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Billeret A, Rousseau C, Thirion R, Baillard-Cosme B, Charras K, Somme D, Thibault R. Assessment of Food Intake Assisted by Photography in Older People Living in a Nursing Home: Maintenance over Time and Performance for Diagnosis of Malnutrition. Nutrients 2023; 15:646. [PMID: 36771353 PMCID: PMC9920108 DOI: 10.3390/nu15030646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
Malnutrition is related to poor outcomes. Food intake semi-quantitative assessment is helpful for malnutrition screening. Aims: to assess maintenance over one month of one-day semi-quantitative assessment of food intake (primary aim) and its performance in diagnosing malnutrition (secondary aim) in older people living in a nursing home. Food portions consumed at lunch and dinner were measured during 20 days by the Simple Evaluation of Food Intake (SEFI)® assisted by photography (SEFI®-AP) in 70 residents. Nutritional status was assessed in each patient during the first week of food intake monitoring according to Global Leadership Initiative on Malnutrition criteria. Food intake was decreased, i.e., SEFI®-AP < 7, in 39% (n = 27/73) of patients. According to the methods, 36 to 48% (n = 25 to 33/73) of patients had malnutrition, and 6 to 37% (n = 4 to 25/73) sarcopenia. According to a generalized linear model on ranks with repeated measures, the SEFI®-AP medians of lunch (p = 0.11) and means of lunch and dinner (p = 0.15) did not vary over time. Day 3 SEFI®-AP anticipated decreased food intake from days 4 to 20, with a sensitivity of 78% (95% confidence interval (CI), 62-94), a specificity of 30% [95%CI, 17-44] and positive and negative predictive values of 41% [95%CI, 28-55] and 68% [95%CI, 48-89]. The performance of SEFI®-AP for diagnosis of malnutrition using calf circumference <31 cm as a phenotypic criterion was correct: area under the curve = 0.71 [95%CI, 0.59-0.83]. SEFI®-AP sensitivity was better if ≤9.5 than <7, and inversely for specificity. The food intake of older people living in nursing homes is stable over one month. One-day SEFI®-AP correctly anticipates food intake during the following month and predicts diagnosis of malnutrition. Any decrease in food intake should lead to suspect malnutrition.
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Affiliation(s)
- Anne Billeret
- CHU Rennes, Service d’Endocrinologie-Diabétologie-Nutrition, Centre labellisé de Nutrition Parentérale au Domicile, INRAE, INSERM, Univ Rennes, NuMeCan, Nutrition Metabolisms Cancer, F-35000 Rennes, France
| | | | - Rémy Thirion
- CHU Rennes, Service de Gériatrie, F-35000 Rennes, France
| | | | - Kevin Charras
- CHU Rennes, Living Lab Vieillissement et Vulnérabilités, F-35000 Rennes, France
| | - Dominique Somme
- CHU Rennes, Living Lab Vieillissement et Vulnérabilités, F-35000 Rennes, France
- CHU Rennes, Service de Gériatrie, CNRS, Arènes—UMR 6051, Inserm, RSMS—U 1309, Living Lab Vieillissement et Vulnérabilités, Univ Rennes, F-35000 Rennes, France
| | - Ronan Thibault
- CHU Rennes, Service d’Endocrinologie-Diabétologie-Nutrition, Centre labellisé de Nutrition Parentérale au Domicile, INRAE, INSERM, Univ Rennes, NuMeCan, Nutrition Metabolisms Cancer, F-35000 Rennes, France
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Arieta LR, Giuliani-Dewig HK, Gerstner GR, Mota JA, Ryan ED. Segmental bioelectrical impedance spectroscopy: A novel field assessment of muscle size and quality in normal weight and obese older men. Exp Gerontol 2022; 162:111745. [DOI: 10.1016/j.exger.2022.111745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/02/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
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de Bisschop C, Caron F, Ingrand P, Bretonneau Q, Dupuy O, Meurice JC. Does branched-chain amino acid supplementation improve pulmonary rehabilitation effect in COPD? Respir Med 2021; 189:106642. [PMID: 34678585 DOI: 10.1016/j.rmed.2021.106642] [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: 06/21/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Muscle wasting is frequent in chronic obstructive lung disease (COPD) and associated with low branched-chain amino acids (BCAA). We hypothesized that BCAA supplementation could potentiate the effect of a pulmonary rehabilitation program (PRP) by inducing muscular change. MATERIALS AND METHODS Sixty COPD patients (GOLD 2-3) were involved in an ambulatory 4-week PRP either with BCAA oral daily supplementation or placebo daily supplementation in a randomized double-blind design. Maximal exercise test including quadriceps oxygenation measurements, functional exercise test, muscle strength, lung function tests, body composition, dyspnea and quality of life were assessed before and after PRP. RESULTS Fifty-four patients (64.9 ± 8.3 years) completed the protocol. In both groups, maximal exercise capacity, functional and muscle performances, quality of life and dyspnea were improved after 4-week PRP (p ≤ 0.01). Changes in muscle oxygenation during the maximal exercise and recovery period were not modified after 4-week PRP in BCAA group. Contrarily, in the placebo group the muscle oxygenation kinetic of recovery was slowed down after PRP. CONCLUSION This study demonstrated that a 4-week PRP with BCAA supplementation is not more beneficial than PRP alone for patients. A longer duration of supplementation or a more precise targeting of patients would need to be investigated to validate an effect on muscle recovery and to demonstrate other beneficial effects.
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Affiliation(s)
| | - Fabrice Caron
- CHU Poitiers, F-86000, Poitiers, France; Centre de Réadaptation Du Moulin Vert, F-86340, Nieuil L'espoir, France
| | - Pierre Ingrand
- Université de Poitiers, CHU Poitiers, INSERM CIC 1402, F-86000, Poitiers, France
| | | | - Olivier Dupuy
- Université de Poitiers, MOVE, F-86000, Poitiers, France
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Ultrasound imaging for sarcopenia, spasticity and painful muscle syndromes. Curr Opin Support Palliat Care 2019; 12:373-381. [PMID: 29912727 DOI: 10.1097/spc.0000000000000354] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW On the basis of its various advantages and the relevant awareness of physicians, ultrasound imaging has overwhelmingly taken its place in the scientific arena. This is true both from the side of daily clinical applications and also from the side of research. Yet, ultrasound provides real-time (diagnostic) imaging and (interventional) guidance for a wide spectrum of muscle disorders. In this regard, this review aims to discuss the potential/actual utility of ultrasound imaging in particular muscle disorders, that is, sarcopenia, spasticity and fibromyalgia/myofascial pain syndrome. RECENT FINDINGS Due to the aging population worldwide and the importance of functionality in the older population, mounting interest has been given to the diagnosis and management of sarcopenia in the recent literature. Likewise, several articles started to report that ultrasound imaging can be used conveniently and effectively in the early diagnosis and quantification of sarcopenia.For spasticity, aside from ultrasound-guided botulinum toxin injections, intriguing attention has been paid to sonographic evaluation of muscle architecture, echogenicity and elasticity in the follow-up of these chronic conditions.As regards painful muscle syndromes, quantitative ultrasound techniques have been shown to detect statistically significant differences between healthy controls and patients with myofascial pain syndrome. SUMMARY Ultrasound imaging seems to be a promising tool that indisputably deserves further research in the management of a wide range of muscle disorders. VIDEO ABSTRACT: http://links.lww.com/COSPC/A17.
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Cossio Bolaños MA, Andruske CL, de Arruda M, Sulla-Torres J, Urra-Albornoz C, Rivera-Portugal M, Luarte-Rocha C, Pacheco-Carrillo J, Gómez-Campos R. Muscle Mass in Children and Adolescents: Proposed Equations and Reference Values for Assessment. Front Endocrinol (Lausanne) 2019; 10:583. [PMID: 31555209 PMCID: PMC6722176 DOI: 10.3389/fendo.2019.00583] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/09/2019] [Indexed: 12/25/2022] Open
Abstract
Objectives: The goal of this study was to develop regression equations to estimate LM with anthropometric variables and to propose percentiles for evaluating by age and sex. Methods: A cross sectional study was conducted with 2,182 Chilean students (1,347 males and 835 females). Ages ranged from 5.0 to 17.9 years old. A total body scan was carried out with the double energy X-ray anthropometry (DXA) to examine and measure lean muscle mass of the entire body. Weight, height, and the circumference of the relaxed right arm were also measured. Results: Four anthropometric equations were generated to predict lean mass for both sexes (R 2 = 83-88%, SEE = 3.7-5.0%, precision = 0.90-0.93, and accuracy = 0.99). The Lambda-mu-sigma method was used to obtain the sex-specific and age-specific percentile curves of lean mass (p3, p5, p10, p15, p25, p50, p75, p85, p90, p95, and p97). Conclusion: The four proposed equations were acceptable in terms of precision and accuracy to estimate lean mass in children and adolescents. The percentiles were created by means of anthropometric equations and real values for DXA. These are fundamental tools for monitoring LM in Chilean children and adolescents of both sexes.
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Affiliation(s)
- Marco A. Cossio Bolaños
- Programa de Doctorado en Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
- *Correspondence: Marco A. Cossio Bolaños
| | | | - Miguel de Arruda
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
| | | | - Camilo Urra-Albornoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | | | | | | | - Rossana Gómez-Campos
- Departamento de Diversidad e Inclusividad Educativa, Universidad Católica del Maule, Talca, Chile
- Rossana Gómez-Campos
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Abstract
Body composition is known to be associated with several diseases, such as cardiovascular disease, diabetes, cancers, osteoporosis and osteoarthritis. Body composition measurements are useful in assessing the effectiveness of nutritional interventions and monitoring the changes associated with growth and disease conditions. Changes in body composition occur when there is a mismatch between nutrient intake and requirement. Altered body composition is observed in conditions such as wasting and stunting when the nutritional intake may be inadequate. Overnutrition on the other hand leads to obesity. Many techniques are available for body composition assessment, which range from simple indirect measures to more sophisticated direct volumetric measurements. Some of the methods that are used today include anthropometry, tracer dilution, densitometry, dual-energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance analysis. The methods vary in their precision and accuracy. Imaging techniques such as nuclear magnetic resonance imaging and computed tomography have become powerful tools due to their ability of visualizing and quantifying tissues, organs, or constituents such as muscle and adipose tissue. However, these methods are still considered to be research tools due to their cost and complexity of use. This review was aimed to describe the commonly used methods for body composition analysis and provide a brief introduction on the latest techniques available.
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Affiliation(s)
- Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bengaluru, India
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De Benedetto F, Pastorelli R, Ferrario M, de Blasio F, Marinari S, Brunelli L, Wouters EFM, Polverino F, Celli BR. Supplementation with Qter ® and Creatine improves functional performance in COPD patients on long term oxygen therapy. Respir Med 2018; 142:86-93. [PMID: 30170808 DOI: 10.1016/j.rmed.2018.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPD patients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPD patients on long-term O2 therapy. METHODS One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
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Affiliation(s)
| | - Roberta Pastorelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | | | | | - Laura Brunelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Bartolome R Celli
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Hübers M, Geisler C, Bosy-Westphal A, Braun W, Pourhassan M, Sørensen TIA, Müller MJ. Association between fat mass, adipose tissue, fat fraction per adipose tissue, and metabolic risks: a cross-sectional study in normal, overweight, and obese adults. Eur J Clin Nutr 2018; 73:62-71. [PMID: 29670259 DOI: 10.1038/s41430-018-0150-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/19/2018] [Accepted: 02/15/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES We investigated whether fat mass (FM) and total adipose tissue (TAT) can be used interchangeably and FM per TAT adds to metabolic risk assessment. SUBJECTS/METHODS Cross-sectional data were assessed in 377 adults (aged 18-60 years; 51.2% women). FM was measured by either 4-compartment (4C) model or quantitative magnetic resonance (QMR); total-, subcutaneous- and visceral adipose tissue (TAT, SAT, VAT), and liver fat by whole-body MRI; leptin, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), C-reactive protein (CRP), and triglycerides; resting energy expenditure and respiratory quotient by indirect calorimetry were determined. Correlations and stepwise multivariate regression analyses were performed. RESULTS FM4C and FMQMR were associated with TAT (r4C = 0.96, rQMR = 0.99) with a mean FM per TAT of 0.85 and 1.01, respectively. Regardless of adiposity, there was a considerable inter-individual variance of FM/TAT-ratio (FM4C/TAT-ratio: 0.77-0.94; FMQMR/TAT-ratio: 0.89-1.10). Both, FM4C and TAT were associated with metabolic risks. Further, FM4C/TAT-ratio was positively related to leptin but inversely with CRP. There was no association between FM4C/TAT-ratio and VAT/SAT or liver fat. FM4C/TAT-ratio added to the variance of leptin and CRP. CONCLUSIONS Independent of FM or TAT, FM4C/TAT-ratio adds to metabolic risk assessment. Therefore, the interchangeable use of FM and TAT to assess metabolic risks is questionable as both parameters may complement each other.
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Affiliation(s)
- Mark Hübers
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Thorkild I A Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research (Section on Metabolic Genetics), and the Department of Public Health, The Faculty of Health and Medical Science, University Copenhagen, Copenhagen, Denmark
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany.
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Vitiello D, Degache F, Saugy JJ, Place N, Schena F, Millet GP. The increase in hydric volume is associated to contractile impairment in the calf after the world's most extreme mountain ultra-marathon. EXTREME PHYSIOLOGY & MEDICINE 2015; 4:18. [PMID: 26500765 PMCID: PMC4618124 DOI: 10.1186/s13728-015-0037-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 09/29/2015] [Indexed: 11/15/2022]
Abstract
Background Studies have recently focused on the effect of running a mountain ultra-marathon (MUM) and their results show muscular inflammation, damage and force loss. However, the link between peripheral oedema and muscle force loss is not really established. We tested the hypothesis that, after a MUM, lower leg muscles’ swelling could be associated with muscle force loss. The knee extensor (KE) and the plantar flexor (PF) muscles’ contractile function was measured by supramaximal electrical stimulations, potentiated low- and high-frequency doublets (PS10 and PS100) of the KE and the PF were measured by transcutaneous electrical nerve stimulation and bioimpedance was used to assess body composition in the runners (n = 11) before (Pre) and after (Post) the MUM and compared with the controls (n = 8). Results The maximal voluntary contraction of the KE and the PF significantly decreased by 20 % Post-MUM in the runners. Hydration of the non-fat mass (NF-Hyd) and extracellular water volume (Ve) were increased by 12 % Post-MUM (p < 0.001) in the runners. Calf circumference (+2 %, p < 0.05) was also increased. Significant relationships were found for percentage increases in Ve and NF-Hyd with percentage decrease in PS10 of the PF (r = −0.68 and r = −0.70, p < 0.05) and with percentage increase of calf circumference (r = 0.72 and r = 0.73, p < 0.05) in the runners. Conclusions The present study suggests that increases in circumference and in hydric volume are associated to contractile impairment in the calf in ultra-marathon runners.
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Affiliation(s)
- Damien Vitiello
- Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Geopolis, 1015 Lausanne, Switzerland ; Health Research Unit, School of Health Sciences, University of Applied Sciences Western Switzerland, Lausanne, Switzerland
| | - Francis Degache
- Health Research Unit, School of Health Sciences, University of Applied Sciences Western Switzerland, Lausanne, Switzerland
| | - Jonas J Saugy
- Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Geopolis, 1015 Lausanne, Switzerland ; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Place
- Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Geopolis, 1015 Lausanne, Switzerland ; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Federico Schena
- Faculty of Motor Sciences, University of Verona, Verona, Italy
| | - Grégoire P Millet
- Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Geopolis, 1015 Lausanne, Switzerland ; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Derivation and validation of simple anthropometric equations to predict adipose tissue mass and total fat mass with MRI as the reference method. Br J Nutr 2015; 114:1852-67. [PMID: 26435103 DOI: 10.1017/s0007114515003670] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The reference organ-level body composition measurement method is MRI. Practical estimations of total adipose tissue mass (TATM), total adipose tissue fat mass (TATFM) and total body fat are valuable for epidemiology, but validated prediction equations based on MRI are not currently available. We aimed to derive and validate new anthropometric equations to estimate MRI-measured TATM/TATFM/total body fat and compare them with existing prediction equations using older methods. The derivation sample included 416 participants (222 women), aged between 18 and 88 years with BMI between 15·9 and 40·8 (kg/m2). The validation sample included 204 participants (110 women), aged between 18 and 86 years with BMI between 15·7 and 36·4 (kg/m2). Both samples included mixed ethnic/racial groups. All the participants underwent whole-body MRI to quantify TATM (dependent variable) and anthropometry (independent variables). Prediction equations developed using stepwise multiple regression were further investigated for agreement and bias before validation in separate data sets. Simplest equations with optimal R (2) and Bland-Altman plots demonstrated good agreement without bias in the validation analyses: men: TATM (kg)=0·198 weight (kg)+0·478 waist (cm)-0·147 height (cm)-12·8 (validation: R 2 0·79, CV=20 %, standard error of the estimate (SEE)=3·8 kg) and women: TATM (kg)=0·789 weight (kg)+0·0786 age (years)-0·342 height (cm)+24·5 (validation: R (2) 0·84, CV=13 %, SEE=3·0 kg). Published anthropometric prediction equations, based on MRI and computed tomographic scans, correlated strongly with MRI-measured TATM: (R (2) 0·70-0·82). Estimated TATFM correlated well with published prediction equations for total body fat based on underwater weighing (R (2) 0·70-0·80), with mean bias of 2·5-4·9 kg, correctable with log-transformation in most equations. In conclusion, new equations, using simple anthropometric measurements, estimated MRI-measured TATM with correlations and agreements suitable for use in groups and populations across a wide range of fatness.
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MacDonald AJ, Johns N, Stephens N, Greig C, Ross JA, Small AC, Husi H, Fearon KCH, Preston T. Habitual Myofibrillar Protein Synthesis Is Normal in Patients with Upper GI Cancer Cachexia. Clin Cancer Res 2014; 21:1734-40. [PMID: 25370466 DOI: 10.1158/1078-0432.ccr-14-2004] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 10/16/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Skeletal muscle wasting and weight loss are characteristic features of cancer cachexia and contribute to impaired function, increased morbidity, and poor tolerance of chemotherapy. This study used a novel technique to measure habitual myofibrillar protein synthesis in patients with cancer compared with healthy controls. EXPERIMENTAL DESIGN An oral heavy water (87.5 g deuterium oxide) tracer was administered as a single dose. Serum samples were taken over the subsequent week followed by a quadriceps muscle biopsy. Deuterium enrichment was measured in body water, serum alanine, and alanine in the myofibrillar component of muscle using gas chromatography-pyrolysis-isotope ratio mass spectrometry and the protein synthesis rate calculated from the rate of tracer incorporation. Net change in muscle mass over the preceding 3 months was calculated from serial CT scans and allowed estimation of protein breakdown. RESULTS Seven healthy volunteers, 6 weight-stable, and 7 weight-losing (≥5% weight loss) patients undergoing surgery for upper gastrointestinal cancer were recruited. Serial CT scans were available in 10 patients, who lost skeletal muscle mass preoperatively at a rate of 5.6%/100 days. Myofibrillar protein fractional synthetic rate was 0.058%, 0.061%, and 0.073%/hour in controls, weight-stable, and weight-losing patients, respectively. Weight-losing patients had higher synthetic rates than controls (P = 0.03). CONCLUSION Contrary to previous studies, there was no evidence of suppression of myofibrillar protein synthesis in patients with cancer cachexia. Our finding implies a small increase in muscle breakdown may account for muscle wasting.
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Affiliation(s)
- Alisdair J MacDonald
- Department of Clinical Surgery, University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Neil Johns
- Department of Clinical Surgery, University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Nathan Stephens
- Department of Clinical Surgery, University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - James A Ross
- Department of Clinical Surgery, University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Alexandra C Small
- Stable Isotope Biochemistry Laboratory, Scottish Universities Research Centre, East Kilbride, United Kingdom
| | - Holger Husi
- Institute of Cardiovascular and Medical Sciences, College of Medicine, Veterinary Medicine and Life Science, University of Glasgow, Glasgow, United Kingdom
| | - Kenneth C H Fearon
- Department of Clinical Surgery, University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom
| | - Tom Preston
- Stable Isotope Biochemistry Laboratory, Scottish Universities Research Centre, East Kilbride, United Kingdom.
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Al-Gindan YY, Hankey C, Govan L, Gallagher D, Heymsfield SB, Lean MEJ. Derivation and validation of simple equations to predict total muscle mass from simple anthropometric and demographic data. Am J Clin Nutr 2014; 100:1041-51. [PMID: 25240071 PMCID: PMC6443297 DOI: 10.3945/ajcn.113.070466] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Muscle mass reflects and influences health status. Its reliable estimation would be of value for epidemiology. OBJECTIVE The aim of the study was to derive and validate anthropometric prediction equations to quantify whole-body skeletal muscle mass (SM) in adults. DESIGN The derivation sample included 423 subjects (227 women) aged 18-81 y with a body mass index (BMI; in kg/m(2)) of 15.9-40.8. The validation sample included 197 subjects (105 women) aged 19-83 y with a BMI of 15.7-36.4. Both samples were of mixed ethnic/racial groups. All underwent whole-body magnetic resonance imaging to quantify SM (dependent variable for multiple regressions) and anthropometric variables (independent variables). RESULTS Two prediction equations with high practicality and optimal derivation correlations with SM were further investigated to assess agreement and bias by using Bland-Altman plots and validated in separate data sets. Including race as a variable increased R(2) by only 0.1% in men and by 8% in women. For men: SM (kg) = 39.5 + 0.665 body weight (BW; kg) - 0.185 waist circumference (cm) - 0.418 hip circumference (cm) - 0.08 age (y) (derivation: R(2) = 0.76, SEE = 2.7 kg; validation: R(2) = 0.79, SEE = 2.7 kg). Bland-Altman plots showed moderate agreement in both derivation and validation analyses. For women: SM (kg) = 2.89 + 0.255 BW (kg) - 0.175 hip circumference (cm) - 0.038 age (y) + 0.118 height (cm) (derivation: R(2) = 0.58, SEE = 2.2 kg; validation: R(2) = 0.59, SEE = 2.1 kg). Bland-Altman plots had a negative slope, indicating a tendency to overestimate SM among women with smaller muscle mass and to underestimate SM among those with larger muscle mass. CONCLUSIONS Anthropometry predicts SM better in men than in women. Equations that include hip circumference showed agreement between methods, with predictive power similar to that of BMI to predict fat mass, with the potential for applications in groups, as well as epidemiology and survey settings.
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Affiliation(s)
- Yasmin Y Al-Gindan
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
| | - Catherine Hankey
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
| | - Lindsay Govan
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
| | - Dympna Gallagher
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
| | - Steven B Heymsfield
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
| | - Michael E J Lean
- From the Department of Human Nutrition (YYA-G, CH, and MEJL) and the Institute of Health and Well Being (LG), College of Medical, Veterinary, and Life Sciences, School of Medicine, University of Glasgow, Glasgow, United Kingdom; the Institute of Human Nutrition, Columbia University, New York, NY (DG); and Pennington Biomedical Research Center, Baton Rouge, LA (SBH)
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Valente-dos-Santos J, Coelho-e-Silva MJ, Machado-Rodrigues AM, Elferink-Gemser MT, Malina RM, Petroski ÉL, Minderico CS, Silva AM, Baptista F, Sardinha LB. Prediction equation for lower limbs lean soft tissue in circumpubertal boys using anthropometry and biological maturation. PLoS One 2014; 9:e107219. [PMID: 25229472 PMCID: PMC4168128 DOI: 10.1371/journal.pone.0107219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 08/11/2014] [Indexed: 12/03/2022] Open
Abstract
Lean soft tissue (LST), a surrogate of skeletal muscle mass, is largely limited to appendicular body regions. Simple and accurate methods to estimate lower limbs LST are often used in attempts to partition out the influence of body size on performance outputs. The aim of the current study was to develop and cross-validate a new model to predict lower limbs LST in boys aged 10–13 years, using dual-energy X-ray absorptiometry (DXA) as the reference method. Total body and segmental (lower limbs) composition were assessed with a Hologic Explorer-W QDR DXA scanner in a cross-sectional sample of 75 Portuguese boys (144.8±6.4 cm; 40.2±9.0 kg). Skinfolds were measured at the anterior and posterior mid-thigh, and medial calf. Circumferences were measured at the proximal, mid and distal thigh. Leg length was estimated as stature minus sitting height. Current stature expressed as a percentage of attained predicted mature stature (PMS) was used as an estimate of biological maturity status. Backward proportional allometric models were used to identify the model with the best statistical fit: ln (lower limbs LST) = 0.838× ln (body mass) +0.476× ln (leg length) – 0.135× ln (mid-thigh circumference) – 0.053× ln (anterior mid-thigh skinfold) – 0.098× ln (medial calf skinfold) – 2.680+0.010× (percentage of attained PMS) (R = 0.95). The obtained equation was cross-validated using the predicted residuals sum of squares statistics (PRESS) method (R2PRESS = 0.90). Deming repression analysis between predicted and current lower limbs LST showed a standard error of estimation of 0.52 kg (95% limits of agreement: 0.77 to −1.27 kg). The new model accurately predicts lower limbs LST in circumpubertal boys.
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Affiliation(s)
| | | | | | - Marije T Elferink-Gemser
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Institute for Studies in Sports and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Robert M Malina
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, United States of America; Department of Kinesiology, Tarleton State University, Stephenville, Texas, United States of America
| | - Édio L Petroski
- Research Centre for Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Fátima Baptista
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
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Clark RV, Walker AC, O'Connor-Semmes RL, Leonard MS, Miller RR, Stimpson SA, Turner SM, Ravussin E, Cefalu WT, Hellerstein MK, Evans WJ. Total body skeletal muscle mass: estimation by creatine (methyl-d3) dilution in humans. J Appl Physiol (1985) 2014; 116:1605-13. [PMID: 24764133 DOI: 10.1152/japplphysiol.00045.2014] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Current methods for clinical estimation of total body skeletal muscle mass have significant limitations. We tested the hypothesis that creatine (methyl-d3) dilution (D3-creatine) measured by enrichment of urine D3-creatinine reveals total body creatine pool size, providing an accurate estimate of total body skeletal muscle mass. Healthy subjects with different muscle masses [n = 35: 20 men (19-30 yr, 70-84 yr), 15 postmenopausal women (51-62 yr, 70-84 yr)] were housed for 5 days. Optimal tracer dose was explored with single oral doses of 30, 60, or 100 mg D3-creatine given on day 1. Serial plasma samples were collected for D3-creatine pharmacokinetics. All urine was collected through day 5. Creatine and creatinine (deuterated and unlabeled) were measured by liquid chromatography mass spectrometry. Total body creatine pool size and muscle mass were calculated from D3-creatinine enrichment in urine. Muscle mass was also measured by magnetic resonance imaging (MRI), dual-energy x-ray absorptiometry (DXA), and traditional 24-h urine creatinine. D3-creatine was rapidly absorbed and cleared with variable urinary excretion. Isotopic steady-state of D3-creatinine enrichment in the urine was achieved by 30.7 ± 11.2 h. Mean steady-state enrichment in urine provided muscle mass estimates that correlated well with MRI estimates for all subjects (r = 0.868, P < 0.0001), with less bias compared with lean body mass assessment by DXA, which overestimated muscle mass compared with MRI. The dilution of an oral D3-creatine dose determined by urine D3-creatinine enrichment provides an estimate of total body muscle mass strongly correlated with estimates from serial MRI with less bias than total lean body mass assessment by DXA.
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Affiliation(s)
- Richard V Clark
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina;
| | - Ann C Walker
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina
| | - Robin L O'Connor-Semmes
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina
| | - Michael S Leonard
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina
| | - Ram R Miller
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina
| | - Stephen A Stimpson
- Muscle Metabolism Discovery Performance Unit, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline R&D, Research Triangle Park, North Carolina
| | | | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana; and
| | - William T Cefalu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana; and
| | - Marc K Hellerstein
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, California
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16
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Age- and gender-dependent values of skeletal muscle mass in healthy children and adolescents. J Cachexia Sarcopenia Muscle 2012; 3:25-9. [PMID: 22451073 PMCID: PMC3302981 DOI: 10.1007/s13539-011-0042-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 10/04/2011] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Skeletal muscle mass (SMM) can be extracted from whole-body scans obtained by X-ray-based dual-photon absorptiometry (DXA). There is a need to establish expected age-dependent values for children and adolescents. METHODS Appendicular lean tissue mass (ALM) was extracted from whole-body DXA scans in 140 healthy children and adolescents (68 females and 72 males). Whole-body SMM was calculated from ALM using equations developed by Kim et al. (Am J Clin Nutr 84:1014-1020, 2006). Age-dependent patterns of increase in SMM were derived by fitting SMM values to equations that consisted of the sum of two logistic expressions, one accounting for SMM changes during growth and the other for SMM changes during puberty. Normal ranges were defined so that 95% of the SMM values were included. The reproducibility of SMM measurements was obtained from whole-body DXA scans repeated on three occasions in each of a separate group of 32 normal children with repositioning between scans. RESULTS Normal ranges are presented as equations describing the age-dependent pattern of increase in SMM as well as population standard deviations that increased steadily with age. For 15 children below age 10, SMM reproducibility (95% CI) was 149 g (119-199 g) while for 17 children and adolescents over age 10, reproducibility was 170 g (138-223 g). CONCLUSION DXA-based measurements of SMM in children and adolescents are reproducible and can be expressed in terms of age-dependent Z scores.
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Chen BB, Shih TTF, Hsu CY, Yu CW, Wei SY, Chen CY, Wu CH, Chen CY. Thigh muscle volume predicted by anthropometric measurements and correlated with physical function in the older adults. J Nutr Health Aging 2011; 15:433-8. [PMID: 21623463 DOI: 10.1007/s12603-010-0281-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES (1) to correlate thigh muscle volume measured by magnetic resonance image (MRI) with anthropometric measurements and physical function in elderly subjects; (2) to predict MRI-measured thigh muscle volume using anthropometric measurements and physical functional status in elderly subjects. DESIGN Cross-sectional, nonrandomized study. SETTING Outpatient clinic in Taiwan. PARTICIPANTS Sixty-nine elderly subjects (33 men and 36 women) aged 65 and older. MEASURMENTS The anthropometric data (including body height, body weight, waist size, and thigh circumference), physical activity and function (including grip strength, bilateral quadriceps muscle power, the up and go test, chair rise, and five meters walk time) and bioelectrical impedance analysis data (including total body fat mass, fat-free mass, and predictive muscle size) were measured. MRI-measured muscle volume of both thighs was used as the reference standard. RESULTS The MRI-measured thigh volume was positively correlated with all anthropometric data, quadriceps muscle power and the up and go test as well as fat-free mass and predictive muscle mass, whereas it was negatively associated with age and walk time. In predicting thigh muscle volume, the variables of age, gender, body weight, and thigh circumference were significant predictors in the linear regression model: Muscle volume (cm3) =4226.3-42.5 × Age (year)-955.7 × gender (male=1, female=2) + 45.9 × body weight(kg) + 60.0 × thigh circumference (cm) (r2 = 0.745, P < 0.001; standard error of the estimate = 581.6 cm3). CONCLUSION The current work provides evidence of a strong relationship between thigh muscle volume and physical function in the elderly. We also developed a prediction equation model using anthropometric measurements. This model is a simple and noninvasive method for everyday clinical practice and follow-up.
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Affiliation(s)
- B B Chen
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University, College of medicine, Yun-Lin Branch
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Lustgarten MS, Fielding RA. Assessment of analytical methods used to measure changes in body composition in the elderly and recommendations for their use in phase II clinical trials. J Nutr Health Aging 2011; 15:368-75. [PMID: 21528163 PMCID: PMC3376910 DOI: 10.1007/s12603-011-0049-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It is estimated that in the next 20 years, the amount of people greater than 65 years of age will rise from 40 to 70 million, and will account for 19% of the total population. Age-related decreases in muscle mass and function, known as sarcopenia, have been shown to be related to functional limitation, frailty and an increased risk of morbidity and mortality. Therefore, with an increasing elderly population, interventions that can improve muscle mass content and/or function are essential. However, analytical techniques used for measurement of muscle mass in young subjects may not be valid for use in the elderly. Therefore, the purpose of this review is to examine the applied specificity and accuracy of methods that are commonly used for measurement of muscle mass in aged subjects, and, to propose specific recommendations for the use of body composition measures in phase II clinical trials of function-promoting anabolic therapies.
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Affiliation(s)
- M S Lustgarten
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Research Center on Aging, Tufts University, Boston, MA 02111-1524, USA
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del Risco Norrlid L, Östergren I. The whole-body counting facility at the Swedish Radiation Safety Authority after relocation. RADIATION PROTECTION DOSIMETRY 2011; 144:433-436. [PMID: 21127035 DOI: 10.1093/rpd/ncq437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The whole-body counting (WBC) facility at the Swedish Radiation Safety Authority was rebuilt in a new location during 2004-2007. In this paper, the relocated WBC facility, its background and the detectors' response are described. The report on the limit of detection is given. The report on a first round of measurements on a non-contaminated group of 24 persons for control of Cesium 137 ((137)Cs) and potassium 40 ((40)K) is also presented. The results of the measurements of the control group compared with those from the previous facility revealed biased values up to 5 %, being this more evident for (40)K, which was underestimated. The correction applied and the determination of the measurement uncertainty are described.
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Affiliation(s)
- L del Risco Norrlid
- Radiation Protection Department, Swedish Radiation Safety Authority, SE-171 16 Stockholm, Sweden.
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Hull HR, Thornton J, Wang J, Pierson RN, Kaleem Z, Pi-Sunyer X, Heymsfield S, Albu J, Fernandez JR, Vanitallie TB, Gallagher D. Fat-free mass index: changes and race/ethnic differences in adulthood. Int J Obes (Lond) 2010; 35:121-7. [PMID: 20531353 DOI: 10.1038/ijo.2010.111] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Nutritional status is assessed by measuring BMI or percent body fat (%fat). BMI can misclassify persons who carry more weight as fat-free mass and %fat can be misleading in cases of malnutrition or in disease states characterized by wasting of lean tissue. The fat-free mass index (FFMI) is proposed to assess body composition in individuals who have a similar body composition but differ in height allowing identification of those suffering from malnutrition, wasting or those that possess a relatively high muscle mass. The purpose was to determine whether the FFMI differs in a group of racially/ethnically diverse adults. DESIGN Cross-sectional. SUBJECTS Subjects were a multi-ethnic sample (Caucasian, CA; African American, AA; Hispanic, HIS and Asian, AS) of 1339 healthy males (n = 480) and females (n = 859) ranging in age from 18-110 years. Total body fat, total fat-free mass and bone mineral density were estimated using dual energy X-ray absorptiometry. RESULTS FFMI differed among the four ethnic groups (P ≤ 0.05) for both genders. A curvilinear relationship was found between age and FFMI for both genders although the coefficients in the quadratic model differed between genders (P ≤ 0.001) indicating the rate of change in FFMI differed between genders. The estimated turning point where FFMI started to decline was in the mid 20s for male and mid 40s for female participants. An age × gender interaction was found such that the rate of decline was greater in male than female participants (P ≤ 0.001). For both genders, FFMI was greatest in AA and the least in AS (P ≤ 0.001). There was no significant interaction between race and age or age(2) (P = 0.06). However, male participants consistently had a greater FFMI than female participants (P ≤ 0.001). CONCLUSIONS These findings have clinical implications for identifying individuals who may not be recognized as being malnourished based on their BMI or %fat but whose fat-free mass corrected for height is relatively low.
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Affiliation(s)
- H R Hull
- Department of Medicine, New York Obesity Nutrition Research Center, St Luke's-Roosevelt Hospital, New York, NY, USA.
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Siervo M, Jebb S. Body Composition Assessment: Theory into Practice: Introduction of Multicompartment Models. ACTA ACUST UNITED AC 2010; 29:48-59. [DOI: 10.1109/memb.2009.935471] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Branski LK, Norbury WB, Herndon DN, Chinkes DL, Cochran A, Suman O, Benjamin D, Jeschke MG. Measurement of body composition in burned children: is there a gold standard? JPEN J Parenter Enteral Nutr 2009; 34:55-63. [PMID: 19884353 DOI: 10.1177/0148607109336601] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Maintaining lean body mass (LBM) after a severe burn is an essential goal of modern burn treatment. An accurate determination of LBM is necessary for short- and long-term therapeutic decisions. The aim of this study was to compare 2 measurement methods for body composition, whole-body potassium counting (K count) and dual x-ray absorptiometry (DEXA), in a large prospective clinical trial in severely burned pediatric patients. METHODS Two-hundred seventy-nine patients admitted with burns covering 40% of total body surface area (TBSA) were enrolled in the study. Patients enrolled were controls or received long-term treatment with recombinant human growth hormone (rhGH). Near-simultaneous measurements of LBM with DEXA and fat-free mass (FFM) with K count were performed at hospital discharge and at 6, 9, 12, 18, and 24 months post injury. Results were correlated using Pearson's regression analysis. Agreement between the 2 methods was analyzed with the Bland-Altman method. RESULTS Age, gender distribution, weight, burn size, and admission time from injury were not significantly different between control and treatment groups. rhGH and control patients at all time points postburn showed a good correlation between LBM and FFM measurements (R(2) between 0.9 and 0.95). Bland-Altman revealed that the mean bias and 95% limits of agreement depended only on patient weight and not on treatment or time postburn. The 95% limits ranged from 0.1 +/- 2.9 kg for LBM or FFM in 7- to 18-kg patients to 16.3 +/- 17.8 kg for LBM or FFM in patients >60 kg. CONCLUSIONS DEXA can provide a sufficiently accurate determination of LBM and changes in body composition, but a correction factor must be included for older children and adolescents with more LBM. DEXA scans are easier, cheaper, and less stressful for the patient, and this method should be used rather than the K count.
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Affiliation(s)
- Ludwik K Branski
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, and Shriners Hospitals for Children, Galveston, Texas 77550, USA
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Thijssen S, Zhu F, Kotanko P, Levin NW. Comment on “Higher Serum Creatinine Concentrations in Black Patients with Chronic Kidney Disease: Beyond Nutritional Status and Body Composition”. Clin J Am Soc Nephrol 2009; 4:1011-3. [DOI: 10.2215/cjn.05951108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Arthurs KL, Andrews DM. Upper extremity soft and rigid tissue mass prediction using segment anthropometric measures and DXA. J Biomech 2009; 42:389-94. [DOI: 10.1016/j.jbiomech.2008.11.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/10/2008] [Accepted: 11/12/2008] [Indexed: 10/21/2022]
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Gobbo LA, Cyrino ES, Petroski ÉL, Cardoso JR, Carvalho FO, Romanzini M, Avelar A. Validação de equações antropométricas para a estimativa da massa muscular por meio de absortometria radiológica de dupla energia em universitários do sexo masculino. REV BRAS MED ESPORTE 2008. [DOI: 10.1590/s1517-86922008000400011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Diferentes equações antropométricas têm sido desenvolvidas e validadas para uso em populações distintas, a partir de modelos multicompartimentais. A absortometria radiológica de dupla energia (DEXA) é uma alternativa multicompartimental de avaliação da composição corporal, ainda pouco utilizada no Brasil para validação e desenvolvimento de equações antropométricas, sobretudo para predição da massa muscular (MM). Assim, o objetivo deste estudo foi validar equações antropométricas para estimativa da MM a partir da DEXA, em universitários brasileiros do sexo masculino. Para tanto, 131 adultos entre 18 e 36 anos (73,9 ± 9,7kg; 177,6 ± 6,4cm; MM = 32,1 ± 3,6kg) foram avaliados por meio da DEXA e de medidas antropométricas (massa corporal, estatura, circunferências e espessura de dobras cutâneas), e analisados mediante utilização de quatro equações preditivas da MM. Foram utilizadas as seguintes análises: estatística descritiva, procedimentos de validação cruzada e análise de concordância (CCI e Bland e Altman). A equação 3 [MM (kg) = E.(0,00744.CBrC² + 0,00088.CCxC² + 0,00441.CPantC²) + 2,4.S - 0,048.Id + R + 7,8] de Lee et al. (Am J Clin Nutr 2000;72:796-803) apresentou validade concorrente, para a avaliação da MM (t = 1,13; r = 0,83; EPE = 2,08; diferença média [d] = 0,21). Além desta, a equação 4, dos mesmos autores [MM (kg) = 0,244.MC + 7,8.E + 6,6.S - 0,098.Id + R - 3,3], com baixos valores de EPE (2,20), erro constante (- 0,72), erro total (2,72) e d (- 0,77) e boas concordâncias (moderada a alta) foi sugerida para utilização na amostra estudada. Novos estudos de validação são sugeridos em amostras diferentes, mediante o uso de DEXA como método de referência. Da mesma forma, sugere-se maior utilização de equações antropométricas para avaliação da MM, sobretudo para o monitoramento das alterações na massa muscular em relação aos processos de crescimento, desenvolvimento e envelhecimento e na avaliação do treinamento físico e esportivo.
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Campbell KL, Ash S, Davies PSW, Bauer JD. Randomized controlled trial of nutritional counseling on body composition and dietary intake in severe CKD. Am J Kidney Dis 2008; 51:748-58. [PMID: 18436085 DOI: 10.1053/j.ajkd.2007.12.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 12/26/2007] [Indexed: 01/04/2023]
Abstract
BACKGROUND Progressive loss of kidney function results in an increased risk of malnutrition. Despite this, there is little evidence informing the impact of nutrition intervention on predialysis patients with chronic kidney disease (CKD; stages 4 and 5). STUDY DESIGN Randomized controlled trial. SETTING & PARTICIPANTS 56 outpatients (men, 62%; mean age, 70.7 +/- 14.0 [SD] years) with CKD were randomly allocated to intervention (n = 29) or control (n = 27) by using a concealed computer-generated sequence. INTERVENTION The intervention group, provided with individualized dietary counseling with regular follow-up aimed at achieving an intake of 0.8 to 1.0 g/kg of protein and greater than 125 kJ/kg of energy, or control, receiving written material only. OUTCOMES & MEASURES Change in body composition (body cell mass, measured by means of total-body potassium, in 40 of 56 participants), nutritional status (Subjective Global Assessment), and energy and protein intake (3-day food record). RESULTS During the 12 weeks, the intervention group had 3.5% (95% confidence interval, -2.1 to 9.1) less decrease in body cell mass, 17.7-kJ/kg/d (95% confidence interval, 8.2 to 27.2) greater increase in energy intake, greater improvement in Subjective Global Assessment (P < 0.01), and no significant difference in protein intake compared with the control group (-0.04 g/kg/d; 95% confidence interval, -0.73 to 0.16). The intervention was associated with greater increases in energy and protein intake in women than men (interaction P < 0.001 for both). LIMITATIONS Power to detect change in body cell mass, potential bias in ascertainment of Subjective Global Assessment. CONCLUSIONS In predialysis patients with CKD, structured nutrition intervention had a greater effect on energy and protein intake in women than men. Additional investigations are warranted to determine the impact on body composition.
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Affiliation(s)
- Katrina L Campbell
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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Kim HW, Chang JH, Park SY, Moon SJ, Kim DK, Lee JE, Han SH, Kim BS, Kang SW, Choi KH, Lee HY, Han DS. Factors associated with Hypokalemia in Continuous Ambulatory Peritoneal Dialysis Patients. Electrolyte Blood Press 2007; 5:102-10. [PMID: 24459508 PMCID: PMC3894509 DOI: 10.5049/ebp.2007.5.2.102] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Accepted: 11/15/2007] [Indexed: 11/05/2022] Open
Abstract
Hypokalemia is a frequent problem in patients on continuous ambulatory peritoneal dialysis (CAPD) and is affected by multiple factors. To evaluate factors associated with hypokalemia, we studied 68 patients on maintenance CAPD treatment for at least six months. In univariate analysis, patients with hypokalemia were associated with older age and the presence of diabetes mellitus. Serum albumin, calcium-phosphate product, triglyceride, body mass index, protein nitrogen appearance, and lean body mass assessed by creatinine kinetics were significantly lower as compared to those without hypokalemia. Serum C-reactive protein was significantly higher in the patients with hypokalemia. Multivariate stepwise linear regression analysis revealed that the serum albumin level and the ultrafiltration volume at the peritoneal equilibration test were independent factors associated with hypokalemia. This suggests that the serum potassium level may be an important nutritional marker in CAPD patients. Further longitudinal investigation is needed to clarify this relationship.
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Affiliation(s)
- Hyun-Wook Kim
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Jae Hyun Chang
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Sun Young Park
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Sung Jin Moon
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Jung Eun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Beum Seok Kim
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Kyu Hun Choi
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Ho Young Lee
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
| | - Dae-Suk Han
- Department of Internal Medicine, Yonsei University College of Medicine, The Institute of Kidney Disease, Yonsei University, Seoul, Korea
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Wang Z, Heshka S, Pietrobelli A, Chen Z, Silva AM, Sardinha LB, Wang J, Gallager D, Heymsfield SB. A new total body potassium method to estimate total body skeletal muscle mass in children. J Nutr 2007; 137:1988-91. [PMID: 17634275 PMCID: PMC2745126 DOI: 10.1093/jn/137.8.1988] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A whole body skeletal muscle [(SM); kg] mass estimation model, based on total body potassium [(TBK); mmol] measured by whole body (40)K counting (WBC) was developed (SM = 0.0082.TBK) and validated in adults in a previous study. It is unknown whether the adult TBK SM prediction model is applicable for pediatric use. The aim of this study was to derive and validate a pediatric TBK SM prediction equation. SM measured by MRI was used as the criterion and TBK was measured by WBC. The protocol was completed in 116 healthy children, 66 males and 50 females, 11.7 +/- 3.5 y (mean +/- SD, range = 5-17 y). A strong linear correlation was observed between TBK and SM (r = 0.984; P < 0.001). The SM:TBK ratio was 0.0071 +/- 0.0008 kg/mmol in the children studied, much lower than the corresponding value of 0.0082 kg/mmol in adults. An empirical SM prediction equation was developed using TBK alone: SM = 0.0085.TBK - 2.83, r(2) = 0.97, SEE = 1.39 kg. Bland-Altman analysis did not disclose a significant bias in the prediction of SM. When biological factors entered along with TBK in the general linear model, another prediction equation was developed: SM = 5.52 + 0.001.TBK (mmol) + 0.081.weight (kg) - 0.049.height (cm) + 0.00004.TBK . height + race (-0.60 for Caucasian, 0.49 for African-American, and 0 for Hispanic). Because the adult TBK SM prediction model is not applicable for pediatric use, this study provides new empirical TBK SM prediction equations that should prove useful for studies on nutrition, growth, and development in children.
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Affiliation(s)
- ZiMian Wang
- Obesity Research Center, St. Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
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Macdonald J, Marcora S, Jibani M, Roberts G, Kumwenda M, Glover R, Barron J, Lemmey A. GFR Estimation Using Cystatin C Is Not Independent of Body Composition. Am J Kidney Dis 2006; 48:712-9. [PMID: 17059990 DOI: 10.1053/j.ajkd.2006.07.001] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Accepted: 07/10/2006] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cystatin C (CysC) is an endogenous marker of glomerular filtration rate (GFR) that is claimed to be unaffected by body composition. In this study, we tested this speculation. METHODS In 77 patients with chronic kidney disease (mean age, 65.1 +/- 11.9 [SD] years; mean indexed GFR, 45.7 +/- 28.6 mL/min/1.73 m(2) [0.76 +/- 0.48 mL/s]), we evaluated kidney function (GFR) by means of inulin clearance. CysC level was determined by using a particle-enhanced turbidimetric immunoassay. Total lean (LM) and fat masses were measured by means of dual-energy x-ray absorptiometry. Multiple regression was used to analyze relationships between absolute GFR, LM, fat mass, demographic and anthropometric variables (age, sex, height, and weight), and CysC levels. Then prediction equations were built that included only CysC level or CysC level and LM. Their performance to predict absolute GFR was evaluated in a subset of patients with extreme body composition (LM or fat mass > +/-1 SD of the entire sample). RESULTS Only absolute GFR and LM significantly explained variance in CysC levels, and an equation including LM explained more variance in absolute GFR than an equation including CysC level alone. Consequently, the equation including LM performed better than the equation with only CysC level, especially in patients with extreme body composition, showing reduced bias and improved limits of agreement and accuracy (71.4% versus 51.4% of patients' predicted GFR did not deviate by >30% of GFR). CONCLUSION LM is a previously unrecognized, but important, factor affecting CysC level, and GFR estimation improves when including LM. CysC level is not independent of body composition, as previously assumed, and hence accounting for body composition improves CysC-based GFR estimation.
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Affiliation(s)
- Jamie Macdonald
- School of Sport, Health and Exercise Sciences, University of Wales-Bangor, Gwynedd, LL57 2PZ, UK.
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Wielopolski L, Ramirez LM, Gallagher D, Sarkar SR, Zhu F, Kaysen GA, Levin NW, Heymsfield SB, Wang ZM. Measuring partial body potassium in the arm versus total body potassium. J Appl Physiol (1985) 2006; 101:945-9. [PMID: 16741259 PMCID: PMC1850529 DOI: 10.1152/japplphysiol.00999.2005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Skeletal muscle (SM), the body's main structural support, has been implicated in metabolic, physiological, and disease processes in humans. Despite being the largest tissue in the human body, its assessment remains difficult and indirect. However, being metabolically active it contains over 50% of the total body potassium (TBK) pool. We present our preliminary results from a new system for measuring partial body K (PBK) that presently are limited to the arm yet provide a direct and specific measure of the SM. This uniquely specific quantification of the SM mass in the arm, which is shielded from the body during measurement, allows us to simplify the assumptions used in deriving the total SM, thereby possibly improving the modeling of the human body compartments. Preliminary results show that PBK measurements are consistent with those from the TBK previously obtained from the same subjects, thus offering a simpler alternative to computed tomography and magnetic resonance imaging used for the same purposes. The PBK system, which can be set up in a physician's office or bedside in a hospital, is completely passive, safe, and inexpensive; it can be used on immobilized patients, children, pregnant women, or other at-risk populations.
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Affiliation(s)
- L Wielopolski
- Brookhaven National Laboratory, Medical Department, Upton, NY 11973, USA.
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31
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Pederson BA, Schroeder JM, Parker GE, Smith MW, DePaoli-Roach AA, Roach PJ. Glucose metabolism in mice lacking muscle glycogen synthase. Diabetes 2005; 54:3466-73. [PMID: 16306363 DOI: 10.2337/diabetes.54.12.3466] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Glycogen is an important component of whole-body glucose metabolism. MGSKO mice lack skeletal muscle glycogen due to disruption of the GYS1 gene, which encodes muscle glycogen synthase. MGSKO mice were 5-10% smaller than wild-type littermates with less body fat. They have more oxidative muscle fibers and, based on the activation state of AMP-activated protein kinase, more capacity to oxidize fatty acids. Blood glucose in fed and fasted MGSKO mice was comparable to wild-type littermates. Serum insulin was lower in fed but not in fasted MGSKO animals. In a glucose tolerance test, MGSKO mice disposed of glucose more effectively than wild-type animals and had a more sustained elevation of serum insulin. This result was not explained by increased conversion to serum lactate or by enhanced storage of glucose in the liver. However, glucose infusion rate in a euglycemic-hyperinsulinemic clamp was normal in MGSKO mice despite diminished muscle glucose uptake. During the clamp, MGSKO animals accumulated significantly higher levels of liver glycogen as compared with wild-type littermates. Although disruption of the GYS1 gene negatively affects muscle glucose uptake, overall glucose tolerance is actually improved, possibly because of a role for GYS1 in tissues other than muscle.
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Affiliation(s)
- Bartholomew A Pederson
- Department of Biochemistry and Molecular Biology and Center for Diabetes Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
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32
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Kaysen GA, Zhu F, Sarkar S, Heymsfield SB, Wong J, Kaitwatcharachai C, Kuhlmann MK, Levin NW. Estimation of total-body and limb muscle mass in hemodialysis patients by using multifrequency bioimpedance spectroscopy. Am J Clin Nutr 2005; 82:988-95. [PMID: 16280429 DOI: 10.1093/ajcn/82.5.988] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Skeletal muscle mass can be measured noninvasively with magnetic resonance imaging (MRI), but this is time-consuming and expensive. OBJECTIVE We evaluated the use of multifrequency bioimpedance spectroscopy (BIS) measurements of intracellular volume (ICV) to model total-body skeletal muscle mass (TBMM) and limb skeletal muscle mass in hemodialysis patients. DESIGN TBMM was measured by MRI in 20 male and 18 female hemodialysis patients with a median (range) age of 54 y (33-73 y), weight of 78.9 kg (43.2-120 kg), and body mass index (BMI; in kg/m2) of 27.3 (19.4-46.6). We measured total body water (TBW) by using D2O dilution, extracellular volume (ECV) as bromide space, and ICV as TBW minus bromide space. Total body potassium (TBK) measured as 40K was used as an independent model of TBMM. BIS was used to measure whole-body TBW (ankle to wrist) and TBW in the arms and legs. BIS-estimated ICV was used to construct models to calculate limb muscle mass and TBMM. The latter was compared with models derived from isotopic methods. RESULTS BIS yielded a model for TBMM [TBMM = 9.52 + 0.331 x ICV + 2.77 (male) + 0.180 x weight (kg) - 0.133 x age] (R2 = 0.937, P < 0.0001) as precise as TBK-measured TBMM [TBMM = 1.29 + 0.00453 x TBK (mEq) + 1.46 (male) + 0.144 x weight (kg) - 0.0565 x age] (R2 = 0.930, P < 0.0001) or isotopic methods. BIS models were also developed for measuring leg and arm muscle mass. CONCLUSION BIS provides an estimate of TBMM that correlates well with isotopic methods in approximating values obtained by MRI and can be used to estimate limb muscle mass.
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Zhu F, Kuhlmann MK, Kaysen GA, Sarkar S, Kaitwatcharachai C, Khilnani R, Stevens L, Leonard EF, Wang J, Heymsfield S, Levin NW. Segment-specific resistivity improves body fluid volume estimates from bioimpedance spectroscopy in hemodialysis patients. J Appl Physiol (1985) 2005; 100:717-24. [PMID: 16254072 DOI: 10.1152/japplphysiol.00669.2005] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Discrepancies in body fluid estimates between segmental bioimpedance spectroscopy (SBIS) and gold-standard methods may be due to the use of a uniform value of tissue resistivity to compute extracellular fluid volume (ECV) and intracellular fluid volume (ICV). Discrepancies may also arise from the exclusion of fluid volumes of hands, feet, neck, and head from measurements due to electrode positions. The aim of this study was to define the specific resistivity of various body segments and to use those values for computation of ECV and ICV along with a correction for unmeasured fluid volumes. Twenty-nine maintenance hemodialysis patients (16 men) underwent body composition analysis including whole body MRI, whole body potassium (40K) content, deuterium, and sodium bromide dilution, and segmental and wrist-to-ankle bioimpedance spectroscopy, all performed on the same day before a hemodialysis. Segment-specific resistivity was determined from segmental fat-free mass (FFM; by MRI), hydration status of FFM (by deuterium and sodium bromide), tissue resistance (by SBIS), and segment length. Segmental FFM was higher and extracellular hydration of FFM was lower in men compared with women. Segment-specific resistivity values for arm, trunk, and leg all differed from the uniform resistivity used in traditional SBIS algorithms. Estimates for whole body ECV, ICV, and total body water from SBIS using segmental instead of uniform resistivity values and after adjustment for unmeasured fluid volumes of the body did not differ significantly from gold-standard measures. The uniform tissue resistivity values used in traditional SBIS algorithms result in underestimation of ECV, ICV, and total body water. Use of segmental resistivity values combined with adjustment for body volumes that are neglected by traditional SBIS technique significantly improves estimations of body fluid volume in hemodialysis patients.
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Affiliation(s)
- F Zhu
- Renal Research Institute, Yorkville Dialysis Center, 1555 3rd Ave. #218, New York, NY 10128, USA.
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Sanada K, Kearns CF, Midorikawa T, Abe T. Prediction and validation of total and regional skeletal muscle mass by ultrasound in Japanese adults. Eur J Appl Physiol 2005; 96:24-31. [PMID: 16235068 DOI: 10.1007/s00421-005-0061-0] [Citation(s) in RCA: 163] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2005] [Indexed: 10/25/2022]
Abstract
The present study was performed to develop regression-based prediction equations for skeletal muscle (SM) mass by ultrasound and to investigate the validity of these equations in Japanese adults. Seventy-two Japanese men (n=38) and women (n=34) aged 18-61 years participated in this study and were randomly separated into two groups: the model development group (n=48) and the validation group (n=24). The total and regional SM mass were measured using magnetic resonance imaging (MRI) 1.5 T-scanners with spin-echo sequence. Contiguous transverse images (about 150 slices) with a slice thickness of 1 cm were obtained from the first cervical vertebra to the ankle joints. The volume of SM was calculated from the summation of digitized cross-sectional area. The SM volume was converted into mass units (kg) by an assumed SM density of 1.04 kg l(-1). The muscle thickness (MTH) was measured by B-mode ultrasound (5 MHz scanning head) at nine sites on the anatomical SM belly. Strong correlations were observed between the site-matched SM mass (total, arm, trunk body, thigh, and lower leg) by MRI measurement and the MTH x height (in m) in the model development group (r=0.83-0.96 in men, r=0.53-0.91 in women, P<0.05). When the SM mass prediction equations were applied to the validation group, significant correlations were also observed between the MRI-measured and predicted SM mass (P<0.05). The predicted total SM mass for the validation group was 19.6 (6.5) kg and was not significantly different from the MRI-measured SM mass of 20.2 (6.5) kg. Bland-Altman analysis did not indicate a bias in prediction of the total SM mass for the validation group (r=0.00, NS). These results suggested that ultrasound-derived prediction equations are a valid method to predict SM mass and an alternative to MRI measurement in healthy Japanese adults.
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Affiliation(s)
- Kiyoshi Sanada
- Tokyo Metropolitan University, 1-1 Minami-Ohsawa Hachioji, Tokyo, 192-0397, Japan.
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Shen W, St-Onge MP, Pietrobelli A, Wang J, Wang Z, Heshka S, Heymsfield SB. Four-compartment cellular level body composition model: comparison of two approaches. ACTA ACUST UNITED AC 2005; 13:58-65. [PMID: 15761163 PMCID: PMC1993905 DOI: 10.1038/oby.2005.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to develop and compare two DXA-based four-compartment [body weight=body cell mass (BCM)+extracellular fluid (ECF)+extracellular solids (ECS)+fat] cellular level models. RESEARCH METHODS AND PROCEDURES Total body potassium (TBK) model: BCM from TBK by whole-body counting-ECF(TBK)=LST-[BCM(TBK)+0.73 x osseous mineral (Mo)]. Bromide model: ECF from sodium bromide dilution-BCM(BROMIDE)=LST-(ECF(BROMIDE)+0.73xMo); Mo and LST measurements came from DXA. The two approaches were evaluated in 99 healthy men and 118 women. RESULTS BCM estimates were highly correlated (r=0.97, p<0.001), as were ECF estimates (r=0.87, p<0.001); a small statistically significant mean difference was present (mean+/-SD; BCM(TBK) model, 30.4+/-8.9 kg; BCM(BROMIDE), 31.4+/-9.3 kg; Delta=1.0+/-2.8 kg; p<0.001; ECF(TBK), 18.5+/-4.2 kg; ECF(BROMIDE), 17.5+/-3.6 kg; Delta=1.0+/-2.8 kg; p<0.001). A high correlation (r=0.97, p<0.001) and good agreement (38.9+/-9.5 vs. 38.9+/-9.5 kg; Delta=0.0+/-2.4 kg; p=0.39) were present between TBW, derived as the sum of intracellular water from TBK and ECW from bromide, and measured TBW by 2H2O dilution. DISCUSSION Two developed four-compartment cellular level DXA models, one of which is appropriate for use in most clinical and research settings, provide comparable results and are applicable for BCM and ECF estimation of subject groups with hydration disturbances.
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Affiliation(s)
- Wei Shen
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
| | - Marie-Pierre St-Onge
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
| | | | - Jack Wang
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
| | - ZiMian Wang
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
| | - Stanley Heshka
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
| | - Steven B. Heymsfield
- Obesity Research Center, St. Luke’s-Roosevelt Hospital, Columbia University College of Physicians and Surgeons and Institute of Human Nutrition, New York, New York
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St-Onge MP, Wang Z, Horlick M, Wang J, Heymsfield SB. Dual-energy X-ray absorptiometry lean soft tissue hydration: independent contributions of intra- and extracellular water. Am J Physiol Endocrinol Metab 2004; 287:E842-7. [PMID: 15238354 DOI: 10.1152/ajpendo.00361.2003] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dual-energy X-ray absorptiometry (DEXA) provides a measure of lean soft tissue (LST). LST hydration, often assumed to be constant, is relevant to several aspects of DEXA body composition estimates. The aims of this study were to develop a theoretical model of LST total body water (TBW) content and to examine hydration effects with empirically derived model coefficients and then to experimentally test the model's prediction that, in healthy adults, LST hydration is not constant but varies as a function of extra- and intracellular water distribution (E/I). The initial phase involved TBW/LST model development and application with empirically derived model coefficients. Model predictions were then tested in a cross-sectional study of 215 healthy adults. LST was measured by DEXA, extracellular water (ECW) by NaBr dilution, intracellular water (ICW) by whole body (40)K counting, and TBW by (2)H(2)O dilution. TBW estimates, calculated as ECW + ICW, were highly correlated with (r = 0.97, SEE = 2.1 kg, P < 0.001) and showed no significant bias compared with TBW measured by (2)H(2)O. Model-predicted TBW/LST was almost identical to experimentally derived values (means +/- SD) in the total group (0.767 vs. 0.764 +/- 0.028). LST hydration was significantly correlated with E/I (total group, r = 0.30, SEE = 0.027, P < 0.001). Although E/I increased with age (men, r = 0.48; women, r = 0.37; both P < 0.001), the association between TBW/LST and age was nonsignificant. Hydration of the DEXA-derived LST compartment is thus not constant but varies predictably with ECW and ICW distribution. This observation has implications for the accuracy of body fat measurements by DEXA and the use of TBW as a means of checking DEXA system calibration.
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Affiliation(s)
- Marie-Pierre St-Onge
- St. Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New Youk, NY 10025, USA
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Wells JCK, Murphy AJ, Buntain HM, Greer RM, Cleghorn GJ, Davies PSW. Adjusting body cell mass for size in women of differing nutritional status. Am J Clin Nutr 2004; 80:333-6. [PMID: 15277153 DOI: 10.1093/ajcn/80.2.333] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Body cell mass (BCM) may be estimated in clinical practice to assess functional nutritional status, eg, in patients with anorexia nervosa. Interpretation of the data, especially in younger patients who are still growing, requires appropriate adjustment for size. Previous investigations of this general issue have addressed chemical rather than functional components of body composition and have not considered patients at the extremes of nutritional status, in whom the ability to make longitudinal comparisons is of particular importance. OBJECTIVE Our objective was to determine the power by which height should be raised to adjust BCM for height in women of differing nutritional status. DESIGN BCM was estimated by (40)K counting in 58 healthy women, 33 healthy female adolescents, and 75 female adolescents with anorexia nervosa. The relation between BCM and height was explored in each group by using log-log regression analysis. RESULTS The powers by which height should be raised to adjust BCM were 1.73, 1.73, and 2.07 in the women, healthy female adolescents, and anorexic female adolescents, respectively. A simplified version of the index, BCM/height(2), was appropriate for all 3 categories and was negligibly correlated with height. CONCLUSIONS In normal-weight women, the relation between height and BCM is consistent with that reported previously between height and fat-free mass. Although the consistency of the relation between BCM and fat-free mass decreases with increasing weight loss, the relation between height and BCM is not significantly different between normal-weight and underweight women. The index BCM/height(2) is easy to calculate and applicable to both healthy and underweight women. This information may be helpful in interpreting body-composition data in clinical practice.
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Affiliation(s)
- Jonathan C K Wells
- MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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38
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Kim J, Heshka S, Gallagher D, Kotler DP, Mayer L, Albu J, Shen W, Freda PU, Heymsfield SB. Intermuscular adipose tissue-free skeletal muscle mass: estimation by dual-energy X-ray absorptiometry in adults. J Appl Physiol (1985) 2004; 97:655-60. [PMID: 15090482 DOI: 10.1152/japplphysiol.00260.2004] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Skeletal muscle (SM) is a large and physiologically important compartment. Adipose tissue is found interspersed between and within SM groups and is referred to as intermuscular adipose tissue (IMAT). The study objective was to develop prediction models linking appendicular lean soft tissue (ALST) estimates by dual-energy X-ray absorptiometry (DXA) with whole body IMAT-free SM quantified by magnetic resonance imaging. ALST and total-body IMAT-free SM were evaluated in 270 healthy adults [body mass index (BMI) of <35 kg/m2]. The SM prediction models were then validated by the leave-one-out method and by application in a new group of subjects who varied in SM mass [anorexia nervosa (AN), n = 23; recreational athletes, n = 16; patients with acromegaly, n = 7]. ALST alone was highly correlated with whole body IMAT-free SM [ model 1: R2 = 0.96, standard error (SE) = 1.46 kg, P < 0.001]; age ( model 2: R2 = 0.97, SE = 1.38 kg, P < 0.001) and sex and race ( model 3: R2 = 0.97, SE = 1.06 kg, both P < 0.001) added significantly to the prediction models. All three models validated in the athletes and patients with acromegaly but significantly ( P < 0.01–0.001) over-predicted SM in the AN group as a whole. However, model 1 was validated in AN patients with BMIs in the model-development group range ( n = 11; BMI of >16 kg/m2) but not in those with a BMI of <16 kg/m2 ( n = 12). The DXA-based models are accurate for predicting IMAT-free SM in selected populations and thus provide a new opportunity for quantifying SM in physiological and epidemiological investigations.
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Affiliation(s)
- Jaehee Kim
- Obesity Research Center, College of Physicians and Surgeons, Columbia University, New York, NY 10025, USA
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39
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He Q, Heo M, Heshka S, Wang J, Pierson RN, Albu J, Wang Z, Heymsfield SB, Gallagher D. Total body potassium differs by sex and race across the adult age span. Am J Clin Nutr 2003; 78:72-7. [PMID: 12816773 DOI: 10.1093/ajcn/78.1.72] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Total body potassium (TBK) is an index of fat-free mass. Data describing changes in TBK in African American, Asian, or Hispanic populations have not been reported. OBJECTIVE The aim was to investigate possible sex and racial differences in TBK in adults over an age range of 70 y. DESIGN The study used longitudinal and cross-sectional data collected in a body-composition unit from 973 men and 1368 women of African American, Asian, white, and Hispanic race-ethnicity. Random coefficient models in which baseline weight and height were taken into account were applied to estimate sex-specific changes in TBK among the 4 racial-ethnic groups. RESULTS The ages of 30 and 31 y were identified for women and men, respectively, as the cutoffs after which TBK began to decline. Both sexes had similar racial-ethnic patterns for expected mean TBK at the age cutoffs: African Americans had the highest value, followed by whites, Hispanics, and Asians. After the age cutoffs, the decline in TBK differed by race and sex. In women, African Americans showed the most rapid decline, whereas Asians had the lowest. In men, Hispanics had the most rapid decline in TBK, followed by African Americans, whites, and Asians. CONCLUSION Significant sex and racial differences exist in the rate of change in TBK with age. Further studies are needed to explore the associations of declining TBK with health risks.
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Affiliation(s)
- Qing He
- Obesity Research Center, St Luke's-Roosevelt Hospital, and Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY 1025, USA
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