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Jung M, Rieder H, Reisert M, Rospleszcz S, Nattenmueller J, Peters A, Schlett CL, Bamberg F, Weiss J. Association between myosteatosis and impaired glucose metabolism: A deep learning whole-body magnetic resonance imaging population phenotyping approach. J Cachexia Sarcopenia Muscle 2024. [PMID: 39009381 DOI: 10.1002/jcsm.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND There is increasing evidence that myosteatosis, which is currently not assessed in clinical routine, plays an important role in risk estimation in individuals with impaired glucose metabolism, as it is associated with the progression of insulin resistance. With advances in artificial intelligence, automated and accurate algorithms have become feasible to fill this gap. METHODS In this retrospective study, we developed and tested a fully automated deep learning model using data from two prospective cohort studies (German National Cohort [NAKO] and Cooperative Health Research in the Region of Augsburg [KORA]) to quantify myosteatosis on whole-body T1-weighted Dixon magnetic resonance imaging as (1) intramuscular adipose tissue (IMAT; the current standard) and (2) quantitative skeletal muscle (SM) fat fraction (SMFF). Subsequently, we investigated the two measures for their discrimination of and association with impaired glucose metabolism beyond baseline demographics (age, sex and body mass index [BMI]) and cardiometabolic risk factors (lipid panel, systolic blood pressure, smoking status and alcohol consumption) in asymptomatic individuals from the KORA study. Impaired glucose metabolism was defined as impaired fasting glucose or impaired glucose tolerance (140-200 mg/dL) or prevalent diabetes mellitus. RESULTS Model performance was high, with Dice coefficients of ≥0.81 for IMAT and ≥0.91 for SM in the internal (NAKO) and external (KORA) testing sets. In the target population (380 KORA participants: mean age of 53.6 ± 9.2 years, BMI of 28.2 ± 4.9 kg/m2, 57.4% male), individuals with impaired glucose metabolism (n = 146; 38.4%) were older and more likely men and showed a higher cardiometabolic risk profile, higher IMAT (4.5 ± 2.2% vs. 3.9 ± 1.7%) and higher SMFF (22.0 ± 4.7% vs. 18.9 ± 3.9%) compared to normoglycaemic controls (all P ≤ 0.005). SMFF showed better discrimination for impaired glucose metabolism than IMAT (area under the receiver operating characteristic curve [AUC] 0.693 vs. 0.582, 95% confidence interval [CI] [0.06-0.16]; P < 0.001) but was not significantly different from BMI (AUC 0.733 vs. 0.693, 95% CI [-0.09 to 0.01]; P = 0.15). In univariable logistic regression, IMAT (odds ratio [OR] = 1.18, 95% CI [1.06-1.32]; P = 0.004) and SMFF (OR = 1.19, 95% CI [1.13-1.26]; P < 0.001) were associated with a higher risk of impaired glucose metabolism. This signal remained robust after multivariable adjustment for baseline demographics and cardiometabolic risk factors for SMFF (OR = 1.10, 95% CI [1.01-1.19]; P = 0.028) but not for IMAT (OR = 1.14, 95% CI [0.97-1.33]; P = 0.11). CONCLUSIONS Quantitative SMFF, but not IMAT, is an independent predictor of impaired glucose metabolism, and discrimination is not significantly different from BMI, making it a promising alternative for the currently established approach. Automated methods such as the proposed model may provide a feasible option for opportunistic screening of myosteatosis and, thus, a low-cost personalized risk assessment solution.
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Affiliation(s)
- Matthias Jung
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hanna Rieder
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Johanna Nattenmueller
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Tilves C, Mueller NT, Zmuda JM, Kuipers AL, Methé B, Li K, Carr JJ, Terry JG, Wheeler V, Nair S, Miljkovic I. Associations of Fecal Microbiota with Ectopic Fat in African Caribbean Men. Microorganisms 2024; 12:812. [PMID: 38674756 PMCID: PMC11052294 DOI: 10.3390/microorganisms12040812] [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: 03/25/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE The gut microbiome has been associated with visceral fat (VAT) in European and Asian populations; however, associations with VAT and with ectopic fats among African-ancestry individuals are not known. Our objective was to investigate cross-sectional associations of fecal microbiota diversity and composition with VAT and ectopic fat, as well as body mass index (BMI), among middle-aged and older African Caribbean men. METHODS We included in our analysis n = 193 men (mean age = 62.2 ± 7.6 years; mean BMI = 28.3 ± 4.9 kg/m2) from the Tobago Health Study. We assessed fecal microbiota using V4 16s rRNA gene sequencing. We evaluated multivariable-adjusted associations of microbiota features (alpha diversity, beta diversity, microbiota differential abundance) with BMI and with computed tomography-measured VAT and ectopic fats (pericardial and intermuscular fat; muscle and liver attenuation). RESULTS Lower alpha diversity was associated with higher VAT and BMI, and somewhat with higher pericardial and liver fat. VAT, BMI, and pericardial fat each explained similar levels of variance in beta diversity. Gram-negative Prevotellaceae and Negativicutes microbiota showed positive associations, while gram-positive Ruminococcaceae microbiota showed inverse associations, with ectopic fats. CONCLUSIONS Fecal microbiota features associated with measures of general adiposity also extend to metabolically pernicious VAT and ectopic fat accumulation in older African-ancestry men.
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Affiliation(s)
- Curtis Tilves
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA;
- LEAD Center, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Noel T. Mueller
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA;
- LEAD Center, Colorado School of Public Health, Aurora, CO 80045, USA
- Department of Pediatrics, Colorado School of Medicine, Aurora, CO 80045, USA
| | - Joseph M. Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.M.Z.); (A.L.K.); (I.M.)
| | - Allison L. Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.M.Z.); (A.L.K.); (I.M.)
| | - Barbara Methé
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA 15213, USA; (B.M.); (K.L.)
| | - Kelvin Li
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA 15213, USA; (B.M.); (K.L.)
| | - John Jeffrey Carr
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.J.C.); (J.G.T.); (S.N.)
| | - James G. Terry
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.J.C.); (J.G.T.); (S.N.)
| | - Victor Wheeler
- Tobago Health Studies Office, TTMF Jerningham Court, James Park Upper Scarborough, Scarborough, Trinidad and Tobago;
| | - Sangeeta Nair
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.J.C.); (J.G.T.); (S.N.)
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.M.Z.); (A.L.K.); (I.M.)
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Yao S, Colangelo LA, Perry AS, Marron MM, Yaffe K, Sedaghat S, Lima JAC, Tian Q, Clish CB, Newman AB, Shah RV, Murthy VL. Implications of metabolism on multi-systems healthy aging across the lifespan. Aging Cell 2024; 23:e14090. [PMID: 38287525 PMCID: PMC11019145 DOI: 10.1111/acel.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/30/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
Aging is increasingly thought to involve dysregulation of metabolism in multiple organ systems that culminate in decreased functional capacity and morbidity. Here, we seek to understand complex interactions among metabolism, aging, and systems-wide phenotypes across the lifespan. Among 2469 adults (mean age 74.7 years; 38% Black) in the Health, Aging and Body Composition study we identified metabolic cross-sectionally correlates across 20 multi-dimensional aging-related phenotypes spanning seven domains. We used LASSO-PCA and bioinformatic techniques to summarize metabolome-phenome relationships and derive metabolic scores, which were subsequently linked to healthy aging, mortality, and incident outcomes (cardiovascular disease, disability, dementia, and cancer) over 9 years. To clarify the relationship of metabolism in early adulthood to aging, we tested association of these metabolic scores with aging phenotypes/outcomes in 2320 participants (mean age 32.1, 44% Black) of the Coronary Artery Risk Development in Young Adults (CARDIA) study. We observed significant overlap in metabolic correlates across the seven aging domains, specifying pathways of mitochondrial/cellular energetics, host-commensal metabolism, inflammation, and oxidative stress. Across four metabolic scores (body composition, mental-physical performance, muscle strength, and physical activity), we found strong associations with healthy aging and incident outcomes, robust to adjustment for risk factors. Metabolic scores for participants four decades younger in CARDIA were related to incident cardiovascular, metabolic, and neurocognitive performance, as well as long-term cardiovascular disease and mortality over three decades. Conserved metabolic states are strongly related to domain-specific aging and outcomes over the life-course relevant to energetics, host-commensal interactions, and mechanisms of innate immunity.
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Affiliation(s)
- Shanshan Yao
- University of PittsburgPittsburghPennsylvaniaUSA
| | | | | | | | | | | | | | - Qu Tian
- National Institute of AgingBaltimoreMarylandUSA
| | - Clary B. Clish
- Broad Institute of Harvard and MITCambridgeMassachusettsUSA
| | | | - Ravi V. Shah
- Vanderbilt University Medical CenterNashvilleTennesseeUSA
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Gao T, Zheng Y, Joyce BT, Kho M, Terry JG, Wang J, Nannini D, Carr JJ, Nair S, Zhang K, Zhao W, Jacobs DR, Schreiner PJ, Greenland P, Lloyd-Jones D, Smith JA, Hou L. Epigenetic Aging Is Associated With Measures of Midlife Muscle Volume and Attenuation in CARDIA Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad261. [PMID: 37956337 PMCID: PMC10876078 DOI: 10.1093/gerona/glad261] [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: 01/13/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND GrimAge acceleration (GAA), an epigenetic marker that represents physiologic aging, is associated with age-related diseases including cancer and cardiovascular diseases. However, the associations between GAA and muscle mass and function are unknown. METHODS We estimated measures of GAA in 1 118 Black and White participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Study at exam years (Y) 15 (2000-2001) and 20 (2005-2006). Abdominal muscle composition was measured using CT scans at the Y25 (2010-2011) visit. We used multivariate regression models to examine associations of GAA estimates with muscle imaging measurements. RESULTS In the CARDIA study, each 1-year higher GAA was associated with an average 1.1% (95% confidence interval [CI]: 0.6%, 1.5%) higher intermuscular adipose tissue (IMAT) volume for abdominal muscles. Each 1-year higher GAA was associated with an average -0.089 Hounsfield unit (HU; 95% CI: -0.146, -0.032) lower lean muscle attenuation and an average -0.049 HU (95% CI: -0.092, -0.007) lower IMAT attenuation for abdominal muscles. Stratified analyses showed that GAA was more strongly associated with higher abdominal muscle IMAT volume in females and significantly associated with lower lean muscle attenuation for White participants only. CONCLUSIONS Higher GAA is associated with higher abdominal muscle IMAT volume and lower lean muscle attenuation in a midlife population.
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Affiliation(s)
- Tao Gao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian T Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Minjung Kho
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - Jun Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Drew Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John Jeffrey Carr
- Department of Radiology, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Yu F, Xing C, Fan Y, Liu Y, Su P, Yang Q, Dong Y, Hou Y, Pan S. Aerobic exercise and metformin on intermuscular adipose tissue (IMAT): insights from multimodal MRI and histological changes in prediabetic rats. Diabetol Metab Syndr 2023; 15:221. [PMID: 37899436 PMCID: PMC10614363 DOI: 10.1186/s13098-023-01183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Physical exercise is the first-line intervention for prediabetes, and metformin is the most widely used oral insulin-sensitizing agent. Moreover, intermuscular adipose tissue (IMAT) directly affects insulin resistance by helping maintain glucose homeostasis. Here, we evaluated the effects of moderate aerobic exercise and/or metformin on histological IMAT parameters in non-streptozotocin-induced prediabetes. METHODS Male Wistar rats with prediabetes fed a high-fat diet and high-sugar drinks were randomly assigned to high-fat diet (PRE), metformin (MET), moderate aerobic exercise (EXE), combined therapy (EMC), or EMC + compound-c (EMA) groups for 4 weeks. Multimodal magnetic resonance imaging (MRI) was then performed, and tissue-specific inflammation and energy and lipid metabolism were evaluated in IMAT. RESULTS The EXE group had lower inflammatory factor levels, lipid metabolism, and mitochondrial oxidative stress, and shorter IMAT adipocyte diameters than the MET group. The MET group exhibited lower IL-1β and Plin5 expression than the PRE group. Furthermore, the IMAT of the EMC group had lower TNF-α and phosphorylated NF-κB levels and higher GLUT1 and GLUT4 expression than the PRE group. Multimodal MRI revealed significant changes in transverse-relaxation time 2, apparent diffusion coefficient, and fractional anisotropy values in the IMAT and muscles, as well as lower IMAT% values in the EXE and EMC groups than in the MET and PRE groups. CONCLUSION Moderate aerobic exercise training can effectively improve IMAT function and structure via the AMP-activated protein kinase pathway in prediabetes. Combining metformin with moderate aerobic exercise might elicit modest synergy, and metformin does not counterbalance the beneficial effects of exercise.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Chuan Xing
- Department of Endocrinology, The People's Hospital of Liaoning Province, Shenyang, China
| | - Yiping Fan
- Department of Nuclear Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanping Liu
- Department of Gastroenterology and Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Su
- Department of Gastroenterology and Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiuhua Yang
- Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, 30912, USA
| | - Yanbin Dong
- Department of Medicine, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA, 30912, USA
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China.
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China.
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Steffen BT, Jacobs DR, Yi SY, Lees SJ, Shikany JM, Terry JG, Lewis CE, Carr JJ, Zhou X, Steffen LM. Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study. Int J Obes (Lond) 2023; 47:939-947. [PMID: 37443272 PMCID: PMC10511315 DOI: 10.1038/s41366-023-01336-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/24/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Artificial sweetener (ArtSw) intakes have been previously associated with higher BMI in observational studies and may promote visceral and skeletal muscle adipose tissue (AT) accumulation. This study aimed to determine whether habitual, long-term ArtSw or diet beverage intakes are related to greater AT depot volumes and anthropometry-related outcomes. METHODS A validated diet history questionnaire was administered at baseline, year 7, and year 20 examinations in 3088 men and women enrolled in the Coronary Artery Risk Development in Young Adults cohort (CARDIA), mean age of 25.2 years and mean BMI of 24.5 kg/m2 at baseline. Volumes of visceral (VAT), intermuscular (IMAT), and subcutaneous adipose tissue (SAT) were assessed by computed tomography at year 25. Linear regression evaluated associations of aspartame, saccharin, sucralose, total ArtSw, and diet beverage intakes with AT volumes, anthropometric measures, and 25-year change in anthropometry. Cox regression estimated associations of ArtSw with obesity incidence. Adjustments were made for demographic and lifestyle factors, total energy intake, and the 2015 healthy eating index. RESULTS Total ArtSw, aspartame, saccharin, and diet beverage intakes were positively associated with VAT, SAT, and IMAT volumes (all ptrend ≤ 0.001), but no associations were observed for sucralose intake (all ptrend > 0.05). In addition, total ArtSw, saccharin, aspartame, and diet beverage intakes were associated with greater body mass index, body weight, waist circumference, and their increases over a 25-year period. Except for saccharin (ptrend = 0.13), ArtSw, including diet soda, was associated with greater risks of incident obesity over a median 17.5-year follow-up (all ptrend < 0.05). CONCLUSIONS Results suggest that long-term intakes of aspartame, saccharin, or diet soda may increase AT deposition and risk of incident obesity independent of diet quality or caloric intake. Coupled with previous evidence, alternatives to national recommendations to replace added sugar with ArtSw should be considered since both may have health consequences.
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Affiliation(s)
- Brian T Steffen
- Division of Computational Health Sciences, Department of Surgery, School of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - So-Yun Yi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Simon J Lees
- Medical Sciences Division, Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James G Terry
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cora E Lewis
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John J Carr
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xia Zhou
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
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Zou X, Zhou X, Li Y, Huang Q, Ni Y, Zhang R, Zhang F, Wen X, Cheng J, Yuan Y, Yu Y, Guo C, Xie G, Ji L. Gender-specific data-driven adiposity subtypes using deep-learning-based abdominal CT segmentation. Obesity (Silver Spring) 2023; 31:1600-1609. [PMID: 37157112 DOI: 10.1002/oby.23741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to quantify abdominal adiposity and generate data-driven adiposity subtypes with different diabetes risks. METHODS A total of 3817 participants from the Pinggu Metabolic Disease Study were recruited. A deep-learning-based recognition model on abdominal computed tomography (CT) images (A-CT model) was developed and validated in 100 randomly selected cases. The volumes and proportions of subcutaneous fat, visceral fat, liver fat, and muscle fat were automatically recognized in all cases. K-means clustering was used to identify subgroups using the proportions of the four fat components. RESULTS The Dice indices among the measurements assessed by the A-CT model and manual evaluation to detect liver fat, muscle fat, and subcutaneous fat areas were 0.96, 0.95, and 0.92, respectively. Three subtypes were generated separately in men and women: visceral fat dominant type (VFD); subcutaneous fat dominant type (SFD); and intermuscular fat dominant type (MFD). Compared with the SFD group, the MFD group had similar diabetes risk, and the VFD group had a 60% higher diabetes risk when age and BMI were adjusted for in men. The adjusted odds ratio for diabetes was 1.92 (95% CI: 1.32-2.78) in the MFD group and 6.14 (95% CI: 4.18-9.03) in the VFD group in women. CONCLUSIONS This study identified gender-specific abdominal adiposity subgroups, which may help clinicians to distinguish diabetes risk quickly and automatically.
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Affiliation(s)
- Xiantong Zou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xianghai Zhou
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, China
| | - Qi Huang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yuan Ni
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Ruiming Zhang
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Fang Zhang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Xin Wen
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Jiayu Cheng
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yanping Yuan
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yue Yu
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Chengcheng Guo
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Guotong Xie
- Ping An Technology (Shenzhen) Co., Ltd., Shanghai, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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Santanasto AJ, Zmuda JM, Cvejkus RK, Gordon CL, Nair S, Carr JJ, Terry JG, Wheeler VW, Miljkovic I. Thigh and Calf Myosteatosis are Strongly Associated with Muscle and Physical Function in African Caribbean Men. J Gerontol A Biol Sci Med Sci 2023; 78:527-534. [PMID: 35661875 PMCID: PMC9977257 DOI: 10.1093/gerona/glac124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND African Caribbeans have higher levels of myosteatosis than other populations; however, little is known about the impact of myosteatosis on physical function in African Caribbeans. Herein, we examined the association between regional myosteatosis of the calf, thigh, and abdomen versus physical function in 850 African-Ancestry men aged 64.2 ± 8.9 (range 50-95) living on the Caribbean Island of Tobago. METHODS Myosteatosis was measured using computed tomography and included intermuscular adipose tissue (IMAT) and muscle density levels of the thigh, calf, psoas, and paraspinous muscles. Outcomes included grip strength, time to complete 5 chair-rises, and 4-meter gait speed. Associations were quantified using separate linear models for each myosteatosis depot and were adjusted for age, height, demographics, physical activity, and chronic diseases. Beta coefficients were presented per standard deviation of each myosteatosis depot. RESULTS Higher thigh IMAT was the only IMAT depot significantly associated with weaker grip strength (β = -1.3 ± 0.43 kg, p = .003). However, lower muscle density of all 4 muscle groups was associated with weaker grip strength (all p < .05). Calf and thigh myosteatosis (IMAT and muscle density) were significantly associated with both worse chair rise time and gait speed (all p < .05), whereas psoas IMAT and paraspinous muscle density were associated with gait speed. CONCLUSION Myosteatosis of the calf and thigh-but not the abdomen-were strongly associated with grip strength and performance measures of physical function in African Caribbean men. However, posterior abdominal myosteatosis may have some utility when abdominal images are all that are available.
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Affiliation(s)
- Adam J Santanasto
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph M Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ryan K Cvejkus
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victor W Wheeler
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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9
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Mohajer B, Moradi K, Guermazi A, Dolatshahi M, Zikria B, Najafzadeh N, Kalyani RR, Roemer FW, Berenbaum F, Demehri S. Diabetes-associated thigh muscle degeneration mediates knee osteoarthritis-related outcomes: results from a longitudinal cohort study. Eur Radiol 2023; 33:595-605. [PMID: 35951046 PMCID: PMC10448875 DOI: 10.1007/s00330-022-09035-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/01/2022] [Accepted: 07/24/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between diabetes mellitus (DM) and longitudinal MRI biomarkers for thigh muscle degeneration in patients with knee osteoarthritis (KOA) and their mediatory role in worsening KOA-related symptoms. METHODS The Osteoarthritis Initiative (OAI) participants with radiographic KOA (Kellgren-Lawrence grade ≥ 2) were included. Thighs and corresponding knees of KOA patients with versus without self-reported DM were matched for potential confounders using propensity score (PS) matching. We developed and used a validated deep learning method for longitudinal thigh segmentation. We assessed the association of DM with 4-year longitudinal muscle degeneration in biomarkers of muscle cross-sectional area (CSA) and contractile percentage (non-fat CSA/total CSA). We further investigated whether DM is associated with 9-year risk of KOA radiographic progression, knee replacement (KR), and symptoms worsening. Finally, we evaluated whether the DM-KOA worsening association is mediated through preceding muscle degeneration. RESULTS After PS matching, 698 thighs/knees were included (185:513 with:without DM; average ± SD age:64 ± 8-years; female/male:1.4). Baseline DM was associated with a decreased contractile percent of total thigh muscles and quadriceps (mean difference, 95%CI -0.16%/year, -0.25 to -0.07, and -0.21%/year, -0.33 to -0.08). DM was also associated with an increased risk of worsening KOA-related symptoms (hazard ratio, 95%CI 1.70, 1.18-2.46) but not radiographic progression or KR. The decrease in quadriceps contractile percent partially mediated the increased risk of symptoms worsening in patients with DM. CONCLUSIONS Baseline DM is associated with thigh muscle degeneration and KOA-related symptoms worsening. As a potentially modifiable risk factor, DM-associated longitudinal thigh muscle degeneration may partially mediate the symptoms worsening in patients with DM and coexisting KOA. KEY POINTS • Diabetes mellitus (DM) is associated with worsening knee osteoarthritis (KOA)-related symptoms. • As a potentially modifiable factor, DM-associated thigh muscle (quadriceps) degeneration partially mediates the worsening of KOA-related symptoms.
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Affiliation(s)
- Bahram Mohajer
- Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD, 21287, USA
| | - Kamyar Moradi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Mahsa Dolatshahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bashir Zikria
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Rita R Kalyani
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne University, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France
| | - Shadpour Demehri
- Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD, 21287, USA.
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10
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Marron MM, Cvejkus RK, Acevedo-Fontanez AI, Kuipers AL, Nair S, Carr JJ, Terry JG, Wheeler V, Miljkovic I. Replacing sedentary time with light activity was associated with less adiposity across several depots in African ancestry men. Obesity (Silver Spring) 2022; 30:2489-2496. [PMID: 36415998 PMCID: PMC9832382 DOI: 10.1002/oby.23582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether displacement of sedentary time with activity was cross-sectionally associated with less adiposity among Black Caribbean men in the Tobago Health Study. METHODS Objectively assessed activity was categorized as sedentary (< 1.5 metabolic equivalents; METs), light (≥ 1.5 to < 3.0 METs), or moderate-to-vigorous (≥ 3.0 METs) using the SenseWear Pro armband. Computed tomography scans of the chest, abdomen, liver, and thigh were used to assess subcutaneous and ectopic adipose tissue. The isotemporal substitution framework paired with linear regression was used to examine associations between activity and adiposity adjusting for age, height, total awake time, and multiple comparisons. RESULTS On average, participants (n = 271) were 63 years old with 11.2 h/d of sedentary behavior, 4.5 h/d of light activity, and 54 min/d of moderate-to-vigorous activity. Replacing sedentary time with light activity was cross-sectionally associated with lower volume and higher density of abdominal and thigh subcutaneous adiposity, visceral adiposity, abdominal and thigh intermuscular adiposity, and pericardial adiposity and higher liver attenuation (p values ≤ 0.0001). CONCLUSIONS Displacement of sedentary time with light activity was associated with less adiposity among this Black Caribbean cohort. Interventions focused on increasing light activity may be easier to maintain than higher intensity interventions and thus may be more successful at reducing adiposity.
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Affiliation(s)
- Megan M. Marron
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ryan K. Cvejkus
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adrianna I. Acevedo-Fontanez
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Allison L. Kuipers
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sangeeta Nair
- Department of Radiology & Radiological Sciences, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - John Jeffrey Carr
- Department of Radiology & Radiological Sciences, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - James G. Terry
- Department of Radiology & Radiological Sciences, Vanderbilt University Medicine Center, Nashville, Tennessee, USA
| | - Victor Wheeler
- Tobago Health Studies Office, Scarborough, Trinidad and Tobago
| | - Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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11
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Chen F, Liu J, Hou D, Li T, Chen Y, Liao Z, Wu L. The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14112272. [PMID: 35684072 PMCID: PMC9183098 DOI: 10.3390/nu14112272] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0−18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04−0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37−0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33−0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.
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Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Yiren Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Zijun Liao
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
- Correspondence: ; Tel.: +86-10-85695537
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12
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Yu F, Fan Y, Sun H, Li T, Dong Y, Pan S. Intermuscular adipose tissue in Type 2 diabetes mellitus: Non-invasive quantitative imaging and clinical implications. Diabetes Res Clin Pract 2022; 187:109881. [PMID: 35483545 DOI: 10.1016/j.diabres.2022.109881] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 12/25/2022]
Abstract
Intermuscular adipose tissue (IMAT) is an ectopic fat depot found beneath the fascia and within the muscles. IMAT modulates muscle insulin sensitivity and triggers local and systemic chronic low-grade inflammation by producing cytokines and chemokines, which underlie the pathogenesis of Type 2 diabetes mellitus (T2DM). Imaging techniques have been increasingly used to non-invasively quantify IMAT in patients with diabetes in research and healthcare settings. In this study, we systematically reviewed the cell of origin and definition of IMAT, and the use of quantitative and functional imaging technology pertinent to the etiology, risk factors, lifestyle modification, and therapeutic treatment of diabetes. The purpose of this article is to provide important insight into the current understanding of IMAT and future prospects of targeting IMAT for T2DM control.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yiping Fan
- Department of Nuclear Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - He Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tianming Li
- Department of Gastroenterology and Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Kim EH, Kim HK, Lee MJ, Bae SJ, Kim KW, Choe J. Association between type 2 diabetes and skeletal muscle quality assessed by abdominal computed tomography scan. Diabetes Metab Res Rev 2022; 38:e3513. [PMID: 34799961 DOI: 10.1002/dmrr.3513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/18/2021] [Accepted: 09/16/2021] [Indexed: 12/25/2022]
Abstract
AIM To examine the association between type 2 diabetes and the amount and quality of trunk muscle as assessed by computed tomography (CT) scan. MATERIALS AND METHODS A total of 20,986 subjects (13,007 men and 7979 women) who underwent abdominal CT scan as part of a routine health check-up were included. The total abdominal muscle area (TAMA) measured at the third lumbar vertebrae was classified into skeletal muscle area (SMA), and intermuscular adipose tissue area. SMA was divided into good quality muscles (normal attenuation muscle area [NAMA]) and poor quality muscles (low attenuation muscle area). NAMA/TAMA index was calculated. RESULTS Subjects with type 2 diabetes had higher values of TAMA and SMA but significantly lower values of NAMA and NAMA/TAMA index. Compared with those in the lowest quartile of NAMA/TAMA index, subjects in the highest quartile had metabolically favourable laboratory findings, a lower prevalence of type 2 diabetes (Q1 vs. Q4: 19.3% vs. 9.5% in men, 12.3% vs. 3.0% in women) and inverse association with type 2 diabetes (odds ratio for Q2, Q3, and Q4: 0.87, 0.78, and 0.75 in men; 0.82, 0.70, and 0.68 in women) after multivariable adjustment. CONCLUSIONS The amount of good quality muscle on CT scan was associated with a lower prevalence of type 2 diabetes.
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Affiliation(s)
- Eun Hee Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Hong-Kyu Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Min Jung Lee
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Sung-Jin Bae
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea
| | - Jaewon Choe
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
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14
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García-Alonso Y, García-Hermoso A, Alonso-Martínez AM, Legarra-Gorgoñon G, Izquierdo M, Ramírez-Vélez R. Associations between physical fitness components with muscle ultrasound parameters in prepuberal children. Int J Obes (Lond) 2022; 46:960-968. [PMID: 35031698 DOI: 10.1038/s41366-022-01066-7] [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: 11/11/2021] [Revised: 12/29/2021] [Accepted: 01/07/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Muscle ultrasound is a convenient technique to visualize normal and pathological muscle tissue as it is non-invasive and real-time. This technique is related to several physical performance parameters and body composition components in adults; however, this relationship remains unexplored in early aged. We aimed to evaluate the association between physical fitness components with muscle ultrasound parameters in prepuberal children. METHODS A sample of 282 prepuberal children aged 5-9 years (144 boys) participated in the study. A trained sonographer obtained six B-mode images from femoral rectus for muscle thickness, subcutaneous adipose tissue (SAT) and area of the muscle of interest, were captured, and muscle ultrasound parameters (echo-intensity: EI uncorrected, EI correct equations) and intramuscular adipose tissue (IMAT) were extracted. Lean muscle tissue has low EI, whereas intramuscular fat and connective tissue have high EI. Physical fitness components (cardiorespiratory fitness, upper and lower muscle strength, speed-agility, and overall fitness levels) were also evaluated. Children were categorized as fit or unfit for each specific fitness test. RESULTS After adjustment for sex and age, higher physical fitness components and overall fitness (z-score) levels were negatively associated with EI, IMAT, and SAT (cardiorespiratory fitness β range = -0.264 to -0.298; upper-muscular strength β range = -0.389 to -0.457; and lower-muscular strength β range = -0.202 to -0.279; and speed-agility β range = -0.257 to -0.302). Children categorized as fit according to four physical fitness components had lower EI uncorrected, EI correct equation 1-2, IMAT, and SAT than unfit children for each respective tests (all Ps < 0.001). CONCLUSION Physical fitness components are inversely associated with EI, IMAT, SAT after adjusting for potential confounders, including sex and age, in prepuberal children. The present study strengthens the idea that muscle and adiposity parameters is affected by physical fitness even from early childhood.
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Affiliation(s)
- Yesenia García-Alonso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Alicia M Alonso-Martínez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Gaizka Legarra-Gorgoñon
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain. .,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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15
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Zhang QH, Xie LH, Zhang HN, Liu JH, Zhao Y, Chen LH, Ju Y, Chen AL, Wang N, Song QW, Xie LZ, Liu AL. Magnetic Resonance Imaging Assessment of Abdominal Ectopic Fat Deposition in Correlation With Cardiometabolic Risk Factors. Front Endocrinol (Lausanne) 2022; 13:820023. [PMID: 35432188 PMCID: PMC9005896 DOI: 10.3389/fendo.2022.820023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Ectopic fat accumulation and abdominal fat distribution may have different cardiometabolic risk profiles. This study aimed to assess the associations between various magnetic resonance imaging (MRI)-acquired fat depots and cardiometabolic risk factors. METHODS A total of 320 subjects with median age of 59 years, 148 men and 172 women, were enrolled in the study. Visceral adipose tissue (VAT) area and fat fraction (FF), subcutaneous adipose tissue (SAT) area and FF at the L1-L2 levels, preperitoneal adipose tissue (pPAT) area and FF, hepatic FF, pancreatic FF, and intramuscular FF were assessed by MRI FF maps. The associations of various MRI-acquired fat depots with blood pressure, glucose, and lipid were examined using sex-stratified linear regression. Logistic regression stratified by sex was used to analyze the association of various MRI-acquired fat depots with the risk of hypertension, T2DM, and dyslipidemia. RESULTS The intraclass correlation coefficient (ICC) values were >0.9, which suggested good interobserver and intraobserver agreement. VAT area, V/S, hepatic fat, pancreatic fat, and pPAT rather than SAT area were significantly associated with multiple cardiometabolic risk factors (all p < 0.05). However, the patterns of these correlations varied by sex and specific risk factors. Also, VAT and SAT FF were only significantly associated with multiple cardiometabolic risk factors in women (all p < 0.05). CONCLUSIONS VAT, hepatic fat, pancreatic fat, and pPAT were associated with cardiovascular metabolic risk factors independent of BMI. The patterns of these correlations were related to gender. These findings further the understanding of the association between ectopic fat deposition and cardiometabolic risk factors and help to better understand the obesity heterogeneity.
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Affiliation(s)
- Qin-He Zhang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lu-Han Xie
- Department of Pathology and Forensics, Dalian Medical University, Dalian, China
| | - Hao-Nan Zhang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing-Hong Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Zhao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Li-Hua Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ye Ju
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - An-Liang Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Nan Wang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qing-Wei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Li-Zhi Xie
- MR Research, GE Healthcare, Beijing, China
| | - Ai-Lian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Ai-Lian Liu,
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Wu L, Chen F, Liu J, Hou D, Li T, Chen Y, Liao Z. The Relationship Between Fat-Free Mass and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:864904. [PMID: 35558370 PMCID: PMC9087035 DOI: 10.3389/fped.2022.864904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the relationship between fat-free mass (FFM) and glucose metabolism in children 0-18 years of age. METHODS We performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase, and the Cochrane Library using the PRISMA 2020 guidelines to 12 October 2021; this encompassed observational studies in which the relationship between FFM and glucose metabolism was assessed. Correlation coefficient (r), regression coefficient (β), and odds ratio (OR) values in the studies were extracted and recorded as the primary data. "Agency for Healthcare Research and Quality" quality-assessment forms recommended for cross-sectional/prevalence studies were applied to evaluate the quality of the selected studies, and we executed R software to combine the pooled data. RESULTS We included eight studies comprising 13,282 individuals, five of which involved the assessment of the relationship between FFM and blood glucose, and four on the relationship between FFM and insulin resistance (IR). Our results showed that FFM was significantly associated with fasting plasma insulin levels (r = 0.34, 95% CI: 0.30-0.39, P < 0.001). Due to high heterogeneity or insufficient quantity of data, the studies of the relationship between FFM and fasting plasma glucose, HOMA-IR, or HbA1c were not congruent, and were therefore not suitable for meta-analysis. CONCLUSION Our results indicated that FFM was significantly associated with fasting plasma insulin levels. As far as we have determined, this is the first-ever systematic review and meta-analysis of the associations between FFM and glucose metabolism in children and adolescents; and our results thus provide novel information to fill a gap in the literature in this area. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150320, PROSPERO CRD42020150320.
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Affiliation(s)
- Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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Kim HK, Kim CH. Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health. Endocrinol Metab (Seoul) 2021; 36:1161-1174. [PMID: 34986299 PMCID: PMC8743592 DOI: 10.3803/enm.2021.1348] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Although age-related changes in skeletal muscles are closely associated with decreases in muscle strength and functional decline, their associations with cardiometabolic diseases in the literature are inconsistent. Such inconsistency could be explained by the fact that muscle quality-which is closely associated with fatty infiltration of the muscle (i.e., myosteatosis)-is as important as muscle quantity in cardiometabolic health. However, muscle quality has been less explored compared with muscle mass. Moreover, the standard definition of myosteatosis and its assessment methods have not been established yet. Recently, some techniques using single axial computed tomography (CT) images have been introduced and utilized in many studies, as the mass and quality of abdominal muscles could be measured opportunistically on abdominal CT scans obtained during routine clinical care. Yet, the mechanisms by which myosteatosis affect metabolic and cardiovascular health remain largely unknown. In this review, we explore the recent advances in the assessment of myosteatosis and its changes associated with aging. We also review the recent literature on the clinical implication of myosteatosis by focusing on metabolic and cardiovascular diseases. Finally, we discuss the challenges and unanswered questions that need addressing to set myosteatosis as a therapeutic target for the prevention or treatment of cardiometabolic diseases.
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Affiliation(s)
- Hong-Kyu Kim
- Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea
- Corresponding authors: Hong-Kyu Kim Subdivision of Endocrinology and Metabolism, Health Screening and Promotion Center, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-4802, Fax: +82-2-3010-4917, E-mail:
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- Chul-Hee Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea Tel: +82-32-621-5155, Fax: +82-32-621-5018, E-mail:
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18
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Wang D, Fang R, Han H, Zhang J, Chen K, Fu X, He Q, Yang Y. Association between visceral adiposity index and risk of prediabetes: A meta-analysis of observational studies. J Diabetes Investig 2021; 13:543-551. [PMID: 34592063 PMCID: PMC8902389 DOI: 10.1111/jdi.13685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/17/2021] [Accepted: 09/18/2021] [Indexed: 12/12/2022] Open
Abstract
Background and Objective Epidemiological studies suggested that the association between the visceral adiposity index (VAI) and the risk of prediabetes is inconsistent. Whether VAI is a useful predictor of prediabetes remains unclear. Up until April 2021, there had been no systematic review on this topic. In this meta‐analysis, the available observational epidemiological evidence was synthesized to identify the association between VAI and prediabetes risk. Methods PubMed, EMBASE, and Cochrane databases in any language were searched systematically from the earliest available online indexing year to April 2021 for relevant observational studies published on the association between VAI and the risk of prediabetes. A random effects model was used to combine quantitatively the odds ratios (ORs) and 95% confidence intervals (CIs). Results Ten relevant studies (2 cohort study, 2 case‐control studies, and 6 cross‐sectional studies) involving 112,603 participants were identified. Compared with the highest VAI, the lowest level of VAI was associated with an increased risk of prediabetes. The pooled OR of VAI for prediabetes was 1.68 (95% CI: 1.44–1.96), with significant heterogeneity across the included studies (P = 0.000, I2 = 91.4%). Exclusion of any single study did not materially alter the combined risk estimate. Conclusions Integrated epidemiological evidence supports the hypothesis that VAI is a lipid combined anthropometric index and may be a risk factor for prediabetes. VAI may be related to a high risk of prediabetes. However, it should be noted that the included studies have a publication bias and there was significant heterogeneity between our pooled estimate.
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Affiliation(s)
- Dan Wang
- Hangzhou Normal University, Hangzhou, China
| | - Rui Fang
- Hunan University of Chinese Medicine, Changsha, China
| | | | - Jidong Zhang
- Hunan University of Chinese Medicine, Changsha, China
| | - Kaifei Chen
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoqing Fu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Qinghu He
- Hunan University of Medicine, Huaihua, China
| | - Yong Yang
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
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19
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Medrano M, Cadenas-Sánchez C, Oses M, Villanueva A, Cabeza R, Idoate F, Sanz A, Rodríguez-Vigil B, Ortega FB, Ruiz JR, Labayen I. Associations of fitness and physical activity with specific abdominal fat depots in children with overweight/obesity. Scand J Med Sci Sports 2021; 32:211-222. [PMID: 34570914 DOI: 10.1111/sms.14065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the relationship between physical fitness and physical activity (PA) with specific abdominal fat depots and their potential implications for cardiometabolic risk and insulin resistance (IR) in children with overweight/obesity. MATERIALS AND METHODS A total of 116 children with overweight/obesity (10.7 ± 1.1 year, 54% girls) participated in the study. Abdominal visceral (VAT), subcutaneous (ASAT), and intermuscular abdominal adipose tissue (IMAAT) were assessed by magnetic resonance imaging. The cardiometabolic risk (MetS) score and the insulin resistance homeostasis model assessment (HOMA-IR) were calculated. Health-related physical fitness components (treadmill test, and 20 m shuttle run, handgrip, standing broad jump and 4 × 10 m tests) were evaluated, and PA was measured (accelerometry). Children were categorized as fit or unfit for each specific fitness test, and as active or inactive. RESULTS Higher VAT, ASAT, and IMAAT were associated with higher MetS score and HOMA-IR (all p < 0.02). A better performance in all fitness tests and total and vigorous PA were strongly associated with lower VAT (all p < 0.04), ASAT (all p < 0.005), and IMAAT (all p < 0.005). Fit or active children had lower VAT, ASAT, and IMAAT (all p < 0.03) than their unfit or inactive counterparts. CONCLUSION These results reinforce the importance of having adequate fitness and PA levels to reduce abdominal fat accumulation in children. Given that VAT, ASAT, and IMAAT are associated with higher risk of developing cardiovascular diseases and type 2 diabetes, the improvement of physical fitness by the promotion of PA should be goals of lifestyle interventions for improving health in children with overweight/obesity.
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Affiliation(s)
- María Medrano
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Cristina Cadenas-Sánchez
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Maddi Oses
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Arantxa Villanueva
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | | | - Aritz Sanz
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain.,Navarrabiomed, Pamplona, Spain
| | - Beatriz Rodríguez-Vigil
- Resonancia Magnética Osatek, Hospital Universitario de Álava Vitoria, Vitoria-Gasteiz, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Jonathan R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, Pamplona, Spain.,Department of Health Sciences, Public University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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20
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Pishgar F, Shabani M, Quinaglia A. C. Silva T, Bluemke DA, Budoff M, Barr RG, Allison MA, Bertoni AG, Post WS, Lima JAC, Demehri S. Adipose tissue biomarkers and type 2 diabetes incidence in normoglycemic participants in the MESArthritis Ancillary Study: A cohort study. PLoS Med 2021; 18:e1003700. [PMID: 34242221 PMCID: PMC8337053 DOI: 10.1371/journal.pmed.1003700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/04/2021] [Accepted: 06/16/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Given the central role of skeletal muscles in glucose homeostasis, deposition of adipose depots beneath the fascia of muscles (versus subcutaneous adipose tissue [SAT]) may precede insulin resistance and type 2 diabetes (T2D) incidence. This study was aimed to investigate the associations between computed tomography (CT)-derived biomarkers for adipose tissue and T2D incidence in normoglycemic adults. METHODS AND FINDINGS This study was a population-based multiethnic retrospective cohort of 1,744 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with normoglycemia (baseline fasting plasma glucose [FPG] less than 100 mg/dL) from 6 United States of America communities. Participants were followed from April 2010 and January 2012 to December 2017, for a median of 7 years. The intermuscular adipose tissue (IMAT) and SAT areas were measured in baseline chest CT exams and were corrected by height squared (SAT and IMAT indices) using a predefined measurement protocol. T2D incidence, as the main outcome, was based on follow-up FPG, review of hospital records, or self-reported physician diagnoses. Participants' mean age was 69 ± 9 years at baseline, and 977 (56.0%) were women. Over a median of 7 years, 103 (5.9%) participants were diagnosed with T2D, and 147 (8.4%) participants died. The IMAT index (hazard ratio [HR]: 1.27 [95% confidence interval [CI]: 1.15-1.41] per 1-standard deviation [SD] increment) and the SAT index (HR: 1.43 [95% CI: 1.16-1.77] per 1-SD increment) at baseline were associated with T2D incidence over the follow-up. The associations of the IMAT and SAT indices with T2D incidence were attenuated after adjustment for body mass index (BMI) and waist circumference, with HRs of 1.23 (95% CI: 1.09-1.38) and 1.29 (95% CI: 0.96-1.74) per 1-SD increment, respectively. The limitations of this study include unmeasured residual confounders and one-time measurement of adipose tissue biomarkers. CONCLUSIONS In this study, we observed an association between IMAT at baseline and T2D incidence over the follow-up. This study suggests the potential role of intermuscular adipose depots in the pathophysiology of T2D. TRIAL REGISTRATION ClinicalTrials.gov NCT00005487.
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Affiliation(s)
- Farhad Pishgar
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Mahsima Shabani
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Thiago Quinaglia A. C. Silva
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - David A. Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Matthew Budoff
- Lundquist Institute at Harbor-University of California Los Angeles School of Medicine, Torrance, California, United States of America
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York, United States of America
- Department of Epidemiology, Columbia University Medical Center, New York, New York, United States of America
| | - Matthew A. Allison
- Division of Preventive Medicine, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Alain G. Bertoni
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Wendy S. Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - João A. C. Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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21
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Miljkovic I, Vella CA, Allison M. Computed Tomography-Derived Myosteatosis and Metabolic Disorders. Diabetes Metab J 2021; 45:482-491. [PMID: 34352985 PMCID: PMC8369205 DOI: 10.4093/dmj.2020.0277] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 06/01/2021] [Indexed: 12/17/2022] Open
Abstract
The role of ectopic adipose tissue infiltration into skeletal muscle (i.e., myosteatosis) for metabolic disorders has received considerable and increasing attention in the last 10 years. The purpose of this review was to evaluate and summarize existing studies focusing on computed tomography (CT)-derived measures of myosteatosis and metabolic disorders. There is consistent evidence that CT-derived myosteatosis contributes to dysglycemia, insulin resistance, type 2 diabetes mellitus, and inflammation, and, to some extent, dyslipidemia, independent of general obesity, visceral fat, and other relevant risk factors, suggesting that it may serve as a tool for metabolic risk prediction. Identification of which muscles should be examined, and the standardized CT protocols to be employed, are necessary to enhance the applicability of findings from epidemiologic studies of myosteatosis. Additional and longer longitudinal studies are necessary to confirm a role of myosteatosis in the development of type 2 diabetes mellitus, and examine these associations in a variety of muscles across multiple race/ethnic populations. Given the emerging role of myosteatosis in metabolic health, well-designed intervention studies are needed to investigate relevant lifestyle and pharmaceutical approaches.
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Affiliation(s)
- Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chantal A. Vella
- Department of Movement Sciences, College of Education, Health and Human Sciences, University of Idaho, Moscow, ID, USA
| | - Matthew Allison
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Corresponding author: Matthew Allison https://orcid.org/0000-0003-0777-8272 Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA E-mail:
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22
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Nachit M, De Rudder M, Thissen JP, Schakman O, Bouzin C, Horsmans Y, Vande Velde G, Leclercq IA. Myosteatosis rather than sarcopenia associates with non-alcoholic steatohepatitis in non-alcoholic fatty liver disease preclinical models. J Cachexia Sarcopenia Muscle 2021; 12:144-158. [PMID: 33244884 PMCID: PMC7890270 DOI: 10.1002/jcsm.12646] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/29/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver (NAFL) disease (NAFLD) is the most common chronic liver disease in the world. While most subjects have 'inert' NAFL, a subset will progress to non-alcoholic steatohepatitis (NASH) and its life-threatening complications. A substantial body of literature supports that a low muscle mass, low strength, and/or muscle fatty infiltration (myosteatosis) are associated with NAFLD severity. Here, we evaluated the muscle compartment in NASH preclinical models to decipher the kinetics of muscle alterations in relation with liver disease progression. METHODS We developed and validated a micro-computed tomography-based methodology to prospectively study skeletal muscle mass and density in muscle and liver (i.e. reflecting fatty infiltration) in a high-throughput and non-invasive manner in three preclinical NAFLD/NASH rodent models: fat aussie (FOZ) mice fed a high-fat diet (FOZ HF), wild-type (WT) mice fed a high-fat high-fructose diet (WT HFF), and WT mice fed a high-fat diet (WT HF). We compared them with WT mice fed a normal diet (WT ND) used as controls. RESULTS -FOZ HF with fibrosing NASH had sarcopenia characterized by a reduced muscle strength when compared with WT HF and WT HFF with early NASH and WT ND controls (165.2 ± 5.2 g vs. 237.4 ± 11.7 g, 256 ± 5.7 g, and 242.9 ± 9.3 g, respectively, P 60; 0.001). Muscle mass or strength was not lower in FOZ HF, WT HF, and WT HFF with early NASH than in controls. Myosteatosis was present in FOZ HF with fibrosing NASH, but also in FOZ HF, WT HF, and WT HFF with early NASH (muscle density = 0.50 ± 0.02, 0.62 ± 0.02, 0.70 ± 0.05, and 0.75 ± 0.03, respectively, with P 60; 0.001 when compared with respective controls). Myosteatosis degree was strongly correlated with NAFLD activity score (r = -0.87, n = 67, P 60; 0.001). In multivariate analysis, the association between myosteatosis and NASH was independent from homeostatic model assessment of insulin resistance and visceral fat area (P 60; 0.05). Myosteatosis degree powerfully discriminated NASH from benign NAFL and normal liver (area under the receiver operating characteristic = 0.96, n = 67, P 60; 0.001). CONCLUSIONS Taken together, our data support that there is no sarcopenia in obese mice with early NASH. In contrast, the severity of myosteatosis reflects on hepatocellular damage and inflammation during early NASH development. This observation prompts us to exploit myosteatosis as a novel non-invasive marker of NASH.
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Affiliation(s)
- Maxime Nachit
- Laboratory of Hepato-Gastroenterology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Maxime De Rudder
- Laboratory of Hepato-Gastroenterology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Jean-Paul Thissen
- Pole of Endocrinology, Diabetes and Nutrition, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | | | | | - Yves Horsmans
- Service d'Hépato-Gastro-Entérologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Greetje Vande Velde
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Molecular Small Animal Imaging Center (MoSAIC), KU Leuven, Leuven, Belgium
| | - Isabelle Anne Leclercq
- Laboratory of Hepato-Gastroenterology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
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23
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Body composition predictors of outcome in patients with COVID-19. Int J Obes (Lond) 2021; 45:2238-2243. [PMID: 34244597 PMCID: PMC8267764 DOI: 10.1038/s41366-021-00907-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/10/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVE Obesity is a strong risk factor for adverse outcomes in patients hospitalized with COVID-19, however, the distribution of fat and the amount of muscle mass are more accurate risk factors than BMI. The objective of this study was to assess body composition measures obtained on opportunistic abdominal CTs as predictors of outcome in patients hospitalized with COVID-19. We hypothesized that elevated visceral and intermuscular adipose tissue would be associated with adverse outcome. SUBJECTS/METHODS Our retrospective study was IRB-approved and HIPAA-compliant. The study group comprised 124 patients (median age: 68 years, IQR: 56, 77; 59 weeks, 65 months) who were admitted with COVID-19 to a single hospital and who had undergone abdominal CT for clinical purposes. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and paraspinal and abdominal muscle cross-sectional areas (CSA) were assessed. Clinical information including prognostic factors, time of admission to the intensive care unit (ICU) and time of death within 28 days were obtained. Multivariate time-to-event competing risk models were fitted to estimate the hazard ratio (HR) for a composite outcome of ICU admission/mortality associated with a one standard deviation increase in each body compositional measure. Each model was adjusted for age, sex, race, BMI, and cardiometabolic comorbidities. RESULTS There were 50 patients who were admitted to the ICU or deceased over a median time of 1 day [IQR 1, 6] from hospital admission. Higher VAT/SAT ratio (HR of 1.30; 95% CI 1.04-1.62, p = 0.022) and higher IMAT CSA (HR of 1.44; 95% CI 1.10-1.89, p = 0.008) were associated with a reduced time to ICU admission or death in adjusted models. CONCLUSION VAT/SAT and IMAT are predictors of adverse outcome in patients hospitalized with COVID-19, independent of other established prognostic factors. This suggests that body composition measures may serve as novel biomarkers of outcome in patients with COVID-19.
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24
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Yu F, He B, Chen L, Wang F, Zhu H, Dong Y, Pan S. Intermuscular Fat Content in Young Chinese Men With Newly Diagnosed Type 2 Diabetes: Based on MR mDIXON-Quant Quantitative Technique. Front Endocrinol (Lausanne) 2021; 12:536018. [PMID: 33868161 PMCID: PMC8044767 DOI: 10.3389/fendo.2021.536018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/12/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Skeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects. METHODS We enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values. RESULTS We found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p<0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p<0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p<0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content. CONCLUSION Deposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Chen
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Fengzhe Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Haidong Zhu
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Yanbin Dong
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Shinong Pan,
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25
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Usui C, Kawakami R, Tanisawa K, Ito T, Tabata H, Iizuka S, Kawamura T, Midorikawa T, Sawada SS, Torii S, Sakamoto S, Suzuki K, Ishii K, Oka K, Muraoka I, Higuchi M. Visceral fat and cardiorespiratory fitness with prevalence of pre-diabetes/diabetes mellitus among middle-aged and elderly Japanese people: WASEDA'S Health Study. PLoS One 2020; 15:e0241018. [PMID: 33079960 PMCID: PMC7575118 DOI: 10.1371/journal.pone.0241018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/06/2020] [Indexed: 12/29/2022] Open
Abstract
The relationships between cardiorespiratory fitness (CRF) measurements not confounded by adiposity and the prevalence of pre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) are not well known. Thus, we aimed to investigate the associations of visceral fat (VF) and CRF with the prevalence of pre-DM/DM among Japanese adults. The study included 970 individuals (327 women and 643 men) who were 40-87 years old and had complete health examinations, abdominal fat area, and fitness data from WASEDA'S Health Study during 2015-2018. The VF area was measured using magnetic resonance imaging. CRF was measured using a cycle ergometer and was defined as VO2peak divided by fat free mass. The pre-DM/DM was identified based on the questionnaire and fasting blood tests. The odds ratios (ORs) and 95% confidence intervals (CIs) for prevalence of pre-DM/DM were calculated. Seventy-three participants had pre-DM and 48 participants had DM. Compared to the low VF group, the high VF group had a higher prevalence of pre-DM/DM (OR: 1.87, 95% CI: 1.18-2.96), although no significant relationship was observed between CRF and pre-DM/DM prevalence (P for trend = 0.239). The sub-group analyses also revealed no significant relationship between CRF and pre-DM/DM prevalence in the low VF group (P for trend = 0.979), although CRF values were inversely related to the prevalence of pre-DM/DM in the high VF group (P for trend = 0.024). Although CRF was not independently related to the prevalence of pre-DM/DM after adjusting for adiposity, higher VF values were related to a higher prevalence of pre-DM/DM. In addition, CRF levels were inversely associated with the prevalence of pre-DM/DM only among high VF individuals.
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Affiliation(s)
- Chiyoko Usui
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- * E-mail:
| | - Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Tomoko Ito
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Hiroki Tabata
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoshi Iizuka
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- Department of Sport Sciences, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Takuji Kawamura
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Taishi Midorikawa
- Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
- College of Health and Welfare, J. F. Oberlin University, Tokyo, Japan
| | | | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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26
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Cheikhi A, Anguiano T, Lasak J, Qian B, Sahu A, Mimiya H, Cohen CC, Wipf P, Ambrosio F, Barchowsky A. Arsenic Stimulates Myoblast Mitochondrial Epidermal Growth Factor Receptor to Impair Myogenesis. Toxicol Sci 2020; 176:162-174. [PMID: 32159786 PMCID: PMC7357174 DOI: 10.1093/toxsci/kfaa031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Arsenic exposure impairs muscle metabolism, maintenance, progenitor cell differentiation, and regeneration following acute injury. Low to moderate arsenic exposures target muscle fiber and progenitor cell mitochondria to epigenetically decrease muscle quality and regeneration. However, the mechanisms for how low levels of arsenic signal for prolonged mitochondrial dysfunction are not known. In this study, arsenic attenuated murine C2C12 myoblasts differentiation and resulted in abnormal undifferentiated myoblast proliferation. Arsenic prolonged ligand-independent phosphorylation of mitochondrially localized epidermal growth factor receptor (EGFR), a major driver of proliferation. Treating cells with a selective EGFR kinase inhibitor, AG-1478, prevented arsenic inhibition of myoblast differentiation. AG-1478 decreased arsenic-induced colocalization of pY845EGFR with mitochondrial cytochrome C oxidase subunit II, as well as arsenic-enhanced mitochondrial membrane potential, reactive oxygen species generation, and cell cycling. All of the arsenic effects on mitochondrial signaling and cell fate were mitigated or reversed by addition of mitochondrially targeted agents that restored mitochondrial integrity and function. Thus, arsenic-driven pathogenesis in skeletal muscle requires sustained mitochondrial EGFR activation that promotes progenitor cell cycling and proliferation at the detriment of proper differentiation. Collectively, these findings suggest that the arsenic-activated mitochondrial EGFR pathway drives pathogenic signaling for impaired myoblast metabolism and function.
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Affiliation(s)
- Amin Cheikhi
- Division of Geriatric Medicine, Department of Medicine
- Department of Environmental and Occupational Health
- Department of Physical Medicine and Rehabilitation
| | | | - Jane Lasak
- Department of Physical Medicine and Rehabilitation
| | - Baoli Qian
- Department of Environmental and Occupational Health
| | - Amrita Sahu
- Department of Physical Medicine and Rehabilitation
| | | | | | | | - Fabrisia Ambrosio
- Department of Environmental and Occupational Health
- Department of Physical Medicine and Rehabilitation
- McGowan Institute for Regenerative Medicine
- Department of Bioengineering
| | - Aaron Barchowsky
- Department of Environmental and Occupational Health
- Department of Bioengineering
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
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Association of smoking with abdominal adipose deposition and muscle composition in Coronary Artery Risk Development in Young Adults (CARDIA) participants at mid-life: A population-based cohort study. PLoS Med 2020; 17:e1003223. [PMID: 32692748 PMCID: PMC7373261 DOI: 10.1371/journal.pmed.1003223] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/18/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Smokers have lower risk of obesity, which some consider a "beneficial" side effect of smoking. However, some studies suggest that smoking is simultaneously associated with higher central adiposity and, more specifically, ectopic adipose deposition. Little is known about the association of smoking with intermuscular adipose tissue (IMAT), an ectopic adipose depot associated with cardiovascular disease (CVD) risk and a key determinant of muscle quality and function. We tested the hypothesis that smokers have higher abdominal IMAT and lower lean muscle quality than never smokers. METHODS AND FINDINGS We measured abdominal muscle total, lean, and adipose volumes (in cubic centimeters) and attenuation (in Hounsfield units [HU]) along with subcutaneous (SAT) and visceral adipose tissue (VAT) volumes using computed tomography (CT) in 3,020 middle-aged Coronary Artery Risk Development in Young Adults (CARDIA) participants (age 42-58, 56.3% women, 52.6% white race) at the year 25 (Y25) visit. The longitudinal CARDIA study was initiated in 1985 with the recruitment of young adult participants (aged 18-30 years) equally balanced by female and male sex and black and white race at 4 field centers located in Birmingham, AL, Chicago, IL, Minneapolis, MN, and Oakland, CA. Multivariable linear models included potential confounders such as physical activity and dietary habits along with traditional CVD risk factors. Current smokers had lower BMI than never smokers. Nevertheless, in the fully adjusted multivariable model with potential confounders, including BMI and CVD risk factors, adjusted mean (95% CI) IMAT volume was 2.66 (2.55-2.76) cm3 in current smokers (n = 524), 2.36 (2.29-2.43) cm3 in former smokers (n = 944), and 2.23 (2.18-2.29) cm3 in never smokers (n = 1,552) (p = 0.007 for comparison of former versus never smoker, and p < 0.001 for comparison of current smoker versus never and former smoker). Moreover, compared to participants who never smoked throughout life (41.6 [41.3-41.9] HU), current smokers (40.4 [39.9-40.9] HU) and former smokers (40.8 [40.5-41.2] HU) had lower lean muscle attenuation suggesting lower muscle quality in the fully adjusted model (p < 0.001 for comparison of never smokers with either of the other two strata). Among participants who had ever smoked, pack-years of smoking exposure were directly associated with IMAT volume (β [95% CI]: 0.017 [0.010-0.025]) (p < 0.001). Despite having less SAT, current smokers also had higher VAT/SAT ratio than never smokers. These findings must be viewed with caution as residual confounding and/or reverse causation may contribute to these associations. CONCLUSIONS We found that, compared to those who never smoked, current and former smokers had abdominal muscle composition that was higher in adipose tissue volume, a finding consistent with higher CVD risk and age-related physical deconditioning. These findings challenge the belief that smoking-associated weight loss or maintenance confers a health benefit.
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Miljkovic I, Kuipers AL, Cvejkus RK, Carr JJ, Terry JG, Thyagarajan B, Wheeler VW, Nair S, Zmuda JM. Hepatic and Skeletal Muscle Adiposity Are Associated with Diabetes Independent of Visceral Adiposity in Nonobese African-Caribbean Men. Metab Syndr Relat Disord 2020; 18:275-283. [PMID: 32392448 DOI: 10.1089/met.2019.0097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Adipose tissue (AT) around and within non-AT organs (i.e., ectopic adiposity) is emerging as a strong risk factor for type 2 diabetes (T2D). Not known is whether major ectopic adiposity depots, such as hepatic, skeletal muscle, and pericardial adiposity (PAT), are associated with T2D independent of visceral adiposity (VAT). More data are particularly needed among high-risk nonobese minority populations, as the race/ethnic gap in T2D risk is greatest among nonobese. Methods: Thus, we measured several ectopic adiposity depots by computed tomography in 718 (mean age = 64 years) African-Caribbean men on the Island of Tobago overall, and stratified by obesity (obese N = 187 and nonobese N = 532). Results: In age, lifestyle risk factors, health status, lipid-lowering medication intake, body mass index and all other adiposity-adjusted regression analyses, and hepatic and skeletal muscle adiposity were associated with T2D among nonobese men only (all P < 0.05), despite no association between VAT and PAT and T2D. Conclusions: Our results support the "ectopic fat syndrome" theory in the pathogenesis of T2D among nonobese African-Caribbean men. Longitudinal studies are needed to clarify the independent role of ectopic adiposity in T2D, and to identify possible biological mechanisms underlying this relationship, particularly in high-risk African ancestry and other nonwhite populations.
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Affiliation(s)
- Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Allison L Kuipers
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ryan K Cvejkus
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Victor W Wheeler
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago, West Indies
| | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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29
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Candan Y, Akinci M, Eraslan O, Yilmaz KB, Karabacak H, Dural HI, Tatar IG, Kaya IO. The Correlation of Intraabdominal Pressure With Renal Resistive Index. J Surg Res 2020; 252:240-246. [PMID: 32304930 DOI: 10.1016/j.jss.2020.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/01/2020] [Accepted: 03/09/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND To evaluate the correlation between intraabdominal pressure (IAP) measured via the bladder and renal resistive index (RRI) measured by Doppler ultrasonography (USG). METHODS Eighty consecutive surgical patients were included into this study. Before Doppler USG evaluation, IAP was measured by a Foley catheter via the bladder. The left and right RRI, the diameters of the inferior vena cava and portal vein were measured by colored Doppler USG. Spearman correlation analysis was used to evaluate the correlation between different measurements. Intraabdominal hypertension (IAH) was defined as of IAP ≥ 12 mmHg. Significantly different variables from the univariate analysis between patients with and without IAH were entered into backward stepwise binary logistic regression analysis of IAH as the dependent variable. P values < 0.05 were accepted as statistically significant. RESULTS In total, 80 patients were included into study. In 27 patients (34%) IAP was normal and in 53 patients (66%) IAH was diagnosed. The Spearman correlation analysis of IAP and the ultrasonographic measurements revealed a strong correlation between RRI and IAP (P < 0.001). Patients with IAH were more likely to be diabetic and had abdominal incisional hernia compared with patients with normal IAP (P < 0.05). The results of the multivariate logistic regression analysis revealed right RRI as the only independent predictor of IAH (B: 57.04, S. E.: 13.7, P < 0.001). CONCLUSIONS There is a strong correlation between IAP and RRI. RRI can be an alternative, noninvasive technique for the diagnosis and follow-up of IAH after further evaluations in different patient groups.
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Affiliation(s)
- Yeliz Candan
- Department of Surgery, University of Health Sciences, Ankara Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Melih Akinci
- Department of Surgery, University of Health Sciences, Gulhane Teaching and Research Hospital, Ankara, Turkey.
| | - Onder Eraslan
- Department of Radiology, Tokat Erbaa Ministry of Health State Hospital, Tokat, Turkey
| | - Kerim Bora Yilmaz
- Department of Surgery, University of Health Sciences, Gulhane Teaching and Research Hospital, Ankara, Turkey
| | - Harun Karabacak
- Department of Surgery, University of Health Sciences, Ankara Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Halil Ibrahim Dural
- Department of Surgery, University of Health Sciences, Ankara Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Idil Gunes Tatar
- Department of Radiology, University of Health Sciences, Ankara Diskapi Teaching and Research Hospital, Ankara, Turkey
| | - Ismail Oskay Kaya
- Department of Surgery, University of Health Sciences, Ankara Diskapi Teaching and Research Hospital, Ankara, Turkey
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30
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Chait A, den Hartigh LJ. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Front Cardiovasc Med 2020; 7:22. [PMID: 32158768 PMCID: PMC7052117 DOI: 10.3389/fcvm.2020.00022] [Citation(s) in RCA: 567] [Impact Index Per Article: 141.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
Adipose tissue plays essential roles in maintaining lipid and glucose homeostasis. To date several types of adipose tissue have been identified, namely white, brown, and beige, that reside in various specific anatomical locations throughout the body. The cellular composition, secretome, and location of these adipose depots define their function in health and metabolic disease. In obesity, adipose tissue becomes dysfunctional, promoting a pro-inflammatory, hyperlipidemic and insulin resistant environment that contributes to type 2 diabetes mellitus (T2DM). Concurrently, similar features that result from adipose tissue dysfunction also promote cardiovascular disease (CVD) by mechanisms that can be augmented by T2DM. The mechanisms by which dysfunctional adipose tissue simultaneously promote T2DM and CVD, focusing on adipose tissue depot-specific adipokines, inflammatory profiles, and metabolism, will be the focus of this review. The impact that various T2DM and CVD treatment strategies have on adipose tissue function and body weight also will be discussed.
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Affiliation(s)
- Alan Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
| | - Laura J den Hartigh
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
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31
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Tilves C, Zmuda JM, Kuipers AL, Carr JJ, Terry JG, Wheeler V, Peddada S, Nair S, Miljkovic I. Associations of Thigh and Abdominal Adipose Tissue Radiodensity with Glucose and Insulin in Nondiabetic African-Ancestry Men. Obesity (Silver Spring) 2020; 28:404-411. [PMID: 31872575 PMCID: PMC6980942 DOI: 10.1002/oby.22695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/29/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Decreased radiodensity of adipose tissue (AT) located in the visceral AT (VAT), subcutaneous AT (SAT), and intermuscular AT (IMAT) abdominal depots is associated with hyperglycemia, hyperinsulinemia, and insulin resistance independent of AT volumes. These associations were sought in African-ancestry men, who have higher risk for type 2 diabetes and have been underrepresented in previous studies. METHODS This cross-sectional analysis included 505 nondiabetic men of African-Caribbean ancestry (median age: 61 years; median BMI: 26.8 kg/m2 ) from the Tobago Health Study. AT volumes and radiodensities were assessed using computed tomography, including abdominal (VAT and SAT) and thigh (IMAT) depots. Associations between AT radiodensities were assessed with fasting serum glucose and insulin and with insulin resistance (updated homeostatic model assessment of insulin resistance, HOMA2-IR). RESULTS Higher radiodensity in any AT depot was associated with lower log-insulin and log-HOMA2-IR (β range: -0.16 to -0.18 for each; all P < 0.0001). No AT radiodensity was associated with glucose. Thigh IMAT radiodensity associations were independent of, and similar in magnitude to, VAT radiodensities. Model fit statistics suggested that AT radiodensities were a better predictor for insulin and insulin resistance compared with AT volumes in individuals with overweight and obesity. CONCLUSIONS AT radiodensities at multiple depots are significantly associated with insulin and insulin resistance in African-ancestry men.
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Affiliation(s)
- Curtis Tilves
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph M. Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allison L. Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victor Wheeler
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad & Tobago
| | - Shyamal Peddada
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sangeeta Nair
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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32
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Tanaka M, Okada H, Hashimoto Y, Kumagai M, Nishimura H, Fukui M. Low-attenuation muscle is a predictor of diabetes mellitus: A population-based cohort study. Nutrition 2020; 74:110752. [PMID: 32203879 DOI: 10.1016/j.nut.2020.110752] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/11/2019] [Accepted: 01/05/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Diabetes mellitus is a major global public health issue. Cross-sectional studies have demonstrated that skeletal muscle quality and quantity by computed tomography (CT) is related to glucose metabolism. However, to our knowledge, no longitudinal study has yet to elucidate the association between muscle quality determined by CT and glucose metabolism. Thus, the aim of this study was to evaluate the association between muscle quality and glucose metabolism. METHODS In this retrospective study, we evaluated data from 621 middle-aged Japanese individuals without diabetes mellitus from a cohort of employees undergoing annual physical examinations. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. Low-attenuation muscle (LAM) and normal-attenuation muscle (NAM) were identified and quantified using thresholds of -29 to +29 HU and +30 to +150 HU, respectively. RESULTS We followed the individuals for a mean period of 3 y, and 27 of them developed diabetes mellitus during this period. Multiple Cox regression analyses revealed that, even after adjustment for visceral fat area index, the LAM index (hazard ratio [HR], 3.07; 95% confidence interval [CI], 1.00-7.52) showed an increased adjusted HR for incident diabetes mellitus. When total SMI and SMD were used in the same models, only total SMD (HR, 0.90; 95% CI, 0.81-0.99) showed a decreased adjusted HR for incident diabetes mellitus. CONCLUSIONS Both LAM index and total SMD were associated with a higher risk for incident diabetes mellitus, whereas NAM index and total SMI were not.
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Affiliation(s)
- Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
| | - Hiroshi Okada
- Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Muneaki Kumagai
- Medical Corporation Soukenkai, Nishimura Clinic, Kyoto, Japan
| | | | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Ferrara D, Montecucco F, Dallegri F, Carbone F. Impact of different ectopic fat depots on cardiovascular and metabolic diseases. J Cell Physiol 2019; 234:21630-21641. [DOI: 10.1002/jcp.28821] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/17/2019] [Accepted: 04/29/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Daniele Ferrara
- Department of Internal Medicine, First Clinic of Internal Medicine University of Genoa Genoa Italy
| | - Fabrizio Montecucco
- Centre of Excellence for Biomedical Research (CEBR), Department of Internal Medicine, First Clinic of Internal Medicine University of Genoa Genoa Italy
- IRCCS Ospedale Policlinico San Martino Genoa—Italian Cardiovascular Network Genoa Italy
| | - Franco Dallegri
- Department of Internal Medicine, First Clinic of Internal Medicine University of Genoa Genoa Italy
- IRCCS Ospedale Policlinico San Martino Genoa—Italian Cardiovascular Network Genoa Italy
| | - Federico Carbone
- Department of Internal Medicine, First Clinic of Internal Medicine University of Genoa Genoa Italy
- IRCCS Ospedale Policlinico San Martino Genoa—Italian Cardiovascular Network Genoa Italy
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