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Aleixo GFP, Hess DL, Fowler ME, Giri S, Williams GR. Racial differences in body composition and survival among older adults with gastrointestinal malignancies. J Geriatr Oncol 2024; 15:101747. [PMID: 38513310 DOI: 10.1016/j.jgo.2024.101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/03/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Muscle and adipose tissue measures can be quantified from routinely obtained computed tomography (CT) images and are predictors of chemotherapy-related toxicities and survival among patients with gastrointestinal (GI) malignancies. Most studies to date have consisted of predominantly White patients, and the role of body composition among minoritized racial groups is unknown. We examined racial differences in body composition and survival among patients with GI malignancies. MATERIALS AND METHODS This was a prospective cohort study of patients with GI malignancies. Single slices of axial CT images from L3 segments were analyzed using Slice-O-Matic software. The skeletal muscle area (cm2) was divided by height to obtain the skeletal muscle index (SMI, cm2/m2). Skeletal muscle radiodensity (SMD) in Hounsfield units (HU) was used for muscle composition. We compared body composition parameters between non-Hispanic (NH)-White and NH-Black participants. Cox models were used to examine the impact of body composition on survival. We proposed new race-specific cutoffs for body composition using optimal stratification. RESULTS Five hundred forty patients were included, of which 24% were NH-Black. In Cox models stratified by race, each 5 cm2/m2 decrease in SMI was associated with increase in risk of all-cause mortality in NH-Black patients (hazard ratio [HR] 1.25; 95% confidence interval [CI] 1.04-1.49 p = 0.02). With the existing cut points, neither sarcopenia nor myosteatosis was associated with worse survival. Using a new cutoff for sarcopenia in NH-Black patients, NH-Black patients with sarcopenia (HR 2.31 95%CI 1.10-4.88 p = 0.03) and myosteatosis (HR 2.63 95% CI 1.25-5.53 p = 0.01) had worse survival. DISCUSSION NH-Black older patients with GI cancers and sarcopenia or myosteatosis have worse overall survival.
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Affiliation(s)
- Gabriel F P Aleixo
- University of Pennsylvania, Department of Hematology and Oncology, Philadelphia, PA, United States of America.
| | - Daniel L Hess
- The University of Alabama at Birmingham, Department of Medicine, Birmingham, AL, United States of America
| | - Mackenzie E Fowler
- The University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL, United States of America
| | - Smith Giri
- The University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America
| | - Grant R Williams
- The University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America
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Yu Y, Su Y, Wang G, Lan M, Liu J, Garcia Martin R, Brandao BB, Lino M, Li L, Liu C, Kahn CR, Meng Q. Reciprocal communication between FAPs and muscle cells via distinct extracellular vesicle miRNAs in muscle regeneration. Proc Natl Acad Sci U S A 2024; 121:e2316544121. [PMID: 38442155 PMCID: PMC10945765 DOI: 10.1073/pnas.2316544121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Abstract
Muscle regeneration is a complex process relying on precise teamwork between multiple cell types, including muscle stem cells (MuSCs) and fibroadipogenic progenitors (FAPs). FAPs are also the main source of intramuscular adipose tissue (IMAT). Muscles without FAPs exhibit decreased IMAT infiltration but also deficient muscle regeneration, indicating the importance of FAPs in the repair process. Here, we demonstrate the presence of bidirectional crosstalk between FAPs and MuSCs via their secretion of extracellular vesicles (EVs) containing distinct clusters of miRNAs that is crucial for normal muscle regeneration. Thus, after acute muscle injury, there is activation of FAPs leading to a transient rise in IMAT. These FAPs also release EVs enriched with a selected group of miRNAs, a number of which come from an imprinted region on chromosome 12. The most abundant of these is miR-127-3p, which targets the sphingosine-1-phosphate receptor S1pr3 and activates myogenesis. Indeed, intramuscular injection of EVs from immortalized FAPs speeds regeneration of injured muscle. In late stages of muscle repair, in a feedback loop, MuSCs and their derived myoblasts/myotubes secrete EVs enriched in miR-206-3p and miR-27a/b-3p. The miRNAs repress FAP adipogenesis, allowing full muscle regeneration. Together, the reciprocal communication between FAPs and muscle cells via miRNAs in their secreted EVs plays a critical role in limiting IMAT infiltration while stimulating muscle regeneration, hence providing an important mechanism for skeletal muscle repair and homeostasis.
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Affiliation(s)
- Yingying Yu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Yang Su
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
- Department of Cell Biology, Third Military Medical University, Chongqing400038, China
| | - Guoxiao Wang
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Miaomiao Lan
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
| | - Jin Liu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
| | - Ruben Garcia Martin
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Bruna Brasil Brandao
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Marsel Lino
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Lei Li
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
| | - Chang Liu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
| | - C. Ronald Kahn
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA02215
| | - Qingyong Meng
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, Department of Genetics and Molecular biology, China Agricultural University, Beijing100193, China
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Ramirez Bustamante CE, Agarwal N, Cox AR, Hartig SM, Lake JE, Balasubramanyam A. Adipose Tissue Dysfunction and Energy Balance Paradigms in People Living With HIV. Endocr Rev 2024; 45:190-209. [PMID: 37556371 PMCID: PMC10911955 DOI: 10.1210/endrev/bnad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Abstract
Over the past 4 decades, the clinical care of people living with HIV (PLWH) evolved from treatment of acute opportunistic infections to the management of chronic, noncommunicable comorbidities. Concurrently, our understanding of adipose tissue function matured to acknowledge its important endocrine contributions to energy balance. PLWH experience changes in the mass and composition of adipose tissue depots before and after initiating antiretroviral therapy, including regional loss (lipoatrophy), gain (lipohypertrophy), or mixed lipodystrophy. These conditions may coexist with generalized obesity in PLWH and reflect disturbances of energy balance regulation caused by HIV persistence and antiretroviral therapy drugs. Adipocyte hypertrophy characterizes visceral and subcutaneous adipose tissue depot expansion, as well as ectopic lipid deposition that occurs diffusely in the liver, skeletal muscle, and heart. PLWH with excess visceral adipose tissue exhibit adipokine dysregulation coupled with increased insulin resistance, heightening their risk for cardiovascular disease above that of the HIV-negative population. However, conventional therapies are ineffective for the management of cardiometabolic risk in this patient population. Although the knowledge of complex cardiometabolic comorbidities in PLWH continues to expand, significant knowledge gaps remain. Ongoing studies aimed at understanding interorgan communication and energy balance provide insights into metabolic observations in PLWH and reveal potential therapeutic targets. Our review focuses on current knowledge and recent advances in HIV-associated adipose tissue dysfunction, highlights emerging adipokine paradigms, and describes critical mechanistic and clinical insights.
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Affiliation(s)
- Claudia E Ramirez Bustamante
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Neeti Agarwal
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aaron R Cox
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sean M Hartig
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jordan E Lake
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at UTHealth, Houston, TX 77030, USA
| | - Ashok Balasubramanyam
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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Choi HN, Kim YS, Yim JE. Association of daily carbohydrate intake with intermuscular adipose tissue in Korean individuals with obesity: a cross-sectional study. Nutr Res Pract 2024; 18:78-87. [PMID: 38352215 PMCID: PMC10861342 DOI: 10.4162/nrp.2024.18.1.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/27/2023] [Accepted: 11/16/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES The prevalence of obesity, a worldwide pandemic, has been increasing steadily in Korea. Reports have shown that increased intermuscular adipose tissue (IMAT) is associated with an increased risk of cardiovascular disease, independent of body mass index. However, the relationship between dietary intake and IMAT accumulation in the Korean population remains undetermined. The objective of this study was to evaluate regional fat compartments using advanced magnetic resonance imaging (MRI) techniques. We also aimed to investigate the association between IMAT amounts and dietary intake, including carbohydrate intake, among Korean individuals with obesity. SUBJECTS/METHODS This cross-sectional study, performed at a medical center in South Korea, recruited 35 individuals with obesity (15 men and 20 women) and classified them into 2 groups according to sex. Anthropometry was performed, and body fat distribution was measured using MRI. Blood parameters, including glucose and lipid profiles, were analyzed using commercial kits. Linear regression analysis was used to test whether the IMAT was associated with daily carbohydrate intake. RESULTS Carbohydrate intake was positively associated with IMAT in all individuals, with adjustments for age, sex, height, and weight. No significant differences in blood indicators were found between the sexes. CONCLUSIONS Regardless of sex and age, higher carbohydrate intake was strongly correlated with greater IMAT accumulation. This suggests the need to better understand sex differences and high carbohydrate diet patterns in relation to the association between obesity and metabolic risk, which may help reduce obesity prevalence.
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Affiliation(s)
- Ha-Neul Choi
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
| | - Young-Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul 02447, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
- Interdisciplinary Program in Senior Human Ecology (BK21 Four Program), Changwon National University, Changwon 51140, Korea
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Rosano C, Newman A, Santanasto A, Zhu X, Goodpaster B, Miljkovic I. Increase in skeletal muscular adiposity and cognitive decline in a biracial cohort of older men and women. J Am Geriatr Soc 2023; 71:2759-2768. [PMID: 37282843 PMCID: PMC10524226 DOI: 10.1111/jgs.18419] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Obesity and loss of muscle mass are emerging as risk factors for dementia, but the role of adiposity infiltrating skeletal muscles is less clear. Skeletal muscle adiposity increases with older age and especially among Black women, a segment of the US population who is also at higher risk for dementia. METHODS In 1634 adults (69-79 years, 48% women, 35% Black), we obtained thigh intermuscular adipose tissue (IMAT) via computerized tomography at Years 1 and 6, and mini-mental state exam (3MS) at Years 1, 3, 5, 8 and 10. Linear mixed effects models tested the hypothesis that increased IMAT (Year 1-6) would be associated with 3MS decline (Year 5-10). Models were adjusted for traditional dementia risk factors at Year 1 (3MS, education, APOe4 allele, diabetes, hypertension, and physical activity), with interactions between IMAT change by race or sex. To assess the influence of other muscle and adiposity characteristics, models accounted for change in muscle strength, muscle area, body weight, abdominal subcutaneous and visceral adiposity, and total body fat mass (all measured in Years 1 and 6). Models were also adjusted for cytokines related to adiposity: leptin, adiponectin, and interleukin-6. RESULTS Thigh IMAT increased by 4.85 cm2 (Year 1-6) and 3MS declined by 3.20 points (Year 6-10). The association of IMAT increase with 3MS decline was statistically significant: an IMAT increase of 4.85 cm2 corresponded to a 3MS decline of an additional 3.60 points (p < 0.0001), indicating a clinically important change. Interactions by race and sex were not significant. CONCLUSIONS Clinicians should be aware that regional adiposity accumulating in the skeletal muscle may be an important, novel risk factor for cognitive decline in Black and White participants independent of changes to muscle strength, body composition and traditional dementia risk factors.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Anne Newman
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Adam Santanasto
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Xiaonan Zhu
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | | | - Iva Miljkovic
- Department of Epidemiology, School of Public Health, University of Pittsburgh
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Eren Cankurtaran R, Güneş YC, Dirican E, Algın O, Cankurtaran D, Yürekli ÖT. Sarcopenia and Myosteatosis Assessed by Magnetic Resonance Enterography May Predict Negative Outcomes in Patients with Crohn's Disease. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2023; 34:839-849. [PMID: 37404120 PMCID: PMC10543407 DOI: 10.5152/tjg.2023.22644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/21/2022] [Indexed: 07/06/2023]
Abstract
BACKGROUND Limited research has examined the clinical consequences of sarcopenia and myosteatosis in Crohn's disease. This study aimed to determine the prevalence, risk factors, and effects of sarcopenia and myosteatosis on prognostic outcomes in Crohn's disease patients who underwent magnetic resonance enterography. MATERIALS AND METHODS This retrospective observational study included 116 Crohn's disease patients who underwent magnetic resonance enterography between January 2015 and August 2021. Skeletal muscle index was the ratio of the cross-sectional area of skeletal muscles at the L3 vertebral level to the square of the neck in cross-sectional imaging. Sarcopenia was defined as skeletal muscle index <38.5 cm2/m2 in women and <52.4 cm2/m2 in men. Myosteatosis was considered positive if the ratio of the mean signal intensity of the psoas muscle to the mean signal intensity of the cerebrospinal fluid was above 0.107. RESULTS Among the negative results in the post-procedure follow-up of the patients, a significant increase was observed in the sarcopenia group regarding abscess and the need for surgery (P < .05). Anti-tumor necrosis factor initiation was found to be significantly higher in the follow-up than in patients without myosteatosis (P = .029). In the multivariate model established with these variables, the presence of sarcopenia in the surgical follow-up was odds ratio = 5.34 (CI: 1.02-28.03, P = .047) and was found to be significantly associated with the increased risk. CONCLUSIONS The presence of myosteatosis and sarcopenia detected in magnetic resonance enterography may be a harbinger of negative outcomes in Crohn's disease patients. Nutritional support should be provided to these patients with the potential to alter the course of the disease.
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Affiliation(s)
- Rasim Eren Cankurtaran
- Department of Gastroenterology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Yasin Celal Güneş
- Department of Radiology, Ankara Ataturk Sanatorium Training and Research Hospital, Ankara, Turkey
| | - Emre Dirican
- Department of Medical Informatics and Biostatistics, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Oktay Algın
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Damla Cankurtaran
- Department of Physical Medicine and Rehabilitation, University of Health of Sciences Dışkapı Education and Research Hospital, Ankara, Turkey
| | - Öykü Tayfur Yürekli
- Department of Gastroenterology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Jevtovic F, Lopez CA, Zheng D, Cortright RN, Biagioni EM, Claiborne A, Isler C, DeVente JE, Houmard JA, May LE, Broskey NT. Differences in substrate metabolism between African American and Caucasian infants: evidence from mesenchymal stem cells. J Appl Physiol (1985) 2023; 134:1312-1320. [PMID: 37055039 PMCID: PMC11215326 DOI: 10.1152/japplphysiol.00737.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023] Open
Abstract
Type 2 diabetes is more prevalent in African American (AA) than Caucasian (C) adults. Furthermore, differential substrate utilization has been observed between AA and C adults, but data regarding metabolic differences between races at birth remains scarce. The purpose of the present study was to determine if there are racial differences in substrate metabolism evident at birth using a mesenchymal stem cells (MSCs) collected from offspring umbilical cords. Using radio-labeled tracers, MSCs from offspring of AA and C mothers were tested for glucose and fatty acid metabolism in the undifferentiated state and while undergoing myogenesis in vitro. Undifferentiated MSCs from AA exhibited greater partitioning of glucose toward nonoxidized glucose metabolites. In the myogenic state, AA displayed higher glucose oxidation, but similar fatty acid oxidation rates. In the presence of both glucose and palmitate, but not palmitate only, AA exhibit a higher rate of incomplete fatty acid oxidation evident by a greater production of acid-soluble metabolites. Myogenic differentiation of MSCs elicits an increase in glucose oxidation in AA, but not in C. Together, these data suggest that metabolic differences between AA and C races exist at birth.NEW & NOTEWORTHY African Americans, when compared with Caucasians, display greater insulin resistance in skeletal muscle. Differences in substrate utilization have been proposed as a factor for this health disparity; however, it remains unknown how early these differences manifest. Using infant umbilical cord-derived mesenchymal stem cells, we tested for in vitro glucose and fatty acid oxidation differences. Myogenically differentiated MSCs from African American offspring display higher rates of glucose oxidation and incomplete fatty acid oxidation.
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Affiliation(s)
- Filip Jevtovic
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Christian A Lopez
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Donghai Zheng
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Ronald N Cortright
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Ericka M Biagioni
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Alex Claiborne
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Christy Isler
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, United States
| | - James E DeVente
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, United States
| | - Joseph A Houmard
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Linda E May
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Nicholas T Broskey
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, United States
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, United States
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
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Goodpaster BH, Bergman BC, Brennan AM, Sparks LM. Intermuscular adipose tissue in metabolic disease. Nat Rev Endocrinol 2022; 19:285-298. [PMID: 36564490 DOI: 10.1038/s41574-022-00784-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
Intermuscular adipose tissue (IMAT) is a distinct adipose depot described in early reports as a 'fatty replacement' or 'muscle fat infiltration' that was linked to ageing and neuromuscular disease. Later studies quantifying IMAT with modern in vivo imaging methods (computed tomography and magnetic resonance imaging) revealed that IMAT is proportionately higher in men and women with type 2 diabetes mellitus and the metabolic syndrome than in people without these conditions and is associated with insulin resistance and poor physical function with ageing. In parallel, agricultural research has provided extensive insight into the role of IMAT and other muscle lipids in muscle (that is, meat) quality. In addition, studies using rodent models have shown that IMAT is a bona fide white adipose tissue depot capable of robust triglyceride storage and turnover. Insight into the importance of IMAT in human biology has been limited by the dearth of studies on its biological properties, that is, the quality of IMAT. However, in the past few years, investigations have begun to determine that IMAT has molecular and metabolic features that distinguish it from other adipose tissue depots. These studies will be critical to further decipher the role of IMAT in health and disease and to better understand its potential as a therapeutic target.
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Affiliation(s)
| | - Bryan C Bergman
- Division of Endocrinology, Diabetes, and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrea M Brennan
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL, USA
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Intermuscular Fat, But Not Subcutaneous Fat, Correlated With Major Complications After Primary Total Hip Arthroplasty. Acad Radiol 2022:S1076-6332(22)00505-0. [DOI: 10.1016/j.acra.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/22/2022]
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10
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Kahn D, Macias E, Zarini S, Garfield A, Zemski Berry K, Gerszten R, Schoen J, Cree‐Green M, Bergman BC. Quantifying the inflammatory secretome of human intermuscular adipose tissue. Physiol Rep 2022; 10:e15424. [PMID: 35980018 PMCID: PMC9387112 DOI: 10.14814/phy2.15424] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/23/2022] [Indexed: 11/24/2022] Open
Abstract
Adipose tissue secretes an abundance of lipid and protein mediators, and this secretome is depot-specific, with local and systemic effects on metabolic regulation. Intermuscular adipose tissue (IMAT) accumulates within the skeletal muscle compartment in obesity, and is associated with insulin resistance and metabolic disease. While the human IMAT secretome decreases insulin sensitivity in vitro, its composition is entirely unknown. The current study was conducted to investigate the composition of the human IMAT secretome, compared to that of the subcutaneous (SAT) and visceral adipose tissue (VAT) depots. IMAT, SAT, and VAT explants from individuals with obesity were used to generate conditioned media. Proteomics analysis of conditioned media was performed using multiplex proximity extension assays, and eicosanoid analysis using liquid chromatography-tandem mass spectrometry. Compared to SAT and/or VAT, IMAT secreted significantly more cytokines (IL2, IL5, IL10, IL13, IL27, FGF23, IFNγ and CSF1) and chemokines (MCP1, IL8, CCL11, CCL20, CCL25 and CCL27). Adipokines hepatocyte growth factor and resistin were secreted significantly more by IMAT than SAT or VAT. IMAT secreted significantly more eicosanoids (PGE2, TXB2 , 5-HETE, and 12-HETE) compared to SAT and/or VAT. In the context of obesity, IMAT is a distinct adipose tissue with a highly immunogenic and inflammatory secretome, and given its proximity to skeletal muscle, may be critical to glucose regulation and insulin resistance.
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Affiliation(s)
- Darcy Kahn
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Emily Macias
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Simona Zarini
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Amanda Garfield
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Karin Zemski Berry
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Robert Gerszten
- The Cardiovascular Research Center and Cardiology DivisionMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
| | - Jonathan Schoen
- Department of SurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Melanie Cree‐Green
- Division of Pediatric EndocrinologyUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Bryan C. Bergman
- Division of Endocrinology, Diabetes, and MetabolismUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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Rosen KA, Thodge A, Tang A, Franz BM, Klochko CL, Soliman SB. The sonographic quantitative assessment of the deltoid muscle to detect type 2 diabetes mellitus: a potential noninvasive and sensitive screening method? BMC Endocr Disord 2022; 22:193. [PMID: 35897066 PMCID: PMC9330649 DOI: 10.1186/s12902-022-01107-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In our previous published study, we demonstrated that a qualitatively assessed elevation in deltoid muscle echogenicity on ultrasound was both sensitive for and a strong predictor of a type 2 diabetes (T2DM) diagnosis. This study aims to evaluate if a sonographic quantitative assessment of the deltoid muscle can be used to detect T2DM. METHODS Deltoid muscle ultrasound images from 124 patients were stored: 31 obese T2DM, 31 non-obese T2DM, 31 obese non-T2DM and 31 non-obese non-T2DM. Images were independently reviewed by 3 musculoskeletal radiologists, blinded to the patient's category. Each measured the grayscale pixel intensity of the deltoid muscle and humeral cortex to calculate a muscle/bone ratio for each patient. Following a 3-week delay, the 3 radiologists independently repeated measurements on a randomly selected 40 subjects. Ratios, age, gender, race, body mass index, insulin usage and hemoglobin A1c were analyzed. The difference among the 4 groups was compared using analysis of variance or chi-square tests. Both univariate and multivariate linear mixed models were performed. Multivariate mixed-effects regression models were used, adjusting for demographic and clinical variables. Post hoc comparisons were done with Bonferroni adjustments to identify any differences between groups. The sample size achieved 90% power. Sensitivity and specificity were calculated based on set threshold ratios. Both intra- and inter-radiologist variability or agreement were assessed. RESULTS A statistically significant difference in muscle/bone ratios between the groups was identified with the average ratios as follows: obese T2DM, 0.54 (P < 0.001); non-obese T2DM, 0.48 (P < 0.001); obese non-T2DM, 0.42 (P = 0.03); and non-obese non-T2DM, 0.35. There was excellent inter-observer agreement (intraclass correlation coefficient 0.87) and excellent intra-observer agreements (intraclass correlation coefficient 0.92, 0.95 and 0.94). Using threshold ratios, the sensitivity for detecting T2DM was 80% (95% CI 67% to 88%) with a specificity of 63% (95% CI 50% to 75%). CONCLUSIONS The sonographic quantitative assessment of the deltoid muscle by ultrasound is sensitive and accurate for the detection of T2DM. Following further studies, this process could translate into a dedicated, simple and noninvasive screening method to detect T2DM with the prospects of identifying even a fraction of the undiagnosed persons worldwide. This could prove especially beneficial in screening of underserved and underrepresented communities.
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Affiliation(s)
- Kelli A Rosen
- Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital/Wayne State University, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Anay Thodge
- Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital/Wayne State University, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Amy Tang
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, MI, 48202, USA
| | - Brendan M Franz
- Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital/Wayne State University, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Chad L Klochko
- Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital/Wayne State University, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Steven B Soliman
- Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital/Wayne State University, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
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12
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Mitochondrial Phenotype as a Driver of the Racial Dichotomy in Obesity and Insulin Resistance. Biomedicines 2022; 10:biomedicines10061456. [PMID: 35740478 PMCID: PMC9220271 DOI: 10.3390/biomedicines10061456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/24/2022] Open
Abstract
African Americans (AA) are disproportionately burdened by metabolic diseases. While largely unexplored between Caucasian (C) and AA, differences in mitochondrial bioenergetics may provide crucial insight to mechanisms for increased susceptibility to metabolic diseases. AA display lower total energy expenditure and resting metabolic rate compared to C, but paradoxically have a higher amount of skeletal muscle mass, suggestive of inherent energetic efficiency differences between these races. Such adaptations would increase the chances of overnutrition in AA; however, these disparities would not explain the racial difference in insulin resistance (IR) in healthy subjects. Hallmarks associated with insulin resistance (IR), such as reduced mitochondrial oxidative capacity and metabolic inflexibility are present even in healthy AA without a metabolic disease. These adaptations might be influential of mitochondrial “substrate preference” and could play a role in disproportionate IR rates among races. A higher glycolytic flux and provision of shuttles transferring electrons from cytosol to mitochondrial matrix could be a contributing factor in development of IR via heightened reactive oxygen species (ROS) production. This review highlights the above concepts and provides suggestions for future studies that could help delineate molecular premises behind potential impairments in insulin signaling and metabolic disease susceptibility in AA.
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13
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Lee EJ, Lee MM, Park S, Jeong KS. Sirt2 positively regulates muscle regeneration after Notexin-induced muscle injury. Exp Mol Pathol 2022; 127:104798. [DOI: 10.1016/j.yexmp.2022.104798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/01/2022] [Accepted: 05/24/2022] [Indexed: 01/04/2023]
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14
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Rubenstein AB, Hinkley JM, Nair VD, Nudelman G, Standley RA, Yi F, Yu G, Trappe TA, Bamman MM, Trappe SW, Sparks LM, Goodpaster BH, Vega RB, Sealfon SC, Zaslavsky E, Coen PM. Skeletal muscle transcriptome response to a bout of endurance exercise in physically active and sedentary older adults. Am J Physiol Endocrinol Metab 2022; 322:E260-E277. [PMID: 35068187 PMCID: PMC8897039 DOI: 10.1152/ajpendo.00378.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Age-related declines in cardiorespiratory fitness and physical function are mitigated by regular endurance exercise in older adults. This may be due, in part, to changes in the transcriptional program of skeletal muscle following repeated bouts of exercise. However, the impact of chronic exercise training on the transcriptional response to an acute bout of endurance exercise has not been clearly determined. Here, we characterized baseline differences in muscle transcriptome and exercise-induced response in older adults who were active/endurance trained or sedentary. RNA-sequencing was performed on vastus lateralis biopsy specimens obtained before, immediately after, and 3 h following a bout of endurance exercise (40 min of cycling at 60%-70% of heart rate reserve). Using a recently developed bioinformatics approach, we found that transcript signatures related to type I myofibers, mitochondria, and endothelial cells were higher in active/endurance-trained adults and were associated with key phenotypic features including V̇o2peak, ATPmax, and muscle fiber proportion. Immune cell signatures were elevated in the sedentary group and linked to visceral and intermuscular adipose tissue mass. Following acute exercise, we observed distinct temporal transcriptional signatures that were largely similar among groups. Enrichment analysis revealed catabolic processes were uniquely enriched in the sedentary group at the 3-h postexercise timepoint. In summary, this study revealed key transcriptional signatures that distinguished active and sedentary adults, which were associated with difference in oxidative capacity and depot-specific adiposity. The acute response signatures were consistent with beneficial effects of endurance exercise to improve muscle health in older adults irrespective of exercise history and adiposity.NEW & NOTEWORTHY Muscle transcript signatures associated with oxidative capacity and immune cells underlie important phenotypic and clinical characteristics of older adults who are endurance trained or sedentary. Despite divergent phenotypes, the temporal transcriptional signatures in response to an acute bout of endurance exercise were largely similar among groups. These data provide new insight into the transcriptional programs of aging muscle and the beneficial effects of endurance exercise to promote healthy aging in older adults.
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Affiliation(s)
- Aliza B Rubenstein
- Department of Neurology, Center for Advanced Research on Diagnostic Assays (CARDA), Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Venugopalan D Nair
- Department of Neurology, Center for Advanced Research on Diagnostic Assays (CARDA), Icahn School of Medicine at Mount Sinai, New York, New York
| | - German Nudelman
- Department of Neurology, Center for Advanced Research on Diagnostic Assays (CARDA), Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Fanchao Yi
- AdventHealth Translational Research Institute, Orlando, Florida
| | - GongXin Yu
- AdventHealth Translational Research Institute, Orlando, Florida
| | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Indianapolis, Indiana
| | - Marcas M Bamman
- Department of Cell, Developmental, and Integrative Biology, UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Scott W Trappe
- Human Performance Laboratory, Ball State University, Indianapolis, Indiana
| | - Lauren M Sparks
- AdventHealth Translational Research Institute, Orlando, Florida
| | | | - Rick B Vega
- AdventHealth Translational Research Institute, Orlando, Florida
| | - Stuart C Sealfon
- Department of Neurology, Center for Advanced Research on Diagnostic Assays (CARDA), Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elena Zaslavsky
- Department of Neurology, Center for Advanced Research on Diagnostic Assays (CARDA), Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paul M Coen
- AdventHealth Translational Research Institute, Orlando, Florida
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15
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Abstract
The Exercise Boom of the 1970's resulted in the adoption of habitual exercise in a significant portion of the population. Many of these individuals are defying the cultural norms by remaining physically active and competing at a high level in their later years. The juxtaposition between masters athletes and non-exercisers demonstrate the importance of remaining physically active throughout the lifespan on physiological systems related to healthspan (years of healthy living). This includes ~50% improved maximal aerobic capacity (VO2max) and enhanced skeletal muscle health (size, function, as well as metabolic and communicative properties) compared to non-exercisers at a similar age. By taking a reductionist approach to VO2max and skeletal muscle health, we can gain insight into how aging and habitual exercise affects the aging process. Collectively, this review provides a physiological basis for the elite performances seen in masters athletes, as well as the health implications of lifelong exercise with a focus on VO2max, skeletal muscle metabolic fitness, whole muscle size and function, single muscle fiber physiology, and communicative properties of skeletal muscle. This review has significant public health implications due to the potent health benefits of habitual exercise across the lifespan.
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Affiliation(s)
- Kevin J Gries
- Exercise and Sports Science, Marian University, Indianapolis, United States
| | - S W Trappe
- Human Performance Laboratory, Ball State University, Muncie, United States
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16
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Tilves C, Zmuda JM, Kuipers AL, Nair S, Carr JJ, Terry JG, Peddada S, Wheeler V, Miljkovic I. Relative associations of abdominal and thigh compositions with cardiometabolic diseases in African Caribbean men. Obes Sci Pract 2021; 7:738-750. [PMID: 34877013 PMCID: PMC8633926 DOI: 10.1002/osp4.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/16/2021] [Accepted: 05/02/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Regional body compositions are differentially associated with cardiometabolic risk factors. Simultaneous inclusion of both upper and lower body composition predictors in models is not often done, and studies which do include both measures (1) tend to exclude some tissue(s) of potential metabolic relevance, and (2) have used study populations with underrepresentation of individuals with African ancestries. Further, most body composition analyses do not employ compositional data analytic approaches, which may result in spurious associations. OBJECTIVE The objective of this analysis was to assess associations of abdominal and thigh adipose (AT) and muscle tissues with hypertension and type 2 diabetes using compositional data analytic methods. RESEARCH DESIGN AND METHODS This cross-sectional analysis included 610 African Caribbean men (median age: 62 years; mean BMI: 27.8 kg/m2). Abdominal (three components: subcutaneous [ASAT] and visceral [VAT] AT, 'other' abdominal tissue) and mid-thigh (four components: subcutaneous and intermuscular AT, muscle, bone) compositions were measured by computed tomography; additive log ratio transformations were applied to each composition. Regression models were used to simultaneously assess associations of abdominal and thigh component ratios with continuous risk factors (blood pressures, fasting glucose and insulin, HOMA-IR) and disease categories. RESULTS A two-fold increase in ASAT:'Other' ratio was associated with higher continuous risk factors and with odds of being in a higher hypertension (OR: 1.77, 95%CI: 1.10-2.84) or diabetes (OR: 1.81, 95%CI: 1.06-3.10) category. A two-fold increased VAT ratio was only associated with higher log-insulin and log-HOMA-IR (β = 0.10, p < 0.05 for both), while a two-fold increased thigh muscle:bone ratio was associated with a lower diabetes category (OR: 0.37, 95%CI: 0.14-1.01). CONCLUSIONS These findings support ASAT as a significant driver of cardiometabolic disease in African Ancestry populations, independent of other abdominal and thigh tissues.
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Affiliation(s)
- Curtis Tilves
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Joseph M. Zmuda
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Allison L. Kuipers
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Sangeeta Nair
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - John Jeffrey Carr
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James G. Terry
- Department of RadiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Shyamal Peddada
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Victor Wheeler
- Tobago Health Studies OfficeScarboroughTobagoTrinidad and Tobago
| | - Iva Miljkovic
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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17
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Lee TY, Jeon YJ, Kim CR, Kang BJ, Park GM. Abdominal Muscles and Metabolic Syndrome According to Patient Sex: A Retrospective Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9091197. [PMID: 34574971 PMCID: PMC8470680 DOI: 10.3390/healthcare9091197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Computed tomography (CT) is a reference method for measuring skeletal muscle mass, and the amount of fat in the skeletal muscle can be calculated based on CT attenuation. This study aimed to comprehensively investigate the effect of muscle quality and quantity on metabolic syndrome (MetS) according to sex. This retrospective cross-sectional study enrolled 8081 individuals aged ≥20 years who underwent self-referral abdominopelvic CT at our hospital. The total abdominal muscle area (TAMA), low-attenuation abdominal muscle area (LAMA), normal-attenuation abdominal muscle area (NAMA), and extramyocellular lipid area (EMCLA) were measured using cross-sectional CT data of the L3 lumbar vertebrae. The TAMA and NAMA showed negative correlations with risk factors for MetS and a positive correlation with high-density lipoprotein cholesterol, whereas the LAMA and EMCLA showed an inverse trend in both the sexes (p < 0.001). After adjusting for various factors, a higher LAMA index and the ratio of LAMA to TAMA were associated with a higher prevalence of MetS. High TAMA indices were associated with a lower prevalence of MetS. Furthermore, muscle quality and quantity were associated with the prevalence of MetS in both males and females. However, the LAMA showed a stronger association with MetS in males than in females.
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Affiliation(s)
- Tae Young Lee
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea;
| | - Young-Jee Jeon
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
- Correspondence: (Y.-J.J.); (C.R.K.); Tel.: +82-52-250-8847 (Y.-J.J.); +82-52-250-8730 (C.R.K.)
| | - Chung Reen Kim
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
- Correspondence: (Y.-J.J.); (C.R.K.); Tel.: +82-52-250-8847 (Y.-J.J.); +82-52-250-8730 (C.R.K.)
| | - Byung Ju Kang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (B.J.K.); (G.-M.P.)
| | - Gyung-Min Park
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (B.J.K.); (G.-M.P.)
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18
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Farsijani S, Santanasto AJ, Miljkovic I, Boudreau RM, Goodpaster BH, Kritchevsky SB, Newman AB. The Relationship Between Intermuscular Fat and Physical Performance Is Moderated by Muscle Area in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:115-122. [PMID: 32614950 DOI: 10.1093/gerona/glaa161] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Age-related deposition of fat in skeletal muscle is associated with functional limitations. Skeletal muscle fat may be present in people with preserved muscle mass or accompanied by muscle wasting. However, it is not clear if the association between muscle fat deposition and physical performance is moderated by muscle mass. OBJECTIVE To determine whether the association between midthigh intermuscular fat and physical performance is moderated by muscle area. METHODS We performed a cross-sectional analysis of the Health, Aging, and, Body Composition (ABC) study data collected in 2002-2003 (n = 1897, women: 52.2%). Midthigh muscle cross-sectional area (by computed tomography) and physical performance measures were compared across quartiles of intermuscular fat absolute area. Moderation analysis was performed to determine the conditional effect of intermuscular fat on physical performance as a function of muscle area. Conditional effects were evaluated at three levels of muscle area (mean and ± 1 standard deviation [SD]; 213.2 ± 53.2 cm2). RESULTS Simple slope analysis showed that the negative association between intermuscular fat area (cm2) and leg strength (N·m) was of greater magnitude (beta coefficient [b], 95% confidence interval [CI] = -0.288 [-0.427, -0.148]) in participants with greater muscle area (ie, 1 SD above the mean) compared to those with lower muscle area (ie, at mean [b = -0.12 {-0.248, 0.008}] or 1 SD below the mean [b = 0.048 {-0.122, 0.217}]). Similarly, the negative association of intermuscular fat with 400-m walk speed (m/s) and chair stand (seconds) was greater in those with higher muscle areas (p < .001) compared to those with lower muscle areas. CONCLUSIONS The association between higher intermuscular fat area and impaired physical function in aging is moderated by muscle area.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Center for Aging and Population Health, University of Pittsburgh, Pennsylvania
| | - Adam J Santanasto
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Center for Aging and Population Health, University of Pittsburgh, Pennsylvania
| | - Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Center for Aging and Population Health, University of Pittsburgh, Pennsylvania
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Center for Aging and Population Health, University of Pittsburgh, Pennsylvania
| | - Bret H Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Orlando, Florida.,Sanford Burnham Presby Medical Discovery Institute, La Jolla, California
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Center for Aging and Population Health, University of Pittsburgh, Pennsylvania
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19
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Miljkovic I, Vella CA, Allison M. Computed Tomography-Derived Myosteatosis and Metabolic Disorders. Diabetes Metab J 2021; 45:482-491. [PMID: 34352985 PMCID: PMC8369205 DOI: 10.4093/dmj.2020.0277] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 06/01/2021] [Indexed: 12/17/2022] Open
Abstract
The role of ectopic adipose tissue infiltration into skeletal muscle (i.e., myosteatosis) for metabolic disorders has received considerable and increasing attention in the last 10 years. The purpose of this review was to evaluate and summarize existing studies focusing on computed tomography (CT)-derived measures of myosteatosis and metabolic disorders. There is consistent evidence that CT-derived myosteatosis contributes to dysglycemia, insulin resistance, type 2 diabetes mellitus, and inflammation, and, to some extent, dyslipidemia, independent of general obesity, visceral fat, and other relevant risk factors, suggesting that it may serve as a tool for metabolic risk prediction. Identification of which muscles should be examined, and the standardized CT protocols to be employed, are necessary to enhance the applicability of findings from epidemiologic studies of myosteatosis. Additional and longer longitudinal studies are necessary to confirm a role of myosteatosis in the development of type 2 diabetes mellitus, and examine these associations in a variety of muscles across multiple race/ethnic populations. Given the emerging role of myosteatosis in metabolic health, well-designed intervention studies are needed to investigate relevant lifestyle and pharmaceutical approaches.
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Affiliation(s)
- Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chantal A. Vella
- Department of Movement Sciences, College of Education, Health and Human Sciences, University of Idaho, Moscow, ID, USA
| | - Matthew Allison
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Corresponding author: Matthew Allison https://orcid.org/0000-0003-0777-8272 Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA E-mail:
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20
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Kim HK, Kim KW, Kim EH, Lee MJ, Bae SJ, Ko Y, Park T, Shin Y, Kim YJ, Choe J. Age-related changes in muscle quality and development of diagnostic cutoff points for myosteatosis in lumbar skeletal muscles measured by CT scan. Clin Nutr 2021; 40:4022-4028. [PMID: 34144412 DOI: 10.1016/j.clnu.2021.04.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS We have sought to develop proper and useful indices for muscle quality measurements other than muscle attenuation (Hounsfield unit; HU) and to determine the diagnostic cutoff points for myosteatosis by using those indices measured at the L3 lumbar vertebrae level by CT scan. METHODS This cross-sectional analysis included 20,664 healthy adult subjects (12,697 men and 7967 women) who underwent abdominal CT scans. Total abdominal muscle area (TAMA), on the L3 vertebra was demarcated using predetermined thresholds. Intermuscular adipose tissue area (IMAT) and skeletal muscle area (SMA) were measured. SMA was divided into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). Their various indices were calculated. We identified the sex-specific mean values of NAMA, LAMA, IMAT, and their indices and the cutoff points equivalent to the T-scores in the young reference group. RESULTS The mean values of the NAMA and NAMA indices decreased with age in both sexes, LAMA, IMAT, and their indices showed an increasing tendency with age in both sexes. When using T-score < -2.0 as the cutoff for myosteatosis, the sex-specific cutoff points of NAMA, NAMA/BMI, NAMA/TAMA index, and SMA and TAMA attenuation in men and women were 103.0 and 64.5 cm2, 4.0 and 2.8, 66.4 and 65.1, 40.2 and 39.9 HU, and 34.1 and 33.5 HU, respectively. Using these cutoff points, the prevalence of myosteatosis by NAMA, NAMA/BMI, NAMA/TAMA index, or SMA or TAMA attenuation ranged from 5.9 to 8.8% in men and from 10.2 to 20.5% in women. CONCLUSIONS The NAMA/TAMA index developed in this study was useful for assessing myosteatosis. This is the first study to report the sex-specific diagnostic cutoff points for myosteatosis of trunk muscles based on T-scores measured by CT scans in healthy population. These diagnostic cutoff points may be particularly useful in the treatment and prevention of sarcopenia and myosteatosis.
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Affiliation(s)
- Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea.
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Eun Hee Kim
- Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Sung-Jin Bae
- Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Yousun Ko
- Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Taeyoung Park
- Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Yongbin Shin
- Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
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21
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Farsijani S, Marron MM, Miljkovic I, Baugh ME, Kritchevsky SB, Newman AB. Metabolic Markers Demonstrate the Heterogeneity of Myosteatosis in Community-Dwelling Older Black Men from the Health ABC Study. Metabolites 2021; 11:metabo11040224. [PMID: 33917005 PMCID: PMC8067743 DOI: 10.3390/metabo11040224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 11/16/2022] Open
Abstract
Myosteatosis is a complex condition, associated with aging and diverse pathological conditions (e.g., diabetes), that contributes to mobility disability. Improved characterization of myosteatosis is required to develop targeted interventions to maintain muscle health in aging. We first determined the associations between plasma metabolites and intermuscular fat (IMF) in a cross-sectional analysis of 313 older Black men from Health ABC Study. Using partial correlation analysis, 34/350 metabolites were associated with IMF, the majority of which were lipids and organic acids. Next, we used Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), as an indicator of metabolic health to delineate the anthropometric, functional, and metabolic heterogeneity of myosteatosis in a case-control matching analysis. We categorized participants based on their IMF and HOMA-IR levels into: Low-IMF with Low- versus High-HOMA, as well as High-IMF with Low- versus High-HOMA. Among participants with similar levels of IMF, those who were metabolically unhealthy, i.e., with High HOMA-IR, had higher fat and lean mass, muscle strength, and had hyperglycemia, hypertriglyceridemia, hyperinsulinemia, and higher levels of plasma metabolites belonging to diacylglycerols, triacylglycerols, fatty acid and aminoacyl-tRNA biosynthesis pathways versus those with Low HOMA-IR. In summary, HOMA-IR delineates the heterogeneity of myosteatosis by distinguishing metabolically healthy versus unhealthy individuals.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Megan M. Marron
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
| | - Mary Elizabeth Baugh
- Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA 24016, USA;
| | - Stephen B. Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Anne B. Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Correspondence:
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Peng LN, Cheng YC, Yu PC, Lee WJ, Lin MH, Chen LK. Oral Nutritional Supplement with β-hydroxy-β-methylbutyrate (HMB) Improves Nutrition, Physical Performance and Ameliorates Intramuscular Adiposity in Pre-Frail Older Adults: A Randomized Controlled Trial. J Nutr Health Aging 2021; 25:767-773. [PMID: 34179932 DOI: 10.1007/s12603-021-1621-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Supplementation of high protein oral nutrition shakes supplemented with β-hydroxy-β-methylbutyrate (HP-HMB) has been shown to improve muscle mass, muscle strength, and physical performance in older adults, but the roles of HP-HMB supplementation on the intramuscular adiposity remained unknown. This 12-week randomized controlled trial evaluated the changes of muscle mass, muscle strength, physical performance and intramuscular adiposity among community-dwelling pre-frail older persons. METHODS This was an open-label, parallel group, randomized controlled trail that enrolled 70 community-dwelling pre-frail older persons without active or uncontrolled conditions, disability or dementia. The intervention group was provided with two services of HP HMB (Ensure® Plus Advance containing 3g HMB) per day for 12 weeks, and the control group was provided with professional nutritional counselling for sufficient protein intake. All participants received functional assessments, laboratory tests and magnetic resonance imaging (MRI) of the dominant leg before and after study. Intramuscular adipose tissue (IMAT) and the mid-thigh cross-sectional area (CSA) of muscle were obtained by MRI, and the IMAT-to-CSA ratio was calculated to evaluate intramuscular adiposity. RESULTS Overall, 62 participants (mean age: 71.1±3.8 years, 69.4% female) completed the study (HP-HMB group: 29, control group: 33) and comparisons of baseline characteristics between groups were not statistically different. For the primary outcome, HP-HMB group showed significant improvements in the CSA of mid-thigh muscle (mean increase of CSA: 149.1±272.3 for HMB group vs -22.9±309.1 mm2 for control group, P=0.045). The improvement of MNA-SF was borderline (0.28±0.75 vs. -0.15±0.94, P=0.064), but serum levels of Vit D were significantly increased in the HMB group (3.83±8.18 vs. -1.30±4.81 ng/mL, P=0.002). Moreover, the body weight and BMI were significantly increased in the HMB group (1.10±1.18 vs. 0.24±1.13 kg, P=0.005; 0.56±0.68 vs. 0.22±0.47 kg/m2, P=0.019). In particular, the IMAT-to-CSA ratio was reduced in the HMB group (-0.38±1.21 vs. -0.02±2.56 %, P=0.06). Using the generalized estimating equation, we found that SPPB score in chair rise test was significantly improved (β=0.71, 95% C.I.0.09-1.33, P=0.026). CONCLUSIONS The 12-week supplementation with high protein oral nutrition shake supplemented with 3g HMB per day significantly increased muscle mass, as well as nutritional status and physical performance, and ameliorated the intramuscular adiposity of pre-frail older persons. Further study is needed to explore the long-term benefits of HP-HMB supplementation on muscle and metabolic health for older adults.
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Affiliation(s)
- L-N Peng
- Prof. Liang-Kung Chen, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei Taiwan; No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan, TEL: +886-2-2877830; FAX: +886-6-28757711,
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23
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Yu F, He B, Chen L, Wang F, Zhu H, Dong Y, Pan S. Intermuscular Fat Content in Young Chinese Men With Newly Diagnosed Type 2 Diabetes: Based on MR mDIXON-Quant Quantitative Technique. Front Endocrinol (Lausanne) 2021; 12:536018. [PMID: 33868161 PMCID: PMC8044767 DOI: 10.3389/fendo.2021.536018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/12/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Skeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects. METHODS We enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values. RESULTS We found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p<0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p<0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p<0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content. CONCLUSION Deposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Chen
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Fengzhe Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Haidong Zhu
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Yanbin Dong
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Shinong Pan,
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Yakout SM, Al-Daghri NM, Bukhari I, Khattak MNK, Sabico S, Alokail MS, Al-Attas OS. Vitamin D level and its relation to muscle and fat mass in adult male Arabs. Saudi J Biol Sci 2020; 27:2452-2456. [PMID: 32884429 PMCID: PMC7451685 DOI: 10.1016/j.sjbs.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 01/15/2023] Open
Abstract
Low levels of vitamin D have been linked with increased adiposity and diminished muscle strength. Whether it is also related to fat deposition in muscle tissues is not studied well. This study explored the associations between circulating 25-hydroxyvitamin D (25(OH)D) and fat deposition in muscle tissues of adult Arab males. A total 465 adult Saudi males were included in this cross-sectional study. Anthropometrics, body composition and muscle strength were assessed. Serum 25(OH)D was determined and quantified enzymatically. They were grouped according to vitamin D status: deficient (25(OH)D < 50 nmol/l) N = 325 (69.9%) and sufficient (25(OH)D > 50 nmol/l)140 (30.1%). Mean level of lean/height2, lean-arm-legs and lean-arms-legs/height2 were significantly higher in 25(OH)D deficient participants (p-values 0.03; 0.05 and 0.01 respectively). Thigh strength was significantly higher in 25(OH)D sufficient participants than their deficient counterparts (p = 0.02). In all participants, a significant correlation between 25(OH)D was observed with age and thigh-strength (p-values < 0.05), while a significant inverse correlation between 25(OH)D and lean/height2, lean-arms-legs, lean-arms-legs/height2, fat (%) region, fat arms, fat legs, fat trunk, lean legs were noted. In conclusion, low circulating 25(OH)D is associated with enhanced fat infiltration in muscle tissues of adult Arab males.
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Affiliation(s)
- Sobhy M Yakout
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ihtisham Bukhari
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.,Translational Research Institute, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Malak N K Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Majed S Alokail
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.,Translational Research Institute, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Omar S Al-Attas
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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25
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Goss AM, Gower B, Soleymani T, Stewart M, Pendergrass M, Lockhart M, Krantz O, Dowla S, Bush N, Garr Barry V, Fontaine KR. Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial. Nutr Metab (Lond) 2020; 17:64. [PMID: 32817749 PMCID: PMC7425171 DOI: 10.1186/s12986-020-00481-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Insulin resistance and accumulation of visceral adipose tissue (VAT) and intermuscular adipose tissue (IMAT) place aging adults with obesity at high risk of cardio-metabolic disease. A very low carbohydrate diet (VLCD) may be a means of promoting fat loss from the visceral cavity and skeletal muscle, without compromising lean mass, and improve insulin sensitivity in aging adults with obesity. Objective To determine if a VLCD promotes a greater loss of fat (total, visceral and intermuscular), preserves lean mass, and improves insulin sensitivity compared to a standard CHO-based/low-fat diet (LFD) in older adults with obesity. Design Thirty-four men and women aged 60–75 years with obesity (body mass index [BMI] 30-40 kg/m2) were randomized to a diet prescription of either a VLCD (< 10:25:> 65% energy from CHO:protein:fat) or LFD diet (55:25:20) for 8 weeks. Body composition by dual-energy X-ray absorptiometry (DXA), fat distribution by magnetic resonance imaging (MRI), insulin sensitivity by euglycemic hyperinsulinemic clamp, and lipids by a fasting blood draw were assessed at baseline and after the intervention. Results Participants lost an average of 9.7 and 2.0% in total fat following the VLCD and LFD, respectively (p < 0.01). The VLCD group experienced ~ 3-fold greater loss in VAT compared to the LFD group (− 22.8% vs − 1.0%, p < 0.001) and a greater decrease in thigh-IMAT (− 24.4% vs − 1.0%, p < 0.01). The VLCD group also had significantly greater thigh skeletal muscle (SM) at 8 weeks following adjustment for change in total fat mass. Finally, the VLCD had greater increases in insulin sensitivity and HDL-C and decreases in fasting insulin and triglycerides compared to the LFD group. Conclusions Weight loss resulting from consumption of a diet lower in CHO and higher in fat may be beneficial for older adults with obesity by depleting adipose tissue depots most strongly implicated in poor metabolic and functional outcomes and by improving insulin sensitivity and the lipid profile. Trial registration NCT02760641. Registered 03 May 2016 - Retrospectively registered.
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Affiliation(s)
- Amy M Goss
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Barbara Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Taraneh Soleymani
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Mariah Stewart
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - May Pendergrass
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Mark Lockhart
- Department of Medicine, Division of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Olivia Krantz
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Shima Dowla
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Nikki Bush
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Valene Garr Barry
- Department of Nutrition Sciences, University of Alabama at Birmingham, 640 Webb Building, 1675 University Blvd, Birmingham, AL 35294-3360 USA
| | - Kevin R Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294 USA
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Neck circumference is associated with adipose tissue content in thigh skeletal muscle in overweight and obese premenopausal women. Sci Rep 2020; 10:8324. [PMID: 32433484 PMCID: PMC7239876 DOI: 10.1038/s41598-020-65204-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/27/2020] [Indexed: 12/15/2022] Open
Abstract
Neck circumference (NC) has been proposed as a simple and practical tool, independently associated with cardiometabolic risk factors. However, the association of NC with inter-muscular adipose tissue (IMAT) is still to be determined. We aimed to examine the association of NC with thigh IMAT, and visceral adipose tissue (VAT) measured with computed tomography (CT) in overweight/obese women. 142 premenopausal overweight and obese Caucasian women participated in this cross-sectional study. NC was measured with an inextensible metallic tape above the thyroid cartilage according to International Society for Advancement of Kinanthropometry protocol. Thigh IMAT and VAT volumes were measured with a single cross-sectional CT. Regarding the covariates, fat mass (FM) was assessed with dual-energy x-ray absorptiometry and physical activity was objectively measured with accelerometry. NC was positively associated with thigh IMAT and VAT volumes (standardized β coefficient: β = 0.45, P-value = ≤0.001, β = 0.60, P = ≤ 0.001; respectively), which persisted after adjusting for age, height, overall FM or moderate-to-vigorous physical activity. Our findings show that NC is associated with thigh IMAT volume in overweight and obese premenopausal Caucasian women, regardless of the amount of lower-body fatness. These results suggest underscoring the relevance of NC as a marker of adipose tissue content in thigh skeletal muscle.
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27
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Association between muscle mass and insulin sensitivity independent of detrimental adipose depots in young adults with overweight/obesity. Int J Obes (Lond) 2020; 44:1851-1858. [PMID: 32404950 PMCID: PMC7483278 DOI: 10.1038/s41366-020-0590-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/08/2020] [Accepted: 04/29/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVE Less muscle mass has been associated with greater insulin resistance, but whether the association is independent of deleterious adipose depots in young adults with overweight/obesity who are at high risk for type 2 diabetes (T2DM) but are otherwise metabolically healthy is not known. The objective of this study was to determine whether muscle mass is independently associated with insulin sensitivity (IS) in young adults with overweight/obesity. SUBJECTS/METHODS Cross-sectional Clinical Research Center study of 132 adults, 21-45yo, BMI ≥ 25 kg/m2 and metabolically healthy without T2DM. Primary independent variable: percent ideal appendicular lean mass (ALM) calculated as measured ALM divided by predicted ALM for age, weight, and height, calculated using validated NHANES data-based equation. Primary dependent variable: IS by Matsuda index. RESULTS Mean age was 34.3 ± 6.8 years, and mean BMI 35.8 ± 5.8 kg/m2 (mean ± SD). Individuals in the highest % ideal ALM tertile had mean IS 45% higher than the lowest tertile [6.94 ± 0.85 vs 4.80 ± 0.56 (mean ± SEM), p = 0.008] (sex interaction p = 0.003). Men in the highest % ideal ALM tertile had mean IS twice the lowest tertile (5.47 ± 0.68 vs 2.68 ± 0.34, p = 0.001), which remained significant controlling for visceral/subcutaneous and intermuscular adipose tissue, and intramyocellular and intrahepatic lipids (p = 0.03). The association was not significant in women. CONCLUSIONS Muscle mass is associated with IS independent of detrimental adipose depots in young men with overweight/obesity, at risk for T2DM but currently metabolically healthy. Muscle mass relative to sex, age, weight, and height-specific norms may be used to ascertain individual T2DM risk associated with low muscle mass.
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Ogawa M, Yoshiko A, Tanaka N, Koike T, Oshida Y, Akima H. Comparing intramuscular adipose tissue on T1-weighted and two-point Dixon images. PLoS One 2020; 15:e0231156. [PMID: 32271803 PMCID: PMC7144956 DOI: 10.1371/journal.pone.0231156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
Purpose The purpose of this study was to compare intramuscular adipose tissue content determined by two-point Dixon imaging and T1-weighted imaging, calculated using thresholding techniques. Methods In total, 19 nonobese younger adults (26.2 ± 4.9 years) and 13 older adults (72.2 ± 6.0 years) were recruited. Axial images of the mid-thigh were taken using T1-weighted and two-point Dixon sequences with a 3.0 T whole-body magnetic resonance device and used to measure intramuscular adipose tissue content of the vastus lateralis, adductor magnus, and long head of the biceps femoris. Results There was no significant difference in intramuscular adipose tissue content between T1-weighted and two-point Dixon imaging for the vastus lateralis (11.0 ± 4.4% and 12.2 ± 2.4%); however, intramuscular adipose tissue content determined by T1-weighted imaging was significantly higher than that of two-point Dixon imaging for the other muscles. Bland-Altman analysis showed a proportional bias for intramuscular adipose tissue calculations in all three muscles. Conclusion The validity of intramuscular adipose tissue content measurements between T1-weighted and two-point Dixon imaging is muscle-specific. This study showed discrepancies of intramuscular adipose tissue content between T1-weighted and two-point Dixon imaging. Advances in knowledge This study’s results suggest that care should be taken when selecting an imaging modality for intramuscular adipose tissue, especially for patients who would be suspected to have higher intramuscular adipose tissue values.
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Affiliation(s)
- Madoka Ogawa
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Aichi, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
- Nippon Sport Science University, Setagaya-ku, Tokyo, Japan
- * E-mail:
| | - Akito Yoshiko
- School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Noriko Tanaka
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Aichi, Japan
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Teruhiko Koike
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
- Graduate School of Medicine, Nagoya University 65 Tsurumai, Nagoya, Aichi, Japan
| | - Yoshiharu Oshida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
- Graduate School of Medicine, Nagoya University 65 Tsurumai, Nagoya, Aichi, Japan
| | - Hiroshi Akima
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Aichi, Japan
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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29
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Tilves C, Zmuda JM, Kuipers AL, Carr JJ, Terry JG, Wheeler V, Peddada S, Nair S, Miljkovic I. Associations of Thigh and Abdominal Adipose Tissue Radiodensity with Glucose and Insulin in Nondiabetic African-Ancestry Men. Obesity (Silver Spring) 2020; 28:404-411. [PMID: 31872575 PMCID: PMC6980942 DOI: 10.1002/oby.22695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/29/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Decreased radiodensity of adipose tissue (AT) located in the visceral AT (VAT), subcutaneous AT (SAT), and intermuscular AT (IMAT) abdominal depots is associated with hyperglycemia, hyperinsulinemia, and insulin resistance independent of AT volumes. These associations were sought in African-ancestry men, who have higher risk for type 2 diabetes and have been underrepresented in previous studies. METHODS This cross-sectional analysis included 505 nondiabetic men of African-Caribbean ancestry (median age: 61 years; median BMI: 26.8 kg/m2 ) from the Tobago Health Study. AT volumes and radiodensities were assessed using computed tomography, including abdominal (VAT and SAT) and thigh (IMAT) depots. Associations between AT radiodensities were assessed with fasting serum glucose and insulin and with insulin resistance (updated homeostatic model assessment of insulin resistance, HOMA2-IR). RESULTS Higher radiodensity in any AT depot was associated with lower log-insulin and log-HOMA2-IR (β range: -0.16 to -0.18 for each; all P < 0.0001). No AT radiodensity was associated with glucose. Thigh IMAT radiodensity associations were independent of, and similar in magnitude to, VAT radiodensities. Model fit statistics suggested that AT radiodensities were a better predictor for insulin and insulin resistance compared with AT volumes in individuals with overweight and obesity. CONCLUSIONS AT radiodensities at multiple depots are significantly associated with insulin and insulin resistance in African-ancestry men.
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Affiliation(s)
- Curtis Tilves
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph M. Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allison L. Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victor Wheeler
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago
| | - Shyamal Peddada
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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Soliman SB, Rosen KA, Williams PC, Spicer PJ, Williams LK, Rao SD, van Holsbeeck MT. The Hyperechoic Appearance of the Deltoid Muscle on Shoulder Ultrasound Imaging as a Predictor of Diabetes and Prediabetes. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:323-329. [PMID: 31423604 DOI: 10.1002/jum.15110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/27/2019] [Accepted: 07/07/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate whether the ultrasound appearance of the deltoid muscle in diabetic patients differs from that in obese nondiabetic patients. METHODS Ultrasound images of the deltoid muscle from 137 type 2 diabetic patients (including 13 prediabetic patients) and 49 obese nondiabetic patients were blindly reviewed by 2 musculoskeletal radiologists, and by a third when arbitration was needed, to determine whether the appearance was "normal," "suspected diabetes," or "definite diabetes." Age, sex, race, body mass index (BMI), insulin use, and hemoglobin A1c were analyzed. This retrospective study included patients presenting between October 2005 and November 2017. Statistical analyses included a 2-sided sample t test or Wilcoxon rank sum test and a χ2 or Fisher exact test. Statistical significance was defined as P < .05. RESULTS The type 2 diabetic patients included 98 women and 39 men aged 29 to 92 years, and the nondiabetic patients included 19 women and 30 men aged 18 to 75 years. A consensus diagnosis of definite diabetes by the musculoskeletal radiologists based on a hyperechoic deltoid was a powerful predictor of diabetes, with a positive predictive value of 89%. A hyperechoic deltoid was also a powerful predictor of prediabetes. Of the 13 prediabetic patients, all had the same hyperechoic appearance of the diabetic deltoid, regardless of BMI. Although obese diabetic patients more often had a diagnosis of definite diabetes, the BMI alone could not explain the increased echogenicity, as obese nondiabetic patients' deltoid muscles did not appear as hyperechoic and were correctly categorized as not having definite diabetes with 82% specificity. CONCLUSIONS The characteristic hyperechoic deltoid appearance is a strong predictor of both diabetes and prediabetes and differs from that of obese nondiabetic patients.
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Affiliation(s)
- Steven B Soliman
- Department of Radiology, Division of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Kelli A Rosen
- Department of Radiology, Division of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Paul C Williams
- Department of Radiology, Division of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Paul J Spicer
- Department of Radiology, Division of Musculoskeletal Radiology, University of Kentucky Healthcare, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - L Keoki Williams
- Center for Health Policy and Health Services Research and Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - Sudhaker D Rao
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, Michigan, USA
- Department of Endocrinology, Diabetes, and Bone and Mineral Disorders, Henry Ford Hospital, Detroit, Michigan, USA
| | - Marnix T van Holsbeeck
- Department of Radiology, Division of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, Michigan, USA
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Collao N, Farup J, De Lisio M. Role of Metabolic Stress and Exercise in Regulating Fibro/Adipogenic Progenitors. Front Cell Dev Biol 2020; 8:9. [PMID: 32047748 PMCID: PMC6997132 DOI: 10.3389/fcell.2020.00009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity is a major public health concern and is associated with decreased muscle quality (i.e., strength, metabolism). Muscle from obese adults is characterized by increases in fatty, fibrotic tissue that decreases the force producing capacity of muscle and impairs glucose disposal. Fibro/adipogenic progenitors (FAPs) are muscle resident, multipotent stromal cells that are responsible for muscle fibro/fatty tissue accumulation. Additionally, they are indirectly involved in muscle adaptation through their promotion of myogenic (muscle-forming) satellite cell proliferation and differentiation. In conditions similar to obesity that are characterized by chronic muscle degeneration, FAP dysfunction has been shown to be responsible for increased fibro/fatty tissue accumulation in skeletal muscle, and impaired satellite cell function. The role of metabolic stress in regulating FAP differentiation and paracrine function in skeletal muscle is just beginning to be unraveled. Thus, the present review aims to summarize the recent literature on the role of metabolic stress in regulating FAP differentiation and paracrine function in skeletal muscle, and the mechanisms responsible for these effects. Furthermore, we will review the role of physical activity in reversing or ameliorating the detrimental effects of obesity on FAP function.
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Affiliation(s)
- Nicolas Collao
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Jean Farup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Michael De Lisio
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON, Canada
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Minett MM, Binkley TL, Holm RP, Runge M, Specker BL. Feasibility and Effects on Muscle Function of an Exercise Program for Older Adults. Med Sci Sports Exerc 2020; 52:441-448. [PMID: 31939912 DOI: 10.1249/mss.0000000000002152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Study objective was to determine feasibility and compliance with a 3-month exercise intervention in older adults, and if peripheral quantitative computed tomography muscle measures and jumping mechanography could detect changes in muscle mass and function. METHODS A parallel group, nonblinded, pilot trial with individuals 70 yr or older randomized to control group of walking-only (WALK) or an intervention group of walking combined with exercises to improve balance and strength (W + EX). Both groups attended similar weekly nutrition education sessions. Body composition, muscle density, intramuscular adipose tissue area, and muscle function were assessed before and after the intervention using dual-energy x-ray, peripheral quantitative computed tomography, functional tests, and mechanography. RESULTS Eighty-five (90%) of 94 individuals enrolled completed (41WALK, 44W + EX). Eighty-six percent of participants attended seven or more nutrition sessions, and log sheets, used to assess exercise compliance, were returned by 66% of participants, and of those, 88% logged activity on 50%+ days. Sixty-seven percent of participants stated that they increased activity levels, and 82% stated that they felt better overall. Both groups increased lean and lost fat mass, resulting in decreases in fat percentage (all, P < 0.05). Intramuscular adipose tissue area decreased and muscle density increased among WALK (P < 0.05 and P = 0.056, respectively) but were not different between groups. Improvement in force efficiency and chair-rise power were greater among W + EX group than WALK (5.9% ± 1.8% vs -1.2% ± 2.0% [P = 0.01] and 0.25 ± 0.19 W·kg and -0.37 ± 0.23 W·kg [P = 0.04], respectively). Differences in mechanography results became greater in a per-protocol analysis. CONCLUSIONS A larger trial is feasible, and the program was well accepted. Both groups showed improvements, the program that included strength and balance lead to greater jump force efficiency and power than walking only. Whether these differences lead to differences in fall rates need to be determined in a larger trial.
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Affiliation(s)
- Maggie M Minett
- Ethel Austin Martin Program, South Dakota State University, Brookings, SD
| | - Teresa L Binkley
- Ethel Austin Martin Program, South Dakota State University, Brookings, SD
| | | | | | - Bonny L Specker
- Ethel Austin Martin Program, South Dakota State University, Brookings, SD
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Sachs S, Zarini S, Kahn DE, Harrison KA, Perreault L, Phang T, Newsom SA, Strauss A, Kerege A, Schoen JA, Bessesen DH, Schwarzmayr T, Graf E, Lutter D, Krumsiek J, Hofmann SM, Bergman BC. Intermuscular adipose tissue directly modulates skeletal muscle insulin sensitivity in humans. Am J Physiol Endocrinol Metab 2019; 316:E866-E879. [PMID: 30620635 PMCID: PMC6580171 DOI: 10.1152/ajpendo.00243.2018] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/30/2018] [Accepted: 12/27/2018] [Indexed: 12/25/2022]
Abstract
Intermuscular adipose tissue (IMAT) is negatively related to insulin sensitivity, but a causal role of IMAT in the development of insulin resistance is unknown. IMAT was sampled in humans to test for the ability to induce insulin resistance in vitro and characterize gene expression to uncover how IMAT may promote skeletal muscle insulin resistance. Human primary muscle cells were incubated with conditioned media from IMAT, visceral (VAT), or subcutaneous adipose tissue (SAT) to evaluate changes in insulin sensitivity. RNAseq analysis was performed on IMAT with gene expression compared with skeletal muscle and SAT, and relationships to insulin sensitivity were determined in men and women spanning a wide range of insulin sensitivity measured by hyperinsulinemic-euglycemic clamp. Conditioned media from IMAT and VAT decreased insulin sensitivity similarly compared with SAT. Multidimensional scaling analysis revealed distinct gene expression patterns in IMAT compared with SAT and muscle. Pathway analysis revealed that IMAT expression of genes in insulin signaling, oxidative phosphorylation, and peroxisomal metabolism related positively to donor insulin sensitivity, whereas expression of macrophage markers, inflammatory cytokines, and secreted extracellular matrix proteins were negatively related to insulin sensitivity. Perilipin 5 gene expression suggested greater IMAT lipolysis in insulin-resistant individuals. Combined, these data show that factors secreted from IMAT modulate muscle insulin sensitivity, possibly via secretion of inflammatory cytokines and extracellular matrix proteins, and by increasing local FFA concentration in humans. These data suggest IMAT may be an important regulator of skeletal muscle insulin sensitivity and could be a novel therapeutic target for skeletal muscle insulin resistance.
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Affiliation(s)
- Stephan Sachs
- Institute for Diabetes and Regeneration, Helmholtz Zentrum München, German Research Center for Environmental Health , Neuherberg , Germany
| | - Simona Zarini
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | - Darcy E Kahn
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | | | - Leigh Perreault
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | - Tzu Phang
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | | | - Allison Strauss
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | - Anna Kerege
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
| | | | | | - Thomas Schwarzmayr
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health , Neuherberg , Germany
| | - Elisabeth Graf
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health , Neuherberg , Germany
| | - Dominik Lutter
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, German Research Center for Environmental Health , Neuherberg , Germany
- German Center for Diabetes Research (DZD), München- Neuherberg , Germany
| | - Jan Krumsiek
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany and German Center for Diabetes Research (DZD) , Neuherberg , Germany
| | - Susanna M Hofmann
- Institute for Diabetes and Regeneration, Helmholtz Zentrum München, German Research Center for Environmental Health , Neuherberg , Germany
- German Center for Diabetes Research (DZD), München- Neuherberg , Germany
- Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians University , Munich , Germany
| | - Bryan C Bergman
- University of Colorado Anschutz Medical Campus , Aurora, Colorado
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Santanasto AJ, Miljkovic I, Cvejkus RC, Gordon CL, Bunker CH, Patrick AL, Wheeler VW, Zmuda JM. Body Composition Remodeling and Incident Mobility Limitations in African Ancestry Men. J Gerontol A Biol Sci Med Sci 2019; 74:400-405. [PMID: 29659706 PMCID: PMC6376082 DOI: 10.1093/gerona/gly067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mobility limitations are common, with higher prevalence in African Americans compared with whites, and are associated with disability, institutionalization, and death. Aging is associated with losses of lean mass and a shift to central adiposity, which are more pronounced in African Americans. We aimed to examine the association of body composition remodeling with incident mobility limitations in older men of African ancestry. METHODS Seven-year changes in body composition were measured using peripheral quantitative computed tomography (pQCT) of the calf and whole-body dual x-ray absorptiometry (DXA) in 505 African ancestry men aged ≥60 years and free of self-reported mobility limitations at baseline. Self-reported incident mobility limitations were assessed at 7-year follow-up. Odds of developing mobility limitations associated with baseline and change in body composition were quantified using separate logistic regression models. RESULTS Seventy-five men (14.9%) developed incident mobility limitations over 6.2 ± 0.6 years. Baseline body composition was not associated with incident mobility limitations. After adjustment for covariates, gaining total and intermuscular fat were associated with incident mobility limitations (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.21-2.13; OR: 1.51; 95% CI: 1.18-1.94). Changes in DXA lean mass were not related to mobility limitations; however, maintaining pQCT calf muscle area was protective against mobility limitations (OR: 0.65; 95% CI: 0.48-0.87). CONCLUSIONS Increases in body fat, and particularly intermuscular fat, and decreases in calf skeletal muscle area were associated with a higher risk of developing mobility limitations. Our findings emphasize the importance of body composition remodeling in the development of mobility limitations among African ancestry men.
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Affiliation(s)
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Ryan C Cvejkus
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | | | | | - Allen L Patrick
- Tobago Health Studies Office, Scarborough, Trinidad and Tobago
| | | | - Joseph M Zmuda
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
- Department of Human Genetics, University of Pittsburgh, Pennsylvania
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Granados A, Gebremariam A, Gidding SS, Terry JG, Carr JJ, Steffen LM, Jacobs DR, Lee JM. Association of abdominal muscle composition with prediabetes and diabetes: The CARDIA study. Diabetes Obes Metab 2019; 21:267-275. [PMID: 30159995 PMCID: PMC6329642 DOI: 10.1111/dom.13513] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 12/28/2022]
Abstract
AIM To evaluate the relationship of abdominal muscle lean tissue and adipose tissue volumes with prediabetes and diabetes. RESEARCH DESIGN AND METHODS We measured abdominal muscle composition in 3170 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent computed tomography (CT) at Year 25 of follow-up (ages, 43-55 years). Multinomial regression analysis was used to evaluate the associations of CT-measured intermuscular adipose tissue (IMAT), lean muscle tissue (lean) and visceral adipose tissue (VAT) volumes with diabetes at any point during the CARDIA study, newly detected prediabetes, prior history of prediabetes, and normal glucose tolerance. Models were adjusted for potential confounding factors: age, sex, race, height, smoking status, hypertension, hyperlipidaemia, cardiorespiratory fitness and study centre. RESULTS Higher IMAT, lean and VAT volumes were all separately associated with a higher prevalence of prediabetes and diabetes. Inclusion of VAT volume in models with both IMAT volume and lean volume attenuated the association of IMAT with both prediabetes and diabetes, but higher lean volume retained its association with prediabetes and diabetes. Individuals in the highest IMAT quartile, coupled with VAT in its lower three quartiles, had a higher prevalence of diabetes, but not of prediabetes, than those with both IMAT and VAT in their respective lower three quartiles. Adjusting for cardiorespiratory fitness did not substantially change the findings. CONCLUSION Higher IMAT volume was associated with a higher prevalence of diabetes even after adjustment for VAT volume. However, further study is warranted to understand the complicated relationship between abdominal muscle and adipose tissues.
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Affiliation(s)
- Andrea Granados
- Department of Pediatrics, Pediatric Endocrinology, Washington University, St Louis, Missouri
| | - Achamyeleh Gebremariam
- Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, Michigan
| | - Samuel S Gidding
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, Delaware
| | - James G Terry
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, Tennessee
| | - John Jeffrey Carr
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, Tennessee
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Joyce M Lee
- Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, Michigan
- Department of Pediatric Endocrinology, University of Michigan, Ann Arbor, Michigan
- Department of Nutrition, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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IL-1β- and IL-4-polarized macrophages have opposite effects on adipogenesis of intramuscular fibro-adipogenic progenitors in humans. Sci Rep 2018; 8:17005. [PMID: 30451963 PMCID: PMC6242986 DOI: 10.1038/s41598-018-35429-w] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/05/2018] [Indexed: 12/22/2022] Open
Abstract
Intramuscular fat deposition represents a negative prognostic factor for several myopathies, metabolic diseases and aging. Fibro-adipogenic progenitors (FAPs) are considered as the main source of intramuscular adipocytes, but the mechanisms controlling their adipogenic potential are still not elucidated in humans. The aim of this study was to explore the regulation of human FAP adipogenesis by macrophages. We found that CD140a-expressing FAPs were located close to CD68 positive macrophages in muscles from patients with Duchenne muscular dystrophy (DMD). This strongly suggests a potential interaction between FAPs and macrophages in vivo. Isolated human primary FAPs were then differentiated in the presence of conditioned media obtained from primary blood monocyte-polarized macrophages. Molecules released by IL-1β-polarized macrophages (M(IL-1β)) drastically reduced FAP adipogenic potential as assessed by decreased cellular lipid accumulation and reduced gene expression of adipogenic markers. This was associated with an increased gene expression of pro-inflammatory cytokines in FAPs. Conversely, factors secreted by IL-4-polarized macrophages (M(IL-4)) enhanced FAP adipogenesis. Finally, the inhibition of FAP adipocyte differentiation by M(IL-1β) macrophages requires the stimulation of Smad2 phosphorylation of FAPs. Our findings identify a novel potential crosstalk between FAPs and M(IL-1β) and M(IL-4) macrophages in the development of adipocyte accumulation in human skeletal muscles.
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Wright CS, Laing EM, Pollock NK, Hausman DB, Weaver CM, Martin BR, McCabe GP, Peacock M, Warden SJ, Hill Gallant KM, Lewis RD. Serum 25-Hydroxyvitamin D and Intact Parathyroid Hormone Influence Muscle Outcomes in Children and Adolescents. J Bone Miner Res 2018; 33:1940-1947. [PMID: 30001469 PMCID: PMC6556206 DOI: 10.1002/jbmr.3550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 01/31/2023]
Abstract
Increases in 25-hydroxyvitamin D concentrations are shown to improve strength in adults; however, data in pediatric populations are scant and equivocal. In this ancillary study of a larger-scale, multi-sited, double-blind, randomized, placebo-controlled vitamin D intervention in US children and adolescents, we examined the associations between changes in vitamin D metabolites and changes in muscle mass, strength, and composition after 12 weeks of vitamin D3 supplementation. Healthy male and female, black and white children and adolescents between the ages of 9 and 13 years from two US states (Georgia 34°N and Indiana 40°N) were enrolled in the study and randomly assigned to receive an oral vitamin D3 dose of 0, 400, 1000, 2000, or 4000 IU/d for 12 weeks between the winter months of 2009 to 2011 (N = 324). Analyses of covariance, partial correlations, and regression analyses of baseline and 12-week changes (post-baseline) in vitamin D metabolites (serum 25(OH)D, 1,25(OH)2 D, intact parathyroid hormone [iPTH]), and outcomes of muscle mass, strength, and composition (total body fat-free soft tissue [FFST], handgrip strength, forearm and calf muscle cross-sectional area [MCSA], muscle density, and intermuscular adipose tissue [IMAT]) were assessed. Serum 25(OH)D and 1,25(OH)2 D, but not iPTH, increased over time, as did fat mass, FFST, forearm and calf MCSA, forearm IMAT, and handgrip strength (p < 0.05). Vitamin D metabolites were not associated with muscle strength at baseline nor after the 12-week intervention. Changes in serum 25(OH)D correlated with decreases in forearm IMAT, whereas changes in serum iPTH predicted increases in forearm and calf MCSA and IMAT (p < 0.05). Overall, increases in 25(OH)D did not influence muscle mass or strength in vitamin D-sufficient children and adolescents; however, the role of iPTH on muscle composition in this population is unknown and warrants further investigation. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Christian S Wright
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Emma M Laing
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Norman K Pollock
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA
| | - Dorothy B Hausman
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Berdine R Martin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - George P McCabe
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Munro Peacock
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Kathleen M Hill Gallant
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
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The Comparative Associations of Ultrasound and Computed Tomography Estimates of Muscle Quality with Physical Performance and Metabolic Parameters in Older Men. J Clin Med 2018; 7:jcm7100340. [PMID: 30308959 PMCID: PMC6210142 DOI: 10.3390/jcm7100340] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 12/22/2022] Open
Abstract
Estimates of muscle tissue composition may have greater prognostic value than lean body mass levels regarding health-related outcomes. Ultrasound provides a relatively low cost, safe, and accessible mode of imaging to assess muscle morphology. The purpose of this study was to determine the construct validity of muscle echogenicity as a surrogate measure of muscle quality in a sample of older, predominantly African American (AA) participants. We examined the association of rectus femoris echogenicity with mid-thigh computed tomography (CT) scan estimates of intra- and intermuscular adipose tissue (IMAT), basic metabolic parameters via blood sample analysis, muscle strength, and mobility status. This observational study was conducted at a federal medical center and included 30 community-dwelling men (age, 62.5 ± 9.2; AA, n = 24; Caucasian, n = 6). IMAT estimates were significantly associated with echogenicity (r = 0.73, p < 0.001). Echogenicity and IMAT exhibited similar associations with the two-hour postprandial glucose values and high-density lipoproteins values (p < 0.04), as well as grip and isokinetic (180°/s) knee extension strength adjusted for body size (p < 0.03). The significant relationship between ultrasound and CT muscle composition estimates, and their comparative association with key health-related outcomes, suggests that echogenicity should be further considered as a surrogate measure of muscle quality.
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Kiefer LS, Fabian J, Rospleszcz S, Lorbeer R, Machann J, Storz C, Kraus MS, Schlett CL, Roemer F, Wintermeyer E, Rathmann W, Nikolaou K, Peters A, Bamberg F. Assessment of the degree of abdominal myosteatosis by magnetic resonance imaging in subjects with diabetes, prediabetes and healthy controls from the general population. Eur J Radiol 2018; 105:261-268. [DOI: 10.1016/j.ejrad.2018.06.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/15/2018] [Accepted: 06/25/2018] [Indexed: 02/02/2023]
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Effects of a High-Protein Diet Including Whole Eggs on Muscle Composition and Indices of Cardiometabolic Health and Systemic Inflammation in Older Adults with Overweight or Obesity: A Randomized Controlled Trial. Nutrients 2018; 10:nu10070946. [PMID: 30041437 PMCID: PMC6073477 DOI: 10.3390/nu10070946] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 12/25/2022] Open
Abstract
Age-related increases in intermuscular adipose tissue (IMAT) impair muscle quality, decrease functional capacity, and promote several cardiometabolic and inflammatory disorders. Whether these age-related alterations in muscle composition improve by consuming a high-protein (HP) diet with whole eggs are unclear. This parallel-design, randomized-controlled trial assessed the effects of a 12-week eucaloric HP diet with three whole eggs per day (1.4 g protein kg−1 day−1) versus a normal-protein diet void of eggs (NP, 0.8 g protein kg−1 day−1) on muscle composition (IMAT), cardiometabolic health, and systemic inflammation in older adults with overweight or obesity (12 men and 10 women; age 70 ± 5 years, BMI 31.3 ± 3.2 kg/m2, mean ± SD). No changes in muscle composition were observed over time, independent of protein intake. Total body weight was reduced in both groups (−3.3 ± 1.2%) and lean mass was preserved only with the HP diet. LDL concentration and hip circumference decreased only with the NP diet, while MCP-1 and HsCRP concentrations increased over time in both groups. A HP diet with whole eggs promotes lean mass retention with modest weight loss, but does not positively influence muscle composition, cardiometabolic health or systemic inflammation, compared to a NP diet void of eggs.
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Bergia RE, Kim JE, Campbell WW. Differential Relationship between Intermuscular Adipose Depots with Indices of Cardiometabolic Health. Int J Endocrinol 2018; 2018:2751250. [PMID: 30254672 PMCID: PMC6142737 DOI: 10.1155/2018/2751250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/29/2018] [Accepted: 08/02/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Globally, accumulation of intermuscular adipose tissue (IMAT) is positively associated with insulin resistance. Whether this association is observed consistently in different skeletal muscles and encompasses other markers of cardiometabolic health is not well known. OBJECTIVES The purpose of this secondary analysis study was to investigate associations among thigh or calf IMAT stores and indices of cardiometabolic health in adults who are overweight and obese participating in dietary interventions. A subset of calf data was analyzed to assess relations between IMAT in the gastrocnemius (type II fiber predominance) and soleus (type I fiber predominance) with markers of cardiometabolic health. MATERIALS AND METHODS Thigh and calf compositions were assessed via magnetic resonance imaging in 113 subjects (mean ± SD, age: 50 ± 16 y (range: 21-77 y), BMI: 31 ± 3 kg/m2), 103 of which completed dietary interventions with or without energy restriction-induced weight loss. A subset of data (n = 37) was analyzed for relations between muscle compartments (gastrocnemius and soleus) and cardiometabolic health. IMAT was regressed separately against fasting serum glucose concentrations, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), and lipids and lipoproteins. RESULTS In general, total thigh IMAT was predictive of markers of glucose control, while total calf IMAT was not. Specifically, baseline thigh IMAT was positively associated with fasting glucose, insulin, and HOMA-IR. IMAT content changes in any depot did not predict improvement in cardiometabolic health. CONCLUSIONS The strength of the relationship between IMAT and glucose control-related indices of cardiometabolic health is dependent on IMAT location. Specifically, greater IMAT in the thigh is a better predictor of cardiometabolic risk than greater IMAT in the calf in adults who are overweight and obese.
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Affiliation(s)
- Robert E. Bergia
- Department of Nutrition Science, Purdue University, West Lafayette IN 47907, USA
| | - Jung Eun Kim
- Food Science and Technology Programme, c/o Department of Chemistry, National University of Singapore, Singapore, Singapore 119077
| | - Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette IN 47907, USA
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Erlandson MC, Wong AKO, Szabo E, Vilayphiou N, Zulliger MA, Adachi JD, Cheung AM. Muscle and Myotendinous Tissue Properties at the Distal Tibia as Assessed by High-Resolution Peripheral Quantitative Computed Tomography. J Clin Densitom 2017; 20:226-232. [PMID: 27956336 DOI: 10.1016/j.jocd.2016.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 09/13/2016] [Accepted: 10/31/2016] [Indexed: 01/17/2023]
Abstract
High-resolution peripheral quantitative computed tomography (HR-pQCT) quantifies bone microstructure and density at the distal tibia where there is also a sizable amount of myotendinous (muscle and tendon) tissue (MT); however, there is no method for the quantification of MT. This study aimed (1) to assess the feasibility of using HR-pQCT distal tibia scans to estimate MT properties using a custom algorithm, and (2) to determine the relationship between MT properties at the distal tibia and mid-leg muscle density (MD) obtained from pQCT. Postmenopausal women from the Hamilton cohort of the Canadian Multicenter Osteoporosis Study had a single-slice (2.3 ± 0.5 mm) 66% site pQCT scan measuring muscle cross-sectional area (MCSA) and MD. A standard HR-pQCT scan was acquired at the distal tibia. HR-pQCT-derived MT cross-sectional area (MTCSA) and MT density (MTD) were calculated using a custom algorithm in which thresholds (34.22-194.32 mg HA/cm3) identified muscle seed volumes and were iteratively expanded. Pearson and Bland-Altman plots were used to assess correlations and systematic differences between pQCT- and HR-pQCT-derived muscle properties. Among 45 women (mean age: 74.6 ± 8.5 years, body mass index: 25.9 ± 4.3 kg/m2), MTD was moderately correlated with mid-leg MD across the 2 modalities (r = 0.69-0.70, p < 0.01). Bland-Altman analyses revealed no evidence of directional bias for MTD-MD. HR-pQCT and pQCT measures of MTCSA and MCSA were moderately correlated (r = 0.44, p < 0.01). Bland-Altman plots for MTCSA revealed that larger MCSAs related to larger discrepancy between the distal and the mid-leg locations. This is the first study to assess the ability of HR-pQCT to measure MT size, density, and morphometry. HR-pQCT-derived MTD was moderately correlated with mid-leg MD from pQCT. This relationship suggests that distal MT may share common properties with muscle throughout the length of the leg. Future studies will assess the value of HR-pQCT-derived MT properties in the context of falls, mobility, and balance.
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Affiliation(s)
- M C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - A K O Wong
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - E Szabo
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | | | | | - J D Adachi
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - A M Cheung
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
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Zhao Q, Zmuda JM, Kuipers AL, Bunker CH, Patrick AL, Youk AO, Miljkovic I. Muscle Attenuation Is Associated With Newly Developed Hypertension in Men of African Ancestry. Hypertension 2017; 69:957-963. [PMID: 28264917 DOI: 10.1161/hypertensionaha.116.08415] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/04/2016] [Accepted: 02/05/2017] [Indexed: 12/25/2022]
Abstract
Increased ectopic adipose tissue infiltration in skeletal muscle is associated with insulin resistance and diabetes mellitus. We evaluated whether change in skeletal muscle adiposity predicts subsequent development of hypertension in men of African ancestry, a population sample understudied in previous studies. In the Tobago Health Study, a prospective longitudinal study among men of African ancestry (age range 40-91 years), calf intermuscular adipose tissue, and skeletal muscle attenuation were measured with computed tomography. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg, or receiving antihypertensive medications. Logistic regression was performed with adjustment for age, insulin resistance, baseline and 6-year change in body mass index, baseline and 6-year change in waist circumference, and other potential confounding factors. Among 746 normotensive men at baseline, 321 (43%) developed hypertension during the mean 6.2 years of follow-up. Decreased skeletal muscle attenuation was associated with newly developed hypertension after adjustment for baseline and 6-year change of body mass index (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]) or baseline and 6-year change of waist circumference (odds ratio [95% confidence interval] per SD, 1.3 [1.0-1.6]). No association was observed between increased intermuscular adipose tissue and hypertension. Our novel findings show that decreased muscle attenuation is associated with newly developed hypertension among men of African ancestry, independent of general and central adiposity and insulin resistance. Further studies are needed to adjust for inflammation, visceral and other ectopic adipose tissue depots, and to confirm our findings in other population samples.
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Affiliation(s)
- Qian Zhao
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Joseph M Zmuda
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Allison L Kuipers
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Clareann H Bunker
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Alan L Patrick
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Ada O Youk
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
| | - Iva Miljkovic
- From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (Q.Z., J.M.Z., A.L.K., C.H.B., I.M.); Tobago Health Studies Office, Scarborough, Trinidad & Tobago (A.L.P.); and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, PA (A.O.Y.)
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Correa-de-Araujo R, Harris-Love MO, Miljkovic I, Fragala MS, Anthony BW, Manini TM. The Need for Standardized Assessment of Muscle Quality in Skeletal Muscle Function Deficit and Other Aging-Related Muscle Dysfunctions: A Symposium Report. Front Physiol 2017; 8:87. [PMID: 28261109 PMCID: PMC5310167 DOI: 10.3389/fphys.2017.00087] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/31/2017] [Indexed: 12/12/2022] Open
Abstract
A growing body of scientific literature suggests that not only changes in skeletal muscle mass, but also other factors underpinning muscle quality, play a role in the decline in skeletal muscle function and impaired mobility associated with aging. A symposium on muscle quality and the need for standardized assessment was held on April 28, 2016 at the International Conference on Frailty and Sarcopenia Research in Philadelphia, Pennsylvania. The purpose of this symposium was to provide a venue for basic science and clinical researchers and expert clinicians to discuss muscle quality in the context of skeletal muscle function deficit and other aging-related muscle dysfunctions. The present article provides an expanded introduction concerning the emerging definitions of muscle quality and a potential framework for scientific inquiry within the field. Changes in muscle tissue composition, based on excessive levels of inter- and intra-muscular adipose tissue and intramyocellular lipids, have been found to adversely impact metabolism and peak force generation. However, methods to easily and rapidly assess muscle tissue composition in multiple clinical settings and with minimal patient burden are needed. Diagnostic ultrasound and other assessment methods continue to be developed for characterizing muscle pathology, and enhanced sonography using sensors to provide user feedback and improve reliability is currently the subject of ongoing investigation and development. In addition, measures of relative muscle force such as specific force or grip strength adjusted for body size have been proposed as methods to assess changes in muscle quality. Furthermore, performance-based assessments of muscle power via timed tests of function and body size estimates, are associated with lower extremity muscle strength may be responsive to age-related changes in muscle quality. Future aims include reaching consensus on the definition and standardized assessments of muscle quality, and providing recommendations to address critical clinical and technology research gaps within the field.
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Affiliation(s)
- Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services Bethesda, MD, USA
| | - Michael O Harris-Love
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical CenterWashington, DC, USA; Geriatrics and Extended Care Service/Research Service, Veterans Affairs Medical CenterWashington, DC, USA; Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington UniversityWashington, DC, USA
| | - Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA, USA
| | | | - Brian W Anthony
- Laboratory for Manufacturing and Productivity, Massachusetts Institute of TechnologyCambridge, MA, USA; Medical Electronic Device Realization Center, Massachusetts Institute of TechnologyCambridge, MA, USA
| | - Todd M Manini
- Department of Aging & Geriatric Research, Institute on Aging, University of Florida College of Medicine Gainesville, FL, USA
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Goedecke JH, George C, Veras K, Peer N, Lombard C, Victor H, Steyn K, Levitt NS. Sex differences in insulin sensitivity and insulin response with increasing age in black South African men and women. Diabetes Res Clin Pract 2016; 122:207-214. [PMID: 27889690 DOI: 10.1016/j.diabres.2016.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/27/2016] [Accepted: 11/14/2016] [Indexed: 02/08/2023]
Abstract
AIMS Black Africans are disproportionally affected by type 2 diabetes, but the pathophysiology is poorly understood. The study aimed to examine the effect of sex and age on insulin sensitivity and insulin response in black South African adults. METHODS This cross-sectional study included a random sample of 179 men and 260 women aged 25-74years with normal glucose tolerance from 5 peri-urban townships in Cape Town, SA. Insulin sensitivity (insulin sensitivity index, ISI0,120) and response (insulinogenic index, IGI), and the disposition index (DI, ISI0,120×IGI), derived from an oral glucose tolerance test, were measured. RESULTS Although men were older (median [interquartile range]: 39 [30-48] vs. 35 [29-44], P=0.021) and had significantly lower BMI than women (22.6 [20.0-25.3] vs. 31.0 [25.9-35.7] kg/m2, P=0.001), DI was not different (P=0.740), but ISI0,120 was higher (P=0.007) and IGI was lower (P=0.074) in men than women, adjusting for age and BMI. With increasing age, DI (β (95%CI): -24.4 (-36.3 to -12.5), P<0.001) and IGI (β (95%CI): -4.9 (-7.5 to -2.2), P<0.001) decreased similarly in both sexes, but ISI0,120 did not change (β (95%CI): 0.005 (-0.20 to 0.03), P=0.675). CONCLUSION Black South African women with normal glucose tolerance have lower insulin sensitivity than their male counterparts, but increase their insulin response to maintain normoglycemia. With increasing age, insulin sensitivity remains unchanged, but the insulin response decreases at a similar rate in men and women.
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Affiliation(s)
- Julia H Goedecke
- Non-Communicable Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa; Division of Exercise Science and Sports Medicine, Department of Human Biology, 3rd Floor Sports Science Institute of South Africa, Boundary Road, Newlands 7700, South Africa.
| | - Cindy George
- Non-Communicable Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa
| | - Katherine Veras
- Division of Exercise Science and Sports Medicine, Department of Human Biology, 3rd Floor Sports Science Institute of South Africa, Boundary Road, Newlands 7700, South Africa; Department of Physiology and Biophysics, University of São Paulo, São Paulo, Brazil
| | - Nasheeta Peer
- Non-Communicable Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa; Division of Diabetes and Endocrinology, Department of Medicine, University of Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa
| | - Hendriena Victor
- Division of Exercise Science and Sports Medicine, Department of Human Biology, 3rd Floor Sports Science Institute of South Africa, Boundary Road, Newlands 7700, South Africa
| | - Krisela Steyn
- Division of Diabetes and Endocrinology, Department of Medicine, University of Cape Town, South Africa
| | - Naomi S Levitt
- Division of Diabetes and Endocrinology, Department of Medicine, University of Cape Town, South Africa
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Giangregorio LM, Gibbs JC, Craven BC. Measuring muscle and bone in individuals with neurologic impairment; lessons learned about participant selection and pQCT scan acquisition and analysis. Osteoporos Int 2016; 27:2433-46. [PMID: 27026329 DOI: 10.1007/s00198-016-3572-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
Peripheral quantitative computed tomography (pQCT) can be used to examine bone strength outcomes and muscle size and fatty infiltration. Our research team and others have used it to examine bone loss after spinal cord injury (SCI). However, the high prevalence of restricted lower extremity range of motion, spasticity, edema, excessive muscle atrophy, or severe osteoporosis necessitates changes to standard protocols for screening, positioning during scan acquisition, and analysis methods. This manuscript outlines the challenges that we experienced using pQCT in individuals with SCI, and provides solutions, ones that may also be applicable when using pQCT in individuals with other chronic conditions or in older adults. Suggestions for participant screening, positioning individuals for scanning while in a wheelchair, scan site selection, need for attendant assistance, and considerations in the presence of secondary complications, such as contracture, spasticity, and paralysis, are presented. In the presence of very low bone mineral density or severe muscle atrophy, the default analysis modes provided by the manufacturer may not provide valid estimates of bone or muscle indices; we propose alternates. We have used watershed segmentation methods to determine muscle size and density based on lower precision error compared to threshold-based edge-detection segmentation, particularly for adults with SCI, where more fatty infiltration was present. By presenting our "lessons learned," we hope to reduce the learning curve for researchers using pQCT in the future.
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Affiliation(s)
- L M Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Avenue W-BMH 1109, Waterloo, ON, Canada.
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
- Research Scientist, Schlegel-UW Research Institute of Aging, Waterloo, ON, Canada.
| | - J C Gibbs
- Department of Kinesiology, University of Waterloo, 200 University Avenue W-BMH 1109, Waterloo, ON, Canada
| | - B C Craven
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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47
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Zhao Q, Zmuda JM, Kuipers AL, Jonnalagadda P, Bunker CH, Patrick AL, Youk AO, Miljkovic I. Greater skeletal muscle fat infiltration is associated with higher all-cause mortality among men of African ancestry. Age Ageing 2016; 45:529-34. [PMID: 27076522 PMCID: PMC4916343 DOI: 10.1093/ageing/afw062] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/16/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND fat infiltration within and around skeletal muscle (i.e. myosteatosis) increases with ageing, is greater in African versus European ancestry men and is associated with poor health. Myosteatosis studies of mortality are lacking, particularly among African ancestry populations. METHODS in the Tobago Health study, a prospective longitudinal study, we evaluated the association of all-cause mortality with quantitative computed tomography (QCT) measured lower leg myosteatosis (intermuscular fat (IM fat) and muscle density) in 1,652 African ancestry men using Cox proportional hazards models. Date of death was abstracted from death certificates and/or proxy. RESULTS one hundred and twelve deaths occurred during follow-up (mean 5.9 years). In all men (age range 40-91 years), higher all-cause mortality was associated with greater IM fat (HR (95% CI) per SD: 1.29 (1.06-1.57)) and lower muscle density (HR (95% CI) per SD lower: 1.37 (1.08-1.75)) in fully adjusted models. Similar mortality hazard rates were seen in the subset of elderly men (aged ≥65 years) with greater IM fat (1.40 (1.11-1.78) or lower muscle density (1.66 (1.24-2.21)) in fully adjusted models. CONCLUSIONS our study identified a novel, independent association between myosteatosis and all-cause mortality in African ancestry men. Further studies are needed to establish whether this association is independent of other ectopic fat depots and to identify possible biological mechanisms underlying this relationship.
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Affiliation(s)
- Qian Zhao
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Joseph M Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Allison L Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | | | - Clareann H Bunker
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Alan L Patrick
- Tobago Health Studies Office, Scarborough, Trinidad and Tobago
| | - Ada O Youk
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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48
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Brioche T, Pagano AF, Py G, Chopard A. Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention. Mol Aspects Med 2016; 50:56-87. [PMID: 27106402 DOI: 10.1016/j.mam.2016.04.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 12/21/2022]
Abstract
Identification of cost-effective interventions to maintain muscle mass, muscle strength, and physical performance during muscle wasting and aging is an important public health challenge. It requires understanding of the cellular and molecular mechanisms involved. Muscle-deconditioning processes have been deciphered by means of several experimental models, bringing together the opportunities to devise comprehensive analysis of muscle wasting. Studies have increasingly recognized the importance of fatty infiltrations or intermuscular adipose tissue for the age-mediated loss of skeletal-muscle function and emphasized that this new important factor is closely linked to inactivity. The present review aims to address three main points. We first mainly focus on available experimental models involving cell, animal, or human experiments on muscle wasting. We next point out the role of intermuscular adipose tissue in muscle wasting and aging and try to highlight new findings concerning aging and muscle-resident mesenchymal stem cells called fibro/adipogenic progenitors by linking some cellular players implicated in both FAP fate modulation and advancing age. In the last part, we review the main data on the efficiency and molecular and cellular mechanisms by which exercise, replacement hormone therapies, and β-hydroxy-β-methylbutyrate prevent muscle wasting and sarcopenia. Finally, we will discuss a potential therapeutic target of sarcopenia: glucose 6-phosphate dehydrogenase.
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Affiliation(s)
- Thomas Brioche
- Université de Montpellier, INRA, UMR 866 Dynamique Musculaire et Métabolisme, Montpellier F-34060, France.
| | - Allan F Pagano
- Université de Montpellier, INRA, UMR 866 Dynamique Musculaire et Métabolisme, Montpellier F-34060, France
| | - Guillaume Py
- Université de Montpellier, INRA, UMR 866 Dynamique Musculaire et Métabolisme, Montpellier F-34060, France
| | - Angèle Chopard
- Université de Montpellier, INRA, UMR 866 Dynamique Musculaire et Métabolisme, Montpellier F-34060, France
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49
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Miljkovic I, Kuipers AL, Cvejkus R, Bunker CH, Patrick AL, Gordon CL, Zmuda JM. Myosteatosis increases with aging and is associated with incident diabetes in African ancestry men. Obesity (Silver Spring) 2016; 24:476-82. [PMID: 26694517 PMCID: PMC4731257 DOI: 10.1002/oby.21328] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/12/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Skeletal muscle fat infiltration (known as myosteatosis) is greater in African compared with European ancestry men and may play an important role in the development of type 2 diabetes (T2D). However, prospective studies examining the magnitude of changes in myosteatosis with aging and their metabolic consequences are sparse. METHODS Longitudinal changes in peripheral quantitative computed tomography measured calf myosteatosis [intermuscular fat (mm(2) ) and skeletal muscle density as a measure of intramuscular fat (mg/cm(3) )] were examined in 1515 Afro-Caribbean men aged 40+ years recruited without regard to their health status. RESULTS During an average of 6.2 years of follow-up, an age-related increase in intermuscular fat and a decrease in skeletal muscle density were observed (all P < 0.0001), which remained significant in those who lost weight, gained weight, or remained weight stable (all P < 0.0001). In addition, muscle density loss accelerated with increasing age (P < 0.0001). Increased intermuscular fat during follow-up was associated with an increased incident risk of T2D independent of factors known to be associated with T2D (odds ratios per 1-SD increase in intermuscular fat = 1.29; 95% CI = 1.08-1.53). CONCLUSIONS Our findings suggest that both inter- and intramuscular fat increase with advancing age and that intermuscular fat contributes to development of T2D among African ancestry men.
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Affiliation(s)
- Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Allison L Kuipers
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ryan Cvejkus
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Clareann H Bunker
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alan L Patrick
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago, West Indies
| | | | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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50
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Ismail C, Zabal J, Hernandez HJ, Woletz P, Manning H, Teixeira C, DiPietro L, Blackman MR, Harris-Love MO. Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia. Front Physiol 2015; 6:302. [PMID: 26578974 PMCID: PMC4625057 DOI: 10.3389/fphys.2015.00302] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/12/2015] [Indexed: 01/24/2023] Open
Abstract
Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups. Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more strongly associated with strength than muscle mass within the study sample.
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Affiliation(s)
- Catheeja Ismail
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center Washington, DC, USA ; Department of Medicine, School of Medicine and Health Sciences, The George Washington University Washington, DC, USA
| | - Johannah Zabal
- Department of Physical Therapy and Health Care Sciences, School of Medicine and Health Sciences, The George Washington University Washington, DC, USA ; Department of Health Sciences, Malek School of Health Professions, Marymount University Arlington, VA, USA
| | - Haniel J Hernandez
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center Washington, DC, USA ; Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center Washington, DC, USA
| | - Paula Woletz
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center Washington, DC, USA
| | - Heather Manning
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University Washington, DC, USA
| | - Carla Teixeira
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center Washington, DC, USA ; The School of Kinesiology and Health Studies, Queen's University Kingston, ON, Canada
| | - Loretta DiPietro
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University Washington, DC, USA
| | - Marc R Blackman
- Department of Medicine, School of Medicine and Health Sciences, The George Washington University Washington, DC, USA ; Departments of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, The George Washington University Washington, DC, USA ; Departments of Medicine and Rehabilitation Medicine, Georgetown University School of Medicine Washington, DC, USA ; The Johns Hopkins University School of Medicine, Johns Hopkins University Baltimore, MD, USA ; Research Service, Veterans Affairs Medical Center Washington, DC, USA
| | - Michael O Harris-Love
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center Washington, DC, USA ; Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University Washington, DC, USA ; Research Service, Veterans Affairs Medical Center Washington, DC, USA
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