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Anderson DB, Beach AJ, Chen L, Feng HJ, McKay MJ, Smith ZA, Weber KA, Wesselink EO, Elliott JM. What is normal age-related thigh muscle composition among 45- to 84-year-old adults from the UK Biobank study. GeroScience 2024:10.1007/s11357-024-01304-y. [PMID: 39133460 DOI: 10.1007/s11357-024-01304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/28/2024] [Indexed: 08/13/2024] Open
Abstract
A loss of skeletal muscle mass and an increase in intramuscular fat are known to occur as we enter middle and older age, but the expected changes or normative values have remained unknown. The primary reason for this is that imaging studies are difficult and expensive to conduct, and consequently, the sample sizes have remained small. The development of the UK Biobank which provides access to a large magnetic resonance imaging (MRI) data set of more than 50,000 participants provides an opportunity to finally address this question of normative values for each age group. The study's primary aim was to determine the age-related changes in thigh muscle composition (e.g., thigh fat-free muscle volume and intramuscular fat) between the ages of 45 and 84 years. The second aim was to analyse associations between thigh fat-free muscle volume and intramuscular fat with lifestyle behaviours (smoking, alcohol consumption, and physical activity), leg pain, and bone mineral density. Fifty thousand three hundred thirty-two participants were included in the study. Total fat-free thigh muscle declined between the ages of 45 and 84 years, while intramuscular fat of the thigh continued to increase. The changes were stable between these age groups. The mean volume of fat-free muscle ranged from 11.16 (SD: 1.40) to 13.26 L (SD: 1.85) in adult males and 7.60 (SD: 0.97) to 8.80 L (SD 1.29) in females between the ages of 45 and 84 years. For intramuscular fat, the change among women was from 6.94% (SD: 1.59) in the 45 to 54 years age bracket to 8.83% (SD: 1.92) in the 75 to 84 age bracket, while for men, it was 5.83% (SD: 1.30) in the 45 to 54 age bracket to 7.85% (SD 1.89) in the 75 to 84 age bracket. The total fat-free muscle volume and intramuscular fat percentage provided can be used for the purpose of reference standards or normative values for adults in the age groups provided. Fat-free muscle and intramuscular fat were found to be associated with a range of health, activity, and leg pain outcomes, and these should be investigated in a follow-up longitudinal imaging study.
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Affiliation(s)
- David B Anderson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Aaron J Beach
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Lingxiao Chen
- Department of Orthopaedics, Shandong University Centre for Orthopaedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK.
| | - Henry J Feng
- University of Sydney, Faculty of Medicine and Health and the Northern Sydney Local Health District, The Kolling Institute, Sydney, Australia
| | - Marnee J McKay
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zachary A Smith
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73116, USA
| | - Kenneth A Weber
- Division of Pain Medicine, Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Evert Onno Wesselink
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - James M Elliott
- University of Sydney, Faculty of Medicine and Health and the Northern Sydney Local Health District, The Kolling Institute, Sydney, Australia
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Seo E, Kwon Y, ALRomi A, Eledreesi M, Park S. A multifaceted and inclusive methodology for the detection of sarcopenia in patients undergoing bariatric surgery: an in-depth analysis of current evidence. Rev Endocr Metab Disord 2024; 25:677-689. [PMID: 38427134 DOI: 10.1007/s11154-023-09864-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 03/02/2024]
Abstract
Bariatric surgery is widely recognized as the most effective intervention for obesity and offers benefits beyond weight loss. However, not all patients achieve satisfactory weight loss, balanced changes in body composition, and resolution of comorbidities. Therefore, thorough pre- and postoperative evaluations are important to predict success and minimize adverse effects. More comprehensive assessments require broadening the focus beyond body weight and fat measurements to consider quantitative and qualitative evaluations of muscles. Introducing the concept of sarcopenia is useful for assessing the degradative and pathological changes in muscles associated with cardiometabolic function, physical performance, and other obesity-related comorbidities in patients undergoing bariatric surgery. However, there is currently no consensus or definition regarding the research and clinical use of sarcopenia in patients undergoing bariatric surgery. Therefore, this review aimed to define the concept of sarcopenia applicable to patients undergoing bariatric surgery, based on the consensus reached for sarcopenia in the general population. We also discuss the methods and significance of measuring muscle mass, quality, and strength, which are key variables requiring a comprehensive assessment.
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Affiliation(s)
- Eunhye Seo
- Keimyung University College of Nursing, Daegu, Republic of Korea
| | - Yeongkeun Kwon
- Division of Foregut Surgery, Korea University College of Medicine, 73 Goryeodae- ro, Seongbuk-gu, 02841, Seoul, Republic of Korea
- Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ahmad ALRomi
- Ministry of Health Jordan, General surgery affiliationision, prince Hamzah hospital, Amman, Jordan
| | | | - Sungsoo Park
- Division of Foregut Surgery, Korea University College of Medicine, 73 Goryeodae- ro, Seongbuk-gu, 02841, Seoul, Republic of Korea.
- Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, Republic of Korea.
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Kronberger C, Mascherbauer K, Willixhofer R, Duca F, Rettl R, Binder-Rodriguez C, Poledniczek M, Ermolaev N, Donà C, Koschutnik M, Nitsche C, Camuz Ligios L, Beitzke D, Badr Eslam R, Bergler-Klein J, Kastner J, Kammerlander AA. Native skeletal muscle T1-time on cardiac magnetic resonance: A predictor of outcome in patients with heart failure with preserved ejection fraction. Eur J Intern Med 2024:S0953-6205(24)00314-5. [PMID: 39048334 DOI: 10.1016/j.ejim.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/13/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is associated with heart failure (HF) hospitalizations and death. Previous studies have shown that altered muscle composition is associated with higher risk of adverse outcome in HFpEF patients. AIM The purpose of our study was to investigate the association between skeletal muscle composition, as measured by skeletal muscle T1-times on cardiac magnetic resonance (CMR) imaging, and adverse outcome. METHODS We measured skeletal muscle T1-times of the back muscles on standard CMR images in a prospective cohort of HFpEF patients. Cox regression models were used to test the association of skeletal muscle T1-times and adverse outcome defined as hospitalization for HF and/or cardiovascular death. RESULTS We included 101 patients (mean age 72±7 years, 71 % female) in our study. The median skeletal muscle T1-times were 842 ms (IQR 806-881 ms). In univariate analysis high muscle T1-time was associated with adverse outcome (HR=1.96 [95 % CI, 1.31-2.94] per every 100 ms increase; p=.001). After adjustment for age, sex, body mass index, left- and right ventricular ejection fraction, N-terminal pro-brain natriuretic peptide and myocardial native T1-times, native skeletal muscle T1-time remained an independent predictor for adverse outcome (HR=1.94 [95 % CI, 1.24-3.03] per every 100 ms increase; p=.004). CONCLUSION In patients with HFpEF, high skeletal muscle T1-times on standard CMR scans are associated with higher rates of HF hospitalizations and cardiovascular death. CONDENSED ABSTRACT Skeletal muscle abnormalities are common in patients with heart failure with preserved ejection fraction (HFpEF). The present study evaluates skeletal muscle composition, as quantified by native skeletal muscle T1-times of the back muscles on standard cardiac magnetic resonance imaging, and assessed the association with adverse outcome, defined as hospitalization for heart failure and/or cardiovascular death. In a prospective cohort of 101 patients with HFpEF, we found that high native skeletal muscle T1-times are associated with an increased risk for adverse outcome. These findings suggest that native skeletal muscle T1-time may serve as marker for improved risk prediction.
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Affiliation(s)
- Christina Kronberger
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Katharina Mascherbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Robin Willixhofer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Franz Duca
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - René Rettl
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Christina Binder-Rodriguez
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Michael Poledniczek
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Nikita Ermolaev
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Carolina Donà
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Matthias Koschutnik
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Christian Nitsche
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Luciana Camuz Ligios
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Dietrich Beitzke
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Roza Badr Eslam
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Jutta Bergler-Klein
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Johannes Kastner
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Andreas A Kammerlander
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
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Nakamura K, Kinugasa Y, Sota T, Hirai M, Kato M, Yamamoto K. The water imbalance of skeletal muscle and muscle weakness in patients with heart failure. ESC Heart Fail 2024. [PMID: 38992950 DOI: 10.1002/ehf2.14950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/26/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024] Open
Abstract
AIMS A high extracellular water (ECW) to intracellular water (ICW) ratio of skeletal muscle as assessed by bioelectrical impedance analysis is reportedly associated with loss of muscle strength. However, the validity of this index for heart failure (HF), which is likely associated with changes in the water distribution, is unclear. METHODS AND RESULTS This study involved 190 patients with HF. The total ECW and ICW of both upper and lower extremities were measured, and a high ECW/ICW ratio was defined as an ECW/ICW ratio higher than the median (≥0.636 for men, ≥0.652 for women). Low muscle strength was defined as reduced handgrip strength according to the criteria established by the Asian Working Group for Sarcopenia. Patients with a high ECW/ICW ratio had a lower handgrip strength (21.1 ± 8.1 kg vs. 27.6 ± 9.3 kg, P ≤ 0.05) and 6 min walk distance (329 ± 116 m vs. 440 ± 114 m) than those with a low ECW/ICW ratio. An increasing ECW and/or decreasing ICW was associated with a higher ECW/ICW ratio and a lower handgrip strength (P < 0.05). In the multivariate logistic regression analysis, a high ECW/ICW ratio and low skeletal muscle mass were independently associated with low muscle strength (P < 0.05). CONCLUSIONS A high ECW/ICW ratio in limb muscles, that is, the water imbalance of increasing ECW and/or decreasing ICW, is useful in assessing muscle quality in patients with HF.
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Affiliation(s)
- Kensuke Nakamura
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Takeshi Sota
- Division of Rehabilitation, Tottori University Hospital, Yonago, Japan
| | - Masayuki Hirai
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masahiko Kato
- Department of Pathobiological Science and Technology, School of Health Science; Major in Clinical Laboratory Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
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Di Vincenzo A, Crescenzi M, Granzotto M, Vecchiato M, Fioretto P, Vettor R, Rossato M. Treatment with dapagliflozin increases FGF-21 gene expression and reduces triglycerides content in myocardial tissue of genetically obese mice. J Endocrinol Invest 2024; 47:1777-1786. [PMID: 38194168 DOI: 10.1007/s40618-023-02273-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND The association between obesity and some cardiovascular complications such as heart failure (HF) is well established, and drugs affecting adiposity are supposed to be promising treatments for these conditions. The sodium-glucose cotransporter-2 inhibitors (SGLT2i) are antidiabetic drugs showing benefits in patients with HF, despite the underlying mechanisms have not been completely understood yet. SGLT2i are supposed to promote systemic effects, such as triglycerides mobilization, through the enhancement of fibroblast growth factor-21 (FGF-21) activity. So, in this study, we evaluated the effects of dapagliflozin treatment on FGF-21 and related receptors (FGF-Rs) gene expression and on lipid content in myocardial tissue in an animal model of genetically induced obesity to unravel possible metabolic mechanisms accounting for the cardioprotection of SGLT2i. METHODS Six-week-old C57BL/6J wild-type mice and B6.V-LEP (ob/ob) mice were randomly assigned to the control or treatment group (14 animals/group). Treatment was based on the administration of dapagliflozin 0.15 mg/kg/day for 4 weeks. The gene expression of FGF-21 and related receptors (FGF-R1, FGF-R3, FGF-R4, and β-klotho co-receptor) was assessed at baseline and after treatment by real-time PCR. Similarly, cardiac triglycerides concentration was measured in the control group and treated animals. RESULTS At baseline, FGF-21 mRNA expression in the heart did not differ between lean and obese ob/ob mice. Dapagliflozin administration significantly increased heart FGF-21 gene expression, but only in ob/ob mice (p < 0.005). Consistently, when measuring the amount of triglycerides in the cardiac tissue, SGLT2i treatment reduced the lipid content in obese ob/ob mice, while no significant effects were observed in treated lean animals (p < 0.001). The overall expression of the FGF-21 receptors was only minimally affected by dapagliflozin treatment both in obese ob/ob mice and in lean controls. CONCLUSIONS Dapagliflozin administration increases FGF-21gene expression and reduces triglyceride content in myocardial tissue of ob/ob mice, while no significant effect was observed in lean controls. These results might help understand the cardiometabolic effects of SGLT2i inducing increased FGF-21 synthesis while reducing lipid content in cardiomyocytes as a possible expression of the switch to different energy substrates. This mechanism could represent a potential target of SGLT2i in obesity-related heart diseases.
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Affiliation(s)
- A Di Vincenzo
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy.
| | - M Crescenzi
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy
| | - M Granzotto
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy
| | - M Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University-Hospital of Padova, Padua, Italy
| | - P Fioretto
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy
| | - R Vettor
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy
| | - M Rossato
- Internal Medicine 3, Department of Medicine, University-Hospital of Padova, Padua, Italy
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Pandey A, Patel KV, Segar MW, Ayers C, Linge J, Leinhard OD, Anker SD, Butler J, Verma S, Joshi PH, Neeland IJ. Effect of liraglutide on thigh muscle fat and muscle composition in adults with overweight or obesity: Results from a randomized clinical trial. J Cachexia Sarcopenia Muscle 2024; 15:1072-1083. [PMID: 38561962 PMCID: PMC11154779 DOI: 10.1002/jcsm.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/28/2024] [Accepted: 02/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Excess muscle fat is observed in obesity and associated with greater burden of cardiovascular risk factors and higher risk of mortality. Liraglutide reduces total body weight and visceral fat but its effect on muscle fat and adverse muscle composition is unknown. METHODS This is a pre-specified secondary analysis of a randomized, double-blind, placebo-controlled trial that examined the effects of liraglutide plus a lifestyle intervention on visceral adipose tissue and ectopic fat among adults without diabetes with body mass index ≥30 kg/m2 or ≥27 kg/m2 and metabolic syndrome. Participants were randomly assigned to a once-daily subcutaneous injection of liraglutide (target dose 3.0 mg) or matching placebo for 40 weeks. Body fat distribution and muscle composition was assessed by magnetic resonance imaging at baseline and 40-week follow-up. Muscle composition was described by the combination of thigh muscle fat and muscle volume. Treatment difference (95% confidence intervals [CI]) was calculated by least-square means adjusted for baseline thigh muscle fat. The association between changes in thigh muscle fat and changes in body weight were assessed using Spearman correlation coefficients. The effect of liraglutide versus placebo on adverse muscle composition, denoted by high thigh muscle fat and low thigh muscle volume, was explored. RESULTS Among the 128 participants with follow-up imaging (92.2% women, 36.7% Black), median muscle fat at baseline was 7.8%. The mean percent change in thigh muscle fat over median follow-up of 36 weeks was -2.87% among participants randomized to liraglutide (n = 73) and 0.05% in the placebo group (absolute change: -0.23% vs. 0.01%). The estimated treatment difference adjusted for baseline thigh muscle fat was -0.24% (95% CI, -0.41 to -0.06, P-value 0.009). Longitudinal change in thigh muscle fat was significantly associated with change in body weight in the placebo group but not the liraglutide group. The proportion of participants with adverse muscle composition decreased from 11.0% to 8.2% over follow-up with liraglutide, but there was no change with placebo. CONCLUSIONS In a cohort of predominantly women with overweight or obesity in the absence of diabetes, once-daily subcutaneous liraglutide was associated with a reduction in thigh muscle fat and adverse muscle composition compared with placebo. The contribution of muscle fat improvement to the cardiometabolic benefits of liraglutide requires further study.
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Affiliation(s)
| | - Kershaw V. Patel
- Department of CardiologyHouston Methodist DeBakey Heart & Vascular CenterHoustonTXUSA
| | | | - Colby Ayers
- University of Texas Southwestern Medical CenterDallasTXUSA
| | - Jennifer Linge
- AMRA Medical and Linköping UniversityLinköpingSweden
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist MedicineLinköping UniversityLinköpingSweden
| | - Olof D. Leinhard
- AMRA Medical and Linköping UniversityLinköpingSweden
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist MedicineLinköping UniversityLinköpingSweden
| | - Stefan D. Anker
- Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) Partner Site BerlinCharité UniversitätsmedizinBerlinGermany
| | - Javed Butler
- Baylor Heart and Vascular InstituteBaylor University Medical CenterDallasTXUSA
- Department of MedicineUniversity of Mississippi School of MedicineJacksonMSUSA
| | - Subodh Verma
- St. Michael's HospitalUniversity of TorontoTorontoONCanada
| | - Parag H. Joshi
- University of Texas Southwestern Medical CenterDallasTXUSA
| | - Ian J. Neeland
- Harrington Heart and Vascular InstituteUniversity Hospitals Cleveland Medical Center and Case Western Reserve University School of MedicineClevelandOHUSA
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Yao S, Colangelo LA, Perry AS, Marron MM, Yaffe K, Sedaghat S, Lima JAC, Tian Q, Clish CB, Newman AB, Shah RV, Murthy VL. Implications of metabolism on multi-systems healthy aging across the lifespan. Aging Cell 2024; 23:e14090. [PMID: 38287525 PMCID: PMC11019145 DOI: 10.1111/acel.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/30/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
Aging is increasingly thought to involve dysregulation of metabolism in multiple organ systems that culminate in decreased functional capacity and morbidity. Here, we seek to understand complex interactions among metabolism, aging, and systems-wide phenotypes across the lifespan. Among 2469 adults (mean age 74.7 years; 38% Black) in the Health, Aging and Body Composition study we identified metabolic cross-sectionally correlates across 20 multi-dimensional aging-related phenotypes spanning seven domains. We used LASSO-PCA and bioinformatic techniques to summarize metabolome-phenome relationships and derive metabolic scores, which were subsequently linked to healthy aging, mortality, and incident outcomes (cardiovascular disease, disability, dementia, and cancer) over 9 years. To clarify the relationship of metabolism in early adulthood to aging, we tested association of these metabolic scores with aging phenotypes/outcomes in 2320 participants (mean age 32.1, 44% Black) of the Coronary Artery Risk Development in Young Adults (CARDIA) study. We observed significant overlap in metabolic correlates across the seven aging domains, specifying pathways of mitochondrial/cellular energetics, host-commensal metabolism, inflammation, and oxidative stress. Across four metabolic scores (body composition, mental-physical performance, muscle strength, and physical activity), we found strong associations with healthy aging and incident outcomes, robust to adjustment for risk factors. Metabolic scores for participants four decades younger in CARDIA were related to incident cardiovascular, metabolic, and neurocognitive performance, as well as long-term cardiovascular disease and mortality over three decades. Conserved metabolic states are strongly related to domain-specific aging and outcomes over the life-course relevant to energetics, host-commensal interactions, and mechanisms of innate immunity.
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Affiliation(s)
- Shanshan Yao
- University of PittsburgPittsburghPennsylvaniaUSA
| | | | | | | | | | | | | | - Qu Tian
- National Institute of AgingBaltimoreMarylandUSA
| | - Clary B. Clish
- Broad Institute of Harvard and MITCambridgeMassachusettsUSA
| | | | - Ravi V. Shah
- Vanderbilt University Medical CenterNashvilleTennesseeUSA
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Maskarinec G, Shvetsov Y, Wong MC, Cataldi D, Bennett J, Garber AK, Buchthal SD, Heymsfield SB, Shepherd JA. Predictors of visceral and subcutaneous adipose tissue and muscle density: The ShapeUp! Kids study. Nutr Metab Cardiovasc Dis 2024; 34:799-806. [PMID: 38218711 PMCID: PMC10922397 DOI: 10.1016/j.numecd.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/02/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Body fat distribution, i.e., visceral (VAT), subcutaneous adipose tissue (SAT) and intramuscular fat, is important for disease prevention, but sex and ethnic differences are not well understood. Our aim was to identify anthropometric, demographic, and lifestyle predictors for these outcomes. METHODS AND RESULTS The cross-sectional ShapeUp!Kids study was conducted among five ethnic groups aged 5-18 years. All participants completed questionnaires, anthropometric measurements, and abdominal MRI scans. VAT and SAT areas at four lumbar levels and muscle density were assessed manually. General linear models were applied to estimate coefficients of determination (R2) and to compare the fit of VAT and SAT prediction models. After exclusions, the study population had 133 male and 170 female participants. Girls had higher BMI-z scores, waist circumference (WC), and SAT than boys but lower VAT/SAT and muscle density. SAT, VAT, and VAT/SAT but not muscle density differed significantly by ethnicity. R2 values were higher for SAT than VAT across groups and improved slightly after adding WC. For SAT, R2 increased from 0.85 to 0.88 (girls) and 0.62 to 0.71 (boys) when WC was added while VAT models improved from 0.62 to 0.65 (girls) and 0.57 to 0.62 (boys). VAT values were significantly lower among Blacks than Whites with little difference for the other groups. CONCLUSION This analysis in a multiethnic population identified BMI-z scores and WC as the major predictors of MRI-derived SAT and VAT and highlights the important ethnic differences that need to be considered in diverse populations.
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Affiliation(s)
| | | | | | - Devon Cataldi
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Andrea K Garber
- University of California at San Francisco, San Francisco, CA, USA
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Zhang T, Li J, Li X, Liu Y. Intermuscular adipose tissue in obesity and related disorders: cellular origins, biological characteristics and regulatory mechanisms. Front Endocrinol (Lausanne) 2023; 14:1280853. [PMID: 37920255 PMCID: PMC10619759 DOI: 10.3389/fendo.2023.1280853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
Intermuscular adipose tissue (IMAT) is a unique adipose depot interspersed between muscle fibers (myofibers) or muscle groups. Numerous studies have shown that IMAT is strongly associated with insulin resistance and muscular dysfunction in people with metabolic disease, such as obesity and type 2 diabetes. Moreover, IMAT aggravates obesity-related muscle metabolism disorders via secretory factors. Interestingly, researchers have discovered that intermuscular brown adipocytes in rodent models provide new hope for obesity treatment by acting on energy dissipation, which inspired researchers to explore the underlying regulation of IMAT formation. However, the molecular and cellular properties and regulatory processes of IMAT remain debated. Previous studies have suggested that muscle-derived stem/progenitor cells and other adipose tissue progenitors contribute to the development of IMAT. Adipocytes within IMAT exhibit features that are similar to either white adipocytes or uncoupling protein 1 (UCP1)-positive brown adipocytes. Additionally, given the heterogeneity of skeletal muscle, which comprises myofibers, satellite cells, and resident mesenchymal progenitors, it is plausible that interplay between these cellular components actively participate in the regulation of intermuscular adipogenesis. In this context, we review recent studies associated with IMAT to offer insights into the cellular origins, biological properties, and regulatory mechanisms of IMAT. Our aim is to provide novel ideas for the therapeutic strategy of IMAT and the development of new drugs targeting IMAT-related metabolic diseases.
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Affiliation(s)
- Ting Zhang
- Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Jun Li
- Department of Orthopedics, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Xi Li
- Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Yanjun Liu
- Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
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10
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Antonopoulos AS, Papastamos C, Cokkinos DV, Tsioufis K, Tousoulis D. Epicardial Adipose Tissue in Myocardial Disease: From Physiology to Heart Failure Phenotypes. Curr Probl Cardiol 2023; 48:101841. [PMID: 37244513 DOI: 10.1016/j.cpcardiol.2023.101841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
Epicardial adipose tissue (EAT) is increasingly being recognized as a determinant of myocardial biology. The EAT-heart crosstalk suggests causal links between dysfunctional EAT and cardiomyocyte impairment. Obesity promotes EAT dysfunction and shifts in secreted adipokines which adversely affect cardiac metabolism, induce cardiomyocyte inflammation, redox imbalance and myocardial fibrosis. Thus, EAT determines cardiac phenotype via effects on cardiac energetics, contractility, diastolic function, and atrial conduction. Vice-versa the EAT is altered in heart failure (HF), and such phenotypic changes can be detected by noninvasive imaging or incorporated in Artificial Intelligence-enhanced tools to aid the diagnosis, subtyping or risk prognostication of HF. In the present article, we summarize the links between EAT and the heart, explaining how the study of epicardial adiposity can improve the understanding of cardiac disease, serve as a source of diagnostic and prognostic biomarkers, and as a potential therapeutic target in HF to improve clinical outcomes.
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Affiliation(s)
- Alexios S Antonopoulos
- 1st Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece; Clinical, Experimental Surgery and Translational Research Centre, Biomedical Research Foundation Academy of Athens, Athens, Greece.
| | - Charalampos Papastamos
- 1st Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece
| | - Dennis V Cokkinos
- Clinical, Experimental Surgery and Translational Research Centre, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Konstantinos Tsioufis
- 1st Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, National and Kapodistrian University of Athens, Athens, Greece
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11
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Hathaway Q, Ibad HA, Bluemke DA, Pishgar F, Kasaiean A, Klein JG, Cogswell R, Allison M, Budoff MJ, Barr RG, Post W, Bredella MA, Lima JAC, Demehri S. Predictive Value of Deep Learning-derived CT Pectoralis Muscle and Adipose Measurements for Incident Heart Failure: Multi-Ethnic Study of Atherosclerosis. Radiol Cardiothorac Imaging 2023; 5:e230146. [PMID: 37908549 PMCID: PMC10613925 DOI: 10.1148/ryct.230146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Purpose To develop a deep learning algorithm capable of extracting pectoralis muscle and adipose measurements and to longitudinally investigate associations between these measurements and incident heart failure (HF) in participants from the Multi-Ethnic Study of Atherosclerosis (MESA). Materials and Methods MESA is a prospective study of subclinical cardiovascular disease characteristics and risk factors for progression to clinically overt disease approved by institutional review boards of six participating centers (ClinicalTrials.gov identifier: NCT00005487). All participants with adequate imaging and clinical data from the fifth examination of MESA were included in this study. Hence, in this secondary analysis, manual segmentations of 600 chest CT examinations (between the years 2010 and 2012) were used to train and validate a convolutional neural network, which subsequently extracted pectoralis muscle and adipose (intermuscular adipose tissue (IMAT), perimuscular adipose tissue (PAT), extramyocellular lipids and subcutaneous adipose tissue) area measurements from 3031 CT examinations using individualized thresholds for adipose segmentation. Next, 1781 participants without baseline HF were longitudinally investigated for associations between baseline pectoralis muscle and adipose measurements and incident HF using crude and adjusted Cox proportional hazards models. The full models were adjusted for variables in categories of demographic (age, race, sex, income), clinical/laboratory (including physical activity, BMI, and smoking), CT (coronary artery calcium score), and cardiac MRI (left ventricular ejection fraction and mass (% of predicted)) data. Results In 1781 participants (median age, 68 (IQR,61, 75) years; 907 [51%] females), 41 incident HF events occurred over a median 6.5-year follow-up. IMAT predicted incident HF in unadjusted (hazard ratio [HR]:1.14; 95% CI: 1.03-1.26) and fully adjusted (HR:1.16, 95% CI: 1.03-1.31) models. PAT also predicted incident HF in crude (HR:1.19; 95% CI: 1.06-1.35) and fully adjusted (HR:1.25; 95% CI: 1.07-1.46) models. Conclusion The study demonstrates that fast and reliable deep learning-derived pectoralis muscle and adipose measurements are obtainable from conventional chest CT, which may be predictive of incident HF.©RSNA, 2023.
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Affiliation(s)
| | | | - David A. Bluemke
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Farhad Pishgar
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Arta Kasaiean
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Joshua G. Klein
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Rebecca Cogswell
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Matthew Allison
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Matthew J. Budoff
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - R. Graham Barr
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Wendy Post
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Miriam A. Bredella
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - João A. C. Lima
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
| | - Shadpour Demehri
- From the School of Medicine, West Virginia University, Morgantown, WV
(Q.H.); Russell H. Morgan Department of Radiology and Radiological Sciences
(H.A.I., F.P., A.K., J.G.K., S.D.) and Division of Cardiology, Department of
Medicine (W.P., J.A.C.L.), Johns Hopkins University School of Medicine, 601 N
Caroline St, JHOC 5165, Baltimore, MD 21287; Department of Radiology, University
of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.);
Department of Medicine, University of Minnesota, Minneapolis, Minn (R.C.);
Department of Family Medicine and Public Health, University of California San
Diego, La Jolla, Calif (M.A.); Lundquist Institute at Harbor-University of
California Los Angeles School of Medicine, Torrance, Calif (M.J.B.); Departments
of Medicine and Epidemiology, Columbia University Medical Center, New York, NY
(R.G.B.); and Department of Radiology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass (M.A.B.)
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12
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Zhang D, Shi W, Ding Z, Park J, Wu S, Zhang J. Association between weight-adjusted-waist index and heart failure: Results from National Health and Nutrition Examination Survey 1999-2018. Front Cardiovasc Med 2022; 9:1069146. [PMID: 36588556 PMCID: PMC9794568 DOI: 10.3389/fcvm.2022.1069146] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/22/2022] [Indexed: 12/16/2022] Open
Abstract
Background Weight-adjusted waist circumference index (WWI) is a novel index positively associated with excessive fat accumulation. The current study aims to evaluate the association between WWI and the prevalent heart failure (HF), and to assess the value of WWI to improve the detection of HF in the general population. Methods A total of 25,509 subjects from National Health and Nutrition Examination Survey 1999-2018 were included into our study. WWI was calculated as WC (cm) divided by the square root of weight (kg). HF was identified according to the subjects' reports. Results The prevalence of reported HF was 2.96%. With adjustment of demographic, anthropometric, laboratory, and medical history data, one SD increment of WWI could cast an additional 19.5% risk for prevalent HF. After separating WWI into quartiles, the fourth quartile had a 1.670 times risk of prevalent HF compared to the first quartile. Furthermore, smooth curve fitting suggested that the association was linear in the entire range of WWI. Moreover, the association was robust to subgroups of age, sex, race, obesity, hypertension, and diabetes. Additionally, ROC analysis revealed a significant improvement for the detection of prevalent HF from WWI (0.890 vs. 0.894, P < 0.001); And continuous net reclassification index (0.225, P < 0.001) and integrated discrimination index (0.004, P < 0.001) also supported the improvement from WWI. Conclusion Our data demonstrated a significant, linear, and robust association between WWI, a simple surrogate for fat mass accumulation, and the risk for prevalent HF in a representative population. Moreover, our results also suggested the potential value of WWI to refine the detection of prevalent HF in the general population.
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Affiliation(s)
- Daoliang Zhang
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Wenrui Shi
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhaohui Ding
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Jieun Park
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shaohui Wu
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China,Shaohui Wu,
| | - Jian Zhang
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China,Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Jian Zhang, ;
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13
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Chen YF, Lee CW, Wu HH, Lin WT, Lee OK. Immunometabolism of macrophages regulates skeletal muscle regeneration. Front Cell Dev Biol 2022; 10:948819. [PMID: 36147742 PMCID: PMC9485946 DOI: 10.3389/fcell.2022.948819] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Sarcopenia is an age-related progressive loss of skeletal muscle mass, quality, and strength disease. In addition, sarcopenia is tightly correlated with age-associated pathologies, such as sarcopenic obesity and osteoporosis. Further understanding of disease mechanisms and the therapeutic strategies in muscle regeneration requires a deeper knowledge of the interaction of skeletal muscle and other cells in the muscle tissue. Skeletal muscle regeneration is a complex process that requires a series of highly coordinated events involving communication between muscle stem cells and niche cells, such as muscle fibro/adipogenic progenitors and macrophages. Macrophages play a critical role in tissue regeneration and the maintenance of muscle homeostasis by producing growth factors and cytokines that regulate muscle stem cells and myofibroblast activation. Furthermore, the aging-related immune dysregulation associated with the release of trophic factors and the polarization in macrophages transiently affect the inflammatory phase and impair muscle regeneration. In this review, we focus on the role and regulation of macrophages in skeletal muscle regeneration and homeostasis. The aim of this review is to highlight the important roles of macrophages as a therapeutic target in age-related sarcopenia and the increasing understanding of how macrophages are regulated will help to advance skeletal muscle regeneration.
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Affiliation(s)
- Yu-Fan Chen
- Center for Translational Genomics Research, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Wei Lee
- Center for Translational Genomics Research, China Medical University Hospital, Taichung, Taiwan
| | - Hao-Hsiang Wu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Stem Cell Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ting Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Doctoral Degree Program of Translational Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei, Taiwan
| | - Oscar K. Lee
- Center for Translational Genomics Research, China Medical University Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Stem Cell Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
- *Correspondence: Oscar K. Lee,
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