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Chakraborty S, Naskar TK, Basu BR. Vitamin D deficiency, insulin resistance, and antimüllerian hormone level: a tale of trio in the expression of polycystic ovary syndrome. F&S SCIENCE 2024:S2666-335X(24)00031-4. [PMID: 38876205 DOI: 10.1016/j.xfss.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE To study the association between altered vitamin D profiles and different indices as well as clinical features of polycystic ovary syndrome (PCOS), including antimüllerian hormone (AMH) levels, phenotypes (A [hyperandrogenism {HA} + ovulatory dysfunction {OD} + polycystic ovarian morphology {PCOM}], B [HA + OD], C [HA + PCOM], and D [OD + PCOM]), insulin resistance, oligomenorrhea, hyperandrogenism, obesity indices, and stress biomarkers in the ethnic population of West Bengal. DESIGN Case-control observational study. SETTING Outpatient department of gynecology and obstetrics and environing. PARTICIPANTS (PATIENTS AND CONTROL) Sample size: case group (PCOS, n = 160), age: 16-38 years, and their gender, age, as well as ethnicity-matched healthy control (n = 160). INTERVENTION(S) In this observational study, a structured questionnaire for menstrual status and to determine the scores of cutaneous manifestations, a bioelectrical impedance analyzer for measurement of anthropometric indices, relevant biochemical assessments (vitamin D, AMH, insulin, glucose, and other associated hormonal profiles), statistical software for the social sciences, and Microsoft Office Excel were used to evaluate as well as analyze different indices. MAIN OUTCOME MEASURE(S) Study of the association of vitamin D deficiency with differential manifestations of PCOS such as phenotypes of the syndrome, altered AMH levels, and risk of insulin resistance. An attempt has been made to determine the cutoff value of AMH of the patients with PCOS belonging to the ethnic population of West Bengal using receiver operating characteristic (ROC). RESULT(S) Vitamin D deficiency was found to be directly correlated with AMH level in PCOS phenotype A (67%), oligomenorrhea, and PCOM, along with a substantial agonistic relationship with insulin resistance in the PCOS population under study. In the PCOS phenotype B, the AMH level was highest, with a cutoff value of 5.27 ng/mL (asymptotic sig. = 0.000, 95% confidence interval: 8.37-9.95, derived by ROC analysis, with area under the ROC curve- area under the curve value = 0.949, sensitivity=0.882, and specificity = 0.880). Oligomenorrhic women with PCOS possess significantly higher values of AMH levels (8.70 ± 3.66 > 3.09 ± 1.86 ng/mL) level than the regular menstrual rhythm within the same group. Patients with PCOS had significantly less skeletal muscle mass and greater subcutaneous fat content than the control group. CONCLUSION(S) 25-hydroxy-vitamin D might be intermeshed with the underlying pathophysiology and severity of PCOS, as well as associated metabolic disorders like insulin resistance. The AMH level is finely tuned by most of the plausible effectors of PCOS and contends to be a promising biomarker for the diagnosis as well as prognosis of PCOS.
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Affiliation(s)
- Sanchari Chakraborty
- Clinicogenomics Lab, Sir Surendranath Banerjea Advanced Research Centre, Department of Physiology, Surendranath College, University of Calcutta, Kolkata, West Bengal, India
| | - Tapan K Naskar
- Department of Gynaecology and Obstetrics, Medical College, Kolkata, West Bengal, India
| | - Barnali R Basu
- Clinicogenomics Lab, Sir Surendranath Banerjea Advanced Research Centre, Department of Physiology, Surendranath College, University of Calcutta, Kolkata, West Bengal, India.
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Chun D, Kim SJ, Suh J, Kim J. Timing, velocity, and magnitude of pubertal changes in body composition: a longitudinal study. Pediatr Res 2024:10.1038/s41390-024-03299-w. [PMID: 38862608 DOI: 10.1038/s41390-024-03299-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/10/2024] [Accepted: 05/19/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Pubertal changes in body composition significantly influence future health, with links to various diseases. This study aimed to evaluate the weight changes, fat-free mass (FFM), and body fat mass (BFM) during pubertal growth in Korean children and adolescents. METHODS We utilized mixed longitudinal data, employing bioelectrical impedance analysis for 4641 height measurements (2204 boys, 2437 girls) from 361 individuals (170 boys, 191 girls) aged 7-18 years. Utilizing the Superimposition by Translation and Rotation (SITAR) model, a shape-invariant growth curve model, reference curves for height, weight, and body composition change velocities were estimated. RESULTS Korean boys experience peak weight velocity (PWV) at an average age of 12.41 years, with a rate of 8.19 kg/year, peak fat-free mass velocity (PFFV) at 12.70 years (7.60 kg/year), and peak body fat mass velocity (PBFV) at 9.69 years (2.67 kg/year). Korean girls show PWV at 11.28 years (6.33 kg/year), PFFV at 11.13 years (4.86 kg/year), and PBFV at 12.33 years (2.72 kg/year). Positive correlations exist among the ages of peak height velocity, PWV, PFFV, and PBFV. CONCLUSIONS This research represents the groundbreaking application of the SITAR model in analyzing changes in body composition during pubertal growth in Korean children and adolescents. IMPACT This study utilized the SITAR model to analyze longitudinal changes in the body composition of the general pediatric population in Korea across pre- and post-pubertal stages, addressing overlooked aspects in cross-sectional studies. Examining growth parameters, including size (mean mass), tempo (timing), and velocity (compression and expansion) for each body component, revealed positive correlations among ages at peak velocities for various body composition parameters. This study can be employed for further investigations that compare the tempo, size, and velocity of various body composition parameters in pediatric disease cohorts and the general population.
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Affiliation(s)
- Dohyun Chun
- College of Business Administration, Kangwon National University, Chuncheon, Gangwon-do, Korea
- The Global Prediction Co., Ltd., Gwangmyeong, Gyeonggi-do, Korea
| | - Seo Jung Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Jihun Kim
- The Global Prediction Co., Ltd., Gwangmyeong, Gyeonggi-do, Korea.
- College of Humanities & Social Sciences Convergence, Yonsei University, Wonju, Gangwon-do, Korea.
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Murphy EK, Bertsch SR, Klein SB, Rashedi N, Sun Y, Joyner MJ, Curry TB, Johnson CP, Regimbal RJ, Wiggins CC, Senefeld JW, Shepherd JRA, Elliott JT, Halter RJ, Vaze VS, Paradis NA. Non-invasive biomarkers for detecting progression toward hypovolemic cardiovascular instability in a lower body negative pressure model. Sci Rep 2024; 14:8719. [PMID: 38622207 PMCID: PMC11018605 DOI: 10.1038/s41598-024-59139-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
Occult hemorrhages after trauma can be present insidiously, and if not detected early enough can result in patient death. This study evaluated a hemorrhage model on 18 human subjects, comparing the performance of traditional vital signs to multiple off-the-shelf non-invasive biomarkers. A validated lower body negative pressure (LBNP) model was used to induce progression towards hypovolemic cardiovascular instability. Traditional vital signs included mean arterial pressure (MAP), electrocardiography (ECG), plethysmography (Pleth), and the test systems utilized electrical impedance via commercial electrical impedance tomography (EIT) and multifrequency electrical impedance spectroscopy (EIS) devices. Absolute and relative metrics were used to evaluate the performance in addition to machine learning-based modeling. Relative EIT-based metrics measured on the thorax outperformed vital sign metrics (MAP, ECG, and Pleth) achieving an area-under-the-curve (AUC) of 0.99 (CI 0.95-1.00, 100% sensitivity, 87.5% specificity) at the smallest LBNP change (0-15 mmHg). The best vital sign metric (MAP) at this LBNP change yielded an AUC of 0.6 (CI 0.38-0.79, 100% sensitivity, 25% specificity). Out-of-sample predictive performance from machine learning models were strong, especially when combining signals from multiple technologies simultaneously. EIT, alone or in machine learning-based combination, appears promising as a technology for early detection of progression toward hemodynamic instability.
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Affiliation(s)
- Ethan K Murphy
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA.
| | - Spencer R Bertsch
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Samuel B Klein
- Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Navid Rashedi
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Yifei Sun
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Timothy B Curry
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Christopher P Johnson
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Riley J Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Jonathon W Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - John R A Shepherd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55902, USA
| | - Jonathan Thomas Elliott
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
- Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Ryan J Halter
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
- Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Vikrant S Vaze
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Norman A Paradis
- Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
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Santos DNDD, Coelho CG, Diniz MDFHS, Duncan BB, Schmidt MI, Bensenor IJM, Szlejf C, Telles RW, Barreto SM. Dynapenia and sarcopenia: association with the diagnosis, duration and complication of type 2 diabetes mellitus in ELSA-Brasil. CAD SAUDE PUBLICA 2024; 40:e00081223. [PMID: 38324863 PMCID: PMC10841377 DOI: 10.1590/0102-311xen081223] [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: 05/08/2023] [Revised: 09/15/2023] [Accepted: 10/16/2023] [Indexed: 02/09/2024] Open
Abstract
Sarcopenia (the loss of muscle mass, strength and skeletal muscle function) increases mortality and the risk of hospitalization in the older population. Although it is known that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of dynapenia and sarcopenia, few studies have investigated these conditions in middle-aged populations. The objective of this study was to investigate whether T2DM, its duration, the presence of albuminuria, and glycemic control are associated with sarcopenia and its components in adults. The cross-sectional analysis was based on data from visit 2 of the Brazilian Longitudinal Study of Adult Health (2012-2014). The 2018 European Working Group on Sarcopenia in Older People criteria were used to define dynapenia, low appendicular muscle mass (LAMM), and sarcopenia (absent/probable/confirmed). The explanatory variables were: T2DM; duration of T2DM; T2DM according to the presence of albuminuria; and glycemic control (HbA1C < 7%) among people with T2DM. A total of 12,132 participants (mean age = 55.5, SD: 8.9 years) were included. The odds ratio for LAMM was greater among those with T2DM, T2DM duration from 5 to 10 years, and T2DM without albuminuria. Chances of dynapenia were higher among those with T2DM, T2DM duration > 10 years, and T2DM with and without albuminuria. The variables T2DM, T2DM ≥ 10 years, and T2DM with albuminuria increased the odds of probable sarcopenia, and T2DM duration from 5 to 10 years increased the odds of confirmed sarcopenia. The results support the importance of frequently monitoring the musculoskeletal mass and strength of individuals with T2DM to prevent sarcopenia and related outcomes.
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Affiliation(s)
| | - Carolina Gomes Coelho
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | - Bruce Bartholow Duncan
- Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maria Inês Schmidt
- Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Claudia Szlejf
- Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil
| | - Rosa Weiss Telles
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Sandhi Maria Barreto
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Leong LT, Wong MC, Liu YE, Glaser Y, Quon BK, Kelly NN, Cataldi D, Sadowski P, Heymsfield SB, Shepherd JA. Generative deep learning furthers the understanding of local distributions of fat and muscle on body shape and health using 3D surface scans. COMMUNICATIONS MEDICINE 2024; 4:13. [PMID: 38287144 PMCID: PMC10824755 DOI: 10.1038/s43856-024-00434-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Body shape, an intuitive health indicator, is deterministically driven by body composition. We developed and validated a deep learning model that generates accurate dual-energy X-ray absorptiometry (DXA) scans from three-dimensional optical body scans (3DO), enabling compositional analysis of the whole body and specified subregions. Previous works on generative medical imaging models lack quantitative validation and only report quality metrics. METHODS Our model was self-supervised pretrained on two large clinical DXA datasets and fine-tuned using the Shape Up! Adults study dataset. Model-predicted scans from a holdout test set were evaluated using clinical commercial DXA software for compositional accuracy. RESULTS Predicted DXA scans achieve R2 of 0.73, 0.89, and 0.99 and RMSEs of 5.32, 6.56, and 4.15 kg for total fat mass (FM), fat-free mass (FFM), and total mass, respectively. Custom subregion analysis results in R2s of 0.70-0.89 for left and right thigh composition. We demonstrate the ability of models to produce quantitatively accurate visualizations of soft tissue and bone, confirming a strong relationship between body shape and composition. CONCLUSIONS This work highlights the potential of generative models in medical imaging and reinforces the importance of quantitative validation for assessing their clinical utility.
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Affiliation(s)
- Lambert T Leong
- Molecular Bioscience and Bioengineering at University of Hawaii, Honolulu, HI, USA
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Michael C Wong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yong E Liu
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yannik Glaser
- Information and Computer Science at University of Hawaii, Honolulu, HI, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Devon Cataldi
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Peter Sadowski
- Information and Computer Science at University of Hawaii, Honolulu, HI, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LO, USA
| | - John A Shepherd
- Molecular Bioscience and Bioengineering at University of Hawaii, Honolulu, HI, USA.
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA.
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Sasmita BR, Zhao Y, Gong M, Luo S, Huang B. Edema Index Predicts Mortality in Patients with Chronic Heart Failure: A Prospective, Observational Study. Glob Heart 2024; 19:5. [PMID: 38250704 PMCID: PMC10798169 DOI: 10.5334/gh.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Chronic fluid accumulation or congestion is considered an important pathophysiologic mechanism in heart failure, leading to cardinal symptoms such as dyspnea, pulmonary congestion, and pitting edema. Edema index (EI) recently emerged as a surrogate for extracellular volume status and has been proven to be able to reflect one's congestion status. In this study, we aimed to evaluate the prognostic value of EI in patients with chronic heart failure (CHF). Methods A total of 401 consecutive patients with CHF between August 2019 and October 2021 were prospectively enrolled. EI was obtained by InBody S10. The primary endpoint was long-term all-cause and cardiovascular mortality. Results Patients with high EI (>0.397) tended to be older, presented with atrial fibrillation, have higher N-terminal brain natriuretic peptide, and have higher creatinine (all p < 0.05). During a median follow-up of 1200 days, the all-cause and cardiovascular mortality rate was significantly higher in the high EI group compared to the low EI group (all-cause mortality rate 43.8% vs. 30.3%, p < 0.001, and cardiovascular mortality rate 17.5% vs. 13.0%, p < 0.001, respectively). In the multivariate Cox proportional hazard analysis, EI > 0.397 was an independent predictor for both all-cause mortality (HR 1.959; 95% CI 1.304, 2.944; p = 0.001) and cardiovascular mortality (HR 2.051; 95% CI 1.276, 3.296; p = 0.003). Conclusions Admission EI could be used as a marker for predicting long-term mortality in patients with CHF, and higher EI was associated with an increased risk of all-cause and cardiovascular mortality. Furthermore, EI-guided management could be a promising therapy in patients with CHF.
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Affiliation(s)
- Bryan Richard Sasmita
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Yuhe Zhao
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
- Department of Cardiology, Chongqing Seventh People’s Hospital, Chongqing, China
| | - Ming Gong
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Suxin Luo
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Bi Huang
- Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
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Flore G, Deledda A, Fosci M, Lombardo M, Moroni E, Pintus S, Velluzzi F, Fantola G. Perioperative Nutritional Management in Enhanced Recovery after Bariatric Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6899. [PMID: 37835169 PMCID: PMC10573058 DOI: 10.3390/ijerph20196899] [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: 07/15/2023] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Obesity is a crucial health problem because it leads to several chronic diseases with an increased risk of mortality and it is very hard to reverse with conventional treatment including changes in lifestyle and pharmacotherapy. Bariatric surgery (BS), comprising a range of various surgical procedures that modify the digestive tract favouring weight loss, is considered the most effective medical intervention to counteract severe obesity, especially in the presence of metabolic comorbidities. The Enhanced Recovery After Bariatric Surgery (ERABS) protocols include a set of recommendations that can be applied before and after BS. The primary aim of ERABS protocols is to facilitate and expedite the recovery process while enhancing the overall effectiveness of bariatric procedures. ERABS protocols include indications about preoperative fasting as well as on how to feed the patient on the day of the intervention, and how to nourish and hydrate in the days after BS. This narrative review examines the application, the feasibility and the efficacy of ERABS protocols applied to the field of nutrition. We found that ERABS protocols, in particular not fasting the patient before the surgery, are often not correctly applied for reasons that are not evidence-based. Furthermore, we identified some gaps in the research about some practises that could be implemented in the presence of additional evidence.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Michele Fosci
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy;
| | - Enrico Moroni
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
| | - Stefano Pintus
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Giovanni Fantola
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
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Ji S, Park SJ, Lee JY, Baek JY, Jung HW, Kim K, Yoo HJ, Jang IY, Kim BJ. Lack of association between serum myonectin levels and sarcopenia in older Asian adults. Exp Gerontol 2023; 178:112229. [PMID: 37270069 DOI: 10.1016/j.exger.2023.112229] [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: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
Myonectin is a muscle-secreted factor that helps maintain homeostasis in the body by regulating several functions, including lipid metabolism. Previous studies suggested that myonectin may play a role in muscle health in an autocrine manner, but its impact on human skeletal muscle is still unclear. We aimed to investigate the relationship of serum myonectin levels with sarcopenia and related muscle parameters. We conducted a cross-sectional study of 142 older adults whose muscle mass, grip strength, gait speed, chair stands, and short physical performance battery (SPPB) were evaluated in the geriatric clinic of a tertiary medical center. Sarcopenia was defined based on Asian-specific cutoff values, and circulating myonectin levels were measured using an enzyme immunoassay. Before and after adjusting for age, sex, and body mass index, the serum myonectin level was not significantly different when the patients were stratified by status of sarcopenia, muscle mass, muscle strength, and physical performance. Furthermore, whether given as a continuous variable or divided into quartile groups, the serum myonectin level had no association with the skeletal muscle mass, grip strength, gait speed, chair stand test, or SPPB score. Our findings did not confirm the potential role of myonectin in muscle metabolism observed in experimental research. Thus, serum myonectin levels cannot predict the risk of sarcopenia in older Asian adults.
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Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea; Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
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Catapano A, Trinchese G, Cimmino F, Petrella L, D'Angelo M, Di Maio G, Crispino M, Cavaliere G, Monda M, Mollica MP. Impedance Analysis to Evaluate Nutritional Status in Physiological and Pathological Conditions. Nutrients 2023; 15:nu15102264. [PMID: 37242147 DOI: 10.3390/nu15102264] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
A thorough knowledge of body composition assessment techniques is the cornerstone for initiating a customized nutritional program. The second step is to consider the potential of their application in different physiological and pathological conditions and their effectiveness in the management of a monitoring pathway during dietary interventions. To date, bioimpedance analysis is the most effective and reliable method for assessing body composition due to its advantages in terms of speed of execution, non-invasiveness and low cost. Therefore, this review article aims to analyze the main concepts and application areas of bioimpedance measurement techniques, in particular vector frequency-based analysis (BIVA) systems, in order to assess their validity in both physiological and pathological conditions.
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Affiliation(s)
- Angela Catapano
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
| | - Giovanna Trinchese
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Fabiano Cimmino
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
| | - Lidia Petrella
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Margherita D'Angelo
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Girolamo Di Maio
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Marianna Crispino
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
| | - Gina Cavaliere
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Maria Pina Mollica
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant'Angelo, 80126 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80138 Naples, Italy
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10
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Thomas J, Delaney C, Miller M. The ability of the Global Leadership Initiative on Malnutrition (GLIM) to diagnose protein-energy malnutrition in patients requiring vascular surgery: a validation study. Br J Nutr 2023; 129:49-53. [PMID: 35115059 DOI: 10.1017/s0007114522000344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Identifying nutritional deficits and implementing appropriate interventions in patients requiring vascular surgery is challenging due to the paucity of appropriate screening and assessment tools in this group. This retrospective study aimed to determine the validity of the Global Leadership Initiative on Malnutrition (GLIM) in identifying protein-energy malnutrition (PEM) in inpatients admitted to a vascular surgery unit, using the PG-SGA as the comparator. Diagnostic accuracy and consistency were determined between the GLIM and the Patient-Generated Subjective Global Assessment (PG-SGA) global rating. The GLIM determination was made retrospectively using the relevant parameters collected at baseline in the original study. Two hundred and twenty-four (70·1 % male) participants were included. The prevalence of PEM was 28·6 % on GLIM and 17 % via the PG-SGA. Compared with the PG-SGA, the GLIM achieved sensitivity of 73·7 % and specificity of 80·6 %; however positive predictive value was 43·7 % indicating that the GLIM over-diagnosed malnutrition compared with the PG-SGA. Kappa reached 0·427 indicating moderate diagnostic consistency. Due to the absence of an ideal instrument and the complexity of malnutrition often seen in this group which extends beyond PEM to significant micronutrient deficiencies, further work is required to determine the most appropriate instrument in this patient group, and how micronutrient status can also be included in the overall assessment given the critical role of micronutrients in this group.
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Affiliation(s)
- Jolene Thomas
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia
| | - Christopher Delaney
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia
- Department of Vascular and Endovascular Surgery, Southern Adelaide Local Health Network, Adelaide, South Australia
| | - Michelle Miller
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia
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11
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Anusitviwat C, Vanitcharoenkul E, Chotiyarnwong P, Unnanuntana A. Dual-Frequency Bioelectrical Impedance Analysis is Accurate and Reliable to Determine Lean Muscle Mass in The Elderly. J Clin Densitom 2023; 26:90-96. [PMID: 36567160 DOI: 10.1016/j.jocd.2022.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dual-frequency bioelectrical impedance analysis (DF-BIA) devices are more accessible and affordable than dual-energy X-ray absorptiometry (DXA); however, no studies have reported the accuracy of DF-BIA in body composition measurement, especially in the Thai elderly. The aims of this study were to (1) compare the accuracies of lean muscle masses measured by DF-BIA devices and DXA and (2) assess the reliability of the DF-BIA device. METHODS This cross-sectional study was conducted on participants older than 60 years who visited the Orthopedic Clinic of Siriraj Hospital. Whole-body and appendicular skeletal muscle masses (ASMs) were measured using DF-BIA (Tanita RD-545), with DXA (GE Lunar iDXA) as the standard reference. The test-retest reliability of the DF-BIA and the agreement between the devices were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Regression analysis was used to develop an equation to estimate ASM values from BIA close to those from DXA. RESULTS The mean age of 88 participants was 73.8 (SD 8.0) years, with women predominating (84.1%). The agreement of BIA and DXA was very high for whole-body lean mass (ICC = 0.954) and ASM (ICC = 0.954), but the mean difference in muscle mass from DF-BIA was overestimated. The ICCs of test-retest reliability for whole-body muscle mass and ASM were 0.987 and 0.988, respectively. The equation for corrected ASM was formulated from a linear equation (R2 = 0.93). CONCLUSIONS Although lean muscle mass from DF-BIA was minimally overestimated relative to DXA, this device had high accuracy and reliability for lean muscle mass evaluation in the elderly. DXA and DF-BIA are interchangeable for the assessment of muscle mass.
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Affiliation(s)
- Chirathit Anusitviwat
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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12
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Anwer R, Baig LA, Musharraf M. Validation of HF-Bioelectrical Impedance Analysis versus Body Mass Index in Classifying Overweight and Obese Pakistani Adults. J Multidiscip Healthc 2023; 16:983-996. [PMID: 37056980 PMCID: PMC10089275 DOI: 10.2147/jmdh.s378367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/06/2023] [Indexed: 04/15/2023] Open
Abstract
Purpose To determine the validity of hand-to-foot bioelectrical impedance analysis (HF-BIA) versus body mass index (BMI) to assess overweight and obesity status in adults against a reference method, dual-energy x-ray absorptiometry (DXA). Patients and Methods It is a validation study conducted on 206 Pakistani adults ≥20 years recruited through convenience sampling technique at PNS Shifa Hospital and Jinnah Post Medical Centre, Karachi, Pakistan. Results HF-BIA showed better sensitivity of 90.1% and 100% specificity with no false positive, but 9% false negative as compared to BMI which indicated 80.3% sensitivity and 100% specificity with a false-negative rate of 19.6%.HF-BIA also showed better sensitivity 80.9-97.1% with 100% specificity and PPV across all age groups. The correlation coefficient between BMI and DXA bf% (r=0.67) was moderate and less than the correlation coefficient between HF-BIA and DXA bf % (r=0.87). Kappa agreement showed weak to a fair agreement between BMI and DXA bf % (0.1 overall; 0.22 men; 0.14 women) compared to HF-BIA, which had a better agreement between BIA bf% and DXA bf% (0.43 overall; 0.46 men; 0.34 women). HF-BIA bf % demonstrated a better discriminatory power than BMI (AUC of ≥0.91) and was better predictor of body fat than BMI. Conclusion HF-BIA is a more accurate method than BMI and may be used consistently throughout the country in primary care and research to identify the fat-based overweight and obese in the Pakistani population.
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Affiliation(s)
- Rabia Anwer
- Registered Dietitian Nutritionist, PNS Shifa Hospital, Karachi, 75270, Pakistan
- Correspondence: Rabia Anwer, THB Global, 59 C Khyaban-e-Seher DHA Phase 6, Karachi, 75500, Pakistan, Tel + 92 333-5289010, Email
| | - Lubna Ansari Baig
- Chairperson, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
- Lubna Ansari Baig, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, 75510, Pakistan, Tel +92300-8239680, Email
| | - Mehjabeen Musharraf
- Senior Lecturer, APPNA Institute of Public Health, Jinnah Sindh Medical University Karachi, Karachi, 75510, Pakistan
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Garr Barry V, Chiang JL, Bowman KG, Johnson KD, Gower BA. Bioimpedance-Derived Membrane Capacitance: Clinically Relevant Sources of Variability, Precision, and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:686. [PMID: 36613010 PMCID: PMC9819400 DOI: 10.3390/ijerph20010686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Membrane capacitance (CM), a bioimpedance-derived measure of cell membrane health, has been suggested as an indicator of health status. However, there are few published data to support its use in clinical settings. Hence, this study evaluated clinically relevant sources of variation, precision, and reliability of CM measurements. This longitudinal study included 60 premenopausal women. Sources of variability (e.g., demographics, body composition, serum measures, diet) were identified by stepwise regression. Precision and reliability were assessed by the coefficient of variation (CV), intraclass correlation coefficients (ICC), and technical error of the measurement (TEM) for intra-day (30 min apart) and inter-day measurements (7-14 days apart). Body composition, temperature, and metabolic activity were identified as sources of variability. CM measurements had high precision (CV = 0.42%) and high reliability for intra-day (ICC = 0.996) and inter-day (ICC = 0.959) measurements, independent of menstrual cycle and obesity status. Our results showed that CM measurements are sensitive to clinical factors and have high precision and reliability. The results of this study suggest that CM is sufficiently reliable for health status monitoring in conditions with variation in body composition, metabolic activity, or body temperature among premenopausal women.
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Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Division of Clinical Research, School of Medicine in St. Louis, Washington University, St. Louis, MO 63108, USA
| | - Jasmine L. Chiang
- Department of Obstetrics and Gynecology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Kaylan G. Bowman
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Kristina D. Johnson
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Barbara A. Gower
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
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Tang X, Huang S, Huang L, Feng Z, Wang Z, Yue J, Qiu L. Ultrasound-derived muscle assessment system for older adults: a promising muscle mass estimation tool. Age Ageing 2022; 51:6964937. [PMID: 36580560 PMCID: PMC9799249 DOI: 10.1093/ageing/afac298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Quantitative assessment of muscle mass is a critical step in sarcopenia disease management. Expanding upon the use of ultrasound in foetal growth assessment, we established and validated an ultrasound-derived muscle assessment system for older adults at a risk of sarcopenia. METHODS A total of 669 older adults were recruited in three cohorts in this cross-sectional study. In cohort 1(n = 103), the most valuable sites for skeletal muscle mass index (SMI) estimation were located among 11 ultrasound scanning sites. An ultrasound-derived SMI estimating algorithm based on muscle thickness (MT) was obtained in the modelling group composed of cohorts 1 and 2 (n = 309). The reliability of the muscle mass estimation equation and the validity of the obtained cut-off values were verified in cohort 3 (n = 257), which was selected as the verification group. RESULTS In the modelling group, the cut-off values of ultrasound-derived e-SMI for low SMI were 7.13 kg/m2 for men and 5.81 kg/m2 for women. In the verification group, the intraclass correlation between e-SMI and SMI was 0.885. The sensitivity of the e-SMI in detecting low SMI was 93.6% for men and 89.7% for women, and the negative predictive value was 94.9% for men and 94.7% for women. Combined with the handgrip strength and gait speed, the e-SMI had an overall diagnostic sensitivity of 92.7% and a specificity of 91.0% for sarcopenia. CONCLUSION The ultrasound-derived muscle assessment system can be a promising muscle mass estimation tool and a potential disease classification tool.
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Affiliation(s)
- Xinyi Tang
- Department of Medical Ultrasound and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Songya Huang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Li Huang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ziyan Feng
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ziyao Wang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jirong Yue
- Address correspondence to: Jirong Yue National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, China. E-mail: ; Li Qiu, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, China. E-mail:
| | - Li Qiu
- Address correspondence to: Jirong Yue National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, China. E-mail: ; Li Qiu, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, China. E-mail:
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15
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Baioccato V, Quinto G, Rovai S, Conte F, Dassie F, Neunhäeuserer D, Vecchiato M, Palermi S, Gasperetti A, Bullo V, Camozzi V, Vettor R, Ermolao A, Mioni R. Do Androgenic Pattern, Insulin State and Growth Hormone Affect Cardiorespiratory Fitness and Strength in Young Women with PCOS? Biomedicines 2022; 10:biomedicines10092176. [PMID: 36140277 PMCID: PMC9496105 DOI: 10.3390/biomedicines10092176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, cardiorespiratory fitness (CRF) and strength level were assessed in women with and without polycystic ovary syndrome (PCOS), matched for age, body composition, androgenic pattern and insulinemic pattern. Patients with and without PCOS were evaluated at the Endocrinology Unit and Sport Medicine Division to assess endocrinological (insulinemic, androgenic pattern and growth hormone), anthropometric (with DEXA) and functional parameters (with cardiopulmonary exercise test and handgrip test), as well as physical activity level (with the Global Physical Activity Questionnaire). A total of 31 patients with PCOS and 13 controls were included. No statistically significant differences were found between groups in terms of age, body mass index, body composition, androgenic pattern, insulin state, growth hormone and physical activity level. The PCOS group demonstrated significantly better cardiorespiratory fitness (VO2max per kg (30.9 ± 7.6 vs. 24.8 ± 4.1 mL/kg/min; p = 0.010), VO2max per kg of fat-free mass (52.4 ± 8.9 vs. 45.3 ± 6.2 mL/kg/min; p = 0.018)), strength levels (handgrip per kg (0.36 ± 0.09 vs. 0.30 ± 0.08; p = 0.009), handgrip per kg of fat-free mass (13.03 ± 2.32 vs. 11.50 ± 1.91; p = 0.001)) and exercise capacity (METs at test (14.4 ± 2.72 vs. 12.5 ± 1.72 METs; p = 0.019)). In this study, women with PCOS showed a better cardiorespiratory fitness and strength than the control group. The only determinant that could explain the differences observed seems to be the presence of the syndrome itself. These results suggest that PCOS per se does not limit exercise capacity and does not exclude good functional capacity.
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Affiliation(s)
- Veronica Baioccato
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Giulia Quinto
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Sara Rovai
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Francesca Conte
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Francesca Dassie
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
| | - Daniel Neunhäeuserer
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Marco Vecchiato
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Gasperetti
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Valentina Bullo
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Valentina Camozzi
- Endocrinology Division, Department of Medicine, Padova University Hospital, 35128 Padova, Italy
| | - Roberto Vettor
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Roberto Mioni
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
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16
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Ultrasonografically-Assessed Osteosarcopenic Obesity is Associated With Frailty In Community-Dwelling Older Adults. Nutrition 2022; 103-104:111827. [DOI: 10.1016/j.nut.2022.111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/17/2022] [Accepted: 08/07/2022] [Indexed: 11/22/2022]
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Sylivris A, Mesinovic J, Scott D, Jansons P. Body composition changes at 12 months following different surgical weight loss interventions in adults with obesity: A systematic review and meta-analysis of randomized control trials. Obes Rev 2022; 23:e13442. [PMID: 35257480 PMCID: PMC9286475 DOI: 10.1111/obr.13442] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Abstract
To determine relative lean mass and fat mass changes in adults with obesity following surgical weight loss interventions, a systematic review and meta-analysis was conducted. The Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, and Scopus were screened for eligible studies. Inclusion criteria included randomized controlled trials (RCTs) performed in populations with obesity (body mass index ≥30 kg/m2 ) aged over 18 years, who underwent any type of bariatric surgery and reported body composition measures via dual-energy X-ray absorptiometry or bio-electrical impedance analysis. Authors conducted full text screening and determined that there were six RCTs eligible for inclusion, with data extracted at 12 months post-surgery. Meta-analysis revealed that, relative to gastric banding, Roux-en-Y gastric bypass (RYGB) led to greater total body mass loss (mean difference [MD]: -9.33 kg [95% CI: -12.10, -6.56]) and greater fat mass loss (MD: -8.86 kg [95% CI: -11.80, -5.93], but similar lean mass loss (MD: -0.55 kg [95% CI: -3.82, 2.71]. RYGB also led to similar changes in total body mass, fat mass, and lean mass compared with sleeve gastrectomy. RYGB results in greater 12-month weight and fat loss, but similar changes in lean mass, compared with gastric banding. Further RCTs comparing body composition changes following different bariatric surgery procedures are required.
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Affiliation(s)
- Amy Sylivris
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Paul Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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18
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Maran A, Atkinson SA, Bertram V, Vanniyasingam T, Thabane L, Mottola MF, Phillips SM. Exploring comparative assessment of adiposity measures during pregnancy and postpartum. Clin Nutr ESPEN 2022; 49:365-371. [PMID: 35623838 DOI: 10.1016/j.clnesp.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Excessive adiposity in pregnancy is associated with an altered cardiometabolic profile and adverse maternal and offspring outcomes. Pre-pregnancy body mass index (pBMI) is a proxy measure for adiposity that is most often used in clinical settings; however, it may not identify at-risk pregnancies caused by adiposity-related cardiometabolic dysfunction. The challenge is that validated direct adiposity measures are limited due to the dynamic nature of pregnancy. This exploratory analysis aimed to, 1) evaluate longitudinal changes in % body fat (BF) and the agreement between skinfold thickness (SFT) and bioelectrical impedance analysis (BIA) across pregnancy and in postpartum; 2) compare the discrimination power of SFT, BIA, and pBMI regarding adiposity status; and 3) assess agreement between SFT and BIA with dual-energy X-ray absorptiometry (DXA) in the postpartum. METHODS Participants enrolled in the Be Healthy in Pregnancy (BHIP) RCT (NCT01693510) had demographic data and pBMI collected at enrollment and adiposity measured at 12-17, 26-28, and 36-38 weeks gestation by BIA (%BF) and SFT (sum and %BF), and also by DXA at 6 months postpartum. Agreement between methods was assessed by Bland Altman plots and McNemar's test and C-statistic for discriminative power. RESULTS In 181 women with mean pBMI of 25.1 kg/m2 (min: 17.4 kg/m2, max: 39.6 kg/m2) and age 31.6 (SD: 4.0 yr), maternal adiposity increased significantly (p < 0.001) across pregnancy when measured by the sum of SFT or %BF by BIA, but not %BF by SFT. In early pregnancy, BF by BIA and SFT showed good agreement, with BIA values 1.8% greater than SFT, but low agreement in late pregnancy, with BIA values 7.1% greater than SFT. However, in the postpartum, agreement was similar to early pregnancy, and both BIA and SFT demonstrated good agreement with DXA. By pBMI, 45.5% of participants were categorized as overweight/obese, compared to 66.5% by BIA (p < 0.0001) and 54.5% by SFT (p < 0.0001). CONCLUSIONS In comparison to SFT and BIA, the results suggest that pBMI is less sensitive in identifying participants with excessive adiposity, limiting its use as a screening tool for adiposity-related adverse outcomes in pregnancy. It would be preferable to use a direct measure of adiposity to screen for at-risk pregnancies. Both %BF by BIA and sum of SFT can quantify the change in adiposity across pregnancy and in the postpartum and thus could be adopted as clinical practice tools. Future research efforts should further refine and validate adiposity techniques for use, particularly in mid and late pregnancy. CLINICAL TRIAL The BHIP clinical trial (NCT01693510). REGISTRATION SITE: https://clinicaltrials.gov/ct2/show/NCT01693510.
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Affiliation(s)
- Atherai Maran
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Stephanie A Atkinson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
| | - Valerie Bertram
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Thuva Vanniyasingam
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Lehana Thabane
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Michelle F Mottola
- School of Kinesiology, Western University, London, Ontario, N6A 3K7, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, L8S 4K1, Canada
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Barone M, Losurdo G, Iannone A, Leandro G, Leo AD, Trerotoli P. ASSESSMENT OF BODY COMPOSITION: INTRINSIC METHODOLOGICAL LIMITATIONS AND STATISTICAL PITFALLS. Nutrition 2022; 102:111736. [DOI: 10.1016/j.nut.2022.111736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022]
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20
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Fontes AR, Martins ASDM, Costa BSPD, Noites A, Marques L. Comparison of the effects of shock waves versus radiofrequency on abdominal lipolysis: A randomized clinical trial. J Cosmet Dermatol 2022; 21:3821-3831. [PMID: 35255184 DOI: 10.1111/jocd.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/10/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND High levels of abdominal adiposity mean higher risk of developing cardiovascular diseases. Aerobic exercise per si reduces the risk of developing this type of diseases. Radiofrequency and shockwave therapy showed to be effective in the reduction of localized abdominal fat. AIM (S) To compare the effects of prescribed moderate aerobic exercise associated with 6 sessions of shockwave therapy or radiofrequency, in the subcutaneous abdominal adipose tissue, in overweight female individuals in fertile age. METHODS Randomized clinical trial, with 30 volunteers in fertile age with overweight and/or obese, randomly and equitably allocated in two experimental groups (1-shockwave therapy and 2-radiofrequency) and one control group. Aerobic physical exercise was prescribed to all groups. The values of anthropometric measurements were measured in two moments. The intervention protocol was performed in a clinic for six weeks, with one session per week. The ANOVA test, paired samples t test, Kruskal-Wallis test, and Wilcoxon test were used to compare the results, for a significance level of 0.05. RESULTS Of 28 participants completed the study. There were significant differences in waist circumference reduction between the experimental group 1 and 2 when compared to the control group (p = 0.005 and p = 0.014, respectively). There was a statistically significant reduction in navel level circumference in experimental group 1 when compared to experimental group 2 (p = 0.024) and with the control group (p = 0.016). CONCLUSION Both resources were effective in reducing abdominal measurements when compared to the control group. However, SWT was superior in reducing the navel level circumference.
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Affiliation(s)
| | | | | | - Andreia Noites
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re) habilitation, Polytechnic Institute of Porto, Porto, Portugal
| | - Leila Marques
- Manager of Aesthetics Division, BTL, Porto, Portugal
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21
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Percentage of body fat is associated with increased risk of diverticulosis: A cross sectional study. PLoS One 2022; 17:e0264746. [PMID: 35231075 PMCID: PMC8887776 DOI: 10.1371/journal.pone.0264746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/16/2022] [Indexed: 01/19/2023] Open
Abstract
Background Obesity has been indicated to be a risk factor of diverticulosis. However, plausible relationship remained controversial. This cross-sectional study elucidated the association between percentage of body fat and the risk of diverticulosis. Methods The study was conducted at a single medical center in Taiwan from 2000–2016 which enrolled 5557 adults with age above 20 years old receiving a health examination including self-reported questionnaires, measurement of percentage of body fat (PBF), blood test and colonoscopy at the Tri-Service General Hospital (TSGH). Logistic regressions were used to analyze the association between PBF and diverticulosis. Further stratification of participants was based on age and gender and three extended models were established for multivariable adjustment. Results 243 of 3141 males and 103 of 2416 females were diagnosed with having diverticulosis. After covariates adjustment, only participants in the highest quartile of PBF (Q4 ≥33.8%) showed significantly positive association with the risk diverticulosis (OR 2.089, p <0.001). In subgroup analysis, the odds ratio for having diverticulosis in females was significantly higher than in males. In addition, We found that the odds ratio of having diverticulosis was higher in the group older than 60 years old compared to the younger group (OR 1.052; p<0.001; OR 1.043; p<0.001). Conclusions In conclusion, PBF was a potential risk factor of diverticulosis. Individuals with higher PBF exhibits increased risk of diverticulosis, especially in females. Furthermore, bioelectrical impedance analysis may create a simple, available and radiation-free way to assess the risk of diverticulosis.
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22
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Shin JW, Kim T, Lee BS, Kim O. Factors Affecting Metabolic Syndrome in Individuals With Chronic Spinal Cord Injury. Ann Rehabil Med 2022; 46:24-32. [PMID: 35272437 PMCID: PMC8913272 DOI: 10.5535/arm.21144] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/13/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To assess the validity of different anthropometric measures (waist circumference [WC], body mass index [BMI], and percentage body fat) in diagnosing metabolic syndrome (MetS) among individuals with SCI and provides preliminary data for future studies in setting obesity cutoff values for this population. Methods This was a single-center retrospective cohort study. Sample information, anthropometric measures, and MetS variables of 157 individuals with chronic SCI were collected from an electronic medical records database. Results Increasing age (odds ratio [OR]=1.040, p=0.016) and lower neurological level of injury (OR=1.059, p=0.046) were risk factors for MetS. Male BMI (r=0.380, p<0.001) and male WC (r=0.346, p<0.001) were positively correlated with the number of MetS subfactors. Individuals with non-obese WC, excluding central obesity, were associated with having no MetS subfactors (p=0.005), and individuals with obese WC were associated with one or more subfactors (p=0.005). BMI was associated with MetS diagnosis (area under the curve=0.765, p<0.001), with the calculated cutoff value for BMI being 22.8 kg/m2. Conclusion This study calls for a stricter BMI cutoff for individuals with SCI in diagnosing MetS and warrants a large population-based study to define central obesity according to sex and ethnicity.
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23
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Truche AS, Bailly S, Fabre O, Legrand R, Zaoui P. A Specific High-Protein Weight Loss Program Does Not Impair Renal Function in Patients Who Are Overweight/Obese. Nutrients 2022; 14:384. [PMID: 35057566 PMCID: PMC8780753 DOI: 10.3390/nu14020384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
Although high-protein diets appear to be the most efficient way to lose weight, concerns may arise about their innocuity on renal function. The objective of this study is to assess the impact of a weight loss program on renal function. A multicentric cohort-based study was performed using the RNPC© French national weight loss program. Patients with at least two creatinine measurements at the beginning of the program and at the end of the weight loss phase between 1 January 2016 and 1 July 2021 were included. Renal function was assessed by Modification of Diet in Renal Disease (MDRD) equation-based estimated glomerular filtration rate (eGFR). From 4394 patients with two creatinine measurements included, 1579 (35.9%) had normal eGFR (MDRD 90-120 mL/min/1.73 m2), 210 (4.8%) had hyperfiltration (MDRD > 120 mL/min/1.73 m2), 2383 (54.2%) had chronic kidney disease (CKD) grade 2 (MDRD 60-90 mL/min/1.73 m2), and 221 (5.0%) had CKD grade 3 (MDRD 30-60 mL/min/1.73 m2). Multivariable analyses showed no eGFR change for patients in initial CKD grade 2, normal eGFR and hyperfiltration, and a significant increase in CKD grade 3. The RNPC© program avoids renal function impairment during the two first phases, regardless of the initial eGFR.
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Affiliation(s)
| | - Sébastien Bailly
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France
| | - Odile Fabre
- Groupe Éthique et Santé, Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.)
| | - Rémy Legrand
- Groupe Éthique et Santé, Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.)
| | - Philippe Zaoui
- Service de Néphrologie, Dialyse, Transplantation Rénale, Grenoble Alpes University Hospital, 38700 La Tronche, France;
- AGDUC, Meylan Dialysis Center, 38240 Meylan, France
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Gatev T, Byalkova V, Poromanski I, Velikova T, Vassilev D, Kamenov Z. Omentin-1 and diabetic foot. INT J LOW EXTR WOUND 2022:15347346211069813. [PMID: 34985343 DOI: 10.1177/15347346211069813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction: Diabetic foot disease is an advanced complication of diabetes mellitus, which is associated with severe invalidization and high mortality rate among affected people. Many factors are involved in its pathogenesis but not all of them are fully elucidated. Objectives: Adipose tissue and its hormones - adipokines, are related to diabetic complications and metabolic disorders. Until now, there are limited data on their role in diabetic foot. The aim of this cross-sectional study is to determine the levels of the adipokine omentin-1 in people with and without diabetic foot disease and to look for its potential involvement in this complication. Methods: Eighty patients with type 2 diabetes and mean age of 60.8±10.5 years were included in this study. They were divided into two groups: with (n=36) and without (n=44) diabetic foot disease. Standard antrometric, clinical and laboratory tests were made. Body composition was analyzed by bioelectrical impedance based device. Serum omentin-1 was measured using ELISA method. Results: Levels of omentin-1 were significantly higher among people with diabetic foot disease (700.2±345.1 ng/ml), compared to the other group (560.2±176.7 ng/ml). This difference remained significant even after adjusting for potential confounders. In a regression model omentin-1 proved its predictive value for development of diabetic foot. Conclusion: Adipokines, and particularly omentin-1, might be included in the pathogenesis of diabetic foot disease.
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Affiliation(s)
- Tsvetan Gatev
- Clinic of Endocrinology, University Hospital Alexandrovska, Department of Internal Medicine, 58789Medical University-Sofia, Sofia, Bulgaria
| | | | - Ivan Poromanski
- Clinic of Septic Surgery, 367093UMBALSM N I Pirogov EAD, Sofia, Bulgaria
| | | | - Dobrin Vassilev
- Clinic of Cardiology, University Hospital Alexandrovska, Department of Internal Medicine, 58789Medical University-Sofia, Sofia, Bulgaria
| | - Zdravko Kamenov
- Clinic of Endocrinology, University Hospital Alexandrovska, Department of Internal Medicine, 58789Medical University-Sofia, Sofia, Bulgaria
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Two-dimensional CT measurements enable assessment of body composition on head and neck CT. Eur Radiol 2022; 32:6427-6434. [PMID: 35389049 PMCID: PMC9381610 DOI: 10.1007/s00330-022-08773-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/19/2022] [Accepted: 03/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate whether simple 2D measurements in axial slices of head and neck CT examinations correlate with generally established measurements of body composition in abdominal CT at the height of the third lumbar vertebra and thus allow for an estimation of muscle and fat masses. METHODS One hundred twenty-two patients who underwent concurrent CT of the head and neck and the abdomen between July 2016 and July 2020 were retrospectively included. For a subset of 30 patients, additional bioelectrical impedance analysis (BIA) was available. Areas of paraspinal muscles at the height of the third (C3) and fifth cervical vertebrae (C5) as well as the total cross-sectional area at the height of C3 and at the submandibular level were correlated with the results of abdominal measurements and BIA. Furthermore, intra- and interreader variabilities of all measurements were assessed. RESULTS Regarding adipose tissue, good correlations were found between the total cross-sectional area of the patient's body at the submandibular level and at the height of C3 between both abdominal measurements and BIA results (r = 0.8-0.92; all p < 0.001). Regarding muscle, the total paraspinal muscle area at the height of C3 and C5 showed strong correlations with abdominal measurements and moderate to strong correlations with BIA results (r = 0.44-0.80; all p < 0.001), with the muscle area on C5 yielding slightly higher correlations. CONCLUSIONS Body composition information can be obtained with comparable reliability from head and neck CT using simple biplanar measurements as from abdominal CT. KEY POINTS • The total paraspinal muscle area at the height of C3 and C5 correlates strongly with abdominal muscle mass. • The total cross-sectional area at the submandibular level and at the height of C3 shows good correlations with abdominal fat mass. • The described measurements facilitate a rapid, opportunistic assessment of relevant body composition parameters.
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26
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Soltani M, Baluchi MJ, Boullosa D, Daraei A, Doyle-Baker PK, Saeidi A, Knechtle B, Dehbaghi KM, Mollabashi SS, VanDusseldorp TA, Zouhal H. Effect of Intensity on Changes in Cardiac Autonomic Control of Heart Rate and Arterial Stiffness After Equated Continuous Running Training Programs. Front Physiol 2021; 12:758299. [PMID: 34955880 PMCID: PMC8696079 DOI: 10.3389/fphys.2021.758299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/26/2021] [Indexed: 01/13/2023] Open
Abstract
Background: It is well known that exercise training has positive effects on both cardiac autonomic function and arterial stiffness (AS). However, it is not clear that which exercise training variables, intensity or volume, or both, play a crucial role in this regard. This study investigates the chronic effects of high-volume moderate-intensity training (HVMIT) and low-volume high-intensity training (LVHIT) on heart rate variability (HRV) and AS in sedentary adult men. Materials and Methods: Notably, 45 males (age: 42 ± 5.7 years) were randomly assigned to a control (n = 15), HVMIT (n = 15), or LVHIT (n = 15). The HVMIT group ran three times per week on a treadmill at 50–60% of VO2max for 45–60 min, while the LVHIT trained at 70–85% of VO2max for 25–40 min. Both training protocols were equated by caloric expenditure. HRV, pulse wave velocity (PWV), hemodynamic variables, and body composition were measured before and after 12 weeks. Results: Both protocols (i.e., HVMIT and LVHIT) significantly increased the SD of normal sinus beat intervals (SDNN) and high-frequency (HF) bands (p < 0.05) after 12 weeks. Whereas the low-frequency (LF)-HF ratio decreased significantly in both training protocols (p < 0.05); however, these changes were significantly greater in the LVHIT protocol (p < 0.05). Furthermore, the root mean square of successive RR interval differences (RMSSD) significantly increased only in the LVHIT (p < 0.05). Moreover, a significant decrease in LF and PWV was only observed following the LVHIT protocol (p < 0.05). Some measures of HRV and PWV were significantly correlated (r = 0.275–0.559; p < 0.05). Conclusion: These results show that the LVHIT protocol was more efficient for improving HRV variables and PWV than the HVMIT protocol after 12 weeks of continuous running training. Interestingly, changes in some HRV parameters were related to changes in PWV. Further studies should elaborate on the link between central and peripheral cardiovascular adaptations after continuous and intermittent training regimens differing in intensity.
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Affiliation(s)
- Mohammad Soltani
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Masoud Jokar Baluchi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Daniel Boullosa
- Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.,Sport and Exercise Science, James Cook University, Townsville, QLD, Australia
| | - Ali Daraei
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | | | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, University of Kurdistan, Sanandaj, Iran
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University of Zūrich, Zurich, Switzerland
| | | | | | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, United States
| | - Hassane Zouhal
- Laboratoire Mouvement, Sport, Santé - EA 1274, University of Rennes, Rennes, France.,Institut International des Sciences du Sport (2I2S), Irodouer, France
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Gil S, Kirwan JP, Murai IH, Dantas WS, Merege-Filho CAA, Ghosh S, Shinjo SK, Pereira RMR, Teodoro WR, Felau SM, Benatti FB, de Sá-Pinto AL, Lima F, de Cleva R, Santo MA, Gualano B, Roschel H. A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery. J Cachexia Sarcopenia Muscle 2021; 12:1440-1455. [PMID: 34666419 PMCID: PMC8718087 DOI: 10.1002/jcsm.12815] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/27/2021] [Accepted: 09/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Muscle atrophy and strength loss are common adverse outcomes following bariatric surgery. This randomized, controlled trial investigated the effects of exercise training on bariatric surgery-induced loss of muscle mass and function. Additionally, we investigated the effects of the intervention on molecular and histological mediators of muscle remodelling. METHODS Eighty women with obesity were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 40, age = 42 ± 8 years) or RYGB plus exercise training group (RYGB + ET: n = 40, age = 38 ± 7 years). Clinical and laboratory parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6 month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). A healthy, lean, age-matched control group was recruited to provide reference values for selected variables. RESULTS Surgery resulted in a similar (P = 0.66) reduction in lower-limb muscle strength in RYGB and RYGB+ET (-26% vs. -31%), which was rescued to baseline values in RYGB + ET (P = 0.21 vs. baseline) but not in RYGB (P < 0.01 vs. baseline). Patients in RYGB+ET had greater absolute (214 vs. 120 kg, P < 0.01) and relative (2.4 vs. 1.4 kg/body mass, P < 0.01) muscle strength compared with RYGB alone at POST9. Exercise resulted in better performance in timed-up-and-go (6.3 vs. 7.1 s, P = 0.05) and timed-stand-test (18 vs. 14 repetitions, P < 0.01) compared with RYGB. Fat-free mass was lower (POST9-PRE) after RYBG than RYGB + ET (total: -7.9 vs. -4.9 kg, P < 0.01; lower-limb: -3.8 vs. -2.7 kg, P = 0.02). Surgery reduced Types I (~ - 21%; P = 0.99 between-group comparison) and II fibre cross-sectional areas (~ - 27%; P = 0.88 between-group comparison), which were rescued to baseline values in RYGB+ET (P > 0.05 vs. baseline) but not RYGB (P > 0.01 vs. baseline). RYGB + ET showed greater Type I (5187 vs. 3898 μm2 , P < 0.01) and Type II (5165 vs. 3565 μm2 , P < 0.01) fCSA than RYGB at POST9. RYGB + ET also resulted in increased capillarization (P < 0.01) and satellite cell content (P < 0.01) than RYGB at POST9. Gene-set normalized enrichment scores for the muscle transcriptome revealed that the ubiquitin-mediated proteolysis pathway was suppressed in RYGB + ET at POST9 vs. PRE (NES: -1.7; P < 0.01), but not in RYGB. Atrogin-1 gene expression was lower in RYGB + ET vs. RYGB at POST9 (0.18 vs. 0.71-fold change, P < 0.01). From both genotypic and phenotypic perspectives, the muscle of exercised patients resembled that of healthy lean individuals. CONCLUSIONS This study provides compelling evidence-from gene to function-that strongly supports the incorporation of exercise into the recovery algorithm for bariatric patients so as to counteract the post-surgical loss of muscle mass and function.
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Affiliation(s)
- Saulo Gil
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - John P Kirwan
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Igor H Murai
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Wagner S Dantas
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Carlos Alberto Abujabra Merege-Filho
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sujoy Ghosh
- Laboratory of Computational Biology, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.,Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - Samuel K Shinjo
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Rosa M R Pereira
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Walcy R Teodoro
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sheylla M Felau
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabiana B Benatti
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Applied Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Ana L de Sá-Pinto
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda Lima
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roberto de Cleva
- Gastroenterology Department, Digestive Surgery Division Department of Digestive Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marco Aurélio Santo
- Gastroenterology Department, Digestive Surgery Division Department of Digestive Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Bellver J, Brandão P, Alegre L, Meseguer M. Blastocyst formation is similar in obese and normal weight women: a morphokinetic study. Hum Reprod 2021; 36:3062-3073. [PMID: 34601596 DOI: 10.1093/humrep/deab212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/25/2021] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION Does the embryo cleavage pattern and rate of blastocyst formation differ between normal weight and obese women undergoing IVF? SUMMARY ANSWER Embryo morphokinetic development, final blastocyst formation rate and blastocyst morphology do not differ between obese and normal weight women. WHAT IS KNOWN ALREADY Female obesity has been related to impaired IVF outcomes. Although the mechanisms responsible for this detrimental effect are thought to include impaired oocyte and embryo quality and reduced endometrial receptivity, they are yet to be confirmed. Embryo quality has been commonly assessed using static morphological criteria. Only three studies have analysed the progress of embryos up to the blastocyst stage in women with elevated BMI, but they have used small samples of patients or have obtained contradictory results. STUDY DESIGN, SIZE, DURATION This retrospective, cohort study, was performed from January 2016 to May 2020. A total of 3316 ICSI cycles from 2822 women were included, of which 1251 cycles were part of a preimplantation genetic testing programme. In total, 17 848 embryos were analysed. PARTICIPANTS/MATERIALS, SETTING, METHODS This study reports on the IVF cycles of infertile women, with a known BMI, who underwent ICSI and whose embryos were grown until the fifth/sixth day of development in a time-lapse system. Patients were grouped as follows. Underweight was defined as a BMI <18.5 kg/m2; normal weight was a BMI of 18.5-24.9 kg/m2; overweight was a BMI of 25-29.9 kg/m2; and obesity was a BMI of ≥30 kg/m2. Embryo development was assessed on an external computer with analysis software. MAIN RESULTS AND THE ROLE OF CHANCE Despite an initial slower pattern of embryo development, the blastocyst formation rate on day 5 or on day 5 plus day 6 did not differ in obese women with respect to the other three BMI groups. Moreover, based on the evaluation of inner cell mass and the trophectoderm on both days of blastocyst development, embryo quality was similar across the BMI groups, as were the pattern of development and arrest up to blastocyst formation and the distribution of the categories of full, expanded and hatching blastocysts. LIMITATIONS, REASONS FOR CAUTION Limitations include the retrospective analysis of data, the use of BMI as the only parameter to define normal/abnormal female body weight, and the lack of complete information about clinical outcomes. WIDER IMPLICATIONS OF THE FINDINGS Blastocyst formation and embryo morphokinetics are not affected by female obesity, and the poorer IVF outcomes described for such women are probably due to deficient endometrial receptivity. The role of endometrial progesterone exposure on the day of embryo transfer should be analysed in future studies as a possible determining factor. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used and there are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- José Bellver
- IVI-RMA Valencia, Valencia, Spain.,Department of Pediatrics, Obstetrics & Gynecology, University of Valencia, Valencia, Spain.,IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | | | | | - Marcos Meseguer
- IVI-RMA Valencia, Valencia, Spain.,IVI Foundation, Health Research Institute La Fe, Valencia, Spain
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Body composition and phase angle by bioimpedance in patients with MAFLD. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 45:535-542. [PMID: 34742814 DOI: 10.1016/j.gastrohep.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/11/2021] [Accepted: 10/25/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe the characteristics of the body components and phase angle (PhA) of patients with MAFLD according to those different to fibrosis and hepatic steatosis. MATERIAL AND METHODS Observational and descriptive study in a cohort of 585 volunteers from our center with MAFLD criteria. The risk of liver fibrosis was determined by APRI, NAFLD score and FIB-4; at an indeterminate and high risk of fibrosis, a transient elastography (Fibroscan®) were realized. Bioimpedance body composition analysis (SECA®) was performed. Patients with ET and SECA® registry were included. Bioimpedance body composition analysis (SECA®) was performed. Patients with ET and SECA® registry were included. RESULTS 125 participants (21.4%) were evaluated, age 53.9±13.9 years, 62.1% women, BMI 33.2±5.8kg/m2. The SECA® analysis showed mean fat mass of 42%±7.32 and muscle mass 21.18kg±6.6. The PhA was 5.1±0.69, in women 4.92±0.62 and men 5.41±0.70. PhA in patients without fibrosis was 5.091 vs with fibrosis 5.121 (P=.813). In advanced fibrosis, it reported a low value compared to the rest of the groups (P=.031). The PhA in S3 was higher compared to S1 and S2 (5.3 vs 4.82, 4.81) (P=.027). CONCLUSIONS In MAFLD, the PhA was lower than the healthy Mexican population. In patients without fibrosis and severe steatosis, PhA rises proportionally to the increase in fat mass and BMI and in advanced liver fibrosis, PhA decreases.
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Kim HR, Jeon JW, Bae HJ, Shin JA, Ham YR, Na KR, Lee KW, Choi DE, Hyon YK. Body Fat Plays an Important Role in of Bioimpedance Spectroscopy-Based Dry Weight Measurement Error for Patients with Hemodialysis. Diagnostics (Basel) 2021; 11:diagnostics11101907. [PMID: 34679605 PMCID: PMC8535067 DOI: 10.3390/diagnostics11101907] [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: 09/06/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 12/02/2022] Open
Abstract
Accurate dry weight (DW) estimation is important for hemodialysis patients. Although bioimpedance spectroscopy (BIS) is commonly used to measure DW, the BIS-based DW frequently differs from the clinical DW. We analyzed the characteristics of patients whose BIS-based DWs were over- and underestimated. In this retrospective cohort study, we evaluated 1555 patients undergoing maintenance hemodialysis in Chungnam National University Hospital. The gap (DWCP-BIS) was calculated by comparing the BIS and clinical DWs. We analyzed the clinical characteristics of patients with positive (n = 835) and negative (n = 720) gaps. Compared with other patients, the DWCP-BIS-positive group had higher extracellular water (ECW) level and extracellular/intracellular water index (E/I) and had lower weight, body mass index (BMI), lean tissue index (LTI), fat tissue index (FTI), fat mass (FAT), and adipose tissue mass (ATM). The DWCP-BIS-negative group exhibited elevated BMI, FTI, FAT, and ATM; however, it had lower height, ECW, and E/I. Linear regression analysis revealed that FAT significantly predicted DWCP accuracy. The clinical DW of patients with a low fat mass tended to be underestimated, while the clinical DW of patients with comparatively large fat reserves tended to be overestimated. These characteristics will aid in the reduction of BIS-based DW errors.
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Affiliation(s)
- Hae-Ri Kim
- Department of Nephrology, Chungnam National University Sejong Hospital, Sejong 30099, Korea; (H.-R.K.); (J.-W.J.)
| | - Jae-Wan Jeon
- Department of Nephrology, Chungnam National University Sejong Hospital, Sejong 30099, Korea; (H.-R.K.); (J.-W.J.)
| | - Hong-Jin Bae
- Department of Nephrology, Cheongju St. Mary’s Hospital, Cheongju 28323, Korea;
| | - Jin-Ah Shin
- Department of Medical Science, Medical School, Chungnam National University, Daejeon 35015, Korea;
| | - Young-Rok Ham
- Nephrology, Medical School, Chungnam National University, Daejeon 35015, Korea; (Y.-R.H.); (K.-R.N.); (K.-W.L.)
| | - Ki-Ryang Na
- Nephrology, Medical School, Chungnam National University, Daejeon 35015, Korea; (Y.-R.H.); (K.-R.N.); (K.-W.L.)
| | - Kang-Wook Lee
- Nephrology, Medical School, Chungnam National University, Daejeon 35015, Korea; (Y.-R.H.); (K.-R.N.); (K.-W.L.)
| | - Dae-Eun Choi
- Department of Medical Science, Medical School, Chungnam National University, Daejeon 35015, Korea;
- Nephrology, Medical School, Chungnam National University, Daejeon 35015, Korea; (Y.-R.H.); (K.-R.N.); (K.-W.L.)
- Correspondence: (D.-E.C.); (Y.-K.H.)
| | - Yun-Kyong Hyon
- Division of Industrial Mathematics, Data Analytics Team, National Institute for Mathematical Sciences, Daejeon 34047, Korea
- Correspondence: (D.-E.C.); (Y.-K.H.)
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Memarian E, Nilsson PM, Zia I, Christensson A, Engström G. The risk of chronic kidney disease in relation to anthropometric measures of obesity: A Swedish cohort study. BMC Nephrol 2021; 22:330. [PMID: 34610818 PMCID: PMC8491415 DOI: 10.1186/s12882-021-02531-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been shown that individuals with obesity have a higher risk for chronic kidney disease (CKD). However, it is unclear which measure of obesity is most useful for prediction of CKD in the general population. The aim of this large prospective study was to explore the association between several anthropometric measures of obesity, i. e., body mass index (BMI), waist circumference (WC), waist circumference to height ratio (WHtR), waist-to-hip ratio (WHR), percentage of body fat (BF%), weight, height and incidence of hospitalizations due to CKD, in a population-based cohort study. METHODS The 'Malmö Diet and Cancer Study (MDCS)' cohort in Sweden was examined during 1991 to 1996. A total of 28,449 subjects underwent measurement of anthropometric measures and blood pressure and filled out a questionnaire. Incidence of in- and outpatient hospital visits for CKD was monitored from the baseline examination over a mean follow-up of 18 years. Cox proportional hazards regression was used to explore the association between anthropometric measures and incidence of CKD, with adjustments for risk factors. RESULTS The final study population included 26,723 subjects, 45-73 years old at baseline. Higher values of BMI, WC, WHR, WHtR and weight were associated with an increased risk of developing CKD in both men and women. Only in women, higher values of BF% was associated with higher risk of CKD. Comparing the 4th vs 1st quartile of the obesity measure, the highest hazard ratio (HR) for CKD in men was observed for BMI, HR 1.51 (95% CI: 1.18-1.94) and weight (HR 1.52 (95% CI: 1.19-1.94). For women the highest HR for CKD was observed for BF%, HR 2.01 (95% CI: 1.45-2.78). CONCLUSIONS In this large prospective study, all anthropometric measures of obesity were associated with a substantially increased incidence of CKD, except for BF% in men. Some measures were slightly more predictive for the risk of CKD than others such as BMI and weight in men and BF% in women. In clinical daily practice use of all anthropometric measures of obesity might be equally useful to assess the risk of developing CKD. This study supports the strong evidence for an association between obesity and CKD.
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Affiliation(s)
- Ensieh Memarian
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden.
| | - Peter M Nilsson
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
| | - Isac Zia
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
| | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Lund University, S-20502, Malmo, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Internal Medicine - Epidemiology Research Group, Jan Waldenströms gata 15, 5th floor, Malmo, Sweden
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Schwenger KJP, Kiu A, AlAli M, Alhanaee A, Fischer SE, Allard JP. Comparison of bioelectrical impedance analysis, mass index, and waist circumference in assessing risk for non-alcoholic steatohepatitis. Nutrition 2021; 93:111491. [PMID: 34739937 DOI: 10.1016/j.nut.2021.111491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/23/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease is a leading cause of liver disease worldwide and includes nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Because NASH is associated with obesity severity, routine evaluation of obesity/body fat in clinical settings may help detect patients at risk. The aim of this study was to determine whether assessing body fat by bioelectrical impedance analysis (BIA) is superior to body mass index (BMI) and waist circumference (WC) in assessing the risk for NASH. METHODS In this cross-sectional study, patients were recruited and gave consent from a local hospital. All had a liver biopsy. Measurements before the biopsy included BMI, WC, and BIA. BIA was used to measure percentage body fat and fat mass (kg). Based on histology, patients were grouped into one of three categories: simple steatosis (SS), NASH, or normal liver (NL). RESULTS Of the 139 participants who participated, 39 were classified as SS, 53 as NASH, and 47 as NL. Regardless of sex, patients with NASH had significantly higher BMI, WC, percentage body fat and fat mass than those with NL or SS. These four parameters were significantly positively correlated with liver histology measurements. In all patients, when controlling for sex and age we found that BMI, WC, and BIA were equal at predicting the presence of NASH (P = 0.0571). CONCLUSION All three methods, BIA, BMI, and WC, were comparable in assessing the risk for NASH. For practical purpose in clinical settings, using BMI is acceptable.
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Affiliation(s)
| | - Alexander Kiu
- Toronto General Hospital, University Health Network, Toronto, Canada
| | - Maryam AlAli
- Toronto General Hospital, University Health Network, Toronto, Canada
| | - Amnah Alhanaee
- Tawam Hospital, Abu Dhabi Health Authority, Abu Dhabi, United Arab Emirates
| | - Sandra E Fischer
- Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Johane P Allard
- Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
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Faragli A, Abawi D, Quinn C, Cvetkovic M, Schlabs T, Tahirovic E, Düngen HD, Pieske B, Kelle S, Edelmann F, Alogna A. The role of non-invasive devices for the telemonitoring of heart failure patients. Heart Fail Rev 2021; 26:1063-1080. [PMID: 32338334 PMCID: PMC8310471 DOI: 10.1007/s10741-020-09963-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Heart failure (HF) patients represent one of the most prevalent as well as one of the most fragile population encountered in the cardiology and internal medicine departments nowadays. Estimated to account for around 26 million people worldwide, diagnosed patients present a poor prognosis and quality of life with a clinical history accompanied by repeated hospital admissions caused by an exacerbation of their chronic condition. The frequent hospitalizations and the extended hospital stays mean an extremely high economic burden for healthcare institutions. Meanwhile, the number of chronically diseased and elderly patients is continuously rising, and a lack of specialized physicians is evident. To cope with this health emergency, more efficient strategies for patient management, more accurate diagnostic tools, and more efficient preventive plans are needed. In recent years, telemonitoring has been introduced as the potential answer to solve such needs. Different methodologies and devices have been progressively investigated for effective home monitoring of cardiologic patients. Invasive hemodynamic devices, such as CardioMEMS™, have been demonstrated to be reducing hospitalizations and mortality, but their use is however restricted to limited cases. The role of external non-invasive devices for remote patient monitoring, instead, is yet to be clarified. In this review, we summarized the most relevant studies and devices that, by utilizing non-invasive telemonitoring, demonstrated whether beneficial effects in the management of HF patients were effective.
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Affiliation(s)
- A Faragli
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D Abawi
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - C Quinn
- Department of Biological Sciences, Rensselaer Polytechnic Institute, 110 Eighth Street, Troy, NY, USA
| | - M Cvetkovic
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - T Schlabs
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - E Tahirovic
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - H-D Düngen
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - B Pieske
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Kelle
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - F Edelmann
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Alessio Alogna
- Department of Internal Medicine and Cardiology Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
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Ruiz-Margáin A, Xie JJ, Román-Calleja BM, Pauly M, White MG, Chapa-Ibargüengoitia M, Campos-Murguía A, González-Regueiro JA, Macias-Rodríguez RU, Duarte-Rojo A. Phase Angle From Bioelectrical Impedance for the Assessment of Sarcopenia in Cirrhosis With or Without Ascites. Clin Gastroenterol Hepatol 2021; 19:1941-1949.e2. [PMID: 32890753 DOI: 10.1016/j.cgh.2020.08.066] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Skeletal muscle index (SMI) from computed tomography (CT) reliably assesses sarcopenia, however, it is expensive and involves serial radiation exposure. Phase angle (PhA) from bioimpedance analysis (BIA) is a noninvasive, low cost, bedside nutritional tool used to monitor changes to nutritional interventions. We aimed to compare the performance of PhA with SMI to assess sarcopenia in cirrhosis. METHODS Ambispective cohort study. Consecutive patients with cirrhosis and available images from abdominal CT scan were included. Monofrequency BIA was performed within 2 weeks CT. Spearman's correlation, ROC curve, and survival analysis with Kaplan-Meier, Cox and competing-risk regression were performed. RESULTS 136 patients were included with a mean age of 54.5 years (60% female). Most had decompensated disease (66%) with ascites in 47%, and a mean MELD of 14 ± 6. We found positive correlations between SMI and PhA (r = 0.58 , P < .001), irrespective of the presence of ascites. The AUROC of PhA-sarcopenia in all patients was 0.702; (0.748 in males,0.677 in females). The best cutoffs of PhA for diagnosing sarcopenia were ≤5.6° in males and ≤5.4° in females. SMI and PhA were significantly associated with survival in Kaplan-Meier curves. In multivariable analyses, SMI was outperformed by age and MELD, whereas PhA remained independently associated with mortality. Considering transplantation as a competing risk, regression analysis showed both SMI and PhA to be independent predictors of mortality (sHR:0.95 [0.90-0.99] and sHR:0.61 [0.42-0.88]). CONCLUSION PhA moderately correlates with SMI for the identification of sarcopenia in patients with cirrhosis. However, its prognostic accuracy is comparable to that of SMI, and it is not influenced by ascites.
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Affiliation(s)
- Astrid Ruiz-Margáin
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jesse J Xie
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Berenice M Román-Calleja
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Margaret Pauly
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Michelle G White
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mónica Chapa-Ibargüengoitia
- Department of Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alejandro Campos-Murguía
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José A González-Regueiro
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ricardo U Macias-Rodríguez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Andres Duarte-Rojo
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Center for Liver Disease and Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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The Relationship between Sarcopenic Obesity, Weight-Loss and Maintenance Outcomes during Obesity Management: Are Additional Strategies Required? Clin Pract 2021; 11:525-531. [PMID: 34449572 PMCID: PMC8395568 DOI: 10.3390/clinpract11030069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/05/2021] [Accepted: 08/13/2021] [Indexed: 02/05/2023] Open
Abstract
The lack of long-term maintenance of the weight loss achieved during weight-management programs is the major cause of failure in obesity treatments. The identification of factors related to this outcome has clinical implications. Therefore, we aimed to assess the relationship between sarcopenic obesity (SO) and the weight-loss percentage (WL%). The WL% was measured at the six-month follow-up and after more than 12 months, in 46 adult participants with obesity, during an individualized weight-management program where participants were categorized as having or not having SO at the baseline. At the six-month follow-up, participants with SO did not display a significant difference in terms of WL%, when compared to those without SO (-10.49 ± 5.75% vs. -12.73 ± 4.30%; p = 0.148). However, after a longer term (i.e., >12 months), the WL% appeared to be significantly lower in the former (SO vs. non-SO) (-7.34 ± 6.29% vs. -11.43 ± 4.31%; p = 0.024). In fact, partial correlation analysis revealed a relationship between SO at the baseline and a lower WL% after more than 12 months (ρ = -0.425, p = 0.009), after controlling for age, sex, and body mass index (BMI). Participants with SO appeared to face more difficulties in maintaining the achieved WL over a longer term (>12 months follow-up) by comparison with their counterparts (i.e., non-SO). Should this finding be replicated in larger-sample studies, new strategies should be adopted for these patients in order to improve this clinical outcome, especially during the weight-maintenance phase.
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Schmitz SMT, Schooren L, Kroh A, Koch A, Stier C, Neumann UP, Ulmer TF, Alizai PH. Association of Body Composition and Sarcopenia with NASH in Obese Patients. J Clin Med 2021; 10:jcm10153445. [PMID: 34362228 PMCID: PMC8347969 DOI: 10.3390/jcm10153445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 12/25/2022] Open
Abstract
Obese patients often suffer from sarcopenia or sarcopenic obesity (SO) that can trigger inflammatory diseases including non-alcoholic steatohepatitis (NASH). Sarcopenia and SO can be diagnosed through measuring parameters of body composition such as skeletal muscle mass (SMM), skeletal muscle index (SMI) and fat mass (FM) obtained by bioelectrical impedance analysis (BIA). The aim of this study was to assess the relationship of body composition and NASH in patients with obesity. A total of 138 patients with obesity that underwent bariatric surgery were included in this study. BIA was used to estimate body composition. A liver biopsy was taken intraoperatively and histological assessment of NASH was performed. A total of 23 patients (17%) were classified as NASH and 65 patients (47%) met the criteria for borderline NASH. Body mass index (BMI) was significantly higher in patients with NASH compared to borderline NASH and no NASH (56.3 kg/m2 vs. 51.6 kg/m2 vs. 48.6 kg/m2, p = 0.004). Concerning body composition, FM, but also SMM and SMI were significantly higher in patients with NASH (p-values 0.011, 0.005 and 0.006, resp.). Fat mass index (FMI) and weight-adjusted skeletal muscle index (SMI_weight) failed to reach statistical significance (p-values 0.067 and 0.661). In patients with obesity, higher FM were associated with NASH. Contrary to expectations, SMM and SMI were also higher in patients with NASH. Therefore, higher body fat, rather than sarcopenia and SO, might be decisive for development of NASH in patients with obesity.
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Affiliation(s)
- Sophia Marie-Therese Schmitz
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
- Correspondence: ; Tel.: +49-241-80-89501
| | - Lena Schooren
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
| | - Andreas Kroh
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
| | - Alexander Koch
- Department of Gastroenterology, Digestive Diseases and Intensive Care Medicine, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany;
| | - Christine Stier
- Obesity Center NRW, Sana Kliniken, Krankenhausstr. 42, 50354 Hürth, Germany;
| | - Ulf Peter Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
- Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Tom Florian Ulmer
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
- Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Patrick Hamid Alizai
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany; (L.S.); (A.K.); (U.P.N.); (T.F.U.); (P.H.A.)
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The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women. Diagnostics (Basel) 2021; 11:diagnostics11081370. [PMID: 34441305 PMCID: PMC8391189 DOI: 10.3390/diagnostics11081370] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
Pregnancy is a time of significant changes occurring in the composition of a woman’s body in order to provide support for the growth and development of the foetus. Bioelectrical impedance analysis (BIA) is used to assess the body composition and hydration status. This technique represents a non-invasive, reliable, and fast clinical approach, which is well tolerated by patients. A segmental impedance measurement might be advantageous in pregnant women, particularly in late pregnancy. The purpose of this paper is to provide a review of different applications of BIA in pregnant and postpartum women. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index. The BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications. Studying the mother’s body composition and correlating it with her energy balance could facilitate the development of dietary recommendations for women. Evaluation of the body composition can provide important clues for diagnosis of gestational diabetes mellitus in pregnant women with a low risk of this disease. BIA is also used as one of the additional tests in assessing the risk of developing gestational hypertension and preeclampsia.
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Lee CT, Wang PH. Handgrip strength during admission for COPD exacerbation: impact on further exacerbation risk. BMC Pulm Med 2021; 21:245. [PMID: 34289815 PMCID: PMC8296662 DOI: 10.1186/s12890-021-01610-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background Low handgrip strength (HGS) is independently associated with a higher exacerbation risk in stable chronic obstructive pulmonary disease (COPD); however, the relationship between HGS while being admitted for COPD exacerbation and further exacerbation risk after discharge remains unclear. Methods We enrolled patients admitted for COPD exacerbation between January 2018 and June 2019. HGS tests were done within 3 days after admission. The primary endpoint was exacerbations within 12 months after the index admission, which needed emergency room visits or hospital admission. We analyzed the relationships among demographics, HGS, pulmonary function parameters, and acute exacerbation events. Results Among 43 enrolled patients, 31 (72.1%) participants (HGSw) had HGS weakness (22.1 ± 4.1 kg). The other 12 (27.9%) participants (non-HGSw) had the strength of handgrips 33.7 ± 3.1 kg. HGSw group showed a significantly higher rate of emergency room visits within 6, 9, and 12 months after the index admission than non-HGSw group (0.81 ± 1.30 vs. 0.08 ± 0.29, p = 0.045; 1.26 ± 1.59 vs. 0.17 ± 0.38, P = 0.019; 1.48 ± 1.86 vs. 0.25 ± 0.62, P = 0.027, respectively). There was a trend to have higher admission rate within 9 and 12 months in HGSw group, which did not achieve statistical significance (0.77 ± 1.38 vs. 0.08 ± 0.29, P = 0.064; 0.94 ± 1.56 vs. 0.08 ± 0.29, P = 0.062, respectively). Conclusions HGS weakness measured upon admission for COPD exacerbation was associated with a higher risk of exacerbation in the next year. Trial registration ClinicalTrials.gov Identifier: NCT04885933. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01610-7.
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Affiliation(s)
- Chi-Tai Lee
- Division of Pulmonology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 220, Taiwan, ROC
| | - Ping-Huai Wang
- Division of Pulmonology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 220, Taiwan, ROC. .,Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC.
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Hsu YI, Chen YC, Lee CL, Chang NJ. Effects of Diet Control and Telemedicine-Based Resistance Exercise Intervention on Patients with Obesity and Knee Osteoarthritis: A Randomized Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157744. [PMID: 34360036 PMCID: PMC8345675 DOI: 10.3390/ijerph18157744] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/23/2022]
Abstract
This study investigated the effects of home-based nutritional and telemedicine-based resistance exercise interventions on improving body composition, blood biochemistry, and lower-limb functional performance. In total, 66 obese patients with mild-to-moderate knee osteoarthritis were randomly divided into a diet control group (D), elastic band resistance exercise group (E), and diet control plus elastic band exercise group (D + E). Each group was supervised by a clinical dietitian and follow-up was conducted via telephone calls or a communication application to track the participants’ progress. After 12 weeks of intervention, the D (p < 0.001) and D + E (p < 0.001) groups achieved significant weight loss. The D + E group exhibited a significant reduction in body fat relative to the D (p = 0.019) and E (p = 0.012) groups. Compared with the D (p = 0.002) and E (p = 0.019) groups, the D + E group achieved significant improvements in the timed up-and-go test and Western Ontario and McMaster Universities Osteoarthritis total scale. The D + E group experienced significant improvements in total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.01), and triglyceride levels (p = 0.007) relative to other groups. In conclusion, individual diet control intervention combined with telemedicine-based resistance exercise intervention significantly improved the body composition, blood biochemistry, and lower-limb functional performance of the investigated population with comorbid conditions.
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Affiliation(s)
- Yen-I Hsu
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Nutritional Therapy, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Ying-Chou Chen
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Chia-Lun Lee
- Center for Physical and Health Education, National Sun Yat-Sen University, Kaohsiung 804, Taiwan;
| | - Nai-Jen Chang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.:+886-7-312-1101 (ext. 2646); Fax: +886-7-313-8359
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Canda AS. Muscle mass index estimated by anthropometry vs bioelectrical impedance: Study in athletes competing by weight categories. APUNTS SPORTS MEDICINE 2021. [DOI: 10.1016/j.apunsm.2021.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tsaousi G, Stavrou G, Papakostas P, Pyankova G, Kotzampassi K. Benchmarking the Discriminatory Performance of Body Mass Index and Body Fat for Obesity Detection in Patients Treated by Intragastric Balloon. Obes Surg 2021; 31:4134-4141. [PMID: 34185232 DOI: 10.1007/s11695-021-05530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION/PURPOSE The accuracy of body mass index (BMI) in detecting obesity in patients treated by intragastric balloon (IGB) remains still speculative. We aimed to determine the discriminatory performance of BMI as an estimate of excess body fat (%BF) in an IGB-treated population. MATERIAL AND METHODS Retrospective analysis of prospectively collected data of 476 patients who completed the 6-month IGB treatment period and were subjected to body composition analysis. We evaluated the relationship between BMI and %BF or lean mass and the diagnostic performance of BMI ≥ 30 kg/m2 for adipose tissue detection, stratified by age (< 40 and ≥ 40 years) and gender. Moreover, we identified anthropometric and body composition parameters serving as predictors of obesity according to %BF-based criteria (> 25% in men or > 35% in women). RESULTS Gender emerged as an effect modifier in the quadratic polynomial relationship between BMI and %BF (R2 = 0.849 for men, R2 = 0.715 for women), while BMI was linearly associated with %BF in both age groups (R2 = 0.435 for men, R2 = 0.474 for women). BMI was strongly correlated with both %BF (r = 0.67) and lean mass (r = - 0.65). The overall area under the ROC curve for BMI ≥ 30 kg/m2 to detect %BF was 0.87 (95%CI 0.85-0.90). A regression model including lean mass, total body water, age, BMI, and female gender explained 0.970 of the variance in %BF. CONCLUSION The discriminatory performance of BMI as an estimate of excess body fat is enhanced by the implementation of gender- and age-specific BMI thresholds for defining obesity, in IGB-treated patients.
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Affiliation(s)
- Georgia Tsaousi
- Department of Anesthesiology and ICU, Aristotle University Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece
| | - George Stavrou
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece
- Department of Colorectal Surgery, Addenbrooke's Hospital, Hills Road, CB20QQ, Cambridge, UK
| | - Pyrros Papakostas
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece
| | - Gerry Pyankova
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece
| | - Katerina Kotzampassi
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece.
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Więch P, Chmiel Z, Bazaliński D, Sobolewski M, Sałacińska I. Body Composition and Selected Nutritional Indicators in Healthy Adults-A Cross-Sectional Study. Glob Adv Health Med 2021; 10:21649561211021794. [PMID: 34158999 PMCID: PMC8182172 DOI: 10.1177/21649561211021794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022] Open
Abstract
Background Body mass composition is subject to constant change and is multifactorially
determined. Its analysis in different age groups allows a better
understanding of the determinants of the human organism in health and
disease. Aim The study was aimed to conduct cross-sectional assessment of body composition
and selected nutritional indicators in healthy adults. Methods The cross-sectional study carried out from March 2016 to April 2018 was
preceded by a monthly pilot study. All 1333 adults (women 795, 59.6%) aged
20–59 included in the study were from the urban and rural area of the
Podkarpackie Province (Poland). These adults were classified into four
10-year age bands. To obtain reliable assessment, selected screening
(anthropometry) and in-depth (bioelectrical impedance including phase angle
and bioelectrical impedance vector analysis) methods were used. Results In women, the proportion of individuals affected by overweight and obesity
increases significantly with age, with a less pronounced trend in men, as
reflected in the observed differences in individual body composition
components. A slight (0.45–0.60) correlation was also observed between body
mass index (BMI) and percentage of fat mass (FM %) among men with an
increasing strength of the association with age, decreasing in the
50–59 years group. In the female group, the correlations described are at a
much higher level (0.80 or higher). The described changes in body
composition were reflected in body type from athletic to obese, measured by
means of the bioelectrical impedance vector analysis (BIVA) method. Conclusions Age and gender significantly differentiate body composition of the adult
human body. The body composition analysis should be considered as complement
screening assessment method, especially as a support for the assessment of
nutritional status expressed by BMI.
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Affiliation(s)
- Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Zdzisława Chmiel
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszów University of Technology, Rzeszów, Poland
| | - Izabela Sałacińska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
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A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study. Nutrients 2021; 13:nu13061763. [PMID: 34067248 PMCID: PMC8224682 DOI: 10.3390/nu13061763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Personalized nutrition may be more effective in changing lifestyle behaviors compared to population-based guidelines. This single-arm exploratory study evaluated the impact of a 10-week personalized systems nutrition (PSN) program on lifestyle behavior and health outcomes. Healthy men and women (n = 82) completed the trial. Individuals were grouped into seven diet types, for which phenotypic, genotypic and behavioral data were used to generate personalized recommendations. Behavior change guidance was also provided. The intervention reduced the intake of calories (−256.2 kcal; p < 0.0001), carbohydrates (−22.1 g; p < 0.0039), sugar (−13.0 g; p < 0.0001), total fat (−17.3 g; p < 0.0001), saturated fat (−5.9 g; p = 0.0003) and PUFA (−2.5 g; p = 0.0065). Additionally, BMI (−0.6 kg/m2; p < 0.0001), body fat (−1.2%; p = 0.0192) and hip circumference (−5.8 cm; p < 0.0001) were decreased after the intervention. In the subgroup with the lowest phenotypic flexibility, a measure of the body’s ability to adapt to environmental stressors, LDL (−0.44 mmol/L; p = 0.002) and total cholesterol (−0.49 mmol/L; p < 0.0001) were reduced after the intervention. This study shows that a PSN program in a workforce improves lifestyle habits and reduces body weight, BMI and other health-related outcomes. Health improvement was most pronounced in the compromised phenotypic flexibility subgroup, which indicates that a PSN program may be effective in targeting behavior change in health-compromised target groups.
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Brunani A, Perna S, Soranna D, Rondanelli M, Zambon A, Bertoli S, Vinci C, Capodaglio P, Lukaski H, Cancello R. Body composition assessment using bioelectrical impedance analysis (BIA) in a wide cohort of patients affected with mild to severe obesity. Clin Nutr 2021; 40:3973-3981. [PMID: 34139470 DOI: 10.1016/j.clnu.2021.04.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND & AIMS Obesity is characterized by fat mass excess (FM), extra cellular water increase (ECW) and, with ageing, decrease in fat free mass (FFM). The validity of body impedance analysis (BIA) in patients with mild to severe obesity is still debated. The purpose of this study is to describe the Resistance (Rz) and Reactance (Xc) values obtained by Body Impedance Analysis (BIA) in a wide cohort of Italian patients with mild to severe obesity. The secondary endpoint is to describe the resulting body composition values (as percentage and indexes) in this population. METHODS The study enrolled adult in-patients with mild to severe obesity (classified with class I, II and III obesity) undergoing clinical care rehabilitation program for obesity complications and weight loss. BIA values were grouped by sex, BMI and age classes. RESULTS A total of 8303 patients with obesity, aged 18 to 90 y, were studied. The Resistance (Rz) and Reactance (Xc) were reported by sex, age and BMI classes. In women and men both, the phase angle (PhA) decreases with increasing BMI (kg/m2) and the resulting BIA vector was significantly shifted. The FM index (FMI) was higher (p < 0.0001) in women while FFM index (FFMI) was higher in men (p < 0.0001) and significantly associated with BMI. FFMI decreased with age in both sex (p < 0.0001). Skeletal mass (SM) presents a progressive reduction in relation to age and gender both. CONCLUSIONS The present BIA-based body composition analysis in a wide cohort of mild to severe obese patients revealed a significantly decreased Rz and Xc values with a consequent significant decrease of PhA in a BMI-dependent manner. The body compartments estimation with available equations was BMI, sex and age dependent. These observational results could be the basis for the development of new equations adapted for patients suffering from obesity.
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Affiliation(s)
- Amelia Brunani
- IRCCS Istituto Auxologico Italiano, Division of Rehabilitation Medicine, Research Lab in Biomechanics and Rehabilitation, San Giuseppe Hospital, Piancavallo (VB), Italy.
| | - Simone Perna
- University of Bahrain, Department of Mathematics, College of Science, Sakhir Campus P. O. Box 32038, Kingdom of Bahrain.
| | - Davide Soranna
- IRCCS Istituto Auxologico Italiano, Biostatistic Unit, Milano, Italy.
| | - Mariangela Rondanelli
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Pavia, Italy.
| | - Antonella Zambon
- IRCCS Istituto Auxologico Italiano, Biostatistic Unit, Milano, Italy; University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
| | - Simona Bertoli
- IRCCS Istituto Auxologico Italiano, Obesity Unit, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy; University of Milan, International Center for the Assessment of Nutritional Status (ICANS), Department of Food,Environmental and Nutritional Sciences (DeFENS), Milan, Italy.
| | - Calogero Vinci
- IRCCS Istituto Auxologico Italiano, Obesity Unit, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy.
| | - Paolo Capodaglio
- IRCCS Istituto Auxologico Italiano, Division of Rehabilitation Medicine, Research Lab in Biomechanics and Rehabilitation, San Giuseppe Hospital, Piancavallo (VB), Italy
| | - Henry Lukaski
- University of North Dakota, Department of Kinesiology and Public Health Education, Grand Forks, 58202, ND, USA.
| | - Raffaella Cancello
- IRCCS Istituto Auxologico Italiano, Obesity Unit, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy.
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Kasper AM, Langan-Evans C, Hudson JF, Brownlee TE, Harper LD, Naughton RJ, Morton JP, Close GL. Come Back Skinfolds, All Is Forgiven: A Narrative Review of the Efficacy of Common Body Composition Methods in Applied Sports Practice. Nutrients 2021; 13:nu13041075. [PMID: 33806245 PMCID: PMC8065383 DOI: 10.3390/nu13041075] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 01/11/2023] Open
Abstract
Whilst the assessment of body composition is routine practice in sport, there remains considerable debate on the best tools available, with the chosen technique often based upon convenience rather than understanding the method and its limitations. The aim of this manuscript was threefold: (1) provide an overview of the common methodologies used within sport to measure body composition, specifically hydro-densitometry, air displacement plethysmography, bioelectrical impedance analysis and spectroscopy, ultra-sound, three-dimensional scanning, dual-energy X-ray absorptiometry (DXA) and skinfold thickness; (2) compare the efficacy of what are widely believed to be the most accurate (DXA) and practical (skinfold thickness) assessment tools and (3) provide a framework to help select the most appropriate assessment in applied sports practice including insights from the authors' experiences working in elite sport. Traditionally, skinfold thickness has been the most popular method of body composition but the use of DXA has increased in recent years, with a wide held belief that it is the criterion standard. When bone mineral content needs to be assessed, and/or when it is necessary to take limb-specific estimations of fat and fat-free mass, then DXA appears to be the preferred method, although it is crucial to be aware of the logistical constraints required to produce reliable data, including controlling food intake, prior exercise and hydration status. However, given the need for simplicity and after considering the evidence across all assessment methods, skinfolds appear to be the least affected by day-to-day variability, leading to the conclusion 'come back skinfolds, all is forgiven'.
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Affiliation(s)
- Andreas M. Kasper
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
| | - Carl Langan-Evans
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
| | - James F. Hudson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
| | - Thomas E. Brownlee
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
| | - Liam D. Harper
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; (L.D.H.); (R.J.N.)
| | - Robert J. Naughton
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; (L.D.H.); (R.J.N.)
| | - James P. Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
| | - Graeme L. Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.K.); (C.L.-E.); (J.F.H.); (T.E.B.); (J.P.M.)
- Correspondence: ; Tel.: +44-151-904-6266
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Sizoo D, de Heide LJM, Emous M, van Zutphen T, Navis G, van Beek AP. Measuring Muscle Mass and Strength in Obesity: a Review of Various Methods. Obes Surg 2021; 31:384-393. [PMID: 33159294 PMCID: PMC7808984 DOI: 10.1007/s11695-020-05082-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
Abstract
Lower muscle mass in populations with obesity is associated obesity-related diseases like hypertension and type 2 diabetes mellitus. Bariatric surgery leads to sustained weight loss. During the weight reduction, loss of muscle should be minimized. Thus reliable quantification of muscle mass is much needed and therefore the also the need for validated methods. Imaging methods, magnetic resonance imaging and computed tomography scan, have been the gold standard for many years. However, these methods are costly and have limitations such as the maximum weight. Dual-energy X-ray absorptiometry is currently the most used alternative. Other, less expensive methods are very limited in their validation in populations with morbid obesity. This narrative review summarizes the current knowledge regarding measuring muscle mass and strength in obesity.
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Affiliation(s)
- Dionne Sizoo
- Department of Health and Food, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
- Center Obesity Northern Netherlands (CON), Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
| | - Loek J M de Heide
- Center Obesity Northern Netherlands (CON), Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Marloes Emous
- Center Obesity Northern Netherlands (CON), Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Tim van Zutphen
- Department of Health and Food, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrolog, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - André P van Beek
- Center Obesity Northern Netherlands (CON), Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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[Body composition assessment before and after weight loss following a Roux-en-Y gastric bypass. Are bioimpedanciometry estimations reliable?]. NUTR HOSP 2020; 37:1150-1156. [PMID: 33119392 DOI: 10.20960/nh.02942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: in patients with severe and morbid obesity it has been observed that bioimpedance (BIA) assessment generates an underestimation of fat mass (FM) and weight loss as FM after bariatric surgery, overestimating the loss of fat-free mass (FFM) and muscle mass. Objective: to evaluate the reliability of bioelectrical impedance analysis (BIA) to estimate total body water (TBW), fat-free mass (FFM), fat mass (FM), and its changes after 6 months of a Roux-en-Y gastric bypass (RYGBP), in patients with severe and morbid obesity. Methods: thirty-six patients approved for RYGBP were prospectively studied. TBW was measured by deuterium (D), and FM and FFM were calculated. A dual-frequency BIA device (5 and 200 kHz) (Bodystat Dualscan®) was used to estimate FM, FFM, TBW, extracellular water (ECW), intracellular water (ICW), and ECW/ICW ratio. Results: before RYGBP, BIA overestimated TBW by 2.6 ± 4.3 L (p = 0.002) and FFM by 3.5 ± 5.7 kg (p = 0.002), and underestimated FM% by 2.98 ± 4.7% (p = 0.002). The ECW/ICW ratio showed a significant and positive correlation with the difference BIA-D for FFM (r = 0.49; p = 0.002). After surgery, the differences between BIA and D were not significant, and the estimation error of FFM did not correlate with the ECW/ICW ratio. Conclusions: BIA generates an underestimation of FM as reported in patients with severe and morbid obesity, which is attenuated after weight reduction, underestimating weight loss as FM and overestimating FFM loss. Future research may assess whether these errors are reproduced by other BIA devices.
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Teixeira J, Marroni CA, Zubiaurre PR, Henz A, Faina L, Pinheiro LK, Mottin CC, Fernandes SA. Phase angle and non-alcoholic fatty liver disease before and after bariatric surgery. World J Hepatol 2020; 12:1004-1019. [PMID: 33312425 PMCID: PMC7701974 DOI: 10.4254/wjh.v12.i11.1004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/24/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is a global health problem that is continuing to increase in the young population. In Brazil, the frequency of obesity in 2018 was 19.8%. Several comorbidities are directly associated with obesity, such as non-alcoholic fatty liver disease (NAFLD), which is considered the most common liver disorder in Western countries and affects up to 46% of adults. Bariatric surgery is effective in treating obesity and can improve NAFLD; however, the effect of bariatric surgery on body composition, phase angle (PA), and improving NAFLD needs to be further studied.
AIM To analyze the PA in the postoperative period of bariatric surgery and to correlate it with changes in body composition and liver disease.
METHODS This study is a retrospective cohort study of the analysis of the medical records of patients undergoing bariatric surgery in a reference center of a teaching hospital in Porto Alegre over a 2-year period. Patients older than 18 years whose record contained all information relevant to the study were included. The data analyzed were body composition and PA through electrical bioimpedance and NAFLD through liver biopsy in the pre- and postoperative period. The level of significance adopted for the statistical analyses was 5%.
RESULTS We evaluated 379 patients with preoperative data. Regarding PA, 169 patients were analyzed, and 33 patients had liver biopsy pre- and postoperatively with NAFLD information. In total, 79.4% were female, with a mean age of 39.1 ± 10.6 years. The average body mass index (BMI) was 45.9 ± 7.5 kg/m². The PA showed a mean of 5.8 ± 0.62° in the preoperative period and a significant reduction in the postoperative period. A postoperative reduction in body composition data (skeletal muscle mass, fat percentage, fat mass, body cell mass, BMI and visceral fat area) was shown as well. Regarding liver disease, all patients presented a reduction in the degrees and stages of liver disease in the postoperative period, and some had no degree of liver disease at all.
CONCLUSION PA decreased after bariatric surgery, with a direct correlation with weight loss and changes in body composition. The decrease in PA was not correlated with the improvement in NAFLD.
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Affiliation(s)
- Joise Teixeira
- Department of Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050170, RS, Brazil
| | - Cláudio Augusto Marroni
- Department of Gastroenterology and Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 91760470, RS, Brazil
| | - Paula Rosales Zubiaurre
- Department of Center of Morbid Obesity, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90610000, RS, Brazil
| | - Ana Henz
- Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420060, RS, Brazil
| | - Lais Faina
- Department of Vascular Surgery, Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro 20221161, RJ, Brazil
| | - Lilian Kethelyn Pinheiro
- Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420060, RS, Brazil
| | - Claudio Cora Mottin
- Department of Obesity and Metabolic Syndrome Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, Brazil
| | - Sabrina Alves Fernandes
- Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420060, RS, Brazil
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49
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Hirsch KR, Blue MNM, Trexler ET, Ahuja S, Smith-Ryan AE. Provision of ready-to-drink protein following bariatric surgery: An evaluation of tolerability, body composition, and metabolic rate. Clin Nutr 2020; 40:2319-2327. [PMID: 33158590 DOI: 10.1016/j.clnu.2020.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 08/09/2020] [Accepted: 10/15/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS It is recommended that patients consume at least 60 g of dietary protein per day to attenuate loss of fat-free mass (FFM) following bariatric surgery. To date, research on the effectiveness and tolerability of protein supplementation in bariatric patients is limited. The purpose of the current study was to determine if provision of 12-weeks of daily protein supplementation was an effective and tolerable method of facilitating higher protein intakes in bariatric surgery patients. A secondary aim was to evaluate the effects of protein supplementation on body composition, metabolic rate, and functional outcomes. An exploratory aim was to compare body composition estimates from bioelectrical impedance spectroscopy and dual-energy x-ray absorptiometry. METHODS Bariatric surgery patients (n = 49; 88% female) (mean ± standard deviation; Age: 43.7 ± 10.7 yrs; BMI: 51.2 ± 13.7 kg m-2) were provided with either a 12-week supply of ready-to-drink protein shakes (PRO; n = 25) or instructed to follow standard-of-care recommendations (SOC; n = 24) following surgery. Patients completed measures of body composition (fat mass [FM], percent body fat [%BF], FFM; bioelectrical impedance [BIS] and/or dual-energy x-ray absorptiometry [DXA]), resting metabolic rate (RMR; indirect calorimetry), a 30-s chair stand, and 3-day food logs prior to surgery (base), 3-weeks, 12-weeks, and 24-weeks post-surgery. RESULTS About 80% of all patients achieved the recommended intake of 60 g per day, with no significant differences in protein intake between groups (p < 0.05). Patients in PRO were more likely to increase protein consumption over the course of the entire intervention compared to SOC. Both groups experienced significant decreases in weight, BMI, %BF, FM, FFM, and total body water (TBW) (p < 0.05). The percentage of weight lost as FFM was significantly greater when measured by BIS (39.1%) compared to when measured by DXA (17.8%) (p < 0.05). There was a significant decrease in RMR from base-3 weeks for both groups (p = 0.002; 95% confidence interval [-370.6, -90.7]); there were no significant changes after 3 weeks (p > 0.05). The number of sit-to-stand trials increased at each testing session after the first 3 weeks (p < 0.05). CONCLUSIONS Patients were able to achieve the recommended 60 g of protein per day post-surgery, but the provision of ready-to-drink protein shakes may help bariatric patients achieve higher post-surgery protein intakes. Both groups experienced significant decreases in weight, BMI, and body composition; results varied depending on the method of body composition used. Changes in FFM measured by BIS may reflect greater changes in TBW as opposed to actual muscle mass. Registered at ClinicalTrials.gov, ID#NCT02951663.
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Affiliation(s)
- Katie R Hirsch
- Applied Physiology Lab, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Lab, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Eric T Trexler
- Applied Physiology Lab, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Shawn Ahuja
- Applied Physiology Lab, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Applied Physiology Lab, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA.
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50
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Ugras S. Evaluating of altered hydration status on effectiveness of body composition analysis using bioelectric impedance analysis. Libyan J Med 2020; 15:1741904. [PMID: 32182203 PMCID: PMC7144212 DOI: 10.1080/19932820.2020.1741904] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Body composition analysis may provide valuable information about the assessment of balance between fluid, fat, and fat-free mass. The present study assessed whether the regular increase in water consumption has any significant effects on measurements of body composition using BIA. A total of 140 subjects participated in this study. Body composition analyses of the subjects were performed for five times using foot to foot BIA; first at baseline and four times, after 15 minutes of each 500 mL water intakes. There was overestimation in body fat mass compared to the baseline and increased significantly after water intakes in males (2.08% in 500 mL, 3.80% in 1000 mL, 5.88% in 1500 mL, and 7.92% in 2000 mL, p < 0.05) and in females (3.4% in 500 mL, 5.7% in 1000 mL, 7.8% in 1500 mL, and 9.4% in 2000 mL, p < 0.05). In contrast, there was markedly underestimation of total body water and fat-free mass in males (35% and 50%) and females (17% and 22%), respectively, at the end of the study. Thus, overestimation of body fat mass and lower estimation of total body water and fat-free mass with closely to the amount of water retention using BIA application should be considered in health-related clinical practice.
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Affiliation(s)
- Seda Ugras
- Department of Physiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
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