This systematic review and meta-analysis provides the strongest evidence to date that resistance training is associated with reduced risk of all-cause, cardiovascular disease, and cancer-specific mortality. More research is needed to determine whether any potential mortality benefits gained from resistance training diminish at higher volumes.
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Affiliation(s)
- Prathiyankara Shailendra
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Katherine L Baldock
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - L S Katrina Li
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Jason A Bennie
- Physically Active Lifestyles Group, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia.
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Association of life course adiposity with risk of incident dementia: a prospective cohort study of 322,336 participants. Mol Psychiatry 2022; 27:3385-3395. [PMID: 35538193 DOI: 10.1038/s41380-022-01604-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 01/08/2023]
Abstract
Cohort studies report inconsistent associations between body mass index (BMI) and all-cause incident dementia. Furthermore, evidence on fat distribution and body composition measures are scarce and few studies estimated the association between early life adiposity and dementia risk. Here, we included 322,336 participants from UK biobank to investigate the longitudinal association between life course adiposity and risk of all-cause incident dementia and to explore the underlying mechanisms driven by metabolites, inflammatory cells and brain structures. Among the 322,336 individuals (mean (SD) age, 62.24 (5.41) years; 53.9% women) in the study, during a median 8.74 years of follow-up, 5083 all-cause incident dementia events occurred. The risk of dementia was 22% higher with plumper childhood body size (p < 0.001). A strong U-shaped association was observed between adult BMI and dementia. More fat and less fat-free mass distribution on arms were associated with a higher risk of dementia. Interestingly, similar U-shaped associations were found between BMI and four metabolites (i.e., 3-hydroxybutrate, acetone, citrate and polyunsaturated fatty acids), four inflammatory cells (i.e., neutrophil, lymphocyte, monocyte and leukocyte) and abnormalities in brain structure that were also related to dementia. The findings that adiposity is associated with metabolites, inflammatory cells and abnormalities in brain structure that were related to dementia risk might provide clues to underlying biological mechanisms. Interventions to prevent dementia should begin early in life and include not only BMI control but fat distribution and body composition.
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