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Romero-Márquez JM, Novo-Rodríguez M, Novo-Rodríguez C, Siles-Guerrero V, Herrera-Montes I, Navarro-Pelayo FG, López-de-la-Torre-Casares M, Muñoz-Garach A. Bioelectrical Impedance Vector Analysis, Nutritional Ultrasound ®, and Handgrip Strength as Innovative Methods for Monitoring Critical Anorexia Nervosa Physical Recovery: A Pilot Study. Nutrients 2024; 16:1539. [PMID: 38794777 PMCID: PMC11123858 DOI: 10.3390/nu16101539] [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: 04/23/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Eating disorders (EDs) manifest as persistent disruptions in eating habits or related behaviors, significantly impacting physical health and psychosocial well-being. Nutritional assessment in ED patients is crucial for monitoring treatment efficacy. While dual-energy X-ray absorptiometry (DEXA) remains standard, interest in alternative methods such as bioelectrical impedance vector analysis (BIVA) and Nutritional Ultrasound® (NU) has risen due to their affordability and portability. Additionally, hand dynamometry offers a user-friendly approach to assessing grip strength (HGS), indicative of nutritional status. A prospective study was carried out to evaluate the utility of BIVA, NU®, and HGS in 43 female AN patients. Measurements were taken at baseline and hospital discharge. A total of 41 patients completed the study. After the intervention, numerous BIVA-related parameters such as fat (3.5 ± 2 kg vs. 5.3 ± 2.7 kg, p < 0.001) and free fat mass (33.9 ± 3.8 kg vs. 37.5 ± 4.1 kg, p < 0.001) were partially restored. Similarly, Nutritional Ultrasound® showed promising results in assessing body composition changes such as total abdominal fat tissue (0.5 ± 0.3 cm vs. 0.9 ± 0.3 cm, p < 0.05). In the same way, rectus femoris cross-sectional area values correlated with clinical outcomes such as free fat mass (0.883, p < 0.05) and appendicular muscle mass (0.965, p < 0.001). HGS reached the normality percentile after the intervention (21.6 ± 9.1 kg vs. 25.9 ± 12.3 kg, p < 0.05), demonstrating a significant association between grip strength and body composition parameters such as free fat mass (0.658, p < 0.001) and appendicular muscle mass (0.482, p < 0.001). Incorporating BIVA-, NU®-, and HGS-enhanced nutritional assessment into the treatment of AN patients offers cost-effective, portable, and non-invasive alternatives to DEXA. These techniques offer valuable insights into changes in body composition and nutritional status, which, in turn, facilitate treatment monitoring and contribute to improved patient outcomes.
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Affiliation(s)
- Jose M. Romero-Márquez
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
- Foundation for Biosanitary Research of Eastern Andalusia—Alejandro Otero (FIBAO), 18012 Granada, Spain
| | - María Novo-Rodríguez
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
- Foundation for Biosanitary Research of Eastern Andalusia—Alejandro Otero (FIBAO), 18012 Granada, Spain
| | - Cristina Novo-Rodríguez
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
- Granada Biosanitary Research Institute (Ibs. Granada), 18014 Granada, Spain
| | - Víctor Siles-Guerrero
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
| | - Isabel Herrera-Montes
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
| | | | - Martín López-de-la-Torre-Casares
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
- Granada Biosanitary Research Institute (Ibs. Granada), 18014 Granada, Spain
| | - Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, 18014 Granada, Spain; (M.N.-R.); (C.N.-R.); (V.S.-G.); (I.H.-M.); (M.L.-d.-l.-T.-C.)
- Granada Biosanitary Research Institute (Ibs. Granada), 18014 Granada, Spain
- Network Biomedical Research Center Physiopathology of Obesity and Nutrition (CiberOBN), Carlos III Health Institute, 28029 Madrid, Spain
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Himmerich H, Treasure J. Anorexia nervosa: diagnostic, therapeutic, and risk biomarkers in clinical practice. Trends Mol Med 2024; 30:350-360. [PMID: 38331700 DOI: 10.1016/j.molmed.2024.01.002] [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: 09/14/2023] [Revised: 12/22/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
Abstract
In anorexia nervosa (AN), measurable biological parameters can inform the process of treating patients. Such biomarkers include established laboratory parameters as well as a range of potential future biomarkers, including genetic, metabolomic, microbiomic, endocrine, immunological, hematological, electrophysiological, and neuroimaging parameters. In this opinion article we discuss how these biomarkers can support diagnosic and therapeutic processes at specific steps during the AN treatment cycle, that is, the diagnosis, diagnostic specification, risk management, choice of therapy, therapy monitoring, and treatment review. History-taking, physical and neuropsychological examination, clinical observation, and judgment about treatment success by the patient, their carers, and members of the multidisciplinary team are essential to interpret laboratory and imaging data appropriately and to assess the full clinical picture.
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Affiliation(s)
- Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
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3
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Body composition assessment in adult females with anorexia nervosa and bulimia nervosa - a cross-sectional study comparing dual-energy X-ray absorptiometry scan and isotopic dilution of deuterium. J Nutr 2023; 153:1309-1322. [PMID: 36934952 DOI: 10.1016/j.tjnut.2023.03.019] [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: 09/16/2022] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) compromise individuals' nutritional status, affecting among other organs and systems, bone health. OBJECTIVE This study aimed to assess and compare bone mineral density (BMD) from dual-energy x-ray absorptiometry (DXA) scan and deuterium (D2O) dilution of adult females with anorexia nervosa (AN) and bulimia nervosa (BN). METHODS This was a cross-sectional study with 53 female participants (18-49 years) with a diagnosis of AN (N = 25) or BN (N = 28). DXA scan was performed to assess BMD, fat mass, and fat-free mass, and D2O dilution was used to assess total body water (TBW), fat mass, and fat-free mass. Interviews/questionnaires were used to assess symptoms, illness trajectory, and physical activity. T-test, Chi-squared test, Pearson's linear correlation, linear regressions, and Bland-Altman analyses were performed, with a significance level of 5%. RESULTS TBW below the recommended level for adult females (≥ 45%) was more frequent in BN (60%) compared with AN (21%; P = 0.013). FMI (soft tissue only) (t-test P = 0.06), and FFMI (t-test P = 0.08) agreed between DXA scan and D2O dilution. Only FFMI did not show systematic bias of proportion (β:-0.2, P = 0.177). The diagnosis of BN, binge-eating episodes, and physical activity in AN were associated with the differences in the methods' results. FMI was positively associated with BMD in AN, and both FMI and FFMI were positively associated with BMD in BN. CONCLUSION In adult females with EDs, DXA scan and D2O dilution achieved agreement for FMI and FFMI. Changes in fat mass and fat-free mass are important in understanding the mechanisms behind bone loss in EDs. Protocols for body composition assessment in EDs can help to minimize the effect of the ED diagnosis, ED behaviors (i.e., excessive exercise and purging behaviors) and weight on the accuracy of measurements.
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Caldiroli A, La Tegola D, Affaticati LM, Manzo F, Cella F, Scalia A, Capuzzi E, Nicastro M, Colmegna F, Buoli M, Clerici M, Dakanalis A. Clinical and Peripheral Biomarkers in Female Patients Affected by Anorexia: Does the Neutrophil/Lymphocyte Ratio (NLR) Affect Severity? Nutrients 2023; 15:nu15051133. [PMID: 36904132 PMCID: PMC10005379 DOI: 10.3390/nu15051133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Anorexia Nervosa (AN) is a disabling disorder characterized by extreme weight loss and frequent chronicization, especially in its most severe forms. This condition is associated with a pro-inflammatory state; however, the role of immunity in symptom severity remains unclear. Total cholesterol, white blood cells, neutrophils, lymphocytes, platelets, iron, folate, vitamin D and B12 were dosed in 84 female AN outpatients. Mildly severe (Body Mass Index-BMI ≥ 17) versus severe (BMI < 17) patients were compared using one-way ANOVAs or χ2 tests. A binary logistic regression model was run to investigate the potential association between demographic/clinical variables or biochemical markers and the severity of AN. Patients with severe anorexia (compared to mild forms) were older (F = 5.33; p = 0.02), engaged in more frequent substance misuse (χ2 = 3.75; OR = 3.86; p = 0.05) and had a lower NLR (F = 4.12; p = 0.05). Only a lower NLR was predictive of severe manifestations of AN (OR = 0.007; p = 0.031). Overall, our study suggests that immune alterations may be predictive of AN severity. In more severe forms of AN, the response of the adaptive immunity is preserved, while the activation of the innate immunity may be reduced. Further studies with larger samples and a wider panel of biochemical markers are needed to confirm the present results.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Davide La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Francesca Cella
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Monica Nicastro
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-3755-651904
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Lopes MP, Robinson L, Stubbs B, Dos Santos Alvarenga M, Araújo Martini L, Campbell IC, Schmidt U. Associations between bone mineral density, body composition and amenorrhoea in females with eating disorders: a systematic review and meta-analysis. J Eat Disord 2022; 10:173. [PMID: 36401318 PMCID: PMC9675098 DOI: 10.1186/s40337-022-00694-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lower bone mineral density (BMD) increases the risk of osteoporosis in individuals with eating disorders (EDs), particularly women with anorexia nervosa (AN), making them susceptible to pain and fractures throughout adulthood. In AN, low weight, hypothalamic amenorrhoea, and longer illness duration are established risk factors for low BMD, and in people with other EDs a history of AN seems to be an important risk factor for low BMD. PURPOSE To conduct a systematic review and meta-analysis of BMD in individuals with EDs, including AN, bulimia nervosa (BN), binge-eating disorder (BED) and other specified feeding or eating disorders (OSFED) compared to healthy controls (HC). METHODS Following PRISMA guidelines, electronic databases were reviewed and supplemented with a literature search until 2/2022 of publications measuring BMD (dual-energy X-ray absorptiometry or dual photon absorptiometry) in females with any current ED diagnosis and a HC group. Primary outcomes were spine, hip, femur and total body BMD. Explanatory variables were fat mass, lean mass and ED clinical characteristics (age, illness duration, body mass index (BMI), amenorrhoea occurrence and duration, and oral contraceptives use). RESULTS Forty-three studies were identified (N = 4163 women, mean age 23.4 years, min: 14.0, max: 37.4). No study with individuals with BED met the inclusion criteria. BMD in individuals with AN (total body, spine, hip, and femur), with BN (total body and spine) and with OSFED (spine) was lower than in HC. Meta-regression analyses of women with any ED (AN, BN or OSFED) (N = 2058) showed low BMI, low fat mass, low lean mass and being amenorrhoeic significantly associated with lower total body and spine BMD. In AN, only low fat mass was significantly associated with low total body BMD. CONCLUSION Predictors of low BMD were low BMI, low fat mass, low lean mass and amenorrhoea, but not age or illness duration. In people with EDs, body composition measurement and menstrual status, in addition to BMI, are likely to provide a more accurate assessment of individual risk to low BMD and osteoporosis.
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Affiliation(s)
- Mariana P Lopes
- Nutrition Department, School of Public Health University of São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, São Paulo, 01246-904, Brazil. .,Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 6 De Crespigny Park, London, SE5 8AF, UK.
| | - Lauren Robinson
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 6 De Crespigny Park, London, SE5 8AF, UK
| | - Brendon Stubbs
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 6 De Crespigny Park, London, SE5 8AF, UK.,Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Marle Dos Santos Alvarenga
- Nutrition Department, School of Public Health University of São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, São Paulo, 01246-904, Brazil
| | - Ligia Araújo Martini
- Nutrition Department, School of Public Health University of São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, São Paulo, 01246-904, Brazil
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 6 De Crespigny Park, London, SE5 8AF, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 6 De Crespigny Park, London, SE5 8AF, UK.,Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
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Wagner-Skacel J, Haidacher F, Wiener M, Pahsini K, Marinschek S, Lahousen T, Wonisch W, Bengesser S, Butler MI, Lackner S, Meinitzer A, Enko D, Mörkl S. Oxidative Status in Adult Anorexia Nervosa Patients and Healthy Controls—Results from a Cross-Sectional Pilot Study. Antioxidants (Basel) 2022; 11:antiox11050842. [PMID: 35624706 PMCID: PMC9137881 DOI: 10.3390/antiox11050842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
Oxidative stress describes an imbalance of reactive oxygen species (ROS) and antioxidative defence systems. Recently, the consequences of oxidative stress have become a central field of research and have been linked to the genesis of multiple psychiatric diseases. Some oxidative stress parameters have not been investigated before in anorexia nervosa (AN) patients, including the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) and polyphenols (PPm). In this cross-sectional pilot study, we evaluated these markers together with total peroxides (TOC), antioxidative capacity (TAC), endogenous peroxidase activity (EPA) and antibodies against oxidized LDL (oLAb) in serum samples of 20 patients with AN compared to 20 healthy controls. The antioxidative capacity was significantly decreased in AN patients, with a mean TAC of 1.57 mmol/L (SD: ±0.62); t (34) = −2.181, p = 0.036) compared to HC (mean = 1.91 mmol/L (SD: ±0.56), while the other investigated parameters were not significantly different between the two groups. In AN patients, TAC correlated with EPA (rsp = −0.630, p = 0.009). This study suggests that there is an antioxidative deficiency in AN patients. In this respect, there is a demand for interventional studies to determine whether antioxidants can be used as add-on therapy in the treatment of AN.
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Affiliation(s)
- Jolana Wagner-Skacel
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, 8036 Graz, Austria
| | - Fiona Haidacher
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Markus Wiener
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Karoline Pahsini
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Sabine Marinschek
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Theresa Lahousen
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Willibald Wonisch
- Division of Physiological Chemistry, Medical University of Graz, 8036 Graz, Austria;
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
| | - Mary I. Butler
- Department of Psychiatry and Neurobehavioral Science, University College Cork, T12 YT20 Cork, Ireland;
| | - Sonja Lackner
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, 8036 Graz, Austria;
| | - Andreas Meinitzer
- Division of Medical and Clinical Laboratory Diagnostics, Medical University Graz, 8036 Graz, Austria; (A.M.); (D.E.)
| | - Dietmar Enko
- Division of Medical and Clinical Laboratory Diagnostics, Medical University Graz, 8036 Graz, Austria; (A.M.); (D.E.)
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (J.W.-S.); (F.H.); (M.W.); (K.P.); (S.M.); (T.L.); (S.B.)
- Department of Psychiatry and Neurobehavioral Science, University College Cork, T12 YT20 Cork, Ireland;
- Correspondence: ; Tel.: +43-316-385-81743
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Stadler JT, Lackner S, Mörkl S, Meier-Allard N, Scharnagl H, Rani A, Mangge H, Zelzer S, Holasek SJ, Marsche G. Anorexia Nervosa Is Associated with a Shift to Pro-Atherogenic Low-Density Lipoprotein Subclasses. Biomedicines 2022; 10:biomedicines10040895. [PMID: 35453644 PMCID: PMC9030549 DOI: 10.3390/biomedicines10040895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Anorexia nervosa (AN) is a severe eating disorder affecting primarily female adolescents and younger adults. The energy deprivation associated with AN has been shown to alter lipoprotein metabolism, which may affect cardiovascular risk. However, the mechanisms leading to alterations in the composition, structure, and function of lipoproteins in AN patients are not well-understood yet. Here, we investigated the lipid abnormalities associated with AN, particularly changes in the distribution, composition, metabolism, and function of lipoprotein subclasses. In this exploratory study, we analyzed serum samples of 18 women diagnosed with AN (BMI < 17.5 kg/m2) and 24 normal-weight women (BMI from 18.5−24.9 kg/m2). Using the Quantimetrix Lipoprint® system, we determined low-density lipoprotein (LDL) subclass distribution, including quantitative measurements of very low-density lipoprotein (VLDL), intermediate density lipoprotein (IDL) and high-density lipoprotein (HDL) subclass distribution. We quantified the most abundant apolipoproteins of HDL and assessed lecithin-cholesterol acyltransferase (LCAT) and cholesteryl-ester transfer protein (CETP) activities. In addition, anti-oxidative capacity of apoB-depleted serum and functional metrics of HDL, including cholesterol efflux capacity and paraoxonase activity were assessed. The atherogenic lipoprotein subclasses VLDL and small LDL particles were increased in AN. Levels of VLDL correlated significantly with CETP activity (rs = 0.432, p = 0.005). AN was accompanied by changes in the content of HDL-associated apolipoproteins involved in triglyceride catabolism, such as apolipoprotein C-II (+24%) and apoA-II (−27%), whereas HDL-associated cholesterol, phospholipids, and triglycerides were not altered. Moreover, AN did not affect HDL subclass distribution, cholesterol efflux capacity, and paraoxonase activity. We observed a shift to more atherogenic lipoprotein subclasses in AN patients, whereas HDL functionality and subclass distribution were not altered. This finding underpins potential detrimental effects of AN on lipid metabolism and the cardiovascular system by increasing atherosclerotic risk factors.
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Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.R.)
| | - Sonja Lackner
- Division of Immunology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria;
| | - Nathalie Meier-Allard
- Division of Immunology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.R.)
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Sandra J. Holasek
- Division of Immunology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
- Correspondence: (S.J.H.); (G.M.); Tel.: +43-316-385-74128 (G.M.)
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.R.)
- Correspondence: (S.J.H.); (G.M.); Tel.: +43-316-385-74128 (G.M.)
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Pettersson C, Svedlund A, Wallengren O, Swolin-Eide D, Paulson Karlsson G, Ellegård L. Dietary intake and nutritional status in adolescents and young adults with anorexia nervosa: A 3-year follow-up study. Clin Nutr 2021; 40:5391-5398. [PMID: 34563763 DOI: 10.1016/j.clnu.2021.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/28/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS Patients with anorexia nervosa (AN) restrict their dietary intake leading to malnutrition. Information is scarce on nutrition status during recovery. The aim of the study was to investigate dietary intake, body composition, biochemistry, and status in young women three years after hospital treatment due to severe restrictive AN. METHODS Dietary intake from four-day food records were compared to a reference group and the Nordic Nutrition Recommendations. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Serum levels of vitamin A, E, D, folate, and ferritin were assessed. RESULTS Three years after hospital treatment for AN, 12 subjects (60%) were recovered or in partial remission from AN. Subnormal values of body fat and skeletal muscle mass were present in 30% and 25%. Energy intake was 1730 kcal/day (min-max 705-2441) or 33 kcal/kg/day (16-54). Most (80%) had a total energy intake/day below the estimated needs and 6 (32%) had energy intakes below 1550 kcal/day. Micronutrient intakes from food were low; 16 (85%) had intakes below recommendations of iron, folate, and vitamin D. Serum levels of vitamins A, E, D, and folate were on average adequate; but a subnormal value (<50 nmol/L) of vitamin D was found in 20%. Ferritin levels were significantly lower at follow-up, and 25% had values below reference range. Return of menstruation was dependent of energy intake and body fat. CONCLUSIONS A regular and careful assessment of nutritional status along with nutritional counseling during recovery is recommended to reduce malnutrition in patients with AN.
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Affiliation(s)
- Cecilia Pettersson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Eating Disorder Unit - Children & Young Adults, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Anna Svedlund
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Department of Paediatrics, Gothenburg, Sweden
| | - Ola Wallengren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Diana Swolin-Eide
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Department of Paediatrics, Gothenburg, Sweden
| | - Gunilla Paulson Karlsson
- Eating Disorder Unit - Children & Young Adults, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Ellegård
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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9
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Stadler JT, Lackner S, Mörkl S, Trakaki A, Scharnagl H, Borenich A, Wonisch W, Mangge H, Zelzer S, Meier-Allard N, Holasek SJ, Marsche G. Obesity Affects HDL Metabolism, Composition and Subclass Distribution. Biomedicines 2021; 9:biomedicines9030242. [PMID: 33673728 PMCID: PMC7997277 DOI: 10.3390/biomedicines9030242] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Obesity increases the risk of coronary heart disease, partly due to its strong association with atherogenic dyslipidemia, characterized by high triglycerides and low high-density lipoprotein (HDL) cholesterol levels. Functional impairment of HDL may contribute to the increased cardiovascular mortality, but the effect of obesity on composition, structure, and function of HDL is not well understood. Design and Methods: We determined HDL composition, HDL subclass distribution, parameters of HDL function, and activities of most important enzymes involved in lipoprotein remodeling, including lecithin–cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) in relatively young normal weight (n = 26), overweight (n = 22), and obese (n = 20) women. Results: Obesity (body mass index (BMI) ≥ 30) was associated with noticeable changes in LCAT and CETP activities and altered HDL composition, such as decreased apolipoprotein A-I, cholesterol, and phospholipid content, while pro-inflammatory HDL serum amyloid a content was increased. We observed a marked shift towards smaller HDL subclasses in obesity linked to lower anti-oxidative capacity of serum. LCAT activity, HDL subclass distribution, and HDL-cholesterol were associated with soluble leptin receptor, adiponectin, and liver enzyme activities. Of note, most of these alterations were only seen in obese women but not in overweight women. Conclusions: Obesity markedly affects HDL metabolism, composition, and subclass distribution linked to changes in liver and adipose tissue. HDL dysfunction may contribute to increased cardiovascular risk in obesity.
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Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.T.)
| | - Sonja Lackner
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria;
| | - Athina Trakaki
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.T.)
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Andrea Borenich
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz, Austria;
| | - Willibald Wonisch
- Division of Physiological Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria;
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.M.); (S.Z.)
| | - Nathalie Meier-Allard
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
| | - Sandra J. Holasek
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstraße 31a, 8010 Graz, Austria; (S.L.); (N.M.-A.)
- Correspondence: (S.J.H.); (G.M.); Tel.: +43-316-385-741-28 (G.M.)
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria; (J.T.S.); (A.T.)
- BioTechMed Graz, Mozartgasse 12/II, 8010 Graz, Austria
- Correspondence: (S.J.H.); (G.M.); Tel.: +43-316-385-741-28 (G.M.)
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10
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Lackner S, Meier-Allard N, Mörkl S, Müller W, Fürhapter-Rieger A, Mangge H, Zelzer S, Holasek S. Hypercarotenemia in Anorexia Nervosa Patients May Influence Weight Balance: Results of a Clinical Cross-Sectional Cohort Study. Front Psychiatry 2021; 12:758300. [PMID: 34992554 PMCID: PMC8725815 DOI: 10.3389/fpsyt.2021.758300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/29/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: Anorexia nervosa (AN) can co-occur with hypercarotenemia, a clinical condition characterized by elevated β-carotene in plasma and skin tissue. Carotenoids have known anti-obesogenic effects in adipocyte biology. Thus, carotenoids may potentially play a retarding role in weight gain during the recovery of AN patients. This study evaluated the plasma carotenoid profile and subcutaneous adipose tissue (SAT) in a cohort of AN patients and normal weight (NW) controls. Methods: Plasma concentrations of α-carotene, β-carotene, β-cryptoxanthin, and lycopene were determined by HPLC analysis. SAT thicknesses were measured by a highly accurate and reliable ultrasound technique. Information on dietary intakes were collected by repeated 24-h recalls. Results: Sixty-two females (AN: n = 18, NW: n = 44) were included. The concentrations of β-cryptoxanthin (p = 0.045) and lycopene (p = 0.004) were significantly lower in AN patients. β-carotene levels were higher in AN patients (n.s.) and α-carotene did not differ significantly. SAT thickness was significantly lower in AN patients compared to controls (p < 0.001). β-carotene was significantly negative (r s = -0.471) and lycopene significantly positive (r s = 0.366) correlated with SAT. The correlation of β-carotene and SAT was even higher in the AN group alone (r s = -0.742). Also, β- cryptoxanthin and the sum of provitamin A carotenoids were correlated to SAT (r s = -0.647 and r s = -0.746, respectively) in AN patients. Fruits and vegetable intake did not differ significantly between AN and NW but adjusted for SAT, AN patients consumed relatively higher amounts (p = 0.006). Conclusion: Higher plasma β-carotene concentrations were associated with reduced SAT levels, most probably due to a reduced ability of the remaining adipose tissue to store carotenoids. Thus, the antiobesity effects of carotenoids might impact the treatment success of undernutrition and AN. A systemic carotenoid overload may contribute to changes in adipogenesis and metabolic capacities for energy storage. Therefore, high plasma β-carotene may be a marker of delay in weight recovery in AN patients. Interventional studies should consider including carotenoid-status in AN treatment.
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Affiliation(s)
- Sonja Lackner
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Nathalie Meier-Allard
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Wolfram Müller
- Division of Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Alfred Fürhapter-Rieger
- Division of Biophysics, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Graz, Austria
| | - Sieglinde Zelzer
- Clinical Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
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11
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Sengeis M, Müller W, Störchle P, Fürhapter-Rieger A. Competitive Performance of Kenyan Runners Compared to their Relative Body Weight and Fat. Int J Sports Med 2020; 42:323-335. [PMID: 33053598 DOI: 10.1055/a-1268-8339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Body fat values obtained with various measurement methods deviate substantially in many cases. The standardised brightness-mode ultrasound method was used in 32 Kenyan elite long-distance runners to measure subcutaneous adipose tissue thicknesses at an accuracy and reliability level not reached by any other method. Subcutaneous adipose tissue forms the dominating part of body fat. Additionally, body mass (m), height (h), sitting height (s), leg length, and the mass index MI1 =0.53m/(hs) were determined. MI1 considers leg length, which the body mass index ignores. MI1 values of all participants were higher than their body mass indices. Both indices for relative body weight were within narrow ranges, although thickness sums of subcutaneous adipose tissue deviated strongly (women: 20-82 mm; men: 3-36 mm). Men had 2.1 times more embedded fasciae in the subcutaneous adipose tissue. In the subgroup with personal best times below world record time plus 10%, no correlation between performance and body mass index was found, and there was also no correlation with sums of subcutaneous adipose tissue thicknesses. Within the data ranges found here, extremely low relative body weight or low body fat were no criteria for the level of performance, therefore, pressure towards too low values may be disadvantageous.
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Affiliation(s)
- Marietta Sengeis
- Institute of Biophysics, Medical University of Graz, Graz.,Sport Science, Anthropometry, Leistungssport Austria, High Performance Center, Brunn am Gebirge
| | - Wolfram Müller
- Institute of Biophysics, Medical University of Graz, Graz
| | - Paul Störchle
- Institute of Biophysics, Medical University of Graz, Graz
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12
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Kelso A, Müller W, Fürhapter-Rieger A, Sengeis M, Ahammer H, Steinacker JM. High inter-observer reliability in standardized ultrasound measurements of subcutaneous adipose tissue in children aged three to six years. BMC Pediatr 2020; 20:145. [PMID: 32241257 PMCID: PMC7114789 DOI: 10.1186/s12887-020-02044-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A procedure to measure subcutaneous adipose (SAT) using brightness-mode ultrasound has recently been standardized and applied to various groups of adults including underweight, overweight and obese adults. High reliability of this procedure was found in each of the examined groups. The purpose of this study was to determine inter-observer reliability of the standardized brightness-mode ultrasound measurement of uncompressed SAT in three to six-year-old children. METHODS Three experienced observers independently captured the ultrasound images at the eight standardized measurement sites in each of the 20 children and evaluated their images using an interactive software that detects the SAT contour and automatically measures multiple thicknesses in each image; the mean of these represents SAT thickness at a given site. The children were aged 4.9 ± 1.0 years; their body mass index ranged from 13.6-17.7 kgm- 2. Sound speed was set to 1450 ms- 1 for SAT. RESULTS SAT thickness sums with fibrous structures included (DI) ranged from 25.7-86.4 mm, mean DI was 48.1 ± 15.5 mm. For DI, resulting from 160 measurements by each observer, the intra-class correlation coefficient was 0.998 (95% confidence interval 0.980-0.999), standard error of the estimate was 1.1 mm, and 95% limits of agreement were within ±2.1 mm. The median difference in DI was 0.8 mm, i.e. about 1.9% of mean DI. CONCLUSIONS Inter-observer results in children are comparable to previously described high reliability in adults. This method, which provides a technical thickness measurement accuracy of about 0.1 to 0.2 mm, enables monitoring of subcutaneous adipose tissue in children with a similarly high reliability as was obtained in adults previously. TRIAL REGISTRATION German Institute of Medical Documentation and Information, German Clinical Trials Register (DRKS) ID: DRKS00010089; Date 24/02/2016.
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Affiliation(s)
- A. Kelso
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
| | - W. Müller
- Institute of Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Graz, Austria
| | - A. Fürhapter-Rieger
- Institute of Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Graz, Austria
| | - M. Sengeis
- Institute of Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Graz, Austria
| | - H. Ahammer
- Institute of Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Graz, Austria
| | - J. M. Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany
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13
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Müller W, Fürhapter-Rieger A, Ahammer H, Lohman TG, Meyer NL, Sardinha LB, Stewart AD, Maughan RJ, Sundgot-Borgen J, Müller T, Harris M, Kirihennedige N, Magalhaes JP, Melo X, Pirstinger W, Reguant-Closa A, Risoul-Salas V, Ackland TR. Relative Body Weight and Standardised Brightness-Mode Ultrasound Measurement of Subcutaneous Fat in Athletes: An International Multicentre Reliability Study, Under the Auspices of the IOC Medical Commission. Sports Med 2020; 50:597-614. [PMID: 31571156 PMCID: PMC7018793 DOI: 10.1007/s40279-019-01192-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Fat is a metabolic fuel, but excess body fat is ballast mass, and therefore, many elite athletes reduce body fat to dangerously low levels. Uncompressed subcutaneous adipose tissue (SAT) thickness measured by brightness-mode ultrasound (US) provides an estimate of body fat content. METHODS The accuracy for determining tissue borders is about 0.1-0.2 mm and reliability (experienced measurers) was within ± 1.4 mm (95% limit of agreement, LOA). We present here inter- and intra-measurer scores of three experienced US measurers from each of the centres C1 and C2, and of three novice measurers from each of the centres C3-C5. Each of the five centres measured 16 competitive adult athletes of national or international level, except for one centre where the number was 12. The following sports were included: artistic gymnastics, judo, pentathlon, power lifting, rowing, kayak, soccer, tennis, rugby, basketball, field hockey, water polo, volleyball, American football, triathlon, swimming, cycling, long-distance running, mid-distance running, hurdles, cross-country skiing, snowboarding, and ice hockey. SAT contour was detected semi-automatically: typically, 100 thicknesses of SAT at a given site (i.e., in a given image), with and without fibrous structures, were measured. RESULTS At SAT thickness sums DI (of eight standardised sites) between 6.0 and 70.0 mm, the LOA of experienced measurers was 1.2 mm, and the intra-class correlation coefficient ICC was 0.998; novice measurers: 3.1 mm and 0.988. Intra-measurer differences were similar. The median DI value of all 39 female participants was 51 mm (11% fibrous structures) compared to 17 mm (18%) in the 37 male participants. DISCUSSION DI measurement accuracy and precision enables detection of fat mass changes of approximately 0.2 kg. Such reliability has not been reached with any other method. Although females' median body mass index and mass index were lower than those of males, females' median DI was three times higher, and their percentage of fibrous structures was lower. The standardised US method provides a highly accurate and reliable tool for measuring SAT and thus changes in body fat, but training of measurers is important.
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Affiliation(s)
- Wolfram Müller
- Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria.
| | | | - Helmut Ahammer
- Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
| | | | - Nanna L Meyer
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Luis B Sardinha
- Faculdade Motricidade Humana, CIPER, Universidade Lisboa, Lisbon, Portugal
| | | | | | | | - Tom Müller
- Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
| | - Margaret Harris
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | | | - Joao P Magalhaes
- Faculdade Motricidade Humana, CIPER, Universidade Lisboa, Lisbon, Portugal
| | - Xavier Melo
- Faculdade Motricidade Humana, CIPER, Universidade Lisboa, Lisbon, Portugal
| | - Wolfram Pirstinger
- Biophysics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
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14
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Dalton B, Leppanen J, Campbell IC, Chung R, Breen G, Schmidt U, Himmerich H. A longitudinal analysis of cytokines in anorexia nervosa. Brain Behav Immun 2020; 85:88-95. [PMID: 31077775 DOI: 10.1016/j.bbi.2019.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/17/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Inflammation has been proposed to have a pathophysiological role in anorexia nervosa (AN) and to contribute to the maintenance of the disorder. Longitudinal cytokine research in AN has focused on only a few pro-inflammatory cytokines. We assessed a broad range of cytokines over time in people undergoing specialised treatment for AN. METHOD We measured serum concentrations of 27 cytokines in people with AN (n = 23). Body mass index (BMI), eating disorder (ED) symptoms and general psychopathology were assessed and blood samples were collected within four weeks of the commencement of specialised ED treatment (baseline) and at 12- and 24-week follow-ups. RESULTS Both BMI and ED symptoms improved over the assessment period. Linear mixed models showed that log IL-6 decreased between baseline and week 12 assessments. By week 12, log IL-6 values were comparable to levels in healthy individuals. Log IL-7 increased from week 12 to week 24. DISCUSSION Initially elevated IL-6 serum concentrations appear to 'normalize' during the first 3-months of specialised treatment for AN and this co-occurs with improvements in ED symptoms. Therefore, IL-6 has the potential to be a state biomarker for AN.
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Affiliation(s)
- Bethan Dalton
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Jenni Leppanen
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Raymond Chung
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Gerome Breen
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; National Institute for Health Research Biomedical Research Centre for Mental Health, King's College London, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Hubertus Himmerich
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
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15
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Sengeis M, Müller W, Störchle P, Führhapter-Rieger A. Body weight and subcutaneous fat patterning in elite judokas. Scand J Med Sci Sports 2019; 29:1774-1788. [PMID: 31265152 PMCID: PMC6851779 DOI: 10.1111/sms.13508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/24/2019] [Indexed: 12/21/2022]
Abstract
Body weight and fat are major performance variables in many sports. Extreme weight reduction can lead to severe medical problems. Accurate body composition measurements are fundamental for both medical and performance optimization. Relative body weight in terms of mass index (MI1 = 0.53 M/(hs)), and in terms of body mass index (BMI = M/h2) were determined (h:stature, s:sitting height, M:body mass). Subcutaneous adipose tissue (SAT) was measured using a recently standardized ultrasound (US) method. US thickness sums from eight body sites were measured in 26 female and 35 male judokas of various weight classes. Comparisons of US and skinfold results indicate that the latter can be severely misleading in competitive judokas. Mean MI1 of females was 22.8 kg m−2 (BMI:22.9 kg m−2), males: 26.7 kg m−2 (BMI:26.5 kg m−2), but individual differences MI1‐BMI were larger than 0.5 kg m−2 in 13 and larger than 1.0 kg m−2 in three cases. Medians of SAT thickness sums DI were three‐times higher in females (66.1 mm) than in males (21.8 mm), and the fat patterning differed significantly. Females had 8.6% (median) fibrous structures embedded in SAT, and males 20.2%. Both MI and BMI were not correlated with SAT. Mean pre‐competition weight loss was 4.3% (ie, 3.0 kg), and maximum was 9.2% (7.4 kg), indicating that modifications of weigh‐in procedures are urgently needed. DI‐values mirror the athletes' potential to reduce ballast fat instead of short‐term weight reduction by dehydration; however, weight loss and SAT measured some weeks before the competitions were not correlated. Further, US measurements and medical longitudinal observations are required for discussing the large individual variations and possible fat minimum demands.
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Affiliation(s)
- Marietta Sengeis
- Institute of Biophysics, Medical University of Graz, Graz, Austria.,Institute for Sports Medicine and Science, High Performance Centre Austria, Maria Enzersdorf, Austria
| | - Wolfram Müller
- Institute of Biophysics, Medical University of Graz, Graz, Austria
| | - Paul Störchle
- Institute of Biophysics, Medical University of Graz, Graz, Austria
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