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Day K, Nguo K, A Edwards B, M O'Driscoll D, C Young A, P Haines T, S Hamilton G, Ghazi L, Bristow C, Truby H. Body composition changes and their relationship with obstructive sleep apnoea symptoms, severity: The Sleeping Well Trial. Clin Nutr 2023; 42:1661-1670. [PMID: 37515844 DOI: 10.1016/j.clnu.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND & AIMS Obstructive sleep apnoea (OSA) and obesity share a complex bi-directional relationship as location of body fat and changes in regional body composition may be more important for OSA improvement than changes in total body weight only. The aim of this study was to evaluate the impact of a 6-month weight loss intervention for adults newly diagnosed with moderate-severe OSA and obesity on regional body composition. The secondary aims evaluated the relationship between changes in OSA symptoms and severity and anthropometry and regional body composition during the first 12-months after commencing CPAP and explored differences in outcomes between males and females. METHODS Participants (n = 59) received CPAP overnight at home alongside a 6-month modified fasting intervention with 12-months follow up. Regional body composition was measured by Dual X-ray absorptiometry, (DXA) and anthropometry before and after the lifestyle intervention. OSA severity was measured using the apnoea hypopnea index via overnight polysomnography and OSA symptoms were measured using the Epworth Sleepiness scale. RESULTS Forty-seven adults (74% male) had complete measures available with a mean age of 50.0 y (SD 11.0) and BMI 34.1 kg/m2 (SD 5.0). Following the intervention average fat mass changed by -5.27 kg (5.36), p < 0.001) and visceral adipose tissue (-0.63 kg (0.67), p < 0.001) significantly decreased in males only with a maintenance of fat-free mass (mean -0.41 kg (1.80), p = 0.18). Females (n = 12) had significant decreases in waist circumference (mean -3.36 cm (3.18) p < 0.01), android lean (-0.12 kg (0.04), p < 0.05) and android total mass (-0.28 kg (0.39), p < 0.05) only. Regional body composition changes in males were positively associated with improvements in OSA severity (p < 0.01) but not OSA symptoms. CONCLUSION Improvements in regional body composition were seen in males only which were related to improvements in OSA severity but not OSA symptoms. Females may exhibit different OSA pathophysiology and may require different treatment approaches. TRIAL REGISTRATION https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369975&isReview=trueAACTRN12616000203459 ACTRN12616000203459.
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Affiliation(s)
- Kaitlin Day
- School of Agriculture, Food and Ecosystem Sciences, Faculty of Science, The University of Melbourne, Australia; Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia.
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia
| | - Bradley A Edwards
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Australia; Department of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Denise M O'Driscoll
- Department of Respiratory and Sleep Medicine, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia
| | - Alan C Young
- Department of Respiratory and Sleep Medicine, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia
| | - Terry P Haines
- School of Primary and Allied Health Care, Monash University, Australia
| | - Garun S Hamilton
- School of Clinical Sciences, Monash University, Australia; Monash Lung, Sleep, Allergy and Immunology Department, Monash Health, Australia
| | - Ladan Ghazi
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia
| | - Claire Bristow
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
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Hibbing PR, Shook RP, Panda S, Manoogian EN, Mashek DG, Chow LS. Predicting energy intake with an accelerometer-based intake-balance method. Br J Nutr 2023; 130:344-352. [PMID: 36250527 PMCID: PMC10106530 DOI: 10.1017/s0007114522003312] [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] [Indexed: 11/07/2022]
Abstract
Nutritional interventions often rely on subjective assessments of energy intake (EI), but these are susceptible to measurement error. To introduce an accelerometer-based intake-balance method for assessing EI using data from a time-restricted eating (TRE) trial. Nineteen participants with overweight/obesity (25-63 years old; 16 females) completed a 12-week intervention (NCT03129581) in a control group (unrestricted feeding; n 8) or TRE group (n 11). At the start and end of the intervention, body composition was assessed by dual-energy X-ray absorptiometry (DXA) and daily energy expenditure (EE) was assessed for 2 weeks via wrist-worn accelerometer. EI was back-calculated as the sum of net energy storage (from DXA) and EE (from accelerometer). Accelerometer-derived EI estimates were compared against estimates from the body weight planner of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Mean EI for the control group declined by 138 and 435 kJ/day for the accelerometer and NIDDK methods, respectively (both P ≥ 0·38), v. 1255 and 1469 kJ/day, respectively, for the TRE group (both P < 0·01). At follow-up, the accelerometer and NIDDK methods showed excellent group-level agreement (mean bias of -297 kJ/day across arms; standard error of estimate 1054 kJ/day) but high variability at the individual level (limits of agreement from -2414 to +1824 kJ/day). The accelerometer-based intake-balance method showed plausible sensitivity to change, and EI estimates were biologically and behaviourally plausible. The method may be a viable alternative to self-report EI measures. Future studies should assess criterion validity using doubly labelled water.
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Affiliation(s)
- Paul R. Hibbing
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
| | - Robin P. Shook
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
- School of Medicine, University of MO-Kansas City, 2411 Holmes St, Kansas City, MO 64108, USA
| | - Satchidananda Panda
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Emily N.C. Manoogian
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Douglas G. Mashek
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
| | - Lisa S. Chow
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
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Kishman EE, Breneman CB, Sparks JR, Wang X. Associations between Sleep and Body Composition in Older Women and the Potential Role of Physical Function. Sleep Biol Rhythms 2023; 21:175-183. [PMID: 37193097 PMCID: PMC10168679 DOI: 10.1007/s41105-022-00429-x] [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: 03/14/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
Purpose The relationship between sleep and adiposity in older women remains unclear partly due to the reliance of body mass index as a measure of adiposity. The purpose of this study was to investigate associations between objectively measured sleep characteristics and body composition measured by dual energy x-ray absorptiometry (DXA) in older women. A secondary purpose was to examine if physical function mediates this relationship. Methods Non-obese older women (ages 60-75 years, n=102) were included in the study. Total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and wake after sleep onset (WASO) were determined by actigraphy. A battery of tests was used to assess physical function. Results With adjustment for age, there was a negative association between TST and TIB with lean mass. Both grip strength and dominant leg extension were associated with TST, TIB, and lean mass; the associations between TST and TIB with lean mass were lost after adjusting for grip strength or leg extension strength. Additionally, SE was negatively associated with total, gynoid, and trunk lean mass, and there was a positive association between TST and percent trunk fat, and WASO and gynoid lean mass, with age adjusted. Conclusions Sleep characteristics, TST, TIB, SE, and WASO, were associated body composition measures in this sample of older women. The relationship between TST and TIB with body composition was mediated, in part, by grip strength and leg extension strength.
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Affiliation(s)
- Erin E. Kishman
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
| | - Charity B. Breneman
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
| | - Joshua R. Sparks
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
- Women’s Health and Reproductive Endocrinology Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA USA
| | - Xuewen Wang
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
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Ashby-Thompson M, Heshka S, Rizkalla B, Zurlo R, Lemos T, Janumala I, Goodpaster B, DeLany J, Courcoulas A, Strain G, Pomp A, Kang P, Lin S, Thornton J, Gallagher D. Validity of dual-energy x-ray absorptiometry for estimation of visceral adipose tissue and visceral adipose tissue change after surgery-induced weight loss in women with severe obesity. Obesity (Silver Spring) 2022; 30:1057-1065. [PMID: 35384351 PMCID: PMC10001428 DOI: 10.1002/oby.23415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Reliable and simple methods to quantify visceral adipose tissue (VAT) and VAT changes are needed. This study investigated the validity of dual-energy x-ray absorptiometry (DXA) compared with magnetic resonance imaging (MRI) for estimating VAT cross sectionally and longitudinally after surgery-induced weight loss in women with severe obesity. METHODS Women with obesity (n = 36; mean age 43 [SD 10] years; 89% White) with DXA and MRI before bariatric surgery (T0) at 12 (T12) and 24 months (T24) post surgery were included. CoreScan (GE Healthcare, Chicago, Illinois) estimated VAT from 20% of the distance between the top of the iliac crest and the base of the skull. MRI VAT (total VAT) was measured from the base of the heart to the sacrum/coccyx on a whole-body scan. RESULTS Mean DXA VAT was 45% of MRI VAT at T0, 46% at T12, and 68% at T24. DXA underestimated change in MRI VAT between T0 and T12 by 26.1% (0.81 kg, p = 0.03) and by 71.7% (0.43 kg, p < 0.001) between T12 and T24. The relationship between DXA VAT and MRI VAT differed between T12 and T24 (p value for interaction = 0.03). CONCLUSIONS CoreScan lacks validity for comparing VAT across individuals or for estimating the size of changes within individuals; however, within the limits of measurement error, it may provide a useful indicator of whether some VAT change has occurred within an individual.
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Affiliation(s)
- Maxine Ashby-Thompson
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Molecular Genetics, Deparent of Pediatrics, Columbia University Irving Medical Center, Columbia University, New York, New York, USA
| | - Stanley Heshka
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Bridgette Rizkalla
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Rosalie Zurlo
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Thaisa Lemos
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Isaiah Janumala
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Bret Goodpaster
- AdventHealth Orlando, Translational Research Institute, Orlando, Florida, USA
| | - James DeLany
- AdventHealth Orlando, Translational Research Institute, Orlando, Florida, USA
| | - Anita Courcoulas
- Deparent of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gladys Strain
- Division of Metabolic and Bariatric Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Alfons Pomp
- Deparent of Surgery, University of Montréal, Montréal Quebec, Canada
| | - Patrick Kang
- New York Radiology Partners, New York, New York, USA
| | - Susan Lin
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Center for Family and Community Medicine, Columbia University Medical Center, Columbia University, New York, New York, USA
| | - John Thornton
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, New York, USA
- Division of Endocrinology, Dept. of Medicine, Columbia University Medical Center, New York, New York, USA
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Davidson TL, Ramirez E, Kwarteng EA, Djan KG, Faulkner LM, Parker MN, Yang SB, Zenno A, Kelly NR, Shank LM, Tanofsky-Kraff M, Snelling A, Belson SI, Hyde A, Chen KY, Yanovski JA. Retrieval-induced forgetting in children and adolescents with and without obesity. Int J Obes (Lond) 2022; 46:851-858. [PMID: 35042933 PMCID: PMC8967761 DOI: 10.1038/s41366-021-01036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Previous research indicates that youth with obesity exhibit deficits in executive functioning (EF), which often take the form of impaired response inhibition. One aspect of EF not previously studied in obesity is the adaptive process known as retrieval-induced forgetting (RIF), the suppression/inhibition of intrusive or non-target items by the retrieval of specific items from memory. The present study investigated if child or adolescent obesity disrupts the ability to inhibit retrieval of intrusive memories. SUBJECTS/METHODS We compared the manifestation of RIF in children (ages 8-12) and adolescents (ages 13-18) as a function of their weight status and sex. We also evaluated the effects of these variables on simple recall of items from episodic memory under conditions where competition from intrusive items was reduced. RESULTS Children with obesity did not demonstrate significant RIF, whereas RIF was exhibited by preteens without obesity and by teenage participants with- and without obesity (Weight Status × Age Group interaction p = 0.028). This pattern of results did not differ as a function of sex for either age group. No differences in episodic memory were found. Additional analyses using Age as continuous covariate (and not as a nominal group) comparing participants who exhibited RIF with those who did not, found that the no RIF group consumed fast-food meals more frequently (p = 0.024) and had higher percentages of total body adiposity and android fat compared to the RIF group (p's < 0.05). CONCLUSIONS The findings expand what is known about the effects of childhood obesity on cognitive functioning, identify impaired RIF with specific behavioral and dietary factors and increased adiposity, and suggest the possibility that impairments in the ability to inhibit intrusive memories of food and eating may contribute to poor early-life weight control.
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Affiliation(s)
- Terry L Davidson
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Esther A Kwarteng
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Kweku G Djan
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Loie M Faulkner
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Megan N Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Shanna B Yang
- Nutrition Department, Clinical Research Center, NIH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Anna Zenno
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, 97403-5207, USA
| | - Lisa M Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Anastasia Snelling
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- Department of Health Studies, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Sarah Irvine Belson
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- School of Education, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Alexia Hyde
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Digestive Diseases, Diabetes, and Kidney Disorders, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
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Cruz Rivera PN, Goldstein RL, Polak M, Lazzari AA, Moy ML, Wan ES. Performance of bioelectrical impedance analysis compared to dual X-ray absorptiometry (DXA) in Veterans with COPD. Sci Rep 2022; 12:1946. [PMID: 35121763 PMCID: PMC8816927 DOI: 10.1038/s41598-022-05887-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/18/2022] [Indexed: 12/23/2022] Open
Abstract
We examined the performance of a commercially-available handheld bioimpedance (BIA) device relative to dual X-ray absorptiometry (DXA) to assess body composition differences among Veterans with chronic obstructive pulmonary disease (COPD). Body composition was measured using DXA and BIA (Omron HBF-306C) at a single time point. Correlations between BIA- and DXA-assessed percent fat, fat mass, and fat-free mass were analyzed using Spearman (ρ) and Lin Concordance Correlation Coefficients (ρc). Mean differences in fat mass were visualized using Bland–Altman plots. Subgroup analyses by obesity status (BMI < 30 versus ≥ 30) were performed. Among 50 participants (96% male; mean age: 69.5 ± 6.0 years), BIA-assessed fat mass was strongly correlated (ρ = 0.94) and demonstrate excellent concordance (ρc = 0.95, [95%CI: 0.93–0.98]) with DXA, with a mean difference of 2.7 ± 3.2 kg between BIA and DXA. Although Spearman correlations between BIA- and DXA-assessed percent fat and fat-free mass were strong (ρ = 0.8 and 0.91, respectively), concordance values were only moderate (ρc = 0.67 and 0.74, respectively). Significantly stronger correlations were observed for obese relative to non-obese subjects for total percent fat (ρobese = 0.85 versus ρnon-obese = 0.5) and fat mass (ρobese = 0.96 versus ρnon-obese = 0.84). A handheld BIA device demonstrated high concordance with DXA for fat mass and moderate concordance for total percent fat and fat-free mass. ClinicalTrials.gov: NCT02099799.
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Affiliation(s)
- Paola N Cruz Rivera
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA
| | - Rebekah L Goldstein
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA
| | - Madeline Polak
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA
| | - Antonio A Lazzari
- Primary Care and Rheumatology Sections, VA Boston Healthcare System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA.,Harvard Medical School, Boston, MA, USA
| | - Emily S Wan
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA, 02132, USA. .,Harvard Medical School, Boston, MA, USA. .,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Santini S, Vionnet N, Pasquier J, Suter M, Hans D, Gonzalez-Rodriguez E, Pitteloud N, Favre L. Long-term body composition improvement in post-menopausal women following bariatric surgery: a cross-sectional and case-control study. Eur J Endocrinol 2022; 186:255-263. [PMID: 34879003 PMCID: PMC8789027 DOI: 10.1530/eje-21-0895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/08/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Bariatric surgery (BS) induces loss of body fat mass (FM) with an inexorable loss of lean mass (LM). Menopause leads to deleterious changes in body composition (BC) related to estrogen deficiency including LM loss and increase in total and visceral adipose tissue (VAT). This study aims to describe the long-term weight evolution of post-menopausal women after Roux-en-Y gastric bypass (RYGB) and to compare the BC between BS patients vs post-menopausal non-operated women. DESIGN Cross-sectional study of 60 post-menopausal women who underwent RYGB ≥2 years prior to the study with nested case-control design. METHODS Post-menopausal BS women were matched for age and BMI with controls. Both groups underwent DXA scan, lipids and glucose metabolism markers assessment. RESULTS Median follow-up was 7.5 (2-18) years. Percentage of total weight loss (TWL%) was 28.5 ± 10%. After RYGB, LM percentage of body weight (LM%) was positively associated with TWL% and negatively associated with nadir weight. Forty-one post-BS women were age- and BMI-matched with controls. Post-BS patients showed higher LM% (57.7% (±8%) vs 52.5% (±5%), P = 0.001), reduced FM% (39.4% (±8.4%) vs 45.9% (±5.4%), P < 0.01) and lower VAT (750.6 g (±496) vs 1295.3 g (±688), P < 0.01) with no difference in absolute LM compared to controls. While post-BS women showed a better lipid profile compared to controls, no difference was found in glucose markers. CONCLUSIONS Post-menopausal women after RYGB have a lower FM and VAT, preserved LM and a better lipid profile compared to controls. Weight loss after RYGB seems to have a persistent positive impact on metabolic health.
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Affiliation(s)
- Sara Santini
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Vionnet
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Jérôme Pasquier
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Michel Suter
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland
- Faculty of Biology and medicine, University of Lausanne, Lausanne, Switzerland
| | - Didier Hans
- Faculty of Biology and medicine, University of Lausanne, Lausanne, Switzerland
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Elena Gonzalez-Rodriguez
- Faculty of Biology and medicine, University of Lausanne, Lausanne, Switzerland
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Nelly Pitteloud
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and medicine, University of Lausanne, Lausanne, Switzerland
| | - Lucie Favre
- Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and medicine, University of Lausanne, Lausanne, Switzerland
- Correspondence should be addressed to L Favre;
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Scheer A, Shah A, Ito Ramos de Oliveira B, Moreno-Suarez I, Jacques A, Green D, Maiorana A. Twelve weeks of water-based circuit training exercise improves fitness, body fat and leg strength in people with stable coronary heart disease: a randomised trial. J Physiother 2021; 67:284-290. [PMID: 34518147 DOI: 10.1016/j.jphys.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
QUESTION In people with stable coronary heart disease, what are the effects of water-based circuit training exercise on aerobic capacity, strength and body composition? How do these effects compare with those of gym-based exercise? DESIGN Parallel group, randomised controlled trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS Fifty-two participants with stable coronary heart disease. INTERVENTIONS Twelve weeks of: three 1-hour sessions per week of moderate-intensity water-based circuit training exercise with alternating aerobic and resistance stations (WEX); three 1-hour sessions per week of moderate-intensity gym-based circuit training exercise (GEX); or continuing usual activities (control). OUTCOME MEASURES Aerobic capacity (VO2peak), upper and lower limb one repetition maximum strength (biceps curl, latissimus dorsi pulldown, hamstring curl and leg press), anthropometry (weight, body mass index and girth) and dual energy x-ray absorptiometry. RESULTS Forty-five participants completed the study (WEX n = 15, GEX n = 18, control n = 12). Both training groups significantly improved VO2peak compared with control: WEX by 2.5 ml/kg/min (95% CI 0.6 to 4.4) and GEX by 2.3 ml/kg/min (95% CI 0.6 to 4.0). WEX and GEX improved hamstring strength compared with control: WEX by 6.3 kg (95% CI 1.2 to 11.3) and GEX by 7.6 kg (95% CI 2.9 to 12.2). Compared with control, GEX increased leg press strength by 15.5 kg (95% CI 5.7 to 25.3), whereas the effect of WEX was less clear (MD 7.1 kg, 95% CI -3.5 to 17.7). Only GEX improved latissimus dorsi pulldown strength. Compared with control, total body fat was reduced with WEX (-1.1 kg, 95% CI -2.3 to 0.0) and GEX (-1.2 kg, 95% CI -2.3 to -0.1). There were negligible between-group differences in weight or waist circumference. CONCLUSION WEX was well tolerated and improved aerobic capacity, leg strength and body fat to a similar degree as GEX in people with coronary heart disease. These findings suggest that WEX is an effective exercise training alternative to GEX for people with coronary heart disease. TRIAL REGISTRATION ANZCTR12616000102471.
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Affiliation(s)
- Anna Scheer
- School of Allied Health, Curtin University, Perth, Australia
| | - Amit Shah
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia
| | | | - Ignacio Moreno-Suarez
- School of Allied Health, Curtin University, Perth, Australia; The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Hong Kong
| | - Angela Jacques
- School of Allied Health, Curtin University, Perth, Australia
| | - Daniel Green
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Andrew Maiorana
- School of Allied Health, Curtin University, Perth, Australia; Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia; Allied Health Department, Fiona Stanley Hospital, Perth, Australia.
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9
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Thamnirat K, Taweerat P, Permpongkosol S, Kamolnate N, Kositwattanarerk A, Utamakul C, Chamroonrat W, Sritara C. Precision and Effects of a Small Meal on DXA-Derived Visceral Adipose Tissue, Appendicular Lean Mass, and Other Body Composition Estimates In Nonobese Elderly Men. J Clin Densitom 2021; 24:308-318. [PMID: 32446653 DOI: 10.1016/j.jocd.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Information on precision errors and the least significant change (LSC) of dual energy X-ray absorptiometry (DXA)-derived body composition estimates is scarce, particularly for the appendicular lean mass (ALM) and appendicular lean mass index (ALMI). Overnight fasting is recommended for body composition measurements but has not been well tolerated by some elderly patients. This study aimed to establish precision errors and LSC values of body composition estimates in all regions-including visceral adipose tissue (VAT) and ALM-and the ALMI to assess the effect of a small meal on body composition and to estimate the changes it incurred. METHODOLOGY Our institutional review board approved the study protocol. Altogether, 36 non-obese men aged ≥60 years, having given written informed consent, underwent body composition assessment after fasting overnight except for water. They underwent DXA scans three times, each time with repositioning (to simulate the clinical setting), the last after consuming a standardized meal (210-250 g and 200 cc of water). RESULTS Precision errors and LSC values of DXA-derived body composition estimates in these elderly men tended to be higher than those in reports on younger subjects. Coefficients of variation (CVs (%)) of total bone mass (Tb.BMC) and total lean mass (Tb.LM) were <1%, whereas those of total fat mass (Tb.FM) and total %fat mass (Tb.%FM) were <2%, with LSCs of 45.8 g, 706.52 g, 731.4 g, and 1.15%, respectively. The CVs (LSC) of VAT, ALM, and ALMI were 8.9% (150.65 g), 0.93% (501 g), and 0.94% (0.19), respectively. After meal consumption, the mean changes in Tb.FM, Tb.BMC, and Tb.LM were -100, -8.2, and 440 g, respectively. CONCLUSIONS Effects of a small meal on most parameters were trivial, including those for VAT, ALM, and ALMI, where changes were not statistically significant. None exceeded the LSC of ALM and ALMI, suggesting that a small meal is allowable before these measurements.
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Affiliation(s)
- Kanungnij Thamnirat
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pollawat Taweerat
- Department of Diagnostic Radiology and Nuclear Medicine, Suratthani Cancer Hospital, Suratthani, Thailand
| | - Sompol Permpongkosol
- Department of Surgery, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand
| | - Natechanok Kamolnate
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Arpakorn Kositwattanarerk
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chirawat Utamakul
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichana Chamroonrat
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chanika Sritara
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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10
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Cheung YM, Roff G, Grossmann M. Precision of the Hologic Horizon A dual energy X-ray absorptiometry in the assessment of body composition. Obes Res Clin Pract 2020; 14:514-518. [PMID: 33132075 DOI: 10.1016/j.orcp.2020.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND As the number of individuals with obesity increases, so too will the demand for a precise, cost-effective and safe method to better risk-stratify this heterogenous population. Visceral adipose tissue (VAT) area, a body composition measurement has been associated with the many facets of the metabolic syndrome. AIM To determine the precision of dual energy X-ray absorptiometry (DXA) in providing body composition measurements, including VAT area, using the Hologic Horizon A scanner. METHOD Thirty participants (mean age 64 years, 47% male), underwent two sequential body composition scans. The coefficient of variation (CV) and least significant change (LSC) were calculated for android/gynoid ratio, appendicular lean/height2, lean/height2, total body fat and lean mass, total body mass, and subcutaneous adipose tissue (SAT) and VAT area. Participants were stratified according to age (<70 or ≥70 years), body mass index (BMI) (≤30 kg/m2 or >30 kg/m2) and sex (male or female). The CV was calculated for each parameter and then analysed for differences between groups. RESULTS The CV for all parameters was <3% with the exception of SAT (3.86%). The CV of VAT area was 2.63% with a LSC at 95% confidence of 7.28%. Apart from the CV differences between males and females for android/gynoid ratio (male: 3.56% vs. female: 1.74%, p = 0.01) and SAT area (5.04% vs. 2.46%, p = 0.01), there were no significant differences identified between the calculated CV for all other body composition parameters when participants were stratified by age, BMI and sex. CONCLUSION DXA scanning, using the Hologic Horizon A system, is capable of providing precise body composition measurements.
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Affiliation(s)
- Y M Cheung
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia; Department of Medicine (Austin Health), The University of Melbourne, Australia.
| | - G Roff
- Department of Medicine (Austin Health), The University of Melbourne, Australia
| | - M Grossmann
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia; Department of Medicine (Austin Health), The University of Melbourne, Australia
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11
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Effect of Aerobic Exercise Training and Deconditioning on Oxidative Capacity and Muscle Mitochondrial Enzyme Machinery in Young and Elderly Individuals. J Clin Med 2020; 9:jcm9103113. [PMID: 32993104 PMCID: PMC7601902 DOI: 10.3390/jcm9103113] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
Mitochondrial dysfunction is thought to be involved in age-related loss of muscle mass and function (sarcopenia). Since the degree of physical activity is vital for skeletal muscle mitochondrial function and content, the aim of this study was to investigate the effect of 6 weeks of aerobic exercise training and 8 weeks of deconditioning on functional parameters of aerobic capacity and markers of muscle mitochondrial function in elderly compared to young individuals. In 11 healthy, elderly (80 ± 4 years old) and 10 healthy, young (24 ± 3 years old) volunteers, aerobic training improved maximal oxygen consumption rate by 13%, maximal workload by 34%, endurance capacity by 2.4-fold and exercise economy by 12% in the elderly to the same extent as in young individuals. This evidence was accompanied by a similar training-induced increase in muscle citrate synthase (CS) (31%) and mitochondrial complex I–IV activities (51–163%) in elderly and young individuals. After 8 weeks of deconditioning, endurance capacity (−20%), and enzyme activity of CS (−18%) and complex I (−40%), III (−25%), and IV (−26%) decreased in the elderly to a larger extent than in young individuals. In conclusion, we found that elderly have a physiological normal ability to improve aerobic capacity and mitochondrial function with aerobic training compared to young individuals, but had a faster decline in endurance performance and muscle mitochondrial enzyme activity after deconditioning, suggesting an age-related issue in maintaining oxidative metabolism.
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12
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Fritzen AM, Thøgersen FD, Qadri KAN, Krag T, Sveen ML, Vissing J, Jeppesen TD. Preserved Capacity for Adaptations in Strength and Muscle Regulatory Factors in Elderly in Response to Resistance Exercise Training and Deconditioning. J Clin Med 2020; 9:jcm9072188. [PMID: 32664402 PMCID: PMC7408999 DOI: 10.3390/jcm9072188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022] Open
Abstract
Aging is related to an inevitable loss of muscle mass and strength. The mechanisms behind age-related loss of muscle tissue are not fully understood but may, among other things, be induced by age-related differences in myogenic regulatory factors. Resistance exercise training and deconditioning offers a model to investigate differences in myogenic regulatory factors that may be important for age-related loss of muscle mass and strength. Nine elderly (82 ± 7 years old) and nine young, healthy persons (22 ± 2 years old) participated in the study. Exercise consisted of six weeks of resistance training of the quadriceps muscle followed by eight weeks of deconditioning. Muscle biopsy samples before and after training and during the deconditioning period were analyzed for MyoD, myogenin, insulin-like growth-factor I receptor, activin receptor IIB, smad2, porin, and citrate synthase. Muscle strength improved with resistance training by 78% (95.0 ± 22.0 kg) in the elderly to a similar extent as in the young participants (83.5%; 178.2 ± 44.2 kg) and returned to baseline in both groups after eight weeks of deconditioning. No difference was seen in expression of muscle regulatory factors between elderly and young in response to exercise training and deconditioning. In conclusion, the capacity to gain muscle strength with resistance exercise training in elderly was not impaired, highlighting this as a potent tool to combat age-related loss of muscle function, possibly due to preserved regulation of myogenic factors in elderly compared with young muscle.
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Affiliation(s)
- Andreas Mæchel Fritzen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
- Molecular Physiology Group, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, DK-2100 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-42633359
| | - Frank D. Thøgersen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
| | - Khaled Abdul Nasser Qadri
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
| | - Thomas Krag
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
| | - Marie-Louise Sveen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
- Novo Nordisk A/S, DK-2860 Søborg, Denmark
| | - John Vissing
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
| | - Tina D. Jeppesen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, DK-2100 Copenhagen, Denmark; (F.D.T.); (K.A.N.Q.); (T.K.); (M.-L.S.); (J.V.); (T.D.J.)
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13
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Triggiani AI, Valenzano A, Trimigno V, Di Palma A, Moscatelli F, Cibelli G, Messina G. Heart rate variability reduction is related to a high amount of visceral adiposity in healthy young women. PLoS One 2019; 14:e0223058. [PMID: 31553779 PMCID: PMC6760781 DOI: 10.1371/journal.pone.0223058] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022] Open
Abstract
Several heart rate variability (HRV) studies show abnormalities in autonomic nervous control in obese and overweight subjects. However, some of the results appear to be controversial. Here we investigate the HRV profile in seventy adult normotensive women and its association with general and visceral adiposity. Specifically, we recorded the electrocardiographic (ECG) activity in subjects during a supine resting state for five minutes in a quiet room late in the morning. Total fat mass (TFM) and visceral adipose tissue (VAT) were instead estimated using dual-energy X-ray absorptiometry (DXA). Finally, we used simple a linear regression analysis of frequency and time-domain parameters to study the relationship between HRV and adiposity. Our data showed an overall reduction of the HRV related to an increase of TFM although this regression appeared significant only for high frequencies (HF). When the linear regression was applied between HRV variables and VAT, the slope of the line increases, thus unveiling a statistically significant relation (i.e. the more VAT, the lower HRV). Finally, a control analysis showed that age does not alter the relation between HRV and VAT when used as a confounding factor in multiple regression. To conclude, these findings point to abnormal activity of the autonomic nervous system (ANS) in subjects with an excess of VAT and represent a starting point to determine a non-invasive index of cardiac wellness for clinical and nutritional application.
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Affiliation(s)
- Antonio Ivano Triggiani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- * E-mail:
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Valentina Trimigno
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonella Di Palma
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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14
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Tur JA, Bibiloni MDM. Anthropometry, Body Composition and Resting Energy Expenditure in Human. Nutrients 2019; 11:nu11081891. [PMID: 31416130 PMCID: PMC6724063 DOI: 10.3390/nu11081891] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 12/14/2022] Open
Affiliation(s)
- Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
| | - Maria Del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain
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15
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Murphy J, Bacon SL, Morais JA, Tsoukas MA, Santosa S. Intra-Abdominal Adipose Tissue Quantification by Alternative Versus Reference Methods: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2019; 27:1115-1122. [PMID: 31131996 DOI: 10.1002/oby.22494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/28/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This meta-analysis aimed to assess the agreement between intra-abdominal adipose tissue (IAAT) quantified by alternative methods and the reference standards, computed tomography (CT) and magnetic resonance imaging (MRI). METHODS MEDLINE and EMBASE electronic databases were systematically searched to identify studies that quantified IAAT thickness, area, or volume by a comparator method and CT or MRI. Using an inverse variance weighted approach (random-effects model), the mean differences and 95% limits of agreement (LoA) were pooled between methods. RESULTS The meta-analysis included 24 studies using four comparator methods. The pooled mean differences were -0.3 cm (95% LoA: -3.4 to 3.2 cm; P = 0.400) for ultrasound and -11.6 cm2 (95% LoA: -43.1 to 19.9 cm2 ; P = 0.004) for bioelectrical impedance analysis. Dual-energy x-ray absorptiometry (DXA) quantified both IAAT area and volume with mean differences of 8.1 cm2 (95% LoA: -98.9 to 115.1 cm2 ; P = 0.061) and 10 cm3 (95% LoA: -280 to 300 cm3 ; P = 0.808), respectively. CONCLUSIONS Ultrasound and DXA measure IAAT with minimal bias from CT or MRI, while bioelectrical impedance analysis systematically underestimates IAAT. However, with the exception of DXA for IAAT volume, the wide LoA caution against clinical or research use of the comparator methods and emphasize the need to optimize alternatives to the reference standards.
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Affiliation(s)
- Jessica Murphy
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Montreal Behavioural Medicine Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - José A Morais
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael A Tsoukas
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Metabolism, Obesity and Nutrition Laboratory, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
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Relationship between DXA measured metrics of adiposity and glucose homeostasis; An analysis of the NHANES data. PLoS One 2019; 14:e0216900. [PMID: 31116758 PMCID: PMC6530894 DOI: 10.1371/journal.pone.0216900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/30/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Obesity is associated with insulin resistance and type 2 diabetes. Dual-energy X-ray absorptiometry (DXA) is a means of determining body composition and body fat distribution at different sites including whole body and trunk–locations where there tends to be high correlation at an individual level. Methods We performed an analysis of DXA-derived metrics of adiposity (truncal fat %,subtotal fat % and total fat %) from the NHANES database and then correlated the findings with markers of insulin resistance. We analyzed the data from DXA scans in NHANES 1999–2004. Homeostatic model assessment-insulin resistance and HOMA-β (beta-cell function) were estimated. Spearman correlation coefficients were calculated (ρ) between HOMA-IR,HOMA-β and different measures of obesity (Waist circumference(in cm), Body Mass Index (kg/m2), truncal fat %, subtotal fat % as well as total fat %) to gauge the relationship between markers of glucose homeostasis and DXA derived metrics of obesity. We also performed logarithmic transformation of HOMA-IR as well as HOMA-β to ensure normality of distribution and to meet the criteria for regression analysis. A forward selection model (by outcome and gender) was performed to predict log transformed insulin resistance (log HOMA-IR) as well as log transformed HOMA-β (log HOMA-β,measure of beta cell function) from age, serum triglycerides, HDL, trunk fat % and the SBP (in both males and females separately), after reviewing the spearman correlation coefficients. Results There were a total of 6147 men and 6369 women who were part of the study cohort. There was a positive correlation between markers of adiposity and log HOMA-IR and log HOMA-β in both males and females.Truncal fat % had the highest nonparametric correlation coefficent with log HOMA-IR among the DXA derived fat% (0.54 in males and 048 in females). In the multivariate analysis, truncal fat % was an independent predictor of logHOMA-IR as well as logHOMA-β. In males, the significant predictors of log HOMA-IR were; age, truncal fat % and HDL cholesterol (Adjusted R square of 0.325 (±0.66), F(3,207) = 34.63, p < .01). In females, the significant predictors of log HOMA-IR were; age, truncal fat %, SBP, Serum triglyceride and HDL cholesterol (Adjusted R square of 0.307 (±0.65),F(5,198) = 18.9, p < .01). In both males and females, the significant predictors of log HOMA-β were; age, and truncal fat % (Males; adjusted R square of 0.25 (±0.63), F (2,208) = 36.4, p < .01, Females; adjusted R square of 0.27 (±0.62), F (2,201) = 38.4, p < .01). Conclusions Body fat % on DXA is an imaging biomarker for insulin resistance. Incorporating this important information into DXA acquisitions and reporting frameworks may allow for this information to be available to providers who refer patients for these imaging studies.
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