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Minato-Inokawa S, Tsuboi-Kaji A, Honda M, Takeuchi M, Kitaoka K, Kurata M, Wu B, Kazumi T, Fukuo K. Low muscle mass is associated with low insulin sensitivity, impaired pancreatic β cell function, and high glucose excursion in nondiabetic nonobese Japanese women. Metabol Open 2024; 23:100306. [PMID: 39188637 PMCID: PMC11347059 DOI: 10.1016/j.metop.2024.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Aim We tested whether skeletal muscle mass is associated with insulin sensitivity, pancreatic β-cell function, and postglucose glycemia. Methods Appendicular skeletal muscle mass (ASM) (relative to body size, %ASM) by DXA, surrogate measures of insulin sensitivity, insulin secretion and the disposition index (insulin sensitivity adjusted insulin secretion: a product of the insulinogenic index and Matsuda insulin sensitivity index) inferred from serum insulin kinetics during a 75 g oral glucose tolerance test (OGTT) were evaluated in 168 young and 65 middle-aged women, whose BMI averaged <23.0 kg/m2 and HbA1c ≦ 5.5 %. Results In two groups of women, %ASM was associated negatively with homeostasis model assessment insulin resistance (HOMA-IR) and 2-h insulin (both p < 0.01 or less). In middle-aged women not in young women, %ASM was associated inversely with the Matsuda index (p < 0.001). In middle-aged women only, it also showed a positive association with the disposition index (p = 0.02) and inverse associations with 1-h and 2-h glucose (both p < 0.01) and area under the glucose concentration curve during OGTT (p = 0.006). On multivariate linear regression analyses, 2-h insulin emerged as a determinant of %ASM independently of HOMA-IR in young women (standardized β: 0.287, p < 0.001, R2 = 0.077). In middle-aged women, the Matsuda index emerged as a determinant of %ASM (standardized β: 0.476, p < 0.001) independently of HOMA-IR, log ODI and AUCg and explained 21.3 % of %ASM variability. Post-glucose glycemia and AUCg were higher and log ODI was lower in middle-aged women with low compared with high %ASM. Conclusion Low skeletal muscle mass (relative to body size) was associated with low insulin sensitivity in young and middle-aged Japanese women who were neither obese nor diabetic. Middle-aged women with low muscle mass had low disposition index, an early marker of inadequate pancreatic β-cell compensation, and hence high glucose excursion. Low skeletal muscle mass may be associated with the development of type 2 diabetes at a much lower BMI in Japanese people.
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Affiliation(s)
- Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Ayaka Tsuboi-Kaji
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Advanced Epidemiology, Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Hakuhoukai Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
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Akieda-Asai S, Ma H, Han W, Nagata J, Yamaguchi F, Date Y. Mechanism of muscle atrophy in a normal-weight rat model of type 2 diabetes established by using a soft-pellet diet. Sci Rep 2024; 14:7670. [PMID: 38561446 PMCID: PMC10984920 DOI: 10.1038/s41598-024-57727-2] [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: 11/28/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
Dietary factors such as food texture affect feeding behavior and energy metabolism, potentially causing obesity and type 2 diabetes. We previously found that rats fed soft pellets (SPs) were neither hyperphagic nor overweight but demonstrated glucose intolerance, insulin resistance, and hyperplasia of pancreatic β-cells. In the present study, we investigated the mechanism of muscle atrophy in rats that had been fed SPs on a 3-h time-restricted feeding schedule for 24 weeks. As expected, the SP rats were normal weight; however, they developed insulin resistance, glucose intolerance, and fat accumulation. In addition, skeletal muscles of SP rats were histologically atrophic and demonstrated disrupted insulin signaling. Furthermore, we learned that the muscle atrophy of the SP rats developed via the IL-6-STAT3-SOCS3 and ubiquitin-proteasome pathways. Our data show that the dietary habit of consuming soft foods can lead to not only glucose intolerance or insulin resistance but also muscle atrophy.
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Affiliation(s)
- Sayaka Akieda-Asai
- Frontier Science Research Center, University of Miyazaki, Miyazaki, 889-1692, Japan.
| | - Hao Ma
- Frontier Science Research Center, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Wanxin Han
- Frontier Science Research Center, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Junko Nagata
- Department of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Fumitake Yamaguchi
- Frontier Science Research Center, University of Miyazaki, Miyazaki, 889-1692, Japan
- Department of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Yukari Date
- Frontier Science Research Center, University of Miyazaki, Miyazaki, 889-1692, Japan.
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Shahi A, Tripathi D, Jain M, Jadon RS, Sethi P, Khadgawat R, Khan MA, Madhusudan KS, Prakash S, Vikram NK. Prevalence of sarcopenia and its determinants in people with type 2 diabetes: Experience from a tertiary care hospital in north India. Diabetes Metab Syndr 2023; 17:102902. [PMID: 37980722 DOI: 10.1016/j.dsx.2023.102902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Changes in skeletal muscle mass and quality are associated with type 2 Diabetes (T2D) and its complications. We evaluated the prevalence of sarcopenia in patients with T2D and its association with various anthropometric and metabolic parameters. METHODS A total of 229 patients with T2D, ≥20-60 years, were screened for sarcopenia using handgrip strength (HGS) by dynamometer, physical performance test (by Short Physical and chair stand test), and height-adjusted appendicular skeletal muscle index (ASMI) by Dual Energy X-ray Absorptiometry (DXA) applying Asian Working Group on Sarcopenia (AWGS). Multiple logistic regressions were performed to identify the factors associated with sarcopenia. RESULTS The mean age was 46.2 ± 7.4 years with 55% being women. The prevalence of low HGS, poor physical performance, low ASMI, possible sarcopenia, sarcopenia, and severe sarcopenia was 16.2%, 39.3%, 33%, 43%, 18.8%, and 6.1%, respectively. Age >45 years and use of >2 oral hypoglycaemic agents (OHA's) were risk factors for low HGS (OR:3.51, 95%CI = 1.5-8.3) and low ASMI (OR:2.40, 95%CI = 1.05, 5.49, p-0.04), respectively. Female sex (OR:3.3 1.8-6.1 p < 0.01), age >45 years (OR:2.12, 95% CI = 1.2-3.8 p-0.012) and liver fibrosis (OR: 2.12, 95% CI = 1.01-4.46 p-0.048) were independently associated with poor performance. No association was found with HbA1c, dyslipidaemia, albuminuria, hypertension, or duration of diabetes and sarcopenia. CONCLUSION Sarcopenia is becoming increasingly recognized as a significant complication in younger individuals with T2D, and poor physical performance plays a vital role in its development. The prevalence of sarcopenia rises with advancing age, underscoring the importance of early intervention to address this condition.
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Affiliation(s)
- Anand Shahi
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Divya Tripathi
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mriga Jain
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ranveer S Jadon
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Prayas Sethi
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rajesh Khadgawat
- Departments of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Maroof A Khan
- Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Kumble S Madhusudan
- Departments of Radiodiagnosis and Interventional Radiology and All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shyam Prakash
- Departments of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Naval K Vikram
- Departments of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Park HK, Shim YS, Lee HS, Hwang JS. Reference Ranges of Body Composition Using Dual-Energy X-Ray Absorptiometry and Its Relation to Tri-Ponderal Mass Index. J Clin Densitom 2022; 25:433-447. [PMID: 36114107 DOI: 10.1016/j.jocd.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/14/2022] [Indexed: 11/21/2022]
Abstract
Introduction/background Increased body fat is related to obesity and its comorbidities later in life. To determine the amount of body fat in children and adolescents, reference intervals should be applied. Dual-energy X-ray absorptiometry (DXA) is a good tool for accurately measuring body composition. Methodology The body composition reference ranges in Korean children and adolescents were determined using nationally representative cross-sectional data. The performances of the body mass index (BMI) and tri-ponderal mass index (TMI) in measuring body fat were compared using the reference percentiles derived from this analysis. Results A total of 1,661 subjects (891 boys and men and 770 girls and women) were included. Age- and sex-specific percentiles and the corresponding LMS variables for DXA-assessed parameters for the whole body and the trunk were determined. The coefficients of determination of the whole body FM SDS and FMI SDS for the BMI SDS were 0.783 and 0.784, respectively, and those for the TMI SDS were 0.685 and 0.769, respectively. Conclusion Based on the reference values for body composition, the correlation coefficients of TMI for adjusted FM measured by DXA were comparable to those of BMI. TMI estimated body fat levels more accurately than BMI in this study population.
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Affiliation(s)
- Hong Kyu Park
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
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Pasmans K, Adriaens ME, Olinga P, Langen R, Rensen SS, Schaap FG, Olde Damink SWM, Caiment F, van Loon LJC, Blaak EE, Meex RCR. Hepatic Steatosis Contributes to the Development of Muscle Atrophy via Inter-Organ Crosstalk. Front Endocrinol (Lausanne) 2021; 12:733625. [PMID: 34707570 PMCID: PMC8542925 DOI: 10.3389/fendo.2021.733625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Individuals with hepatic steatosis often display several metabolic abnormalities including insulin resistance and muscle atrophy. Previously, we found that hepatic steatosis results in an altered hepatokine secretion profile, thereby inducing skeletal muscle insulin resistance via inter-organ crosstalk. In this study, we aimed to investigate whether the altered secretion profile in the state of hepatic steatosis also induces skeletal muscle atrophy via effects on muscle protein turnover. To investigate this, eight-week-old male C57BL/6J mice were fed a chow (4.5% fat) or a high-fat diet (HFD; 45% fat) for 12 weeks to induce hepatic steatosis, after which the livers were excised and cut into ~200-µm slices. Slices were cultured to collect secretion products (conditioned medium; CM). Differentiated L6-GLUT4myc myotubes were incubated with chow or HFD CM to measure glucose uptake. Differentiated C2C12 myotubes were incubated with chow or HFD CM to measure protein synthesis and breakdown, and gene expression via RNA sequencing. Furthermore, proteomics analysis was performed in chow and HFD CM. It was found that HFD CM caused insulin resistance in L6-GLUT4myc myotubes compared with chow CM, as indicated by a blunted insulin-stimulated increase in glucose uptake. Furthermore, protein breakdown was increased in C2C12 cells incubated with HFD CM, while there was no effect on protein synthesis. RNA profiling of C2C12 cells indicated that 197 genes were differentially expressed after incubation with HFD CM, compared with chow CM, and pathway analysis showed that pathways related to anatomical structure and function were enriched. Proteomics analysis of the CM showed that 32 proteins were differentially expressed in HFD CM compared with chow CM. Pathway enrichment analysis indicated that these proteins had important functions with respect to insulin-like growth factor transport and uptake, and affect post-translational processes, including protein folding, protein secretion and protein phosphorylation. In conclusion, the results of this study support the hypothesis that secretion products from the liver contribute to the development of muscle atrophy in individuals with hepatic steatosis.
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Affiliation(s)
- Kenneth Pasmans
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Michiel E. Adriaens
- Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
| | - Peter Olinga
- Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands
| | - Ramon Langen
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Sander S. Rensen
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Frank G. Schaap
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - Steven W. M. Olde Damink
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - Florian Caiment
- Department of Toxicogenomics, School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, Netherlands
| | - Luc J. C. van Loon
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Ellen E. Blaak
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Ruth C. R. Meex
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- *Correspondence: Ruth C. R. Meex,
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Gonzales GB, Lelijveld N, Bourdon C, Chimwezi E, Nyirenda MJ, Wells JC, Kerac M, Bandsma RHJ. Childhood Malnutrition and Association of Lean Mass with Metabolome and Hormone Profile in Later Life. Nutrients 2020; 12:E3593. [PMID: 33238545 PMCID: PMC7700560 DOI: 10.3390/nu12113593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022] Open
Abstract
This study aimed to determine the associations of targeted metabolomics and hormone profiles data with lean mass index (LMI), which were estimated using bioelectrical impedance, in survivors of child severe malnutrition (SM) (n = 69) and controls (n = 77) in Malawi 7 years after being treated. Linear associations between individual metabolite or hormone and LMI were determined, including their interaction with nutrition status 7 years prior. Path analysis was performed to determine structural associations. Lastly, predictive models for LMI were developed using the metabolome and hormone profile by elastic net regularized regression (EN). Metabolites including several lipids, amino acids, and hormones were individually associated (p < 0.05 after false discovery rate correction) with LMI. However, plasma FGF21 (Control: β = -0.02, p = 0.59; Case: β = -0.14, p < 0.001) and tryptophan (Control: β = 0.15, p = 0.26; Case: β = 0.70, p < 0.001) were associated with LMI among cases but not among controls (both interaction p-values < 0.01). Moreover, path analysis revealed that tryptophan mediates the association between child SM and LMI. EN revealed that most predictors of LMI differed between groups, further indicating altered metabolic mechanisms driving lean mass accretion among SM survivors later in life.
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Affiliation(s)
- Gerard Bryan Gonzales
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, 6708 WE Wageningen, The Netherlands
- Laboratory of Gastroenterology, Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | | | - Celine Bourdon
- Translational Medicine Program, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (C.B.); (R.H.J.B.)
- The Childhood Acute Illness & Nutrition Network, Nairobi 43640-00100, Kenya
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S, Canada
| | - Emmanuel Chimwezi
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi;
| | | | - Jonathan C. Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK;
| | - Marko Kerac
- Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Robert H. J. Bandsma
- Translational Medicine Program, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (C.B.); (R.H.J.B.)
- The Childhood Acute Illness & Nutrition Network, Nairobi 43640-00100, Kenya
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S, Canada
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Morales-Suarez-Varela M, Peraita-Costa I, Guillamon Escudero C, Llopis-Morales A, Llopis-Gonzalez A. Total body skeletal muscle mass and diet in children aged 6-8 years: ANIVA Study. Appl Physiol Nutr Metab 2019; 44:944-951. [PMID: 31389713 DOI: 10.1139/apnm-2018-0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective was to assess if there was any relationship between the amount of skeletal muscle mass (SMM) in children aged 6-8 years and their nutritional intake. The Valencian Anthropometry and Child Nutrition (ANIVA) study is a cross-sectional study with children aged between 6-8 years (n = 1988) from schools in Valencia. Children were distributed into 4 groups for comparison: normal and high SMM and by sex. Anthropometric data were obtained following World Health Organization protocols. Nutritional intake was measured using a prospective 3-day food journal and the KIDMED questionnaire. Of the whole child sample, 63.9% had high SMM values. No differences were found in adherence to a Mediterranean diet or absolute energy intake. Significant differences were found in the proportion of energy intake in relation to estimated energy requirements and between nutritional intake of certain macro or micronutrients with SMM. This study provides values of SMM for children. Children's adherence to a Mediterranean diet was not related to total SMM. At the same time, the consumption of excess calories or overeating is associated with SMM, with those children overeating more having lower SMM values. The differences in the intake of the other macro- and micronutrients were not associated with children's SMM.
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Affiliation(s)
- Maria Morales-Suarez-Varela
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Isabel Peraita-Costa
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Carlos Guillamon Escudero
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain
| | - Agustin Llopis-Morales
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain
| | - Agustin Llopis-Gonzalez
- Public Health and Environmental Care Unit, Department of Preventive Medicine and Public Health, University of Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
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Pomeroy E, Mushrif-Tripathy V, Cole TJ, Wells JCK, Stock JT. Ancient origins of low lean mass among South Asians and implications for modern type 2 diabetes susceptibility. Sci Rep 2019; 9:10515. [PMID: 31324875 PMCID: PMC6642207 DOI: 10.1038/s41598-019-46960-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 07/05/2019] [Indexed: 12/21/2022] Open
Abstract
Living South Asians have low lean tissue mass relative to height, which contributes to their elevated type 2 diabetes susceptibility, particularly when accompanied by obesity. While ongoing lifestyle transitions account for rising obesity, the origins of low lean mass remain unclear. We analysed proxies for lean mass and stature among South Asian skeletons spanning the last 11,000 years (n = 197) to investigate the origins of South Asian low lean mass. Compared with a worldwide sample (n = 2,003), South Asian skeletons indicate low lean mass. Stature-adjusted lean mass increased significantly over time in South Asia, but to a very minor extent (0.04 z-score units per 1,000 years, adjusted R2 = 0.01). In contrast stature decreased sharply when agriculture was adopted. Our results indicate that low lean mass has characterised South Asians since at least the early Holocene and may represent long-term climatic adaptation or neutral variation. This phenotype is therefore unlikely to change extensively in the short term, so other strategies to address increasing non-communicable disease rates must be pursued.
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Affiliation(s)
- Emma Pomeroy
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge, CB2 3DZ, UK.
| | - Veena Mushrif-Tripathy
- Department of Archaeology, Deccan College Postgraduate and Research Institute, Yerwada, Pune, 411 006, India
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Jay T Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology, University of Cambridge, Pembroke Street, Cambridge, CB2 3DZ, UK
- Department of Anthropology, University of Western Ontario, London, Ontario, N6A 5C2, Canada
- Department of Archaeology, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, Jena, Germany, Jena, Germany
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Shirley MK, Arthurs OJ, Seunarine KK, Cole TJ, Eaton S, Williams JE, Clark CA, Wells JCK. Metabolic rate of major organs and tissues in young adult South Asian women. Eur J Clin Nutr 2018; 73:1164-1171. [PMID: 30405209 PMCID: PMC6373842 DOI: 10.1038/s41430-018-0362-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/18/2018] [Accepted: 10/22/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Major organ-specific and tissue-specific metabolic rate (Ki) values were initially estimated using in vivo methods, and values reported by Elia (Energy metabolism: tissue determinants and cellular corollaries, Raven Press, New York, 1992) were subsequently supported by statistical analysis. However, the majority of work to date on this topic has addressed individuals of European descent, whereas population variability in resting energy metabolism has been reported. We aimed to estimate Ki values in South Asian females. SUBJECTS/METHODS This cross-sectional study recruited 70 healthy young women of South Asian ancestry. Brain and organs were measured using magnetic resonance imaging, skeletal muscle mass by dual-energy X-ray absorptiometry, fat mass by the 4-component model, and whole-body resting energy expenditure by indirect calorimetry. Organ and tissue Ki values were estimated indirectly using regression analysis through the origin. Preliminary analysis suggested overestimation of heart mass, hence the modeling was repeated with a literature-based 22.5% heart mass reduction. RESULTS The pattern of derived Ki values across organs and tissues matched that previously estimated in vivo, but the values were systematically lower. However, adjusting for the overestimation of heart mass markedly improved the agreement. CONCLUSIONS Our results support variability in Ki values among organs and tissues, where some are more metabolically "expensive" than others. Initial findings suggesting lower organ/tissue Ki values in South Asian women were likely influenced by heart mass estimation bias. The question of potential ethnic variability in organ-specific and tissue-specific energy metabolism requires further investigation.
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Affiliation(s)
| | - Owen J Arthurs
- UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Radiology, Great Ormond Street Hospital, London, UK
| | | | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Simon Eaton
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jane E Williams
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chris A Clark
- UCL Great Ormond Street Institute of Child Health, London, UK
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Pomeroy E, Macintosh A, Wells JC, Cole TJ, Stock JT. Relationship between body mass, lean mass, fat mass, and limb bone cross-sectional geometry: Implications for estimating body mass and physique from the skeleton. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:56-69. [PMID: 29344931 PMCID: PMC6178563 DOI: 10.1002/ajpa.23398] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Estimating body mass from skeletal dimensions is widely practiced, but methods for estimating its components (lean and fat mass) are poorly developed. The ability to estimate these characteristics would offer new insights into the evolution of body composition and its variation relative to past and present health. This study investigates the potential of long bone cross-sectional properties as predictors of body, lean, and fat mass. MATERIALS AND METHODS Humerus, femur and tibia midshaft cross-sectional properties were measured by peripheral quantitative computed tomography in sample of young adult women (n = 105) characterized by a range of activity levels. Body composition was estimated from bioimpedance analysis. RESULTS Lean mass correlated most strongly with both upper and lower limb bone properties (r values up to 0.74), while fat mass showed weak correlations (r ≤ 0.29). Estimation equations generated from tibial midshaft properties indicated that lean mass could be estimated relatively reliably, with some improvement using logged data and including bone length in the models (minimum standard error of estimate = 8.9%). Body mass prediction was less reliable and fat mass only poorly predicted (standard errors of estimate ≥11.9% and >33%, respectively). DISCUSSION Lean mass can be predicted more reliably than body mass from limb bone cross-sectional properties. The results highlight the potential for studying evolutionary trends in lean mass from skeletal remains, and have implications for understanding the relationship between bone morphology and body mass or composition.
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Affiliation(s)
- Emma Pomeroy
- School of Natural Sciences and PsychologyLiverpool John Moores UniversityLiverpool, L3 3AFUnited Kingdom
| | - Alison Macintosh
- ADaPt Project, PAVE Research Group, Department of Archaeology and AnthropologyUniversity of CambridgeCambridge, CB2 3QGUnited Kingdom
| | - Jonathan C.K. Wells
- UCL Great Ormond Street Institute of Child HealthLondon, WC1N 1EHUnited Kingdom
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child HealthLondon, WC1N 1EHUnited Kingdom
| | - Jay T. Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology and AnthropologyUniversity of CambridgeCambridge, CB2 3QGUnited Kingdom
- Department of AnthropologyUniversity of Western OntarioLondonOntario, N6A 3K7Canada
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11
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Nakadate Y, Sato H, Sato T, Codere-Maruyama T, Matsukawa T, Schricker T. Body mass index predicts insulin sensitivity during cardiac surgery: a prospective observational study. Can J Anaesth 2018; 65:551-559. [DOI: 10.1007/s12630-018-1081-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/28/2017] [Accepted: 12/30/2017] [Indexed: 01/08/2023] Open
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12
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Yang CW, Li CI, Li TC, Liu CS, Lin CH, Lin WY, Lin CC. The joint association of insulin sensitivity and physical activity on the skeletal muscle mass and performance in community-dwelling older adults. Exp Gerontol 2017; 95:34-38. [DOI: 10.1016/j.exger.2017.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/16/2017] [Accepted: 05/05/2017] [Indexed: 12/22/2022]
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13
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Nagrani R, Mhatre S, Rajaraman P, Soerjomataram I, Boffetta P, Gupta S, Parmar V, Badwe R, Dikshit R. Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity. Eur J Cancer 2016; 66:153-61. [PMID: 27573429 PMCID: PMC5040194 DOI: 10.1016/j.ejca.2016.07.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Current evidence suggests that the relationship between obesity and breast cancer (BC) risk may vary between ethnic groups. METHODS A total of 1633 BC cases and 1504 controls were enrolled in hospital-based case-control study in Mumbai, India, from 2009 to 2013. Along with detailed questionnaire, we collected anthropometric measurements on all participants. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence interval (CI) for BC risk associated with anthropometry measurements, stratified on tumour subtype and menopausal status. RESULTS Waist-to-hip ratio (WHR) of ≥0.95 was strongly associated with risk of BC compared to WHR ≤0.84 in both premenopausal (OR = 4.3; 95% CI: 2.9-6.3) and postmenopausal women (OR = 3.4; 95% CI: 2.4-4.8) after adjustment for body mass index (BMI). Premenopausal women with a BMI ≥30 were at lower risk compared to women with normal BMI (OR = 0.5; 95% CI: 0.4-0.8). A similar protective effect was observed in women who were postmenopausal for <10 years (OR = 0.6; 95% CI: 0.4-0.9) but not in women who were postmenopausal for ≥10 years (OR = 1.8; 95% CI: 1.1-3.3). Overweight and obese women (BMI: 25-29.9 and ≥ 30 kg/m(2), respectively) were at increased BC risk irrespective of menopausal status if their WHR ≥0.95. Central obesity (measured in terms of WC and WHR) increased the risk of both premenopausal and postmenopausal BCs irrespective of hormone receptor (HR) status. CONCLUSIONS Central obesity appears to be a key risk factor for BC irrespective of menopausal or HR status in Indian women with no history of hormone replacement therapy.
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Affiliation(s)
- R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India
| | - S Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India
| | - P Rajaraman
- Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA
| | - I Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX, France
| | - P Boffetta
- Institute For Translational Epidemiology, Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA
| | - S Gupta
- Advanced Centre for Treatment, Research and Education in Cancer, Navi Mumbai, Maharashtra 400 012, India
| | - V Parmar
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra 400 012, India
| | - R Badwe
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra 400 012, India
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India.
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14
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Wells JCK, Pomeroy E, Walimbe SR, Popkin BM, Yajnik CS. The Elevated Susceptibility to Diabetes in India: An Evolutionary Perspective. Front Public Health 2016; 4:145. [PMID: 27458578 PMCID: PMC4935697 DOI: 10.3389/fpubh.2016.00145] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/24/2016] [Indexed: 01/11/2023] Open
Abstract
India has rapidly become a "diabetes capital" of the world, despite maintaining high rates of under-nutrition. Indians develop diabetes at younger age and at lower body weights than other populations. Here, we interpret these characteristics in terms of a "capacity-load" model of glucose homeostasis. Specifically, we assume that glycemic control depends on whether the body's "metabolic capacity," referring to traits, such as pancreatic insulin production and muscle glucose clearance, is able to resolve the "metabolic load" generated by high levels of body fat, high dietary glycemic load, and sedentary behavior. We employ data from modern cohorts to support the model and the interpretation that elevated diabetic risk among Indian populations results from the high metabolic load imposed by westernized lifestyles acting on a baseline of low metabolic capacity. We attribute this low metabolic capacity to the low birth weight characteristic of Indian populations, which is associated with short stature and low lean mass in adult life. Using stature as a marker of metabolic capacity, we review archeological and historical evidence to highlight long-term declines in Indian stature associated with adaptation to several ecological stresses. Underlying causes may include increasing population density following the emergence of agriculture, the spread of vegetarian diets, regular famines induced by monsoon failure, and the undermining of agricultural security during the colonial period. The reduced growth and thin physique that characterize Indian populations elevate susceptibility to truncal obesity, and increase the metabolic penalties arising from sedentary behavior and high glycemic diets. Improving metabolic capacity may require multiple generations; in the meantime, efforts to reduce the metabolic load will help ameliorate the situation.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health , London , UK
| | - Emma Pomeroy
- McDonald Institute for Archaeological Research, University of Cambridge , Cambridge , UK
| | | | - Barry M Popkin
- Nutrition Department, Gillings Global School of Public Health, University of North Carolina School of Public Health , Chapel Hill, NC , USA
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15
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Eastwood SV, Tillin T, Wright A, Mayet J, Godsland I, Forouhi NG, Whincup P, Hughes AD, Chaturvedi N. Thigh fat and muscle each contribute to excess cardiometabolic risk in South Asians, independent of visceral adipose tissue. Obesity (Silver Spring) 2014; 22:2071-9. [PMID: 24862429 PMCID: PMC4150020 DOI: 10.1002/oby.20796] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 05/09/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To compare fat distribution and associations between fat depots and cardiometabolic traits in South Asians and Europeans. METHODS Five hundred and fourteen South Asians and 669 Europeans, aged 56-86. Questionnaires, record review, blood testing, and coronary artery calcification scores provided diabetes and clinical plus subclinical coronary heart disease (CHD) diagnoses. Abdominal visceral (VAT) and subcutaneous adipose tissue, thigh subcutaneous adipose tissue (TSAT), intermuscular and intramuscular thigh fat and thigh muscle were measured by CT. RESULTS Accounting for body size, South Asians had greater VAT and TSAT than Europeans, but less thigh muscle. Associations between depots and disease were stronger in South Asians than Europeans. In multivariable analyses in South Asians, VAT was positively associated with diabetes and CHD, while TSAT and thigh muscle were protective for diabetes, and thigh muscle for CHD. Differences in VAT and thigh muscle only partially explained the excess diabetes and CHD in South Asians versus Europeans. Insulin resistance did not account for the effects of TSAT or thigh muscle. CONCLUSIONS Greater VAT and TSAT and lesser thigh muscle in South Asians contributed to ethnic differences in cardiometabolic disease. Effects of TSAT and thigh muscle were independent of insulin resistance.
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Affiliation(s)
- Sophie V Eastwood
- National Heart and Lung Institute, Imperial College LondonLondon, UK
- Correspondence: Sophie V. Eastwood ()
| | - Therese Tillin
- National Heart and Lung Institute, Imperial College LondonLondon, UK
| | - Andrew Wright
- Department of Medicine, Imperial College Healthcare NHS TrustLondon, UK
| | - Jamil Mayet
- National Heart and Lung Institute, Imperial College LondonLondon, UK
| | - Ian Godsland
- Department of Endocrinology and Metabolic Medicine, Imperial College LondonUK
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of CambridgeCambridge, UK
| | - Peter Whincup
- Division of Population Health Sciences and Education, St. George's University of LondonLondon, UK
| | - Alun D Hughes
- National Heart and Lung Institute, Imperial College LondonLondon, UK
| | - Nishi Chaturvedi
- National Heart and Lung Institute, Imperial College LondonLondon, UK
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Cohen DD, Gómez-Arbeláez D, Camacho PA, Pinzon S, Hormiga C, Trejos-Suarez J, Duperly J, Lopez-Jaramillo P. Low muscle strength is associated with metabolic risk factors in Colombian children: the ACFIES study. PLoS One 2014; 9:e93150. [PMID: 24714401 PMCID: PMC3979680 DOI: 10.1371/journal.pone.0093150] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/28/2014] [Indexed: 01/23/2023] Open
Abstract
Purpose In youth, poor cardiorespiratory and muscular strength are associated with elevated metabolic risk factors. However, studies examining associations between strength and risk factors have been done exclusively in high income countries, and largely in Caucasian cohorts. The aim of this study was to assess these interactions in schoolchildren in Colombia, a middle income Latin American country. Methods We measured body mass index, body composition, handgrip strength (HG), cardiorespiratory fitness (CRF) and metabolic risk factors in 669 low-middle socioeconomic status Colombian schoolchildren (mean age 11.52±1.13, 47% female). Associations between HG, CRF and metabolic risk factors were evaluated. Results HG and CRF were inversely associated with blood pressure, HOMA index and a composite metabolic risk score (p<0.001 for all) and HG was also inversely associated with triglycerides and C-reactive protein (CRP) (both p<0.05). Associations between HG and risk factors were marginally weakened after adjusting for CRF, while associations between CRF and these factors were substantially weakened after adjusting for HG. Linear regression analyses showed inverse associations between HG and systolic BP (β = −0.101; p = 0.047), diastolic BP (β = −0.241; p> = 0.001), HOMA (β = −0.164; p = 0.005), triglycerides (β = −0.583; p = 0.026) and CRP (β = −0.183; p = 0.037) but not glucose (p = 0.698) or HDL cholesterol (p = 0.132). The odds ratios for having clustered risk in the weakest quartile compared with the strongest quartile were 3.0 (95% confidence interval: 1.81–4.95). Conclusions In Colombian schoolchildren both poorer handgrip strength/kg body mass and cardiorespiratory fitness were associated with a worse metabolic risk profile. Associations were stronger and more consistent between handgrip and risk factors than between cardiorespiratory fitness and these risk factors. Our findings indicate the addition of handgrip dynamometry to non-invasive youth health surveillance programs would improve the accuracy of the assessment of cardio-metabolic health.
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Affiliation(s)
- Daniel Dylan Cohen
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
- Facultad de la Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Diego Gómez-Arbeláez
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
- Facultad de la Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Paul Anthony Camacho
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - Sandra Pinzon
- Facultad de la Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Claudia Hormiga
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - Juanita Trejos-Suarez
- Facultad de la Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - John Duperly
- Facultad de Medicina, Universidad de Los Andes, Bogota, Colombia
| | - Patricio Lopez-Jaramillo
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
- Facultad de la Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
- * E-mail:
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Kulkarni B, Kuper H, Radhakrishna KV, Hills AP, Byrne NM, Taylor A, Sullivan R, Bowen L, Wells JC, Ben-Shlomo Y, Davey Smith G, Ebrahim S, Kinra S. The association of early life supplemental nutrition with lean body mass and grip strength in adulthood: evidence from APCAPS. Am J Epidemiol 2014; 179:700-9. [PMID: 24553777 PMCID: PMC3939852 DOI: 10.1093/aje/kwt332] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In the present study, we examined the associations of early nutrition with adult lean body mass (LBM) and muscle strength in a birth cohort that was established to assess the long-term impact of a nutrition program. Participants (n = 1,446, 32% female) were born near Hyderabad, India, in 29 villages from 1987 to 1990, during which time only intervention villages (n = 15) had a government program that offered balanced protein-calorie supplementation to pregnant women and children. Participants’ LBM and appendicular skeletal muscle mass were measured using dual energy x-ray absorptiometry; grip strength and information on lifestyle indicators, including diet and physical activity level, were also obtained. Ages (mean = 20.3 years) and body mass indexes (weight (kg)/height (m)2; mean = 19.5) of participants in 2 groups were similar. Current dietary energy intake was higher in the intervention group. Unadjusted LBM and grip strength were similar in 2 groups. After adjustment for potential confounders, the intervention group had lower LBM (β = −0.75; P = 0.03), appendicular skeletal muscle mass, and grip strength than did controls, but these differences were small in magnitude (<0.1 standard deviation). Multivariable regression analyses showed that current socioeconomic position, energy intake, and physical activity level had a positive association with adult LBM and muscle strength. This study could not detect a “programming” effect of early nutrition supplementation on adult LBM and muscle strength.
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Affiliation(s)
- Bharati Kulkarni
- Correspondence to Dr. Bharati Kulkarni, Clinical Division, National Institute of Nutrition, Jamai Osmania P.O., Hyderabad 500007 India (e-mail: )
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18
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Ostler JE, Maurya SK, Dials J, Roof SR, Devor ST, Ziolo MT, Periasamy M. Effects of insulin resistance on skeletal muscle growth and exercise capacity in type 2 diabetic mouse models. Am J Physiol Endocrinol Metab 2014; 306:E592-605. [PMID: 24425761 PMCID: PMC3948983 DOI: 10.1152/ajpendo.00277.2013] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Type 2 diabetes mellitus is associated with an accelerated muscle loss during aging, decreased muscle function, and increased disability. To better understand the mechanisms causing this muscle deterioration in type 2 diabetes, we assessed muscle weight, exercise capacity, and biochemistry in db/db and TallyHo mice at prediabetic and overtly diabetic ages. Maximum running speeds and muscle weights were already reduced in prediabetic db/db mice when compared with lean controls and more severely reduced in the overtly diabetic db/db mice. In contrast to db/db mice, TallyHo muscle size dramatically increased and maximum running speed was maintained during the progression from prediabetes to overt diabetes. Analysis of mechanisms that may contribute to decreased muscle weight in db/db mice demonstrated that insulin-dependent phosphorylation of enzymes that promote protein synthesis was severely blunted in db/db muscle. In addition, prediabetic (6-wk-old) and diabetic (12-wk-old) db/db muscle exhibited an increase in a marker of proteasomal protein degradation, the level of polyubiquitinated proteins. Chronic treadmill training of db/db mice improved glucose tolerance and exercise capacity, reduced markers of protein degradation, but only mildly increased muscle weight. The differences in muscle phenotype between these models of type 2 diabetes suggest that insulin resistance and chronic hyperglycemia alone are insufficient to rapidly decrease muscle size and function and that the effects of diabetes on muscle growth and function are animal model-dependent.
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MESH Headings
- Animals
- Animals, Outbred Strains
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Disease Models, Animal
- Hypoglycemic Agents/therapeutic use
- Insulin/therapeutic use
- Insulin Resistance
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Motor Activity
- Muscle Development/drug effects
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/pathology
- Phosphorylation/drug effects
- Physical Endurance/drug effects
- Prediabetic State/complications
- Prediabetic State/drug therapy
- Prediabetic State/metabolism
- Prediabetic State/pathology
- Proteasome Endopeptidase Complex/drug effects
- Proteasome Endopeptidase Complex/metabolism
- Protein Processing, Post-Translational/drug effects
- Sarcopenia/complications
- Sarcopenia/prevention & control
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Affiliation(s)
- Joseph E Ostler
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, Ohio; and
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Wells JCK, Cole TJ. Height, adiposity and hormonal cardiovascular risk markers in childhood: how to partition the associations? Int J Obes (Lond) 2014; 38:930-5. [PMID: 24509503 PMCID: PMC4088335 DOI: 10.1038/ijo.2014.24] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 01/14/2014] [Accepted: 01/17/2014] [Indexed: 01/19/2023]
Abstract
Objective: Obesity is associated with rapid growth during childhood. There is uncertainty over how to adjust for body size, when using adiposity as a proxy for cardiovascular risk. We studied associations of height, body composition (by dual-energy X-ray absorptiometry) and cardiovascular risk markers (insulin resistance (IR), leptin) in children. Methods: Using partial correlations in 172 children aged 7–12 years, we investigated associations of (a) fat mass with IR or leptin, adjusting for height or lean mass, and (b) height or lean mass with IR or leptin, adjusting for fat mass. Analyses were conducted both cross-sectionally at each age, and for changes between 7 and 12 years. Results: Height, fat mass, lean mass, IR and leptin were all inter-correlated at all ages. Although fat mass was strongly associated with IR and leptin, height was independently negatively associated with leptin (whole sample, adjusting for age: boys r=−0.12, girls r=−0.13; P<0.001). Independent of adiposity, height was also associated with insulin IR (whole sample, adjusting for age: boys r=0.11, girls r=0.20; P<0.001). When analysed by year of age, these associations tended to remain significant at older ages. Change in height from 7 to 12 years was also associated with change in IR (boys: r=0.18, P<0.05; girls: r=0.34, P<0.01), independently of change in adiposity, with similar findings for lean mass. Conclusions: During childhood, markers of cardiovascular risk have a complex profile, associated with growth as well as fat accumulation. Taller and faster-growing children have elevated risk markers, independently of their adiposity. These findings have implications for the interpretation of pediatric indices of adiposity that aim to adjust for body size. Adiposity indices that perform best at summarizing metabolic risk may not be those that perform best at understanding the developmental aetiology of risk.
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Affiliation(s)
- J C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - T J Cole
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, University College, London, UK
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Bakker LEH, Sleddering MA, Schoones JW, Meinders AE, Jazet IM. Pathogenesis of type 2 diabetes in South Asians. Eur J Endocrinol 2013; 169:R99-R114. [PMID: 23939919 DOI: 10.1530/eje-13-0307] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The risk of developing type 2 diabetes mellitus (T2DM) is exceptionally high among both native and migrant South Asians. T2DM occurs more often and at a younger age and lower BMI, and the risk of coronary artery and cerebrovascular disease, and renal complications is higher for South Asians compared with people of White Caucasian descent. The high prevalence of T2DM and its related complications in South Asians, which comprise one-fifth of the total world's population, poses a major health and socioeconomic burden. The underlying cause of this excess risk, however, is still not completely understood. Therefore, gaining insight into the pathogenesis of T2DM in South Asians is of great importance. The predominant mechanism, in this ethnicity seems to be insulin resistance (IR) rather than an impaired β-cell function. In this systematic review, we describe several possible mechanisms that may underlie or contribute to the increased IR observed in South Asians.
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Affiliation(s)
- Leontine E H Bakker
- Department of General Internal Medicine and Endocrinology Walaeus Library, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
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Are ethnic and gender specific equations needed to derive fat free mass from bioelectrical impedance in children of South asian, black african-Caribbean and white European origin? Results of the assessment of body composition in children study. PLoS One 2013; 8:e76426. [PMID: 24204625 PMCID: PMC3799736 DOI: 10.1371/journal.pone.0076426] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 08/26/2013] [Indexed: 12/01/2022] Open
Abstract
Background Bioelectrical impedance analysis (BIA) is a potentially valuable method for assessing lean mass and body fat levels in children from different ethnic groups. We examined the need for ethnic- and gender-specific equations for estimating fat free mass (FFM) from BIA in children from different ethnic groups and examined their effects on the assessment of ethnic differences in body fat. Methods Cross-sectional study of children aged 8–10 years in London Primary schools including 325 South Asians, 250 black African-Caribbeans and 289 white Europeans with measurements of height, weight and arm-leg impedance (Z; Bodystat 1500). Total body water was estimated from deuterium dilution and converted to FFM. Multilevel models were used to derive three types of equation {A: FFM = linear combination(height+weight+Z); B: FFM = linear combination(height2/Z); C: FFM = linear combination(height2/Z+weight)}. Results Ethnicity and gender were important predictors of FFM and improved model fit in all equations. The models of best fit were ethnicity and gender specific versions of equation A, followed by equation C; these provided accurate assessments of ethnic differences in FFM and FM. In contrast, the use of generic equations led to underestimation of both the negative South Asian-white European FFM difference and the positive black African-Caribbean-white European FFM difference (by 0.53 kg and by 0.73 kg respectively for equation A). The use of generic equations underestimated the positive South Asian-white European difference in fat mass (FM) and overestimated the positive black African-Caribbean-white European difference in FM (by 4.7% and 10.1% respectively for equation A). Consistent results were observed when the equations were applied to a large external data set. Conclusions Ethnic- and gender-specific equations for predicting FFM from BIA provide better estimates of ethnic differences in FFM and FM in children, while generic equations can misrepresent these ethnic differences.
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Trikudanathan S, Raji A, Chamarthi B, Seely EW, Simonson DC. Comparison of insulin sensitivity measures in South Asians. Metabolism 2013; 62:1448-54. [PMID: 23906497 PMCID: PMC3889665 DOI: 10.1016/j.metabol.2013.05.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/15/2013] [Accepted: 05/28/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE South Asians have increased visceral adiposity, insulin resistance and greater prevalence of type 2 diabetes and cardiovascular disease when compared to Caucasians of European origin. Surrogate markers of insulin resistance such as the composite insulin sensitivity (Matsuda) index correlate with glucose clamps in other populations, but ethnicity can affect these indices. We compared the Matsuda index, homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and triglyceride/HDL ratio to insulin sensitivity derived from euglycemic clamps in healthy South Asians and Caucasians. MATERIALS/METHODS Twenty-three healthy South Asians and 18 Caucasians matched for age (mean±SE=33.6±2.1 vs. 36.0±3.0 years) and BMI (25.2±1.1 vs. 24.6±0.9 kg/m(2)) underwent 75 g oral glucose tolerance test (OGTT), 2-h euglycemic hyperinsulinemic clamp (240 pmol·m(-2)·min(-1)), fasting lipid profile, and anthropometric measures. RESULTS South Asians had higher fasting insulin (41±5 vs. 21±2 pmol/l; p=0.002) and lower HDL-C (1.25±0.06 vs. 1.56±0.10 mmol/l; p=0.010), but similar fasting glucose (5.0±0.1 vs. 4.9±0.1 mmol/l) levels vs. Caucasians. South Asians had significantly decreased measures of insulin sensitivity derived from both the euglycemic clamp (24.9±1.3 vs. 41.4±1.9 μmol·kg(-1)·min(-1); p<0.0001) and OGTT (Matsuda Index 7.60±0.99 vs. 13.60±1.79; p=0.004). The Matsuda index correlated highly with clamp insulin sensitivity in South Asians (r=0.50; p=0.014) and Caucasians (r=0.47; p=0.046). HOMA-IR, QUICKI, and triglyceride/HDL ratio correlated with clamp values in South Asians, but not in Caucasians. CONCLUSIONS In South Asians, Matsuda index, HOMA-IR, QUICKI, and triglyceride/HDL ratio offer simple and valid surrogate measures of insulin sensitivity that can be employed in larger clinical or epidemiological studies in this ethnic group.
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Affiliation(s)
- Subbulaxmi Trikudanathan
- Division of Endocrinology, Diabetes Hypertension Department of Medicine Brigham Women's Hospital Harvard Medical School, Boston, MA
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Nightingale CM, Rudnicka AR, Owen CG, Wells JCK, Sattar N, Cook DG, Whincup PH. Influence of adiposity on insulin resistance and glycemia markers among U.K. Children of South Asian, black African-Caribbean, and white European origin: child heart and health study in England. Diabetes Care 2013; 36:1712-9. [PMID: 23315600 PMCID: PMC3661837 DOI: 10.2337/dc12-1726] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Ethnic differences in type 2 diabetes risk between South Asians and white Europeans originate before adult life and are not fully explained by higher adiposity levels in South Asians. Although metabolic sensitivity to adiposity may differ between ethnic groups, this has been little studied in childhood. We have therefore examined the associations among adiposity, insulin resistance, and glycemia markers in children of different ethnic origins. RESEARCH DESIGN AND METHODS Cross-sectional study of 4,633 9- to 10-year-old children (response rate 68%) predominantly of South Asian, black African-Caribbean, and white European origin (n = 1,266, 1,176, and 1,109, respectively) who had homeostasis model assessments of insulin resistance (HOMA-IR), glycemia markers (HbA1c and fasting glucose), and adiposity (BMI, waist circumference, skinfold thicknesses, and bioimpedance [fat mass]). RESULTS All adiposity measures were positively associated with HOMA-IR in all ethnic groups, but associations were stronger among South Asians compared to black African-Caribbeans and white Europeans. For a 1-SD increase in fat mass percentage, percentage differences in HOMA-IR were 37.5% (95% CI 33.3-41.7), 29.7% (25.8-33.8), and 27.0% (22.9-31.2), respectively (P interaction < 0.001). All adiposity markers were positively associated with HbA1c in South Asians and black African-Caribbeans but not in white Europeans; for a 1-SD increase in fat mass percentage, percentage differences in HbA1c were 0.04% (95% CI 0.03-0.06), 0.04% (0.02-0.05), and 0.02% (-0.00 to 0.04), respectively (P interaction < 0.001). Patterns for fasting glucose were less consistent. CONCLUSIONS South Asian children are more metabolically sensitive to adiposity. Early prevention or treatment of childhood obesity may be critical for type 2 diabetes prevention, especially in South Asians.
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Affiliation(s)
- Claire M Nightingale
- Division of Population Health Sciences and Education, St George’s, University of London, London, UK.
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The effect of a controlled 8-week metabolic ward based lysine supplementation on muscle function, insulin sensitivity and leucine kinetics in young men. Clin Nutr 2012; 31:903-10. [DOI: 10.1016/j.clnu.2012.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/07/2012] [Accepted: 03/24/2012] [Indexed: 11/15/2022]
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Kim J. Gender Difference in Association Between Appendicular Skeletal Muscle Mass and Cardiometabolic Abnormalities in Normal-Weight and Obese Adults. Asia Pac J Public Health 2012. [DOI: 10.1177/1010539512466912] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The objective of this study was to investigate whether the relationships of appendicular muscle mass (ASM) with insulin resistance (IR) and metabolic syndrome (MS) vary by gender or obesity. Data of 10 146 normal-weight and obese men and women aged 19 to 93 years from the Korea National Health and Nutrition Examination Survey in 2009 and 2010 were analyzed. In normal-weight men and women, unadjusted odds ratio (OR) of being MS and IR significantly increased with lower ASM/wt. After adjusting for lifestyle factors, these ORs were still significant in normal-weight men but not in women. After controlling for other covariates, lower ASM/wt was related to higher risk for IR but not to MS in obese men. In obese women, relationship of lower ASM/wt with higher risk for MS disappeared after adjusting for covariates. Association between skeletal muscle mass and cardiometabolic abnormalities is dependent on gender and obesity in Korean adults.
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Bhatt SP, Nigam P, Misra A, Guleria R, Luthra K, Jain SK, Qadar Pasha MA. Association of the Myostatin gene with obesity, abdominal obesity and low lean body mass and in non-diabetic Asian Indians in north India. PLoS One 2012; 7:e40977. [PMID: 22916099 PMCID: PMC3423417 DOI: 10.1371/journal.pone.0040977] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 06/20/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To determine the association of the A55T and K153R polymorphisms of the Myostatin gene with obesity, abdominal obesity and lean body mass (LBM) in Asian Indians in north India. MATERIALS AND METHODS A total of 335 subjects (238 men and 97 women) were assessed for anthropometry, % body fat (BF), LBM and biochemical parameters. Associations of Myostatin gene polymorphisms were evaluated with anthropometric, body composition and biochemical parameters. In A55T polymorphism, BMI (p=0.04), suprailiac skinfold (p=0.05), total skinfold (p=0.008), %BF (p=0.002) and total fat mass (p=0.003) were highest and % LBM (p=0.03) and total LBM (Kg) were lowest (p=0.04) in subjects with Thr/Thr genotype as compared to other genotypes. Association analysis of K153R polymorphism showed that subjects with R/R genotype had significantly higher BMI (p=0.05), waist circumference (p=0.04), %BF (p=0.04) and total fat mass (p=0.03), and lower %LBM (p=0.02) and total LBM [(Kg), (p=0.04)] as compared to other genotypes. Using a multivariate logistic regression model after adjusting for age and sex, subjects with Thr/Thr genotype of A55T showed high risk for high %BF (OR, 3.92, 95% Cl: 2.61-12.41), truncal subcutaneous adiposity (OR, 2.9, 95% Cl: 1.57-6.60)] and low LBM (OR, 0.64, 95% CI: 0.33-0.89) whereas R/R genotype of K153R showed high risk of obesity (BMI; OR, 3.2, 95% CI: 1.2-12.9; %BF, OR, 3.6, 95% CI: 1.04-12.4), abdominal obesity (OR, 2.12, 95% CI: 2.71-14.23) and low LBM (OR, 0.61, 95% CI: 0.29-0.79). CONCLUSIONS/SIGNIFICANCE We report that variants of Myostatin gene predispose to obesity, abdominal obesity and low lean body mass in Asian Indians in north India.
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Affiliation(s)
- Surya Prakash Bhatt
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Nigam
- Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
| | - Anoop Misra
- Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, Chirag Enclave, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S. K. Jain
- Department of Biotechnology, Jamia Hamdard, New Delhi, India
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Lin SL, Lee SL, Hui LL, Au Yeung SL, Tse MA, Leung GM, Schooling CM. Pubertal muscle mass and diabetes markers in Chinese adolescents. Am J Hum Biol 2012; 24:183-5. [PMID: 22287498 DOI: 10.1002/ajhb.22210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 09/30/2011] [Accepted: 11/16/2011] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Diabetes is common in China despite a relatively nonobese population. We hypothesized that testosterone driven muscle mass acquisition at puberty may be relevant. We examined the associations of testosterone with muscle mass and of muscle mass with fasting glucose in Chinese adolescents. METHODS In 40 adolescents (20 boys and 20 girls, age 12.9 ± 0.1 years) from Hong Kong's "Children of 1997" birth cohort, we used multivariable linear regression to assess adjusted associations of testosterone and fasting glucose (from a morning blood sample) with muscle and fat mass from a dual-energy X-ray absorptiometry scan. RESULTS Testosterone was positively associated with muscle mass (0.05 kg, 95% confidence interval (CI) 0.01 to 0.09, per pg/ml testosterone). Muscle mass was associated with lower glucose (-0.04 mmol/l, 95% CI -0.08 to -0.01 per kg muscle mass) adjusted for sex and fat mass. CONCLUSIONS Environmentally driven muscle mass acquisition at puberty could influence diabetes.
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Affiliation(s)
- Shi Lin Lin
- Life Course and Lifestyle Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
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Muscular strength and markers of insulin resistance in European adolescents: the HELENA Study. Eur J Appl Physiol 2011; 112:2455-65. [PMID: 22052103 DOI: 10.1007/s00421-011-2216-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 10/17/2011] [Indexed: 01/01/2023]
Abstract
The aim of the study was to examine the association of muscular strength with markers of insulin resistance in European adolescents. The study comprised a total of 1,053 adolescents (499 males; 12.5-17.5 years) from ten European cities participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study. Muscular strength was measured by the handgrip strength and standing long jump tests. Cardiorespiratory fitness was measured by the 20-m shuttle run test. Fasting insulin and glucose were measured and the homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) indices were calculated. Weight, height, waist circumference and skinfold thickness were measured, and body mass index (BMI) was calculated. In males, the handgrip strength and standing long jump tests were negatively associated with fasting insulin and HOMA (all P < 0.05) after controlling for pubertal status, country and BMI or waist circumference. When skinfold thickness was included in the model, the association became non-significant. In females, the standing long jump test was negatively associated with fasting insulin and HOMA (all P < 0.001) after controlling for pubertal status, country and surrogate markers of total or central body fat (BMI, waist circumference or skinfold thickness). Findings were retained in males, but not in females after controlling for cardiorespiratory fitness. The findings of the present study suggest that preventive strategies should focus not only on decreasing fatness and increasing cardiorespiratory fitness but also on enhancing muscular strength.
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Abstract
PURPOSE OF REVIEW There has been a great deal of interest in the thin-fat phenotype evident in Asian Indians and its risk associations in the epidemic of noncommunicable chronic disease associated with it. The cause of this phenotype is probably related to lifestyle and environment; however, genotypic and epigenetic modifications in utero also have been considered. RECENT FINDINGS The thin-fat phenotype occurs when fat is added to an already thin frame. This may occur with rural-urban migration, when positive energy balance occurs in a migrating population who were predominantly thin and physically active to begin with. The role of the pre-existing skeletal muscle mass and its interaction with newly deposited fat must be considered. The thin-fat phenotype may be programmed during fetal growth, but the evidence for this phenomenon is still not completely clear. Finally, although there is increased chronic disease morbidity at lower BMI and younger age in south Asian populations, BMI-related mortality does not appear to follow this trend. SUMMARY At present, the weight of evidence appears to link the thin-fat phenotype to an environmental and lifestyle phenomenon occurring in previously thin people. This is particularly relevant in India, given the pace of transition over the last two decades.
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Affiliation(s)
- Anura V Kurpad
- St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India.
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Muniyappa R, Irving BA, Unni US, Briggs WM, Nair KS, Quon MJ, Kurpad AV. Limited predictive ability of surrogate indices of insulin sensitivity/resistance in Asian-Indian men. Am J Physiol Endocrinol Metab 2010; 299:E1106-12. [PMID: 20943755 PMCID: PMC3006259 DOI: 10.1152/ajpendo.00454.2010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Insulin resistance is highly prevalent in Asian Indians and contributes to worldwide public health problems, including diabetes and related disorders. Surrogate measurements of insulin sensitivity/resistance are used frequently to study Asian Indians, but these are not formally validated in this population. In this study, we compared the ability of simple surrogate indices to accurately predict insulin sensitivity as determined by the reference glucose clamp method. In this cross-sectional study of Asian-Indian men (n = 70), we used a calibration model to assess the ability of simple surrogate indices for insulin sensitivity [quantitative insulin sensitivity check index (QUICKI), homeostasis model assessment (HOMA2-IR), fasting insulin-to-glucose ratio (FIGR), and fasting insulin (FI)] to predict an insulin sensitivity index derived from the reference glucose clamp method (SI(Clamp)). Predictive accuracy was assessed by both root mean squared error (RMSE) of prediction as well as leave-one-out cross-validation-type RMSE of prediction (CVPE). QUICKI, FIGR, and FI, but not HOMA2-IR, had modest linear correlations with SI(Clamp) (QUICKI: r = 0.36; FIGR: r = -0.36; FI: r = -0.27; P < 0.05). No significant differences were noted among CVPE or RMSE from any of the surrogate indices when compared with QUICKI. Surrogate measurements of insulin sensitivity/resistance such as QUICKI, FIGR, and FI are easily obtainable in large clinical studies, but these may only be useful as secondary outcome measurements in assessing insulin sensitivity/resistance in clinical studies of Asian Indians.
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Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes (Lond) 2010; 35:167-87. [PMID: 20644557 DOI: 10.1038/ijo.2010.135] [Citation(s) in RCA: 267] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
South Asians are at higher risk than White Caucasians for the development of obesity and obesity-related non-communicable diseases (OR-NCDs), including insulin resistance, the metabolic syndrome, type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). Rapid nutrition and lifestyle transitions have contributed to acceleration of OR-NCDs in South Asians. Differences in determinants and associated factors for OR-NCDs between South Asians and White Caucasians include body phenotype (high body fat, high truncal, subcutaneous and intra-abdominal fat, and low muscle mass), biochemical parameters (hyperinsulinemia, hyperglycemia, dyslipidemia, hyperleptinemia, low levels of adiponectin and high levels of C-reactive protein), procoagulant state and endothelial dysfunction. Higher prevalence, earlier onset and increased complications of T2DM and CHD are often seen at lower levels of body mass index (BMI) and waist circumference (WC) in South Asians than White Caucasians. In view of these data, lower cut-offs for obesity and abdominal obesity have been advocated for Asian Indians (BMI; overweight >23 to 24.9 kg m(-2) and obesity ≥ 25 kg m(-2); and WC; men ≥ 90 cm and women ≥ 80 cm, respectively). Imbalanced nutrition, physical inactivity, perinatal adverse events and genetic differences are also important contributory factors. Other differences between South Asians and White Caucasians include lower disease awareness and health-seeking behavior, delayed diagnosis due to atypical presentation and language barriers, and religious and sociocultural factors. All these factors result in poorer prevention, less aggressive therapy, poorer response to medical and surgical interventions, and higher morbidity and mortality in the former. Finally, differences in response to pharmacological agents may exist between South Asians and White Caucasians, although these have been inadequately studied. In view of these data, prevention and management strategies should be more aggressive for South Asians for more positive health outcomes. Finally, lower cut-offs of obesity and abdominal obesity for South Asians are expected to help physicians in better and more effective prevention of OR-NCDs.
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Affiliation(s)
- A Misra
- National Diabetes, Obesity, and Cholesterol Disorders Foundation (N-DOC), New Delhi, India.
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Cardiac autonomic responses to hyperinsulinemia are associated with skeletal muscle function in healthy human subjects. Auton Neurosci 2009; 152:96-100. [PMID: 19884049 DOI: 10.1016/j.autneu.2009.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 06/17/2009] [Accepted: 09/28/2009] [Indexed: 12/17/2022]
Abstract
Hyperinsulinemia related to obesity may result in activation of the sympathetic nervous system (SNS). Acute autonomic responsiveness to insulin is influenced by body composition, particularly obesity. However, it is unclear whether skeletal muscle mass or function determines autonomic responsiveness to insulin. While muscle function is associated with insulin sensitivity, there are no studies that have assessed if skeletal muscle function modulates autonomic responses to hyperinsulinemia. Fifty healthy men (aged 18-35years) were evaluated for skeletal muscle function (hand grip strength and static and dynamic endurance) and then divided into low and high endurance (LE and HE) groups. Heart rate variability (HRV) in the frequency domain was measured during a hyperinsulinemic euglycemic clamp (HEC). With hyperinsulinemia, the HE group had a higher increment in total power of HRV (1615+/-2536 vs. 97+/-1943, P=0.08) and normalized low frequency (LF) HRV (16.2+/-17.9 vs. -1.3+/-14.8, P=0.008) as compared to the LE group. A significant reduction in the normalized high frequency (HF) HRV was seen in the HE group but not in the LE group (-12.3+/-12.9 vs. 1.7+/-13.9, P=0.009); this translated into an increase in LF/HF ratio for the HE group and but not the LE group (1.21+/-1.8 vs. -0.08+/-0.65, P=0.016). The present study indicates that there are differential cardiac autonomic responses to hyperinsulinemia in healthy human subjects with variable skeletal muscle function.
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