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Flores-Opazo M, Kopinke D, Helmbacher F, Fernández-Verdejo R, Tuñón-Suárez M, Lynch GS, Contreras O. Fibro-adipogenic progenitors in physiological adipogenesis and intermuscular adipose tissue remodeling. Mol Aspects Med 2024; 97:101277. [PMID: 38788527 DOI: 10.1016/j.mam.2024.101277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/27/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
Excessive accumulation of intermuscular adipose tissue (IMAT) is a common pathological feature in various metabolic and health conditions and can cause muscle atrophy, reduced function, inflammation, insulin resistance, cardiovascular issues, and unhealthy aging. Although IMAT results from fat accumulation in muscle, the mechanisms underlying its onset, development, cellular components, and functions remain unclear. IMAT levels are influenced by several factors, such as changes in the tissue environment, muscle type and origin, extent and duration of trauma, and persistent activation of fibro-adipogenic progenitors (FAPs). FAPs are a diverse and transcriptionally heterogeneous population of stromal cells essential for tissue maintenance, neuromuscular stability, and tissue regeneration. However, in cases of chronic inflammation and pathological conditions, FAPs expand and differentiate into adipocytes, resulting in the development of abnormal and ectopic IMAT. This review discusses the role of FAPs in adipogenesis and how they remodel IMAT. It highlights evidence supporting FAPs and FAP-derived adipocytes as constituents of IMAT, emphasizing their significance in adipose tissue maintenance and development, as well as their involvement in metabolic disorders, chronic pathologies and diseases. We also investigated the intricate molecular pathways and cell interactions governing FAP behavior, adipogenesis, and IMAT accumulation in chronic diseases and muscle deconditioning. Finally, we hypothesize that impaired cellular metabolic flexibility in dysfunctional muscles impacts FAPs, leading to IMAT. A deeper understanding of the biology of IMAT accumulation and the mechanisms regulating FAP behavior and fate are essential for the development of new therapeutic strategies for several debilitating conditions.
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Affiliation(s)
| | - Daniel Kopinke
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, 32610, FL, USA; Myology Institute, University of Florida College of Medicine, Gainesville, FL, USA.
| | | | - Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA; Laboratorio de Fisiología Del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Chile.
| | - Mauro Tuñón-Suárez
- Laboratorio de Fisiología Del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Chile.
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Parkville 3010, Australia.
| | - Osvaldo Contreras
- Developmental and Regenerative Biology Division, Victor Chang Cardiac Research Institute, Darlinghurst, NSW, 2010, Australia; School of Clinical Medicine, UNSW Sydney, Kensington, NSW 2052, Australia.
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Sabatino A, Pacchiarini MC, Regolisti G, Ciuni A, Sverzellati N, Lesignoli M, Picetti E, Fiaccadori E, Di Mario F. The impact of muscle mass and myosteatosis on mortality in critically ill patients with Sars-Cov2-related pneumonia. Clin Nutr ESPEN 2023; 58:409-415. [PMID: 38057033 DOI: 10.1016/j.clnesp.2023.11.006] [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: 08/01/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS Sars-Cov-2 pneumonia can lead to severe complications, requiring invasive mechanical ventilation and admission to the intensive care unit (ICU). Low muscle quantity and quality (the latter evaluated by the amount of ectopic fat infiltration in the muscle [myosteatosis]) at ICU admission are associated with worse outcomes in critically ill patients. The purpose of the present study is to assess muscle mass and myosteatosis of paravertebral skeletal muscle, in critically ill patients with Sars-Cov2 pneumonia and its association with mortality. METHODS We conducted a retrospective observational study in 110 critically ill patients with severe Sars-Cov-2 pneumonia that had a high - resolution chest Computerized Tomography (HR-CT) at ICU admission. We acquired CT images at the level of the thoracic 12 (T12) vertebral body and measured skeletal muscle area (SMA), intermuscular adipose tissue (IMAT), and low attenuation muscle area (LAMA). Patients were followed until ICU mortality or discharge. RESULTS Patients were 59.8 ± 8.1 years old, 77% were male. Seventy-nine percent of patients were considered at nutritional risk, and 22% were obese. Average Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 17 ± 5.4, and the overall ICU mortality was 48,2% (53/110). At ICU admission, both parameters of myosteatosis were associated with higher mortality (IMAT [per 10% increase] HR: 2.01 (95% Confidence Interval [CI] 1.27 to 3.17), P = 0.003; LAMA HR [per 10% increase]: 1.53 (95% CI 1.10 to 2.13), P = 0.012). CONCLUSION Myosteatosis as assessed by CT scans plays a relevant role as a prognostic marker in critically ill patients with Sars-Cov2 severe pneumonia.
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Affiliation(s)
- Alice Sabatino
- Nephrology Unit, Parma University Hospital, Parma, Italy.
| | - Maria Chiara Pacchiarini
- Nephrology Unit, Parma University Hospital, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Regolisti
- Department of Medicine and Surgery, University of Parma, Parma, Italy; UO Clinica e Immunologia Medica, Parma University Hospital, Parma, Italy
| | - Andrea Ciuni
- Department of Radiologic Sciences, Parma University Hospital, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Radiologic Sciences, Parma University Hospital, Parma, Italy
| | - Matteo Lesignoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Edoardo Picetti
- UOC Rianimazione 1, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Enrico Fiaccadori
- Nephrology Unit, Parma University Hospital, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
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Suka Aryana IGP, Paulus IB, Kalra S, Daniella D, Kuswardhani RAT, Suastika K, Wibisono S. The Important Role of Intermuscular Adipose Tissue on Metabolic Changes Interconnecting Obesity, Ageing and Exercise: A Systematic Review. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:54-59. [PMID: 37313233 PMCID: PMC10258613 DOI: 10.17925/ee.2023.19.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/25/2023] [Indexed: 06/15/2023]
Abstract
As age increases, adipose tissue infiltrates muscle tissue and leads to sarcopenia. When excessive accumulation of adipose tissue accompanied progressive decrease in lean body mass especially visceral fat, termed as sarcopenic obesity (SO) and related metabolic intermuscular adipose tissue (IMAT) is an ectopic tissue found between muscle groups, and is distinct from subcutaneous adipose tissue. Until now, the association between IMAT and metabolic health was not understood. This study is the first systematic review assessing the association between IMAT and metabolic health. The PubMed, Science Direct and Cochrane databases were searched for studies reporting IMAT and metabolic risk. The descriptions of the extracted data are guided by the Preferred Reporting Items for Systematic Reviews (PRISMA) statement with a Grading of Recommendations Assessment, Development and Evaluation approach. This study is registered at PROSPERO (identifier: CRD42022337518). Six studies were pooled and reviewed using critical appraisal by the Newcastle Ottawa Scale and Centre for Evidence-Based Medicine checklist. Two clinical trials and four observational trials were included. Our results reveal that IMAT is associated with metabolic risk, especially in older adults and patients with obesity. However, in a person with abdominal obesity, VAT has a more significant role in metabolic risk than IMAT. The largest decrease in IMAT was achieved by combining aerobic with resistance training.
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Affiliation(s)
- I Gusti Putu Suka Aryana
- Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Udayana University/Prof. I Goesti Ngoerah Gde Ngoerah Teaching Hospital, Denpasar, Bali, Indonesia
| | | | - Sanjay Kalra
- Bharti Hospital, Karnal, India
- Department of Research, Chandigarh University, Chandigarh, India
| | - Dian Daniella
- Department of Internal Medicine, Faculty of Medicine, Udayana University/ I Goesti Ngoerah Gde Ngoerah Teaching Hospital, Bali, Denpasar, Indonesia
| | - Raden Ayu Tuty Kuswardhani
- Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Udayana University/ I Goesti Ngoerah Gde Ngoerah Teaching Hospital, Denpasar, Bali, Indonesia
| | - Ketut Suastika
- Division of Endocrinology and Metabolism, Department of Internal Medicin, Faculty of Medicine, Udayana University/ I Goesti Ngoerah Gde Ngoerah Teaching Hospital, Denpasar, Bali, Indonesia
| | - Sony Wibisono
- Division of Endocrinology and Metabolism, Airlangga University, Soetomo Teaching Hospital, Surabaya, Indonesia
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Bai C, Wang Y, Niu Z, Guan Y, Huang J, Nian X, Zuo F, Zhao J, Kazumi T, Wu B. Exenatide improves hepatocyte insulin resistance induced by different regional adipose tissue. Front Endocrinol (Lausanne) 2022; 13:1012904. [PMID: 36246878 PMCID: PMC9558273 DOI: 10.3389/fendo.2022.1012904] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is resulted from energy surplus and is characterized by abnormal adipose tissue accumulation and/or distribution. Adipokines secreted by different regional adipose tissue can induce changes in key proteins of the insulin signaling pathway in hepatocytes and result in impaired hepatic glucose metabolism. This study aimed to investigate whether exenatide affects key proteins of IRS2/PI3K/Akt2 signaling pathway in hepatocytes altered by the different regional fat depots. Six non-obese patients without endocrine diseases were selected as the research subjects. Their subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)were co-cultured with HepG2 cells in the transwell chamber. In the presence or absence of exenatide, adipokines content in the supernatant of each experimental group was detected by ELISA. In addition, HepG2 cells in each co-culture group with and without insulin were collected, and the expression of key proteins IRS2, p-IRS2(S731), PI3K-p85, Akt2, and p-Akt2(S473) was detected by western blotting (WB). The results showed that the adipokines IL-8, MCP-1, VEGF, and sTNFR2 in the supernatant of HepG2 cells induced by different regional adipose tissue were significantly higher than those in the HepG2 group, and VAT released more adipokines than SAT. Furthermore, these adipokines were significantly inhibited by exenatide. Importantly, the different regional fat depot affects the IRS2/PI3K/Akt2 insulin signaling pathway of hepatocytes. Exenatide can up-regulate the expression of hepatocyte proteins IRS2, PI3K-p85, p-Akt2(S731) inhibited by adipose tissue, and down-regulate the expression of hepatocyte proteins p-IRS2(S731) promoted by adipose tissue. The effect of VAT on the expression of these key proteins in hepatocytes is more significant than that of SAT. But there was no statistical difference in the expression of Akt2 protein among each experimental group, suggesting that exenatide has no influence on the expression of Akt2 protein in hepatocytes. In conclusion, exenatide may improve hepatic insulin resistance (IR) by inhibiting adipokines and regulating the expression of key proteins in the IRS2/PI3K/Akt2 pathway.
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Affiliation(s)
- Chuanmin Bai
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Yujun Wang
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Zhi Niu
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Yaxin Guan
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Jingshan Huang
- School of Computing, University of South Alabama, Mobile, AL, United States
| | - Xin Nian
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Fan Zuo
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Juan Zhao
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Tsutomu Kazumi
- Open Research Center for Studying of Lifestyle−Related Diseases, Mukogawa Women’s University, Nishinomiya, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Japan
- Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Japan
| | - Bin Wu
- Department of Endocrinology, First Affiliated Hospital, Kunming Medical University, Kunming, China
- *Correspondence: Bin Wu,
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Verdú E, Homs J, Boadas-Vaello P. Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413333. [PMID: 34948944 PMCID: PMC8705491 DOI: 10.3390/ijerph182413333] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022]
Abstract
A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as well as pathological pain behaviors. These health concerns are related to the crosstalk between adipose tissue and body systems, leading to pathophysiological changes to the latter. To deal with these health issues, it has been suggested that physical exercise may reverse part of these obesity-related pathologies by modulating the cross talk between the adipose tissue and body systems. In this context, this review was carried out to provide knowledge about (i) the structural and functional changes in tissues, organs, and body systems from accumulation of fat in obesity, emphasizing the crosstalk between fat and body tissues; (ii) the crosstalk between fat and body tissues triggering pain; and (iii) the effects of physical exercise on body tissues and organs in obese and non-obese subjects, and their impact on pathological pain. This information may help one to better understand this crosstalk and the factors involved, and it could be useful in designing more specific training interventions (according to the nature of the comorbidity).
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Affiliation(s)
- Enrique Verdú
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
| | - Judit Homs
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Department of Physical Therapy, EUSES-University of Girona, 17190 Salt, Spain
| | - Pere Boadas-Vaello
- Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, 17003 Girona, Spain;
- Correspondence: (E.V.); (P.B.-V.)
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Colleluori G, Villareal DT. Aging, obesity, sarcopenia and the effect of diet and exercise intervention. Exp Gerontol 2021; 155:111561. [PMID: 34562568 DOI: 10.1016/j.exger.2021.111561] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/25/2022]
Abstract
The number of adults 65 years and older is increasing worldwide and will represent the 20% of the population by 2030. Half of them will suffer from obesity. The decline in muscle mass and strength, known as sarcopenia, is very common among older adults with obesity (sarcopenic obesity). Sarcopenic obesity is strongly associated with frailty, cardiometabolic dysfunction, physical disability, and mortality. Increasing efforts have been hence made to identify effective strategies able to promote healthy aging and curb the obesity pandemic. Among these, lifestyle interventions consisting of diet and exercise protocols have been extensively explored. Importantly, diet-induced weight loss is associated with fat, muscle, and bone mass losses, and may further exacerbate age-related sarcopenia and frailty outcomes in older adults. Successful approaches to induce fat mass loss while preserving lean and bone mass are critical to reduce the aging- and obesity-related physical and metabolic complications and at the same time ameliorate frailty. In this review article, we discuss the most recent evidence on the age-related alterations in adipose tissue and muscle health and on the effect of calorie restriction and exercise approaches for older adults with obesity and sarcopenia, emphasizing the existing gaps in the literature that need further investigation.
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Affiliation(s)
- Georgia Colleluori
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, Ancona, Italy; Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX, USA; Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Dennis T Villareal
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX, USA; Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Kaźmierski J, Miler P, Pawlak A, Jerczyńska H, Woźniak J, Frankowska E, Brzezińska A, Woźniak K, Krejca M, Wilczyński M. Elevated Monocyte Chemoattractant Protein-1 as the Independent Risk Factor of Delirium after Cardiac Surgery. A Prospective Cohort Study. J Clin Med 2021; 10:jcm10081587. [PMID: 33918634 PMCID: PMC8070441 DOI: 10.3390/jcm10081587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The pathogenesis of postoperative delirium is largely unknown. The primary objective of this study is to assess whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and high-sensitivity C-reactive protein (hsCRP) are associated with postoperative delirium in patients who have undergone cardiac surgery. The secondary objective is to investigate whether any association between raised inflammatory biomarkers levels and delirium is related to surgical and anesthetic procedures or mediated by pre-existing psychiatric conditions associated with raised pro-inflammatory markers levels. METHODS The patients were screened for cognitive impairment one day preoperatively with the use of the Mini-Mental State Examination Test and the Clock Drawing Test. A diagnosis of major depressive disorder (MDD) and anxiety disorders was established on the basis of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. RESULTS Postoperative delirium developed in 34% (61 of 177) of patients. Both pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p = 0.001; p < 0.001; p < 0.001, respectively. However, according to a multivariable logistic regression analysis, only a raised MCP-1 concentration before surgery was independently associated with postoperative delirium, and related to advancing age, preoperative anxiety disorders and prolonged intubation. CONCLUSIONS The present study suggests that an elevated preoperative MCP-1 concentration is associated with delirium after cardiac surgery. Monitoring of this inflammatory marker may reveal the cardiovascular disease (CVD) patients who are at risk of neuropsychiatric syndromes development.
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Affiliation(s)
- Jakub Kaźmierski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland; (J.W.); (E.F.)
- Correspondence: ; Tel.: +48-42-675-7372
| | - Piotr Miler
- Central Clinical Hospital of Medical University of Lodz, 92-216 Lodz, Poland; (P.M.); (A.P.); (A.B.)
| | - Agnieszka Pawlak
- Central Clinical Hospital of Medical University of Lodz, 92-216 Lodz, Poland; (P.M.); (A.P.); (A.B.)
| | - Hanna Jerczyńska
- CoreLab Central Scientific Laboratory of Medical University of Lodz, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Joanna Woźniak
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland; (J.W.); (E.F.)
| | - Emilia Frankowska
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland; (J.W.); (E.F.)
| | - Agnieszka Brzezińska
- Central Clinical Hospital of Medical University of Lodz, 92-216 Lodz, Poland; (P.M.); (A.P.); (A.B.)
| | - Katarzyna Woźniak
- Department of Cardiac Surgery, Medical University of Lodz, 92-213 Lodz, Poland; (K.W.); (M.K.); (M.W.)
| | - Michał Krejca
- Department of Cardiac Surgery, Medical University of Lodz, 92-213 Lodz, Poland; (K.W.); (M.K.); (M.W.)
| | - Mirosław Wilczyński
- Department of Cardiac Surgery, Medical University of Lodz, 92-213 Lodz, Poland; (K.W.); (M.K.); (M.W.)
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Relationship between muscle mass index and LDL cholesterol target levels: Analysis of two studies of the Korean population. Atherosclerosis 2021; 325:1-7. [PMID: 33857762 DOI: 10.1016/j.atherosclerosis.2021.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Decreased skeletal muscle mass is an important change in body composition with aging. Maintaining the optimal low-density lipoprotein (LDL) cholesterol level is crucial for the prevention of cardiovascular diseases (CVD). We investigated whether muscle mass was associated with dyslipidemia. METHODS We analyzed the data of 17,546 adults from the 2008-2011 Korean National Health and Nutrition Examination Survey (KNHANES) and 5126 adults from the Korean Genome and Epidemiology Study (KoGES). Participants were classified into the lower skeletal muscle mass index (LSMI) group and normal group. LSMI was defined as body mass index (BMI)-adjusted appendicular skeletal muscle mass <0.789 (men) and <0.512 (women) in the KNHANES, and as sex-specific lowest quintile of the BMI-adjusted total skeletal muscle mass in the KoGES. Participants were defined as having dyslipidemia when the serum LDL cholesterol levels were higher than their LDL cholesterol management targets based on their CVD risk level. RESULTS The odds ratio with 95% confidence interval (CI) for dyslipidemia of the LSMI group was 1.230 (1.016-1.488, p = 0.034) after adjusting for confounding variables compared to the normal group in the 2008-2011 KNHANES. In the KoGES, the hazard ratio with 95% CI for incident dyslipidemia of the LSMI group compared to the normal group was 1.225 (1.101-1.364, p < 0.001). Regardless of abdominal obesity, LSMI was significantly associated with a higher risk of incident dyslipidemia. CONCLUSIONS LSMI was associated with dyslipidemia regardless of abdominal obesity. Prevention of muscle mass loss may be an important strategy for LDL cholesterol management.
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Body composition predictors of outcome in patients with COVID-19. Int J Obes (Lond) 2021; 45:2238-2243. [PMID: 34244597 PMCID: PMC8267764 DOI: 10.1038/s41366-021-00907-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/10/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVE Obesity is a strong risk factor for adverse outcomes in patients hospitalized with COVID-19, however, the distribution of fat and the amount of muscle mass are more accurate risk factors than BMI. The objective of this study was to assess body composition measures obtained on opportunistic abdominal CTs as predictors of outcome in patients hospitalized with COVID-19. We hypothesized that elevated visceral and intermuscular adipose tissue would be associated with adverse outcome. SUBJECTS/METHODS Our retrospective study was IRB-approved and HIPAA-compliant. The study group comprised 124 patients (median age: 68 years, IQR: 56, 77; 59 weeks, 65 months) who were admitted with COVID-19 to a single hospital and who had undergone abdominal CT for clinical purposes. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and paraspinal and abdominal muscle cross-sectional areas (CSA) were assessed. Clinical information including prognostic factors, time of admission to the intensive care unit (ICU) and time of death within 28 days were obtained. Multivariate time-to-event competing risk models were fitted to estimate the hazard ratio (HR) for a composite outcome of ICU admission/mortality associated with a one standard deviation increase in each body compositional measure. Each model was adjusted for age, sex, race, BMI, and cardiometabolic comorbidities. RESULTS There were 50 patients who were admitted to the ICU or deceased over a median time of 1 day [IQR 1, 6] from hospital admission. Higher VAT/SAT ratio (HR of 1.30; 95% CI 1.04-1.62, p = 0.022) and higher IMAT CSA (HR of 1.44; 95% CI 1.10-1.89, p = 0.008) were associated with a reduced time to ICU admission or death in adjusted models. CONCLUSION VAT/SAT and IMAT are predictors of adverse outcome in patients hospitalized with COVID-19, independent of other established prognostic factors. This suggests that body composition measures may serve as novel biomarkers of outcome in patients with COVID-19.
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Affiliation(s)
- Elizabeth E Ha
- From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY
| | - Robert C Bauer
- From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY
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Terry JG, Shay CM, Schreiner PJ, Jacobs DR, Sanchez OA, Reis JP, Goff DC, Gidding SS, Steffen LM, Carr JJ. Intermuscular Adipose Tissue and Subclinical Coronary Artery Calcification in Midlife: The CARDIA Study (Coronary Artery Risk Development in Young Adults). Arterioscler Thromb Vasc Biol 2017; 37:2370-2378. [PMID: 29025708 PMCID: PMC5699947 DOI: 10.1161/atvbaha.117.309633] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 10/02/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Excess deposition of fat within and around vital organs and nonadipose tissues is hypothesized to contribute to cardiovascular disease (CVD) risk. We evaluated the association of abdominal intermuscular adipose tissue (IMAT) volume with coronary artery calcification in the CARDIA study (Coronary Artery Risk Development in Young Adults) participants. APPROACH AND RESULTS We measured IMAT in the abdominal muscles, visceral adipose tissue and pericardial adipose tissue, and coronary artery calcification using computed tomography in 3051 CARDIA participants (56% women) at the CARDIA year 25 examination (2010-2011). Mean IMAT volume and mean IMAT/total muscle volume (IMAT normalized for muscle size) were calculated in a 10-mm block of slices centered at L3-L4. Multivariable analyses included potential confounders and traditional cardiovascular disease risk factors. Compared with the lowest quartile, the upper quartile of abdominal IMAT volume was associated with higher coronary artery calcification prevalence (odds ratio [95% confidence interval], 1.6 [1.2-2.1]) after adjusting for cardiovascular disease risk factors. Results were similar for highest versus lowest quartile of IMAT normalized to total muscle volume (odds ratio [95% confidence interval], 1.5 [1.1-2.0]). Significant associations of higher IMAT and normalized IMAT with coronary artery calcification prevalence persisted when body mass index, visceral adipose tissue, or pericardial adipose tissue were added to the models. CONCLUSIONS In a large, community-based, cross-sectional study, we found that higher abdominal skeletal muscle adipose tissue volume was associated with subclinical atherosclerosis independent of traditional cardiovascular disease risk factors and other adipose depots.
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Affiliation(s)
- James G Terry
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.).
| | - Christina M Shay
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - Pamela J Schreiner
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - David R Jacobs
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - Otto A Sanchez
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - Jared P Reis
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - David C Goff
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - Samuel S Gidding
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - Lyn M Steffen
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.)
| | - John Jeffrey Carr
- From the Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN (J.G.T., J.J.C.); American Heart Association, Dallas, TX (C.M.S.); School of Public Health (P.J.S., D.R.J., L.M.S.) and Department of Medicine (O.A.S.), University of Minnesota, Minneapolis; Department of Internal Medicine (O.A.S.); National Institutes of Health, Bethesda, MD (J.P.R., D.C.G.); and A.I. DuPont Hospital of Children, Wilmington, DE (S.S.G.).
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Wu H, Ballantyne CM. Skeletal muscle inflammation and insulin resistance in obesity. J Clin Invest 2017; 127:43-54. [PMID: 28045398 DOI: 10.1172/jci88880] [Citation(s) in RCA: 384] [Impact Index Per Article: 54.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Obesity is associated with chronic inflammation, which contributes to insulin resistance and type 2 diabetes mellitus. Under normal conditions, skeletal muscle is responsible for the majority of insulin-stimulated whole-body glucose disposal; thus, dysregulation of skeletal muscle metabolism can strongly influence whole-body glucose homeostasis and insulin sensitivity. Increasing evidence suggests that inflammation occurs in skeletal muscle in obesity and is mainly manifested by increased immune cell infiltration and proinflammatory activation in intermyocellular and perimuscular adipose tissue. By secreting proinflammatory molecules, immune cells may induce myocyte inflammation, adversely regulate myocyte metabolism, and contribute to insulin resistance via paracrine effects. Increased influx of fatty acids and inflammatory molecules from other tissues, particularly visceral adipose tissue, can also induce muscle inflammation and negatively regulate myocyte metabolism, leading to insulin resistance.
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