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Cruz E Souza ILDP, de Oliveira DC, Souza TB, Ramírez PC, Soares NC, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre TDS. Dynapenia and sarcopenia identify walking speed decline in women but not in men. Arch Gerontol Geriatr 2024; 126:105545. [PMID: 38950511 DOI: 10.1016/j.archger.2024.105545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/17/2024] [Accepted: 06/22/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE To determine the best indicator of mobility decline between dynapenia, low skeletal muscle mass index (SMMI), and sarcopenia defined by the EWGSOP2 using different cutoff points for grip strength. METHODS A longitudinal study was conducted with a follow-up of eight years, involving 2,680 individuals aged 60 and older who participated in the ELSA study with a walking speed greater than 0.8 m/s at baseline. Dynapenia was defined using different cutoff points for grip strength. SMMI was defined by the 20th percentile of the entire ELSA sample distribution and sarcopenia was defined based on the EWGSOP2, using different cutoff points for grip strength. Mobility was analysed using the walking speed test. RESULTS Over time, the greatest decline in walking speed occurred in dynapenic women with grip strength < 17 kg (-0.005 m/s per year; 95 % CI: -0.01 to -0.001) and < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001). With regards to sarcopenia, the greatest walking speed decline occurred in women with probable sarcopenia when defined by grip strength < 17 kg [(-0.006 m/s per year; 95 % CI: -0.01 to -0.001) or grip strength < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001)]. Dynapenia in men as well as low SMMI and sarcopenia in men and women did not enable identifying the risk of mobility decline. CONCLUSION Dynapenia and probable sarcopenia defined by grip strength < 17 kg and < 20 kg enabled identifying walking speed decline over time only in women.
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Affiliation(s)
| | | | | | - Paula Camila Ramírez
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil; Escuela de Fisioterapia, Universidad Industrial de Santander, Colombia
| | | | - Mariane Marques Luiz
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, Brazil; Postgraduate Program in Gerontology, Universidade Federal de São Carlos, Brazil; Department of Epidemiology and Public Health, University College London, London, UK; Gerontology Department, Universidade Federal de São Carlos, Brazil.
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de Souza AF, Ramírez PC, Capra de Oliveira D, Máximo RDO, Luiz MM, Delinocente MLB, Spexoto MCB, Steptoe A, De Oliveira C, Alexandre TDS. Frailty or sarcopenia: which is a better indicator of mortality risk in older adults? J Epidemiol Community Health 2024:jech-2024-222678. [PMID: 39393902 DOI: 10.1136/jech-2024-222678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 09/21/2024] [Indexed: 10/13/2024]
Abstract
BACKGROUND Despite the different conditions, frailty and sarcopenia overlap regarding their common link: the assessment of walking speed and muscle strength. This study aimed to compare the frailty phenotype to the sarcopenia using different cut-off points for low grip strength to determine which better identifies mortality risk over a 14-year follow-up period. METHODS 4597 participants in the English Longitudinal Study of Ageing. Frailty was measured using the Fried phenotype. Sarcopenia (European Working Group on Sarcopenia in Older People 2) was defined using different cut-off points for low grip strength (<36, <32, <30, <27 and <26 kg for men and <23, <21, <20 and <16 kg for women), low skeletal muscle mass index (<9.36 kg/m² for men and<6.73 kg/m² for women) and slowness (gait speed: ≤0.8 m/s). Cox models were run and adjusted for sociodemographic, behavioural and clinical factors. RESULTS When the coexistence of frailty and sarcopenia is considered, only the cut-off points <36 kg for men and <23 kg for women to define low grip strength identified the risk of mortality among individuals classified as having probable sarcopenia (HR=1.17, 95% CI 1.02 to 1.34), sarcopenia (HR=1.31, 95% CI 1.07 to 1.60) and severe sarcopenia (HR=1.62, 95% CI 1.33 to 1.96). In this situation, frailty identified the mortality risk (HR=1.49, 95% CI 1.22 to 1.81), whereas pre-frailty did not. Sarcopenia using other cut-off points for defining low grip strength did not identify mortality risk. CONCLUSION Sarcopenia using <36 kg for men and <23 kg for women as cut-off points seems to be better than the frailty phenotype for identifying the risk of mortality in older adults.
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Affiliation(s)
- Aline Fernanda de Souza
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Paula Camila Ramírez
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | | | - Mariane Marques Luiz
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar De Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
- Postgraduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
- Gerontology Department, Federal University of São Carlos, São Carlos, Brazil
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Rodriguez C, Mota JD, Palmer TB, Heymsfield SB, Tinsley GM. Skeletal muscle estimation: A review of techniques and their applications. Clin Physiol Funct Imaging 2024; 44:261-284. [PMID: 38426639 DOI: 10.1111/cpf.12874] [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: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Quantifying skeletal muscle size is necessary to identify those at risk for conditions that increase frailty, morbidity, and mortality, as well as decrease quality of life. Although muscle strength, muscle quality, and physical performance have been suggested as important assessments in the screening, prevention, and management of sarcopenic and cachexic individuals, skeletal muscle size is still a critical objective marker. Several techniques exist for estimating skeletal muscle size; however, each technique presents with unique characteristics regarding simplicity/complexity, cost, radiation dose, accessibility, and portability that are important factors for assessors to consider before applying these modalities in practice. This narrative review presents a discussion centred on the theory and applications of current non-invasive techniques for estimating skeletal muscle size in diverse populations. Common instruments for skeletal muscle assessment include imaging techniques such as computed tomography, magnetic resonance imaging, peripheral quantitative computed tomography, dual-energy X-ray absorptiometry, and Brightness-mode ultrasound, and non-imaging techniques like bioelectrical impedance analysis and anthropometry. Skeletal muscle size can be acquired from these methods using whole-body and/or regional assessments, as well as prediction equations. Notable concerns when conducting assessments include the absence of standardised image acquisition/processing protocols and the variation in cut-off thresholds used to define low skeletal muscle size by clinicians and researchers, which could affect the accuracy and prevalence of diagnoses. Given the importance of evaluating skeletal muscle size, it is imperative practitioners are informed of each technique and their respective strengths and weaknesses.
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Affiliation(s)
- Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob D Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Steven B Heymsfield
- Metabolism and Body Composition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Yang Y, Li Q, Qiu W, Zhang H, Qiu Y, Yuan J, Zha Y. Trajectory of mid-arm subcutaneous fat, muscle mass predicts mortality in hemodialysis patients independent of body mass index. Sci Rep 2024; 14:14005. [PMID: 38890351 PMCID: PMC11189518 DOI: 10.1038/s41598-024-64728-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
Although decreasing body mass index (BMI) is associated with higher mortality risk in patients undergoing hemodialysis (HD), BMI neither differentiates muscle and fat mass nor provides information about the variations of fat distribution. It remains unclear whether changes over time in fat and muscle mass are associated with mortality. We examined the prognostic significance of trajectory in the triceps skinfold (TSF) thickness and mid-upper arm circumference (MUAC). In this multicenter prospective cohort study, 972 outpatients (mean age, 54.5 years; 55.3% men) undergoing maintenance HD at 22 treatment centers were included. We calculated the relative change in TSF and MUAC over a 1-year period. The outcome was all-cause mortality. Kaplan-Meier, Cox proportional hazard analyses, restricted cubic splines, and Fine and Gray sub-distribution hazards models were performed to examine whether TSF and MUAC trajectories were associated with all-cause mortality. During follow-up (median, 48.0 months), 206 (21.2%) HD patients died. Compared with the lowest trajectory group, the highest trajectories of TSF and MUAC were independently associated with lower risk for all-cause mortality (HR = 0.405, 95% CI 0.257-0.640; HR = 0.537; 95% CI 0.345-0.837; respectively), even adjusting for BMI trajectory. Increasing TSF and MUAC over time, measured as continuous variables and expressed per 1-standard deviation decrease, were associated with a 55.7% (HR = 0.443, 95% CI 0.302-0.649), and 97.8% (HR = 0.022, 95% CI 0.005-0.102) decreased risk of all-cause mortality. Reduction of TSF and MUAC are independently associated with lower all-cause mortality, independent of change in BMI. Our study revealed that the trajectory of TSF thickness and MUAC provides additional prognostic information to the BMI trajectory in HD patients.
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Affiliation(s)
- Yuqi Yang
- School of Basic Medicine, Guangzhou Medical University, Guangzhou, China
- Department of Nephrology, Guizhou Provincial People's Hospital, Zhongshan East Road, Guiyang, China
| | - Qian Li
- Department of Nephrology, Guizhou Provincial People's Hospital, Zhongshan East Road, Guiyang, China
| | - Wanting Qiu
- School of Basic Medicine, Guangzhou Medical University, Guangzhou, China
| | - Helin Zhang
- School of Basic Medicine, Guangzhou Medical University, Guangzhou, China
| | - Yuyang Qiu
- School of Basic Medicine, Guangzhou Medical University, Guangzhou, China
| | - Jing Yuan
- Department of Nephrology, Guizhou Provincial People's Hospital, Zhongshan East Road, Guiyang, China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People's Hospital, Zhongshan East Road, Guiyang, China.
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Kim D, Kim HJ, Song TJ. Association of body composition indices with cardiovascular outcomes: a nationwide cohort study. Am J Clin Nutr 2024; 119:876-884. [PMID: 38408726 DOI: 10.1016/j.ajcnut.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/03/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Previous studies regarding BMI (kg/m2) and associated cardiovascular outcomes yield inconsistent results. OBJECTIVES We aimed to investigate the association between body composition and cardiovascular outcomes according to BMI categories in the Korean general population. METHODS A total of 2,604,401 participants were enrolled in this nationwide cohort study using the National Health Insurance Service-Health Checkup data set. Predicted lean BMI (pLBMI), body fat mass index (pBFMI), and appendicular skeletal muscle mass index (pASMMI) were calculated using validated anthropometric prediction equations. A multivariable time-dependent Cox regression analysis was conducted to assess the association with cardiovascular outcomes. The results were presented with adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), considering BMI categories (BMI < 18.5, BMI 18.5-24.9, BMI 25-29.9, and BMI ≥ 30). RESULTS Higher pLBMI and pASMMI were correlated with a reduced risk of composite cardiovascular outcomes. For pLBMI, HR was 0.910 (95% CI: 0.908, 0.913, P < 0.001) for males and 0.905 (95% CI: 0.899, 0.910, P < 0.001) for females. For pASMMI, HR was 0.825 (95% CI: 0.820, 0.829, P < 0.001) for males and 0.788 (95% CI: 0.777, 0.800, P < 0.001) for females. Conversely, a higher pBFMI was associated with an increased risk, with HR of 1.082 (95% CI: 1.071, 1.093, P < 0.001) for males and 1.181 (95% CI: 1.170, 1.192, P < 0.001) for females. Subgroup analysis based on BMI categories revealed no significant risk association for pBFMI in the BMI < 18.5 group. In the group with BMI ≥ 30, neither pLBMI nor pASMMI demonstrated a significant risk association. CONCLUSIONS Our results highlight the value of pLBMI, pBFMI, and pASMMI as variables for assessing risk of composite cardiovascular outcomes. The significance of indicators may vary depending on BMI categories.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Kim
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
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Jian Z, Meng Z, Yao G, Liu H, Yang J, Wu Y, Liu W, Cheng L. Relationship between low relative muscle mass and aortic regional morphological changes in adults underwent contrast CT scans for cancer diagnostics. J Nutr Health Aging 2024; 28:100167. [PMID: 38307783 DOI: 10.1016/j.jnha.2024.100167] [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: 10/23/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES Low muscle mass is related to cardiovascular risk factors. This study aimed to investigate whether relative low muscle mass is related to the diameter and tortuosity of the aorta. METHODS We performed a cross-sectional study of 208 adults without known cardiovascular disease who underwent Computed Tomography (CT) enhanced scan between 2020 and 2021. Skeletal muscle index (SMI) was estimated. The morphology of the aorta was measured by diameter and tortuosity using CT. We assessed the relationship between SMI and diameter and tortuosity of the aorta using Spearman correlation analysis and univariate and multivariate-adjusted regression models. RESULTS Of all -individuals, 124 (59.6%) were male. The average age was 60.13 ± 16.33 years old. SMI was inversely associated with the diameter and tortuosity of the aorta (p < 0.05). Specifically, in a multivariable-adjusted model adjusting for potential confounders, a one-unit increase in the SMI was associated with a -13.56mm(95% confidence intervals (CI): -18.16 to -8.96, p < 0.001), -7.93 mm (95% CI: -10.85 to -5.02, p < 0.001), -8.01 mm (95% CI: -11.30 to -4.73, p < 0.001), -5.16 mm (95% CI: -7.57 to -2.75, p < 0.001) and -2.73 mm (95% CI: -5.18 to -0.27, p = 0.031) increase in L1-L5 diameter respectively, a -0.89 (95% CI: -1.14 to -0.64, p < 0.001) increase in the aorta tortuosity, a -0.48 (95% CI: -0.59 to -0.36, p < 0.001) increase in the descending thoracic aorta tortuosity, and a -0.44 (95% CI: -0.52 to -0.35, p < 0.001) increase in the abdominal aorta tortuosity. CONCLUSIONS Relative muscle mass was negatively associated with the diameter and tortuosity of the aorta, suggesting muscle mass maintenance may play a role in preventing aortic morphological changes.
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Affiliation(s)
- Zhijie Jian
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China
| | - Zixuan Meng
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China
| | - Guolin Yao
- Department of Medical Imaging, Xi'an Gao Xin Hospital, Xi'an 710075, P.R. China
| | - Hui Liu
- Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Jian Yang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China
| | - Yue Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China
| | - Wenjun Liu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China.
| | - Lele Cheng
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P.R. China.
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Duarte CK, de Abreu Silva L, Castro CF, Ribeiro MV, Saldanha MF, Machado AM, Jansen AK. Prediction equations to estimate muscle mass using anthropometric data: a systematic review. Nutr Rev 2023; 81:1414-1440. [PMID: 37815928 DOI: 10.1093/nutrit/nuad022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
CONTEXT Reduced muscle mass is linked to poor outcomes in both inpatients and outpatients, highlighting the importance of muscle mass assessment in clinical practice. However, laboratory methods to assess muscle mass are not yet feasible for routine use in clinical practice because of limited availability and high costs. OBJECTIVE This work aims to review the literature on muscle mass prediction by anthropometric equations in adults or older people. DATA SOURCES The following databases were searched for observational studies published until June 2022: MEDLINE, Embase, Scopus, SPORTDiscus, and Web of Science. DATA EXTRACTION Of 6437 articles initially identified, 63 met the inclusion criteria for this review. Four independent reviewers, working in pairs, selected and extracted data from those articles. DATA ANALYSIS Two studies reported new equations for prediction of skeletal muscle mass: 10 equations for free-fat mass and lean soft tissue, 22 for appendicular lean mass, 7 for upper-body muscle mass, and 7 for lower-body muscle mass. Twenty-one studies validated previously proposed equations. This systematic review shows there are numerous equations in the literature for muscle mass prediction, and most are validated for healthy adults. However, many equations were not always accurate and validated in all groups, especially people with obesity, undernourished people, and older people. Moreover, in some studies, it was unclear if fat-free mass or lean soft tissue had been assessed because of an imprecise description of muscle mass terminology. CONCLUSION This systematic review identified several feasible, practical, and low-cost equations for muscle mass prediction, some of which have excellent accuracy in healthy adults, older people, women, and athletes. Malnourished individuals and people with obesity were understudied in the literature, as were older people, for whom there are only equations for appendicular lean mass. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021257200.
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Affiliation(s)
- Camila Kümmel Duarte
- are with the Postgraduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana de Abreu Silva
- are with the Postgraduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Fernandes Castro
- are with the Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Vassallo Ribeiro
- are with the Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelle Ferreira Saldanha
- are with the Postgraduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriane Moreira Machado
- is with the Department of Nutrition, Faculdade Dinâmica do Vale do Piranga, Ponte Nova, Minas Gerais, Brazil
| | - Ann Kristine Jansen
- are with the Postgraduate Program in Nutrition and Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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McCarthy C, Tinsley GM, Yang S, Irving BA, Wong MC, Bennett JP, Shepherd JA, Heymsfield SB. Smartphone prediction of skeletal muscle mass: model development and validation in adults. Am J Clin Nutr 2023; 117:794-801. [PMID: 36822238 PMCID: PMC10315403 DOI: 10.1016/j.ajcnut.2023.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Skeletal muscle is a large and clinically relevant body component that has been difficult and impractical to quantify outside of specialized facilities. Advances in smartphone technology now provide the opportunity to quantify multiple body surface dimensions such as circumferences, lengths, surface areas, and volumes. OBJECTIVES This study aimed to test the hypothesis that anthropometric body measurements acquired with a smartphone application can be used to accurately estimate an adult's level of muscularity. METHODS Appendicular lean mass (ALM) measured by DXA served as the reference for muscularity in a sample of 322 adults. Participants also had digital anthropometric dimensions (circumferences, lengths, and regional and total body surface areas and volumes) quantified with a 20-camera 3D imaging system. Least absolute shrinkage and selection operator (LASSO) regression procedures were used to develop the ALM prediction equations in a portion of the sample, and these models were tested in the remainder of the sample. Then, the accuracy of the prediction models was cross-validated in a second independent sample of 53 adults who underwent ALM estimation by DXA and the same digital anthropometric estimates acquired with a smartphone application. RESULTS LASSO models included multiple significant demographic and 3D digital anthropometric predictor variables. Evaluation of the models in the testing sample indicated respective RMSEs in women and men of 1.56 kg and 1.53 kg and R2's of 0.74 and 0.90, respectively. Cross-validation of the LASSO models in the smartphone application group yielded RMSEs in women and men of 1.78 kg and 1.50 kg and R2's of 0.79 and 0.95; no significant differences or bias between measured and predicted ALM values were observed. CONCLUSIONS Smartphone image capture capabilities combined with device software applications can now provide accurate renditions of the adult muscularity phenotype outside of specialized laboratory facilities. Am J Clin Nutr 2023;x:xx. This trial was registered at clinicaltrials.gov as NCT03637855 (https://clinicaltrials.gov/ct2/show/NCT03637855), NCT05217524 (https://clinicaltrials.gov/ct2/show/NCT05217524), and NCT03771417 (https://clinicaltrials.gov/ct2/show/NCT03771417).
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Affiliation(s)
- Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Brian A Irving
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Michael C Wong
- University of Hawaii Cancer Center, Honolulu, HI, United States
| | | | - John A Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States.
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9
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Ramírez PC, de Oliveira Máximo R, Capra de Oliveira D, de Souza AF, Marques Luiz M, Bicigo Delinocente ML, Steptoe A, de Oliveira C, da Silva Alexandre T. Dynapenic Abdominal Obesity as a Risk Factor for Metabolic Syndrome in Individual 50 Years of Age or Older: English Longitudinal Study of Ageing. J Nutr Health Aging 2023; 27:1188-1195. [PMID: 38151869 DOI: 10.1007/s12603-023-2039-1] [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: 06/04/2023] [Accepted: 10/09/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To analyse whether dynapenic abdominal obesity is a risk factor for Metabolic syndrome (MetS) and its components in individuals 50 years of age or older. DESIGN A longitudinal study was conducted with an eight-year follow-up. SETTING Representative sample of community-dwelling participants of the English Longitudinal Study of Ageing (ELSA). PARTICIPANTS 3,952 individuals free of MetS at baseline. MEASUREMENTS Dynapenic abdominal obesity was defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The participants were classified as non-abdominally obese/non-dynapenic (NAO/ND - reference group), abdominally obese/non-dynapenic (AO/ND), non-abdominally obese/dynapenic (NAO/D) and abdominally obese/dynapenic (AO/D). The outcome was the incidence of MetS based on the presence of three or more of the following criteria: hypertriglyceridemia, hyperglycaemia, low HDL cholesterol, arterial hypertension or body mass index ≥ 30 kg/m2 throughout eight-year follow-up. Additionally, the incidence of each component of MetS was also analyzed. Poisson regression models were run and controlled for sociodemographic, behavioural and clinical variables. RESULTS The mean age of the participants was 65 years and 55% were women. The prevalence of AO/ND, NAO/D and AO/D were 35.3, 4.3 and 2.2%, respectively. At the end of follow-up 558 incident cases of MetS were recorded. The adjusted model demonstrated that although abdominal obesity was a risk factor for MetS (IRR: 2.26; 95% CI: 1.87 - 2.73), the IRR was greater in AO/D individuals (IRR: 3.34; 95% CI: 2.03 - 5.50) compared with ND/NAO group. Furthermore, ND/AO was a risk factor for incidence of hypertriglyceridemia (IRR: 1.27; 95% CI: 1.06 - 1.52), hyperglycaemia (IRR: 1.41; 95% CI: 1.18 - 1.69), low HDL cholesterol (IRR: 1.70; 95% CI: 1.32 - 2.19) and BMI ≥ 30 kg/m2 (IRR: 2.58; 95% CI: 2.04 - 3.26) while D/AO was a risk factor for hyperglycaemia (IRR: 1.78; 95% CI: 1.02 - 3.10), low HDL cholesterol (IRR: 2.36; 95% CI: 1.10 - 5.08), and BMI ≥ 30 kg/m2 (IRR: 2.79; 95% CI: 1.38 - 5.62). CONCLUSIONS Dynapenic abdominal obesity increases the risk of MetS, with a higher IRR compared to obesity alone. The understanding of this synergic action could guide specific clinical strategies, enabling the prevention of metabolic changes that can lead to cardiovascular disease, disability and death.
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Affiliation(s)
- P C Ramírez
- Tiago da Silva Alexandre. Departamento de Gerontologia, Universidade Federal de São Carlos, Rodovia Washington Luís, km 235, SP-310. CEP 13565-905, São Carlos, São Paulo. Brazil. E-mail: ,
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Sattar N, McMurray JJV, McInnes IB, Aroda VR, Lean MEJ. Treating chronic diseases without tackling excess adiposity promotes multimorbidity. Lancet Diabetes Endocrinol 2023; 11:58-62. [PMID: 36460014 DOI: 10.1016/s2213-8587(22)00317-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 12/03/2022]
Abstract
Few people now reach old age without taking multiple drugs, often attending various clinics, and undergoing secondary or tertiary investigations. Most chronic conditions are, to differing extents, caused or exacerbated by excess adiposity, but weight management is rarely discussed or attempted for patients. Furthermore, progressive symptoms usually attributed to ageing (eg, musculoskeletal pains, fatigue, and breathlessness), and which create considerable health-care demands, can also be attributed to the accumulation of body fat over time. For many symptoms and diseases that are more frequently reported in people with excess adiposity (such as depression), there exist potentially multidirectional, causal relationships that generate a cycle of clinical and social deterioration. There is insufficient research on the effects of effective weight management on these clinically demanding, age and weight-mediated symptoms. Based on current evidence, we suggest that policy makers need to be more proactive in obesity prevention and effective weight management should receive research funding to match the search for novel therapeutics for secondary chronic diseases.
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Affiliation(s)
- Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
| | - John J V McMurray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Iain B McInnes
- College of Medical, Veterinary & Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Vanita R Aroda
- Brigham and Women's Hospital, Division of Endocrinology, Diabetes and Hypertension; Harvard Medical School, Boston, MA, USA
| | - Mike E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Glasgow, UK
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11
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Delinocente MLB, Luiz MM, de Oliveira DC, de Souza AF, Ramírez PC, de Oliveira Máximo R, Soares NC, Steptoe A, de Oliveira C, da Silva Alexandre T. Are Serum 25-Hydroxyvitamin D Deficiency and Insufficiency Risk Factors for the Incidence of Dynapenia? Calcif Tissue Int 2022; 111:571-579. [PMID: 36109388 PMCID: PMC9613743 DOI: 10.1007/s00223-022-01021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022]
Abstract
Epidemiological evidence showing the association between low 25(OH)D and age-related reduction in neuromuscular strength (dynapenia) is a paucity and controversial and, to date, the effect of osteoporosis and vitamin D supplementation on these associations has not been measured. Thus, we analyze whether serum 25(OH)D deficiency and insufficiency are risk factors for the incidence of dynapenia in individuals aged 50 or older and whether osteoporosis or vitamin D supplementation modify these associations. For that, 3205 participants of the ELSA study who were non-dynapenic at baseline were followed for 4 years. Vitamin D was measured at baseline by the serum concentration of 25(OH)D and classified as sufficient (> 50 nmol/L), insufficient (≥ 30 and ≤ 50 nmol/L) or deficient (< 30 nmol/L). The incidence of dynapenia was determined by a grip strength < 26 kg for men and < 16 kg for women at the end of the 4-year follow-up. Poisson regression models were adjusted by sociodemographic, behavioral, clinical and biochemical characteristics. Serum 25(OH)D deficient was a risk factor for the incidence of dynapenia (IRR = 1.70; 95% CI 1.04-2.79). When only individuals without osteoporosis and those who did not use vitamin D supplementation were analyzed, both serum 25(OH)D deficiency (IRR = 1.78; 95% CI 1.01-3.13) and insufficiency (IRR = 1.77; 95% CI 1.06-2.94) were risk factors for the incidence of dynapenia. In conclusion, a serum level of 25(OH)D < 30 nmol/L is a risk factor for the incidence of dynapenia. Among individuals without osteoporosis and those who do not take vitamin D supplementation, the threshold of risk is higher (≤ 50 nmol/L).
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Affiliation(s)
| | - Mariane Marques Luiz
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Aline Fernanda de Souza
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Paula Camila Ramírez
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | - Natália Cochar Soares
- Post Graduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Post Graduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil.
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil.
- Department of Epidemiology and Public Health, University College London, London, UK.
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, SP-310, Brazil.
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12
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Gupta M, Lehl SS, Lamba AS. Ultrasonography for Assessment of Sarcopenia: A Primer. J Midlife Health 2022; 13:269-277. [PMID: 37324795 PMCID: PMC10266568 DOI: 10.4103/jmh.jmh_234_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/05/2023] [Accepted: 02/13/2023] [Indexed: 06/17/2023] Open
Abstract
The human skeletal muscle has a pivotal role in preserving health by maintaining mobility, balance, and metabolic homeostasis. Significant muscle loss as a part of aging and accelerated by disease leads to sarcopenia which becomes an important predictor of quality of life in older persons. Therefore, clinical screening for sarcopenia and validation by precise qualitative and quantitative measurement of skeletal muscle mass (MM) and function is at the center-stage of translational research. Many imaging modalities are available, each having their strengths and limitations, either in interpretation, technical processes, time constraints, or expense. B-mode ultrasonography (US) is a relatively novel approach to evaluating muscle. It can measure several parameters such as MM and architecture simultaneously including muscle thickness, cross-sectional area, echogenicity, pennate angle, and fascicle length. It can also evaluate dynamic parameters like muscle contraction force and muscle microcirculation. US has not gained global attention due to a lack of consensus on standardization and diagnostic threshold values to diagnose sarcopenia. However, it is an inexpensive and widely available technique with clinical applicability. The ultrasound-derived parameters correlate well with strength and functional capacity and provide potential prognostic information. Our aim is to present an update on the evidence-based role of this promising technique in sarcopenia, its advantages over the existing modalities, and its limitations in actual practice with the hope that it may emerge as the "stethoscope" for community diagnosis of sarcopenia.
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Affiliation(s)
- Monica Gupta
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Sarabmeet Singh Lehl
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Amtoj Singh Lamba
- Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
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13
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Spexoto MCB, Ramírez PC, de Oliveira Máximo R, Steptoe A, de Oliveira C, Alexandre TDS. European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) criteria or slowness: which is the best predictor of mortality risk in older adults? Age Ageing 2022; 51:6649128. [PMID: 35906934 PMCID: PMC9338689 DOI: 10.1093/ageing/afac164] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 01/11/2023] Open
Abstract
Objectives to analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults. Methods a longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up. Results compared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16–1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24–1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49–2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off. Conclusions using LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults.
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Affiliation(s)
- Maria Claudia Bernardes Spexoto
- Food, Nutrition and Health Postgraduate Program, Federal University of Grande Dourados, Dourados, Brazil.,Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Paula Camila Ramírez
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Department of Epidemiology and Public Health, University College London, London, UK.,Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil
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14
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Digital Anthropometry for Body Circumference Measurements: European Phenotypic Variations throughout the Decades. J Pers Med 2022; 12:jpm12060906. [PMID: 35743690 PMCID: PMC9224732 DOI: 10.3390/jpm12060906] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/27/2023] Open
Abstract
This review summarizes body circumference-based anthropometrics that are in common use for research and in some cases clinical application. These include waist and hip circumference-based central body indices to predict cardiometabolic risk: waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, a body shape index (ABSI), hip index (HI), and body roundness index (BRI). Limb circumference measurements are most often used to assess sarcopenia and include: thigh circumference, calf circumference, and mid-arm circumference. Additionally, this review presents fascinating recent developments in optic-based imaging technologies that have elucidated changes over the last decades in average body size and shape in European populations. The classical apple and pear shape concepts of body shape difference remain useful, but novel and exciting 3-D optical “e-taper” measurements provide a potentially powerful new future vista in anthropometrics.
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15
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Haworth L, May K, Janssen J, Selfe J, Chohan A. The impact of breast support garments on fit, support and posture of larger breasted women. APPLIED ERGONOMICS 2022; 101:103701. [PMID: 35151120 DOI: 10.1016/j.apergo.2022.103701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Due to current measurement, sizing and fitting approaches, poor bra fit is prevalent amongst larger breasted women. The impact of improving bra fit hasn't yet been explored. This pre-clinical study aimed to explore immediate and short-term biomechanical responses to changing breast support garment. Asymptomatic participants (n=24) performed a static standing task, drop jumps and seated typing whilst kinematic data from the breasts and spine were recorded. Three breast support conditions were assessed: Usual, professionally fitted bra in the immediate term (PFB), and the same professionally fitted bra after four weeks wear (PFB28). Bra fit assessments were included for both bras. All participants failed the bra fit assessment when wearing the Usual bra and 67% (n=16) failed when wearing the PFB. Less bra fit issues were present in the PFB, resulting in immediate biomechanical changes relating to breast support and spinal posture, yet nothing in the short term (PFB28). This research sets the foundations for future work to investigate whether the implementation of better fitting breast support garments can influence musculoskeletal pain amongst larger breasted women, whilst attributing potential improvement of symptoms, objective measures of breast support and spinal posture.
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Affiliation(s)
- Lauren Haworth
- University of Central Lancashire, Allied Health Professions Research Unit, Preston, UK.
| | - Karen May
- University of Central Lancashire, School of Medicine, Preston, UK.
| | - Jessie Janssen
- IMC University of Applied Science Krems, Institute of Therapeutic and Midwifery Sciences, Krems, Austria.
| | - James Selfe
- Manchester Metropolitan University, Health, Psychology and Communities, Manchester, UK.
| | - Ambreen Chohan
- University of Central Lancashire, Allied Health Professions Research Unit, Preston, UK.
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16
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Kim SR, Lee G, Choi S, Oh YH, Son JS, Park M, Park SM. Changes in predicted lean body mass, appendicular skeletal muscle mass, and body fat mass and cardiovascular disease. J Cachexia Sarcopenia Muscle 2022; 13:1113-1123. [PMID: 35212175 PMCID: PMC8978024 DOI: 10.1002/jcsm.12962] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 01/05/2022] [Accepted: 02/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Little is known about the association of changes in two body components, muscle and fat mass, with the risk of cardiovascular disease (CVD) among young adults. We investigated the association of changes in predicted lean body mass index (LBMI), appendicular skeletal muscle mass index (ASMI), and body fat mass index (BFMI) with the development of CVD among young adults. METHODS This nationwide, population-based cohort study included 3 727 738 young adults [2 406 046 (64.5%) men and 1 321 692 (35.5%) women] aged 20-39 years without a previous history of CVD who underwent two health screening examinations during 2009-2010 and 2011-2012. Using validated and robust prediction equations, we calculated the changes in predicted LBMI, ASMI, and BFMI from the first to the second examinations. RESULTS The mean (SD) age was 32.2 (4.9) years, and 2 406 046 (64.5%) of the participants were men. A total of 23 344 CVD events were detected during 22 257 632 person-years of follow-up. Each 1 kg/m2 increase in predicted LBMI and ASMI change was associated with a reduced risk of CVD among men [adjusted hazard ratio (aHR): 0.86, 95% confidence interval (CI) 0.82-0.91; aHR: 0.76, 95% CI 0.69-0.82, respectively] and women (aHR: 0.77, 95% CI 0.63-0.95; aHR: 0.75, 95% CI 0.59-0.96). Each 1 kg/m2 increase in predicted BFMI change was associated with an increased risk of CVD among men (aHR: 1.16, 95% CI 1.10-1.22) and women (aHR: 1.32, 95% CI 1.06-1.65). In both sexes, decreases in predicted LBMI and ASMI were associated with greater CVD risk, and decreased predicted BFMI was associated with a reduced CVD risk. Those who maintained their BMI between -1 and +1 kg/m2 also had a decreased risk of CVD per 1 kg/m2 increase in predicted LBMI and ASMI change among men (aHR: 0.86, 95% CI 0.80-0.92; aHR: 0.85, 95% CI 0.76-0.95) and women (aHR: 0.62, 95% CI 0.47-0.83; aHR: 0.59, 95% CI 0.44-0.80) and had a greater risk of CVD per 1 kg/m2 increase in predicted BFMI change among men (aHR: 1.17, 95% CI 1.10-1.25) and women (aHR: 1.64, 95% CI 1.20-2.23). Regardless of changes in weight, such as from normal to obese or vice versa, these results were consistent. CONCLUSIONS Among young adults, increased predicted muscle mass or decreased predicted fat mass were associated with a reduced risk of development of CVD. Decreased predicted muscle mass or increased predicted fat mass were associated with an elevated risk of development of CVD.
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Affiliation(s)
- Seong Rae Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, South Korea.,Department of Family Medicine, Jeju National University Hospital, Jeju, South Korea
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Minseon Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
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17
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Kouvari M, Polyzos SA, Chrysohoou C, Skoumas J, Pitsavos CS, Panagiotakos DB, Mantzoros CS. Skeletal Muscle Mass and Abdominal Obesity are Independent Predictors of Hepatic Steatosis and Interact to Predict Ten-Year Cardiovascular Disease Incidence: Data from the ATTICA Cohort Study. Clin Nutr 2022; 41:1281-1289. [DOI: 10.1016/j.clnu.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/28/2022] [Accepted: 03/20/2022] [Indexed: 11/03/2022]
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18
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Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S, Del Grande F, Sconfienza LM. Sarcopenia: imaging assessment and clinical application. Abdom Radiol (NY) 2022; 47:3205-3216. [PMID: 34687326 PMCID: PMC8536908 DOI: 10.1007/s00261-021-03294-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023]
Abstract
Sarcopenia is a progressive, generalized skeletal muscle disorder characterized by reduction of muscle mass and strength. It is associated with increased adverse outcomes including falls, fractures, physical disability, and mortality, particularly, in elderly patients. Nowadays, sarcopenia has become a specific imaging biomarker able to predict clinical outcomes of patients. Muscle fibre reduction has shown to be an unfavourable pre-operative predictive factor in patients with cancer, and is associated with worse clinical outcomes in terms of postoperative complications, morbidity, mortality, and lower tolerance of chemoradiation therapy. Several imaging modalities, including dual-energy X-ray absorptiometry, CT, MRI, and US can be used to estimate muscle mass and quality to reach the diagnosis of sarcopenia. This article reviews the clinical implications of sarcopenia, how this condition can be assessed through different imaging modalities, and future perspectives of imaging of sarcopenia.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland ,Ospedale Evangelico Betania, Napoli, Italy
| | - Domenico Albano
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy ,grid.10776.370000 0004 1762 5517Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Salvatore Gitto
- grid.4708.b0000 0004 1757 2822Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Gaetano Ruffo
- grid.417776.4IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
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19
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Saka K, Konishi M, Kagiyama N, Kamiya K, Saito H, Saito K, Ogasahara Y, Maekawa E, Misumi T, Kitai T, Iwata K, Jujo K, Wada H, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Makino A, Oka K, Kimura K, Tamura K, Momomura SI, Matsue Y. Impact of physical performance on exercise capacity in older patients with heart failure with reduced and preserved ejection fraction. Exp Gerontol 2021; 156:111626. [PMID: 34780931 DOI: 10.1016/j.exger.2021.111626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Low physical performance may contribute to reduced exercise capacity in older patients with heart failure (HF). We sought to identify the determinants of exercise capacity out of a plethora of background factors, including measures of physical performance. METHODS We performed a post-hoc analysis of a cohort study that included 1205 consecutive older (age ≥ 65 years) hospitalized patients (the median age, 80 years; 57.4% males). RESULTS Low physical performance, defined as ≤1.0 m/s for gait speed, ≥12 s for the 5-time chair stand test, or ≤ 9 points for the Short Physical Performance Battery in both sexes, was seen in 83.9% of the cohort. Multivariate regression analysis revealed that each parameter of physical performance (i.e., gait speed, chair stand test, and balance test) was identified as an independent determinant of lower exercise capacity assessed using the 6-min walking distance. In a logistic regression model, low physical performance predicted short (<300 m) 6-min walking distance (adjusted odds ratio 10.28, 95% CI 6.01-17.60, p < 0.001). No interaction was detected between patients with preserved and reduced ejection fraction. CONCLUSIONS Low physical performance was prevalent and independently associated with exercise capacity in older patients with HF, irrespective of preserved or reduced ejection fraction.
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Affiliation(s)
- Kenichiro Saka
- Department of Cardiovascular Medicine, Yokosuka City Hospital, Yokosuka, Japan; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masaaki Konishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
| | - Nobuyuki Kagiyama
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Japan; Department of Digital Health and Telemedicine R&D, Juntendo University, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Japan
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, and Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Japan; Department of Rehabilitation, Kameda Medical Center, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan; Department of Rehabilitation, Kobe City Medical Center General Hospital, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, and Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Japan
| | | | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Japan
| | - Akihiro Makino
- Department of Rehabilitation, Kitasato University Medical Center, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Center, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, and Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Japan
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20
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Kusunoki H, Tabara Y, Tsuji S, Wada Y, Tamaki K, Nagai K, Itoh M, Sano K, Amano M, Maeda H, Sugita H, Hasegawa Y, Kishimoto H, Shimomura S, Igase M, Shinmura K. Estimation of Muscle Mass Using Creatinine/Cystatin C Ratio in Japanese Community-Dwelling Older People. J Am Med Dir Assoc 2021; 23:902.e21-902.e31. [PMID: 34437868 DOI: 10.1016/j.jamda.2021.07.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Sarcopenia is defined as a combination of low skeletal muscle mass index (SMI), weak muscle strength, and reduced physical function. Recently, many studies have reported that the creatinine/cystatin C ratio (Cr/CysC) is useful for evaluating muscle mass. We designed a cross-sectional study with separate model development and validation groups to develop a prediction equation to estimate bioimpedance analysis (BIA)-measured SMI with Cr/CysC. DESIGN The current study was a retrospective cross-sectional study. SETTING AND PARTICIPANTS The model development group included 908 subjects (288 men and 620 women) from the Frail Elderly in the Sasayama-Tamba Area (FESTA) study, and the validation group included 263 subjects (112 men and 151 women) from participants in the medical checkup program at the Anti-Aging Center in Ehime Prefecture. MEASURES Multivariate regression analysis indicated that age, hemoglobin (Hb), body weight (BW), and Cr/CysC were independently associated with SMI in both men and women. The SMI prediction equation was developed as follows: Men:4.17-0.012×Age+1.24×(Cr/CysC)-0.0513×Hb+0.0598×BW Women:3.55-0.00765×Age+0.852×(Cr/CysC)-0.0627×Hb+0.0614×BW RESULTS: The SMI prediction equation was applied to the validation group and strong correlations were observed between the BIA-measured and predicted SMI (pSMI) in men and women. According to the receiver operator characteristic (ROC) analysis, the areas under the curve were 0.93 (specificity 89.0%, sensitivity 87.2%) among men and 0.88 (specificity 83.6%, sensitivity 79.6%) among women for using pSMI to identify low SMI in the model development group. The pSMI also indicated high accuracy in ROC analysis for low SMI in the validation group. The Bland-Altman plot regression showed good agreement between BIA-measured and pSMI. CONCLUSIONS AND IMPLICATIONS Our new prediction equation to estimate SMI is easy to calculate in daily clinical practice and would be useful for diagnosing sarcopenia.
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Affiliation(s)
- Hiroshi Kusunoki
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yosuke Wada
- Department of General Medicine and Community Health Science, Sasayama Medical Center Hyogo College of Medicine, Sasayama, Hyogo, Japan; Department of Rehabilitation Medicine, Sasayama Medical Center Hyogo College of Medicine, Sasayama, Hyogo, Japan
| | - Kayoko Tamaki
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Koutatsu Nagai
- School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Masako Itoh
- School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Kyoko Sano
- School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Manabu Amano
- School of Pharmacy, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Hatsuo Maeda
- School of Pharmacy, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Hideyuki Sugita
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Soji Shimomura
- Department of General Medicine and Community Health Science, Sasayama Medical Center Hyogo College of Medicine, Sasayama, Hyogo, Japan
| | - Michiya Igase
- Department of Anti-aging Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Ken Shinmura
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Department of General Medicine and Community Health Science, Sasayama Medical Center Hyogo College of Medicine, Sasayama, Hyogo, Japan
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21
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He L, Yang N, Wang J, Huang J, Li W, Xu L, Ping F, Li Y, Zhang H. Mid-Arm Muscle and Subcutaneous Fat Associated with All-Cause Mortality Independent of BMI: A Prospective Cohort Study. Obesity (Silver Spring) 2021; 29:1203-1214. [PMID: 34021531 DOI: 10.1002/oby.23179] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to systematically evaluate the association between triceps skinfold (TSF) thickness (which indicates subcutaneous fat) mid-arm muscle circumference (MAMC; which reflects muscle mass), mid-upper arm circumference (MUAC), and all-cause mortality. METHODS A total of 17,717 adults from the China Health and Nutrition Survey (1993-2015) were included. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. The joint effect of TSF thickness and MAMC was examined, and planned subgroup analyses were performed. RESULTS The highest quartiles of TSF thickness, MAMC, and MUAC were significantly associated with low all-cause mortality, independent of BMI (TSF thickness: HR = 0.704 [95% CI: 0.575-0.862]; MAMC: HR = 0.729 [95% CI: 0.607-0.876]; MUAC: HR = 0.713 [95% CI: 0.583-0.872]). A 1-SD increase showed comparable risk reductions for TSF thickness and MAMC (14.6% and 14.0%), with 16.1% risk reductions in MUAC. There were positive additive interactions between TSF thickness and MAMC. The inverse association existed in young, middle-aged, and elderly participants (P-heterogeneity > 0.05). CONCLUSIONS Mid-arm muscle and subcutaneous fat were inversely associated with all-cause mortality, independent of BMI, beyond the elderly population. Mid-arm muscle and subcutaneous fat made comparable contributions to and had positive joint effects on all-cause mortality.
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Affiliation(s)
- Liyun He
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Na Yang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jialu Wang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jingyue Huang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lingling Xu
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fan Ping
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuxiu Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Huabing Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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22
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Canda AS. Muscle mass index estimated by anthropometry vs bioelectrical impedance: Study in athletes competing by weight categories. APUNTS SPORTS MEDICINE 2021. [DOI: 10.1016/j.apunsm.2021.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Jyväkorpi SK, Urtamo A, Kivimäki M, Salomaa V, Strandberg TE. Association of midlife body composition with old-age health-related quality of life, mortality, and reaching 90 years of age: a 32-year follow-up of a male cohort. Am J Clin Nutr 2020; 112:1287-1294. [PMID: 32844221 DOI: 10.1093/ajcn/nqaa230] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Overweight and obesity increase the risk of morbidity and mortality. The relations between body composition at midlife, health-related quality of life (HRQoL) in old age, and longevity are, however, less studied. OBJECTIVES We examined the association of midlife body composition with successful aging, defined as high HRQoL and reaching 90 y of age, during 32 y follow-up. METHODS Participants were 1354 men from the Helsinki Businessmen Study, born 1919-1934. In 1985/1986 (mean age: 60 y) various health measurements were performed. Percentages of body fat (BF) and skeletal muscle mass (SM) were calculated using validated formulas (including waist and hip circumferences, weight, and age) and divided into quartiles. In 2000 and 2007 (mean ages: 74 and 80 y, respectively), HRQoL was assessed using RAND-36/Short Form-36 scales. Mortality was retrieved from registers through 2018, and longevity determined by calculating the proportion of participants reaching 90 y. Logistic regression was used to assess ORs with 95% CIs. RESULTS Higher SM% at midlife in 1985/1986 was associated (P < 0.05) with higher scores in the RAND-36 scales of physical functioning, role limitations caused by physical health problems, vitality, social functioning, and general health in old age in 2000. In 2007 only the association with physical domain (physical functioning, role limitations caused by physical health problems) remained statistically significant (P < 0.01). BF% quartiles in 1985/1986 were inversely associated with several RAND-36 scales in 2000 and 2007. During the 32-y follow-up, 982 participants died and 281 reached 90 y of age. Being in the highest SM% quartile at midlife increased (adjusted OR: 2.32; 95% CI: 1.53, 3.53; lowest SM% quartile as reference) and being in the highest BF% quartile decreased (OR: 0.43; 95% CI: 0.28, 0.66; lowest BF% quartile as reference) the odds of reaching 90 y. CONCLUSIONS Desirable body composition in terms of both fat and skeletal muscle mass at midlife was associated with successful aging in men.This trial was registered at clinicaltrials.gov as NCT02526082.
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Affiliation(s)
- Satu K Jyväkorpi
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Annele Urtamo
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Kivimäki
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
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Grip Strength and Demographic Variables Estimate Appendicular Muscle Mass Better Than Bioelectrical Impedance in Taiwanese Older Persons. J Am Med Dir Assoc 2020; 22:760-765. [PMID: 32948471 DOI: 10.1016/j.jamda.2020.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to develop an equation model combining physical fitness and anthropometric parameters and compare its results with those of bioelectrical impedance analysis (BIA)-measured lean mass (LM) using dual-energy X-ray absorptiometry (DXA)-measured appendicular muscle mass (AMM) as reference. DESIGN Observational analysis. SETTING AND PARTICIPANTS Healthy community-dwelling older subjects. METHODS A total of 1020 participants were randomly allocated to the development group (development group, n = 510) or the cross-validation group (validation group, n = 510). Body composition was measured using both DXA and BIA, and physical fitness parameters, including grip strength, timed stepping test, sit-to-stand test, flexibility, and walking speed were also assessed. A prediction equation model of AMM by stepwise linear regression analysis that included or excluded 1 independent variable at each step, based on the P value of significance (P < .05), was developed. RESULTS Using weight, sex, height, and handgrip strength as independent variables, the equation AMM = -9.833 + 0.397 × weight (kg) + 4.433 × sex + 0.121 × height (cm) + 0.061 × handgrip strength (kg) best predicts DXA-measured AMM (adjusted R2 = 0.914, SEE = 2.062, P < .001). The predicted AMM was more highly correlated with DXA-measured AMM than the commonly used BIA-measured LM (R2= 0.9158 and 0.8427, respectively, both P < .001). Using DXA-measured AMM as reference, the Bland-Altman plot showed mean differences of -0.03 kg and -0.12 kg, with limits of agreement of -3.98 to 3.92 kg and -5.97 to 5.73 kg for the predicted AMM and BIA-measured AMM, respectively. CONCLUSIONS AND IMPLICATIONS The proposed equation offers a practical alternative method for estimating AMM that is less facility-dependent and more easy to use and affordable than instrumental studies.
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25
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Diniz KGD, Vieira DA, Colosimo EA, Coelho MPP, Bering T, Teixeira R, Correia MITD, Rocha GA, Silva LD. Derivation and validation of a simple anthropometric equation to predict fat-free mass in patients with chronic hepatitis C. Clin Nutr 2020; 40:1281-1288. [PMID: 32861484 DOI: 10.1016/j.clnu.2020.08.011] [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] [Received: 05/18/2020] [Revised: 07/11/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Loss of skeletal muscle mass is very common in chronic liver diseases and affects 30.0-70.0% of the patients with cirrhosis. Given the relevance of muscle wasting in hepatic diseases, a practical screening tool for earlier detection of skeletal muscle mass loss is of utmost significance. AIMS To develop and validate a simple anthropometric prediction equation for fat-free mass estimation by using Bioelectrical Impedance Analysis (BIA) as a reference method in patients with chronic hepatitis C (CHC). METHODS We prospectively, included 209 CHC patients, randomly allocated into two groups, 158 patients in a development model (derivation sample) and 51 patients in a validation group (validation sample). Predictive equations were developed using backward stepwise multiple regression and the most adequate and simplest derived predictive equation was further explored for agreement and bias in the validation sample. The accuracy of the predictive equation was evaluated using the coefficient of determination (R2). RESULTS The predictive equation with an optimal R2 was Fat-Free Mass (Kg) = Sex × 0.17 + Height (m) × 16.83 + Weight (Kg) × 0.62 + Waist Circumference (cm) × (-0.15) + Weight (Kg) × Sex × (-0.30) + Sex × Waist Circumference (cm) × 0.14-6.23; where sex = 1 for female and 0 for male. R2 = 0.93, standard error of the estimate = 2.6 Kg and coefficient of variation = 20.0%, p < 0.001. CONCLUSIONS Our developed and cross-validated anthropometric prediction equation for fat-free mass estimation by using BIA attained a high coefficient of determination, a low standard error of the estimate, and lowermost coefficient of variation. This study indicates that predictive equations may be reliable and useful alternative methods for clinical evaluation of fat-free mass in patients with CHC.
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Affiliation(s)
- Kiara Gonçalves Dias Diniz
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Diego Alves Vieira
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Enrico Antonio Colosimo
- Department of Statistics, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marta Paula Pereira Coelho
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Tatiana Bering
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Department of Food and Nutrition, Universidade Federal de Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Rosangela Teixeira
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Gifone Aguiar Rocha
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Luciana Diniz Silva
- Sciences Applied to Adult Health Care Post-Graduate Programme, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
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Lee G, Chang J, Hwang SS, Son JS, Park SM. Development and validation of prediction equations for the assessment of muscle or fat mass using anthropometric measurements, serum creatinine level, and lifestyle factors among Korean adults. Nutr Res Pract 2020; 15:95-105. [PMID: 33542795 PMCID: PMC7838475 DOI: 10.4162/nrp.2021.15.1.95] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/06/2020] [Accepted: 06/01/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008–2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland–Altman plot and intraclass correlation coefficient (ICC). RESULTS The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS All equations had low bias, moderate agreement based on the Bland–Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.
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Affiliation(s)
- Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
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Williamson K, Nimegeer A, Lean M. Rising prevalence of BMI ≥40 kg/m 2 : A high-demand epidemic needing better documentation. Obes Rev 2020; 21:e12986. [PMID: 32017386 PMCID: PMC7078951 DOI: 10.1111/obr.12986] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/31/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Abstract
Whilst previously rare, some surveys indicate substantial increases in the population with body mass index (BMI) ≥40 kg/m2 since the 1980s. Clinicians report emerging care challenges for this population, often with high resource demands. Accurate prevalence data, gathered using reliable methods, are needed to inform health care practice, planning, and research. We searched digitally for English language sources with measured prevalence data on adult BMI ≥40 collected since 2010. The search strategy included sources identified from recent work by NCD-RisC (2017), grey sources, a literature search to find current sources, and digital snowball searching. Eighteen countries, across five continents, reported BMI ≥40 prevalence data in surveys since 2010: 12% of eligible national surveys examined. Prevalence of BMI ≥40 ranged from 1.3% (Spain) to 7.7% (USA) for all adults, 0.7% (Serbia) to 5.6% (USA) for men, and 1.8% (Poland) to 9.7% (USA) for women. Limited trend data covering recent decades support significant growth of BMI ≥40 population. Methodological limitations include small samples and data collection methods likely to exclude people with very high BMIs. BMI ≥40 data are not routinely reported in international surveys. Lack of data impairs surveillance of population trends, understanding of causation, and societal provision for individuals living with higher weights.
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Affiliation(s)
- Kath Williamson
- School of Medicine, Dentistry and NursingUniversity of GlasgowGlasgowUK
- NHS LothianEdinburghUK
| | - Amy Nimegeer
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Michael Lean
- School of Medicine, Dentistry and NursingUniversity of GlasgowGlasgowUK
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Heymsfield SB, Stanley A, Pietrobelli A, Heo M. Simple Skeletal Muscle Mass Estimation Formulas: What We Can Learn From Them. Front Endocrinol (Lausanne) 2020; 11:31. [PMID: 32117059 PMCID: PMC7012897 DOI: 10.3389/fendo.2020.00031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/15/2020] [Indexed: 12/13/2022] Open
Abstract
One century ago Harris and Benedict published a short report critically examining the relations between body size, body shape, age, and basal metabolic rate. At the time, basal metabolic rate was a vital measurement in diagnosing diseases such as hypothyroidism. Their conclusions and basal metabolic rate prediction formulas still resonate today. Using the Harris-Benedict approach as a template, we systematically examined the relations between body size, body shape, age, and skeletal muscle mass (SM), the main anatomic feature of sarcopenia. The sample consisted of 12,330 non-Hispanic (NH) white and NH black participants in the US National Health and Nutrition Survey who had complete weight, height, waist circumference, age, and dual-energy X-ray (DXA) absorptiometry data. A conversion formula was used to derive SM from DXA-measured appendicular lean soft tissue mass. Weight, height, waist circumference, and age alone and in combination were significantly correlated with SM (all, p < 0.001). Advancing analyses through the aforementioned sequence of predictor variables allowed us to establish how at the anatomic level these body size, body shape, and age measures relate to SM much in the same way the Harris-Benedict equations provide insights into the structural origins of basal heat production. Our composite series of SM prediction equations should prove useful in modeling efforts and in generating hypotheses aimed at understanding how SM relates to body size and shape across the adult lifespan.
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Affiliation(s)
- Steven B. Heymsfield
- Department of Metabolism-Body Composition, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
- *Correspondence: Steven B. Heymsfield
| | - Abishek Stanley
- Department of Metabolism-Body Composition, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Angelo Pietrobelli
- Department of Metabolism-Body Composition, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Verona University Medical School, Verona, Italy
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
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Han TS, Callis TG, Sharma P, Lean MEJ. Secular trends in adiposity and musculoskeletal dimensions of elite heavyweight boxers between 1889 and 2019. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00598-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Purpose
With improving nutrition and health, athletes have grown taller and heavier over the past century. Since there is no weight restriction in the heavyweight class, secular changes in anthropometric measurements of heavyweight boxers may mirror those of contemporary general populations.
Objectives
We aimed to (1) examine secular trends in adiposity and musculoskeletal measurements in heavyweight boxers, (2) determine anthropometric differences between champions and unsuccessful challengers.
Methods
Detailed demographics taken at time of contest (first official World Championship to current contest: 1889–2019) were collected from media archives.
Results
All 237 boxers (83 champions, 154 challengers) contesting a recognised heavyweight World Championships were identified. They had mean (± SD) age = 28.9 ± 4.1 years, height = 187.3 ± 6.5 cm, reach = 195.2 ± 9.4 cm, weight = 97.5 ± 11.5 kg, BMI = 27.8 ± 2.4 kg/m2 and waist = 87.9 ± 6.2 cm. Contest years explained 25.9% (p < 0.001) of the variance in BMI for champions and 30.9% (p < 0.001) for challengers, 9.1% (p < 0.071) in WC for champions and 19.9% (p < 0.001) for challengers. Contest years correlated with height (r = 0.531, p < 0.001), reach (r = 0.341, p < 0.001), weight (r = 0.603, p < 0.001) and BMI (r = 0.370, p = 0.001) among all documented boxers, and with waist only in challengers (r = 0.349, p < 0.001) but not in champions (r = 0.078, p = 0.509). Compared with challengers, champions had greater stature by + 3.4 cm (p < 0.001), reach + 3.6 cm (p = 0.005) and weight + 3.7 kg (p = 0.017), with similar BMI and waist. Champions had larger biceps and forearms but did not differ from challengers in other musculoskeletal dimensions.
Conclusions
Over 130 years elite heavyweight boxers have increased in size (BMI) and reach but waists in champions have remained static. Being heavier, taller with longer and bigger arms, but with similar in BMI and waist, appear to be differentiating factors between champions and challengers.
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Wu P, Chen L, Jin J, Zhang Y, Su C, Wu C, Lang J, Chen L, Jin K. Estimation of appendicular skeletal muscle: Development and validation of anthropometric prediction equations in Chinese patients with knee osteoarthritis. Australas J Ageing 2019; 39:e119-e126. [PMID: 31400038 DOI: 10.1111/ajag.12709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/19/2019] [Accepted: 07/03/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop anthropometric prediction equations for estimating appendicular skeletal muscle (ASM) in Chinese knee osteoarthritis patients. METHODS Subjects were divided into the model development group (MD group: 104 cases, 47 men and 57 women) and cross-validation group (CV group: 69 cases, 38 men and 31 women). Stepwise multiple linear regression analyses were undertaken in the MD group to identify the best equations. Agreement between the estimated ASM and ASM measured by dual-energy X-ray absorptiometry (DXA) was tested in the CV group. RESULTS Two models were developed in the MD group. Validation in the CV group showed that our models (R2 = 0.83 and R2 = 0.90) had a high coefficient of determination. The mean bias of ASM estimated by the two models from the ASM measured by DXA in the CV group showed no significant difference (P > 0.05). CONCLUSION These models could be useful for older Chinese patients with knee osteoarthritis to estimate ASM.
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Affiliation(s)
- Peng Wu
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li Chen
- Biomedicine, The University of Melbourne, Melbourne, Vic., Australia
| | - Jianfeng Jin
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yiou Zhang
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chenxian Su
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Congcong Wu
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junzhe Lang
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Chen
- Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Keke Jin
- Pathophysiology, Wenzhou Medical University, Wenzhou, China
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Han TS, Al-Gindan YY, Govan L, Hankey CR, Lean MEJ. Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults. Acta Diabetol 2019; 56:947-954. [PMID: 30927105 PMCID: PMC6597601 DOI: 10.1007/s00592-019-01328-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/19/2019] [Indexed: 02/06/2023]
Abstract
AIMS Type 2 diabetes (T2D) is known to be associated with high BMI and waist circumference (WC). These measures do not discriminate well between skeletal muscle (SM) and body fat (BF), which may have opposite influences. METHODS We conducted a secondary analysis of population-based data from 58,128 aged 18-85 yrs from Scottish Health Surveys (2003, 2008-2011) and Health Surveys for England (2003-2006, 2008-2013), excluding pregnant women and insulin-treated diabetes. Logistic regression was used to assess associations of known T2D, and of screened HbA1c > 48 mmol/mol (> 6.5%), with sex-specific quintiles of BMI, WC, and BF% and SM% estimated by validated anthropometric equations, adjusted for age, sex, smoking, ethnicity, country, and survey year. RESULTS As expected, ORs for having known T2D rose with quintiles of BMI (1, 1.5, 2.3, 3.1, and 6.5) and WC (1, 1.8, 2.5, 3.5, and 8.7). Compared to the lowest BF% quintile, OR for having T2D in highest BF% quintile was 11.1 (95% CI = 8.4-14.6). Compared to the highest SM% quintile, OR for having T2D in lowest SM% quintile was 2.0 (1.7-2.4). Of 72 adults with T2D/HbA1c > 6.5% in the lowest quintile of BF%, 27 (37.5%) were in quintile 1 of SM%. Similar patterns of OR were observed for having HbA1c > 6.5% in those without known T2D. CONCLUSIONS Estimated BF% associates strongly with T2D. Low SM% also has a significant association, suggesting a neglected aspect of aetiology within T2D. These two simple measures with biological relevance, available from data collected in most health surveys, may be more useful than the purely statistical terms BMI.
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Affiliation(s)
- T S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK.
- Department of Diabetes and Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, UK.
| | - Y Y Al-Gindan
- Department of Nutrition, School of Medicine, University of Glasgow, Glasgow, UK
- Department of Clinical Nutrition, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - L Govan
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C R Hankey
- Department of Nutrition, School of Medicine, University of Glasgow, Glasgow, UK
| | - M E J Lean
- Department of Nutrition, School of Medicine, University of Glasgow, Glasgow, UK.
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[Early prevention and nutritional education]. SOINS; LA REVUE DE RÉFÉRENCE INFIRMIÈRE 2019; 64:25-28. [PMID: 30771844 DOI: 10.1016/j.soin.2018.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To be effective, prevention must not remain a theoretical concept and its implementation must not be perceived negatively. Ignorance and prejudices need to be overcome. From conception to adolescence, simple and easy-to-follow nutritional education measures, as well as practical and concrete advice, can be easily applied. Caregivers have an important role to play in communicating these guidelines.
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Establishment of Prediction Equations of Lean Body Mass Suitable for Chinese Adults. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1757954. [PMID: 31341889 PMCID: PMC6612995 DOI: 10.1155/2019/1757954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/29/2019] [Accepted: 06/09/2019] [Indexed: 11/25/2022]
Abstract
Aim To develop predictive equations of lean body mass (LBM) suitable for healthy southern Chinese adults with a large sample. LBM measured by dual-energy X-ray absorptiometry (DXA) are considered as the standard ones. Methods Retrospective analysis was conducted on the consecutive people who did total body measurement with DXA from July 2005 to October 2015. People with diseases that might affect LBM were excluded and overall 12,194 subjects were included in this study. Information about the 10,683 subjects (2,987 males and 7,696 females) from July 2005 to November 2014 was used to establish equations. These subjects were grouped by sex and then subdivided according to their body mass index (BMI). The female group was divided into another two subgroups: the premenopausal and postmenopausal subgroups. Equations were developed through stepwise multilinear regression analysis of height, weight, age, and BMI. Information about the 1,511 subjects (395 males and 1116 females) from December 2014 to October 2015 was used to verify the established equations. Results BMI, height, weight, and age were introduced into the equations as independent variables in the male group, while age was proved to have no influence on LBM in the female group. Regrouping according to BMI or menopause did not increase the predictive ability of equations. Good agreement between LBM evaluated by equation (LBM_PE) and LBM measured by DXA (LBM_DXA) was observed in both the male and female groups. Conclusion Predictive equations of LBM suitable for healthy southern Chinese adults are established with a large sample. BMI was related to LBM content; however, there is no need for further group based on BMI or menopause while developing LBM questions.
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Bentov I, Kaplan SJ, Pham TN, Reed MJ. Frailty assessment: from clinical to radiological tools. Br J Anaesth 2019; 123:37-50. [PMID: 31056240 DOI: 10.1016/j.bja.2019.03.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 02/05/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022] Open
Abstract
Frailty is a syndrome of cumulative decline across multiple physiological systems, which predisposes vulnerable adults to adverse events. Assessing vulnerable patients can potentially lead to interventions that improve surgical outcomes. Anaesthesiologists who care for older patients can identify frailty to improve preoperative risk stratification and subsequent perioperative planning. Numerous clinical tools to diagnose frailty exist, but none has emerged as the standard tool to be used in clinical practice. Radiological modalities, such as computed tomography and ultrasonography, are widely performed before surgery, and are therefore available to be used opportunistically to objectively evaluate surrogate markers of frailty. This review presents the importance of frailty assessment by anaesthesiologists; lists common clinical tools that have been applied; and proposes that utilising radiological imaging as an objective surrogate measure of frailty is a novel, expanding approach for which anaesthesiologists can significantly contribute to broad implementation.
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Affiliation(s)
- Itay Bentov
- Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
| | - Stephen J Kaplan
- Section of General, Thoracic, and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA
| | - Tam N Pham
- Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA
| | - May J Reed
- Division of Gerontology and Geriatric Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA
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Han TS, Al-Gindan YY, Govan L, Hankey CR, Lean MEJ. Associations of body fat and skeletal muscle with hypertension. J Clin Hypertens (Greenwich) 2018; 21:230-238. [PMID: 30525280 DOI: 10.1111/jch.13456] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/20/2018] [Accepted: 10/02/2018] [Indexed: 11/30/2022]
Abstract
Hypertension is known to be associated with obesity, while its relationship to skeletal muscle, SM (SM; a marker of general health and body function), remains uncertain. We analyzed population-based data of 22 591 men (mean age: 51.6 ± 16.9 years) and 27 845 nonpregnant women (50.6 ± 16.9 years) from Scottish Health Surveys (2003, 2008-2011) and Health Surveys for England (2003-2006, 2008-2013) including 2595 non-insulin- and 536 insulin-treated diabetic patients. Compared with normotensive individuals (no hypertension history with normal systolic [SBP < 140 mm Hg] and diastolic blood pressure [DBP < 90 mm Hg]), percent body fat (BF%) was significantly higher and percent SM lower (P < 0.001) in undetected (no hypertension history with raised SBP ≥ 140 and/or DBP ≥ 90 mm Hg), controlled (hypertension history with normal BP), uncontrolled (hypertension history with raised BP), and untreated hypertension. The prevalences of hypertension within BF% quintiles were 11.8%, 24.8%, 41.4%, 56.8%, and 71.6% and SM% quintiles were 67.5%, 53.3%, 39.5%, 27.4%, and 18.5%. Compared to referent groups (lowest BF% quintile or highest SM% quintile), odds ratio (age, sex, smoking, ethnicity, country, survey year, and diabetes adjusted) for having all types of hypertension in the highest BF% quintile was 5.5 (95% confidence interval = 5.0-5.9) and lowest SM% quintile was 2.3 (2.2-2.5). Compared with those without diabetes, individuals with diabetes had a 2.3-fold-2.6-fold greater risk of hypertension, independent of confounding factors and BF% or SM%. The associations of hypertension with BF% were higher than those with body mass index (BMI). In conclusion, both BF and SM should be considered when analyzing results from health surveys, rather than relying on BMI which does not discriminate between the two.
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Affiliation(s)
- Thang S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK.,Department of Diabetes and Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, UK
| | - Yasmin Y Al-Gindan
- Human Nutrition, School of Medicine, University of Glasgow, Glasgow, UK.,Department of Clinical Nutrition, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Lindsay Govan
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Michael E J Lean
- Human Nutrition, School of Medicine, University of Glasgow, Glasgow, UK
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Carnevale V, Castriotta V, Piscitelli PA, Nieddu L, Mattera M, Guglielmi G, Scillitani A. Assessment of Skeletal Muscle Mass in Older People: Comparison Between 2 Anthropometry-Based Methods and Dual-Energy X-ray Absorptiometry. J Am Med Dir Assoc 2018; 19:793-796. [DOI: 10.1016/j.jamda.2018.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/11/2018] [Accepted: 05/20/2018] [Indexed: 12/25/2022]
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He X, Liu C, Chen Y, He J, Dong Y. Overweight Without Central Obesity, Cardiovascular Risk, and All-Cause Mortality. Mayo Clin Proc 2018; 93:709-720. [PMID: 29656788 DOI: 10.1016/j.mayocp.2018.01.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/23/2018] [Accepted: 01/29/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the association of overweight without central obesity with risks of mortality. PATIENTS AND METHODS We included 14,299 participants in the Third National Health and Nutrition Examination Survey (from October 18, 1988, through October 15, 1994). According to their body mass index and waist circumference, participants were categorized into 7 anthropometric groups. Logistic regression models were used to assess the relation of cardiovascular risk factors (hypertension, diabetes, or hypercholesterolemia) and 10-year cardiovascular risk to anthropometric groups. Cox proportional hazards models were used to assess the risk of all-cause mortality, and competing-risks regression models were used for calculating cardiovascular and noncardiovascular mortality. RESULTS Compared with those with normal body mass index and waist circumference, overweight men without central obesity were more likely to have all 3 cardiovascular risk factors and a high cardiovascular risk, whereas women in this anthropometric group were more likely to have hypercholesterolemia. In proportional hazards models, overweight without central obesity was associated with lower all-cause mortality among men in the population with cardiovascular risk factors (hazard ratio, 0.71; 95% CI, 0.56-0.89; P=.004) and the general population (hazard ratio, 0.72; 95% CI, 0.60-0.87; P=.001), whereas results of these comparisons among women were not significant (P>.05). In competing risk analyses, overweight men without central obesity had a lower risk of noncardiovascular mortality, but not cardiovascular mortality. CONCLUSION Although overweight without central obesity was associated with cardiovascular risk factors and a high cardiovascular risk among men, men in this anthropometric group had a lower mortality risk.
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Affiliation(s)
- Xin He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Chen Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yili Chen
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Jiangui He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yugang Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
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Jing Y, Han TS, Alkhalaf MM, Lean MEJ. Attenuation of the association between sugar-sweetened beverages and diabetes risk by adiposity adjustment: a secondary analysis of national health survey data. Eur J Nutr 2018; 58:1703-1710. [PMID: 29766286 PMCID: PMC6561981 DOI: 10.1007/s00394-018-1716-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 05/09/2018] [Indexed: 01/05/2023]
Abstract
Purpose While weight gain and obesity are the dominant factors, dietary sugar and specifically sugar-sweetened beverages (SSB) has been implicated in causing type 2 diabetes (T2DM). We assessed how much of the apparent effect of SSB is explained by adiposity, but not captured by adjustment for BMI, which is a poor index of body fat. Methods We examined data from 5187 adults (mean age 50.8 years, SD = 16.4, 172 (3.3%) T2DM), from the Scottish Health Survey 2003 and 2008–2010 databases. Logistic regression was used to assess the association between SSB consumption and T2DM (non-insulin treated) and its attenuation (reduction in odds ratios, ORs), after entering published anthropometric indices of adiposity into the regression model, adjusted for age, sex, social class, education, smoking, alcohol consumption and physical activity. Results Compared with low SSB categories (“less often/never”, once/week or 1–3 times/month), the OR without adiposity adjustment for having T2DM in high SSB consumers (2–3, 4–5, ≥ 6/day) was 2.56 (95% CI 1.12–5.83; p = 0.026). That OR was marginally changed by adjusting for BMI (+ 4.3%), WC (+ 5.5%) or total body fat (− 4.3%), but greatly attenuated by adjusting for estimated %body fat (− 23.4%). These indices had similar influences on the associations between SSB and T2DM combining known T2DM patients with unknown HbA1c > 6.5%, > 48 mmol/mol. Conclusions Associations between SSB and T2DM are attenuated more markedly by adjustment with estimated %body fat than with BMI, indicating an adiposity effect not captured using BMI. Future research should employ best available estimates of adiposity.
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Affiliation(s)
- Yi Jing
- Human Nutrition, School of Medicine, University of Glasgow, Level 2, New Lister Building, 10-16 Alexandra Parade, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Thang S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK.,Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, UK
| | - Majid M Alkhalaf
- Human Nutrition, School of Medicine, University of Glasgow, Level 2, New Lister Building, 10-16 Alexandra Parade, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, University of Glasgow, Level 2, New Lister Building, 10-16 Alexandra Parade, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK.
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Durrand JW, Wagstaff K, Kasim A, Cawthorn L, Danjoux GR, Kothmann E. Reliability of repeated arm-crank cardiopulmonary exercise tests in patients with small abdominal aortic aneurysm. Anaesthesia 2018; 73:967-971. [PMID: 29727012 DOI: 10.1111/anae.14312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2018] [Indexed: 11/28/2022]
Abstract
Arm-crank ergometry may be useful in patients unable to pedal, for instance due to peripheral arterial disease. Twenty participants with small abdominal aortic aneurysm undertook two serial arm-crank tests and then a pedal test, four of whom had indeterminate anaerobic thresholds, precluding analysis. The mean (SD) peak arm and leg oxygen consumptions in 16 participants were 13.71 (2.62) ml.kg-1 .min-1 and 16.82 (4.44) ml.kg-1 .min-1 , with mean (SD) individual differences of 3.11 (2.48) ml.kg-1 .min-1 , p = 0.0001. The respective values at the anaerobic thresholds were 7.83 (1.58) ml O2 .kg-1 .min-1 and 10.09 (3.15) ml O2 .kg-1 .min-1 , with mean (SD) individual differences of 2.26 (2.34) ml O2 .kg-1 .min-1 , p = 0.0001. The correlation coefficients (95%CI) for peak oxygen consumption and anaerobic threshold were 0.88 (0.62-1.0) and 0.70 (0.32-1.0). There were no significant differences in serial arm-crank tests, with intracluster correlations (95%CI) of 0.87 (0.86-0.88) and 0.65 (0.61-0.69) for peak oxygen consumption and anaerobic threshold, respectively.
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Affiliation(s)
- J W Durrand
- Northern School of Anaesthesia and Intensive Care Medicine, Health Education North East, Newcastle-upon-Tyne, UK
| | - K Wagstaff
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - A Kasim
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - L Cawthorn
- Department of Anaesthesia, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - G R Danjoux
- Department of Anaesthesia, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.,Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - E Kothmann
- Department of Anaesthesia, North Tees and Hartlepool NHS Foundation Trust, Middlesbrough, UK
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Gómez Campos R, Pacheco Carrillo J, Almonacid Fierro A, Urra Albornoz C, Cossío-Bolaños M. Validation of equations and proposed reference values to estimate fat mass in Chilean university students. ACTA ACUST UNITED AC 2018; 65:156-163. [PMID: 29396215 DOI: 10.1016/j.endinu.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 11/02/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES (i) To propose regression equations based on anthropometric measures to estimate fat mass (FM) using dual energy X-ray absorptiometry (DXA) as reference method, and (ii)to establish population reference standards for equation-derived FM. MATERIAL AND METHODS A cross-sectional study on 6,713 university students (3,354 males and 3,359 females) from Chile aged 17.0 to 27.0years. Anthropometric measures (weight, height, waist circumference) were taken in all participants. Whole body DXA was performed in 683 subjects. A total of 478 subjects were selected to develop regression equations, and 205 for their cross-validation. Data from 6,030 participants were used to develop reference standards for FM. Equations were generated using stepwise multiple regression analysis. Percentiles were developed using the LMS method. RESULTS Equations for men were: (i) FM=-35,997.486 +232.285 *Weight +432.216 *CC (R2=0.73, SEE=4.1); (ii)FM=-37,671.303 +309.539 *Weight +66,028.109 *ICE (R2=0.76, SEE=3.8), while equations for women were: (iii)FM=-13,216.917 +461,302 *Weight+91.898 *CC (R2=0.70, SEE=4.6), and (iv) FM=-14,144.220 +464.061 *Weight +16,189.297 *ICE (R2=0.70, SEE=4.6). Percentiles proposed included p10, p50, p85, and p95. CONCLUSION The developed equations provide valid and accurate estimation of FM in both sexes. The values obtained using the equations may be analyzed from percentiles that allow for categorizing body fat levels by age and sex.
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Affiliation(s)
- Rossana Gómez Campos
- Universidad Autónoma de Chile, Talca, Chile; Facultad de Educación Física, Universidad Estadual de Campinas, Sao Paulo, Brasil
| | - Jaime Pacheco Carrillo
- Departamento de Ciencias de la Educación, Profesor de Educación Física, Universidad del Bio Bio, Chillán, Chile
| | | | - Camilo Urra Albornoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Marco Cossío-Bolaños
- Universidad Autónoma de Chile, Talca, Chile; Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile; Instituto de Deporte Universitario, Universidad Nacional de San Agustín, Arequipa, Perú.
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Tomás MT, Galán-Mercant A, Carnero EA, Fernandes B. Functional Capacity and Levels of Physical Activity in Aging: A 3-Year Follow-up. Front Med (Lausanne) 2018; 4:244. [PMID: 29376052 PMCID: PMC5767296 DOI: 10.3389/fmed.2017.00244] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 12/15/2017] [Indexed: 12/21/2022] Open
Abstract
Over the last decades, the world elderly population has increased exponentially and this tendency will continue during the coming years; from 2000 to 2050, people over 60 will double and those over 80 will quadruple. Loss of independence occurs as people age due to mobility restrictions, frailty, and decreased functional fitness and cognitive abilities. Evidence has shown that appropriate programs and policies contribute to keep older adults healthy and independent over time. The purpose of this chapter is to report the results of our 3-year follow-up study designed to characterize functional physical fitness in a sample of Portuguese community-dwelling older adults to propose a set of functional parameters that decline the most. We studied a group of 43 elderly people, aged 60 and over. Variables assessed on the participants were anthropometric measurements, functional capacity with the Senior Fitness Test battery (muscle strength, aerobic endurance, flexibility, agility, and dynamic balance), handgrip strength, levels of physical activity, and balance. Three years after the first assessment, a second assessment of the same variables was conducted. We analyzed what were the variables that, for this group, were related with a healthier aging and the relation with different physical activity levels. Our study showed that the distance covered in 6-min walk test and handgrip strength seem to explain a great amount of variability on functional variables that have changed on this period (68% of balance, lower and upper functional strength, respectively) and the active participants showed less decrements with aging in anthropometric and functional variables than those inactive or insufficiently active (p < 0.05). Greater importance should be given to prescription of exercise targeting older adults and, specifically, walking and manual activities should be given more attention as components of a community exercise program.
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Affiliation(s)
- Maria Teresa Tomás
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
| | | | - Elvis Alvarez Carnero
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL, United States
| | - Beatriz Fernandes
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
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Development and validation of anthropometric prediction equations for lean body mass, fat mass and percent fat in adults using the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Br J Nutr 2017; 118:858-866. [PMID: 29110742 DOI: 10.1017/s0007114517002665] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Quantification of lean body mass and fat mass can provide important insight into epidemiological research. However, there is no consensus on generalisable anthropometric prediction equations to validly estimate body composition. We aimed to develop and validate practical anthropometric prediction equations for lean body mass, fat mass and percent fat in adults (men, n 7531; women, n 6534) from the National Health and Nutrition Examination Survey 1999-2006. Using a prediction sample, we predicted each of dual-energy X-ray absorptiometry (DXA)-measured lean body mass, fat mass and percent fat based on different combinations of anthropometric measures. The proposed equations were validated using a validation sample and obesity-related biomarkers. The practical equation including age, race, height, weight and waist circumference had high predictive ability for lean body mass (men: R 2=0·91, standard error of estimate (SEE)=2·6 kg; women: R 2=0·85, SEE=2·4 kg) and fat mass (men: R 2=0·90, SEE=2·6 kg; women: R 2=0·93, SEE=2·4 kg). Waist circumference was a strong predictor in men only. Addition of other circumference and skinfold measures slightly improved the prediction model. For percent fat, R 2 were generally lower but the trend in variation explained was similar. Our validation tests showed robust and consistent results with no evidence of substantial bias. Additional validation using biomarkers demonstrated comparable abilities to predict obesity-related biomarkers between direct DXA measurements and predicted scores. Moreover, predicted fat mass and percent fat had significantly stronger associations with obesity-related biomarkers than BMI did. Our findings suggest the potential application of the proposed equations in various epidemiological settings.
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Skupski DW, Owen J, Kim S, Fuchs KM, Albert PS, Grantz KL. Estimating Gestational Age From Ultrasound Fetal Biometrics. Obstet Gynecol 2017; 130:433-441. [PMID: 28697101 PMCID: PMC5712287 DOI: 10.1097/aog.0000000000002137] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the accuracy of a new formula with one developed in 1984 (and still in common use) and to develop and compare racial and ethnic-specific and racial and ethnic-neutral formulas. METHODS The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons was a prospective cohort study that recruited women in four self-reported racial-ethnic groups-non-Hispanic black, Hispanic, non-Hispanic white, and Asian-with singleton gestations from 12 U.S. centers (2009-2013). Women with a certain last menstrual period confirmed by first-trimester ultrasonogram had longitudinal fetal measurements by credentialed study ultrasonographers blinded to the gestational age at their five follow-up visits. Regression analyses were performed with linear mixed models to develop gestational age estimating formulas. Repeated cross-validation was used for validation. The estimation error was defined as the mean squared difference between the estimated and observed gestational age and was used to compare the formulas' accuracy. RESULTS The new formula estimated the gestational age (±2 SD) within ±7 days from 14 to 20 weeks of gestation, ±10 days from 21 to 27 weeks of gestation, and ±17 days from 28 to 40 weeks of gestation. The new formula performed significantly better than a formula developed in 1984 with an estimation error of 10.4 compared with 11.2 days from 21 to 27 weeks of gestation and 17.0 compared with 19.8 days at 28-40 weeks of gestation, respectively. Racial and ethnic-specific formulas did not outperform the racial and ethnic-neutral formula. CONCLUSION The NICHD gestational age estimation formula is associated with smaller errors than a well-established historical formula. Racial and ethnic-specific formulas are not superior to a racial-ethnic-neutral one.
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Affiliation(s)
- Daniel W Skupski
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Queens, New York; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama; the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; and the Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
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Cova I, Pomati S, Maggiore L, Forcella M, Cucumo V, Ghiretti R, Grande G, Muzio F, Mariani C. Nutritional status and body composition by bioelectrical impedance vector analysis: A cross sectional study in mild cognitive impairment and Alzheimer's disease. PLoS One 2017; 12:e0171331. [PMID: 28187148 PMCID: PMC5302822 DOI: 10.1371/journal.pone.0171331] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/18/2017] [Indexed: 01/22/2023] Open
Abstract
AIMS Analysis of nutritional status and body composition in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). METHODS A cross-sectional study was performed in a University-Hospital setting, recruiting 59 patients with AD, 34 subjects with MCI and 58 elderly healthy controls (HC). Nutritional status was assessed by anthropometric parameters (body mass index; calf, upper arm and waist circumferences), Mini Nutritional Assessment (MNA) and body composition by bioelectrical impedance vector analysis (BIVA). Variables were analyzed by analysis of variance and subjects were grouped by cognitive status and gender. RESULTS Sociodemographic variables did not differ among the three groups (AD, MCI and HC), except for females' age, which was therefore used as covariate in a general linear multivariate model. MNA score was significantly lower in AD patients than in HC; MCI subjects achieved intermediate scores. AD patients (both sexes) had significantly (p<0.05) higher height-normalized impedance values and lower phase angles (body cell mass) compared with HC; a higher ratio of impedance to height was found in men with MCI with respect to HC. With BIVA method, MCI subjects showed a significant displacement on the RXc graph on the right side indicating lower soft tissues (Hotelling's T2 test: men = 10.6; women = 7.9;p < 0,05) just like AD patients (Hotelling's T2 test: men = 18.2; women = 16.9; p<0,001). CONCLUSION Bioelectrical parameters significantly differ from MCI and AD to HC; MCI showed an intermediate pattern between AD and HC. Longitudinal studies are required to investigate if BIVA could reflect early AD-changes in body composition in subjects with MCI.
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Affiliation(s)
- Ilaria Cova
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
- * E-mail:
| | - Simone Pomati
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Laura Maggiore
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Marica Forcella
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Valentina Cucumo
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Roberta Ghiretti
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Giulia Grande
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
| | - Fulvio Muzio
- Dietetic and Clinical Nutrition Unit, ASST Fatebenefratelli-Sacco, "Luigi Sacco" University Hospital, Milan, Italy
| | - Claudio Mariani
- Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, ASST Fatebenefratelli-Sacco, “Luigi Sacco” University Hospital, Milan, Italy
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Tanamas SK, Lean MEJ, Combet E, Vlassopoulos A, Zimmet PZ, Peeters A. Changing guards: time to move beyond body mass index for population monitoring of excess adiposity. QJM 2016; 109:443-446. [PMID: 26527773 DOI: 10.1093/qjmed/hcv201] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Indexed: 11/14/2022] Open
Abstract
With the obesity epidemic, and the effects of aging populations, human phenotypes have changed over two generations, possibly more dramatically than in other species previously. As obesity is an important and growing hazard for population health, we recommend a systematic evaluation of the optimal measure(s) for population-level excess body fat. Ideal measure(s) for monitoring body composition and obesity should be simple, as accurate and sensitive as possible, and provide good categorization of related health risks. Combinations of anthropometric markers or predictive equations may facilitate better use of anthropometric data than single measures to estimate body composition for populations. Here, we provide new evidence that increasing proportions of aging populations are at high health-risk according to waist circumference, but not body mass index (BMI), so continued use of BMI as the principal population-level measure substantially underestimates the health-burden from excess adiposity.
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Affiliation(s)
- S K Tanamas
- From the 1Baker IDI Heart and Diabetes Institute, the Alfred Centre, Level 4, 99 Commercial Road, Melbourne, Victoria 3004, Australia
| | - M E J Lean
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Royal Infirmary Campus, Alexandra Parade, Glasgow G31 2ER, UK
| | - E Combet
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Royal Infirmary Campus, Alexandra Parade, Glasgow G31 2ER, UK
| | - A Vlassopoulos
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Royal Infirmary Campus, Alexandra Parade, Glasgow G31 2ER, UK
| | - P Z Zimmet
- From the 1Baker IDI Heart and Diabetes Institute, the Alfred Centre, Level 4, 99 Commercial Road, Melbourne, Victoria 3004, Australia
| | - A Peeters
- From the 1Baker IDI Heart and Diabetes Institute, the Alfred Centre, Level 4, 99 Commercial Road, Melbourne, Victoria 3004, Australia
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Kamiya K, Masuda T, Matsue Y, Inomata T, Hamazaki N, Matsuzawa R, Tanaka S, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Izumi T, Ako J. Complementary Role of Arm Circumference to Body Mass Index in Risk Stratification in Heart Failure. JACC-HEART FAILURE 2016; 4:265-73. [DOI: 10.1016/j.jchf.2015.11.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/05/2015] [Accepted: 11/13/2015] [Indexed: 11/27/2022]
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Han TS, Lean ME. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. JRSM Cardiovasc Dis 2016; 5:2048004016633371. [PMID: 26998259 PMCID: PMC4780070 DOI: 10.1177/2048004016633371] [Citation(s) in RCA: 220] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 12/25/2022] Open
Abstract
The metabolic syndrome is a condition characterized by a special constellation of reversible major risk factors for cardiovascular disease and type 2 diabetes. The main, diagnostic, components are reduced HDL-cholesterol, raised triglycerides, blood pressure and fasting plasma glucose, all of which are related to weight gain, specifically intra-abdominal/ectopic fat accumulation and a large waist circumference. Using internationally adopted arbitrary cut-off values for waist circumference, having metabolic syndrome doubles the risk of cardiovascular disease, but offers an effective treatment approach through weight management. Metabolic syndrome now affects 30-40% of people by age 65, driven mainly by adult weight gain, and by a genetic or epigenetic predisposition to intra-abdominal/ectopic fat accumulation related to poor intra-uterine growth. Metabolic syndrome is also promoted by a lack of subcutaneous adipose tissue, low skeletal muscle mass and anti-retroviral drugs. Reducing weight by 5-10%, by diet and exercise, with or without, anti-obesity drugs, substantially lowers all metabolic syndrome components, and risk of type 2 diabetes and cardiovascular disease. Other cardiovascular disease risk factors such as smoking should be corrected as a priority. Anti-diabetic agents which improve insulin resistance and reduce blood pressure, lipids and weight should be preferred for diabetic patients with metabolic syndrome. Bariatric surgery offers an alternative treatment for those with BMI ≥ 40 or 35-40 kg/m(2) with other significant co-morbidity. The prevalence of the metabolic syndrome and cardiovascular disease is expected to rise along with the global obesity epidemic: greater emphasis should be given to effective early weight-management to reduce risk in pre-symptomatic individuals with large waists.
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Affiliation(s)
- Thang S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London (ICR2UL) and Ashford and St Peter's NHS Foundation Trust, UK
| | - Mike Ej Lean
- Human Nutrition, School of Medicine, University of Glasgow, UK
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Pérez-Zepeda MU, Gutiérrez-Robledo LM. Calf circumference predicts mobility disability: A secondary analysis of the Mexican health and ageing study. Eur Geriatr Med 2016; 7:262-266. [PMID: 27656259 DOI: 10.1016/j.eurger.2016.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Calf circumference is a surrogate measurement of muscle mass. However, there is scarce evidence on its validity in predicting adverse outcomes such as mobility disability. The aim of this report is to determine if calf circumference could predict incident mobility disability in Mexican 60-year or older adults. METHODS This is a secondary analysis of the Mexican Health and Aging Study and in particular of its two first waves. Sixty-year or older adults without mobility disability in the first assessment were included and followed-up for two years. Calf circumference quartile groups were compared to test the difference of incident mobility disability. Logistic regression models were fitted to test the independent association when including confounding variables. RESULTS A total of 745 older adults were assessed, from which 24.4% of the older adults developed mobility disability at follow-up. A calf circumference > 38 cm was associated with a higher risk of developing mobility disability, even after adjustment in the multivariate model, with an odds ratio 0.55 (95% confidence interval 0.31-0.99, P = 0.049). CONCLUSIONS High calf circumference in Mexican older adults is independently associated with incident mobility disability. This could reflect the impact of adverse health conditions such as obesity (with high fat tissue) or edema. Further research should aim at testing these results in different populations.
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Affiliation(s)
- M U Pérez-Zepeda
- Geriatric Epidemiology Department at National Institute of Geriatrics, Mexico City, Mexico
| | - L M Gutiérrez-Robledo
- Head Office of the National Institute of Geriatrics, Periférico Sur 2767, colonia San Jerónimo Lídice, delegación Magdalena Contreras, 10200 México Distrito Federal, Mexico City, Mexico
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Anthropometrics and Body Composition. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Pérez-Zepeda M, Sánchez-Garrido N, González-Lara M, Gutiérrez-Robledo L. Sarcopenia prevalence using simple measurements and population-based cutoff values. THE JOURNAL OF LATIN AMERICAN GERIATRIC MEDICINE 2016; 2:8-13. [PMID: 29057380 PMCID: PMC5647144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To estimate the prevalence of sarcopenia in Mexican older adults using simple measurements and tailored cutoff values for the components of the European Working Group on Sarcopenia in Older People algorithm. MATERIAL AND METHODS This study used cross-sectional data from the third wave (2012) of the Mexican Health and Aging Study. Gait speed and handgrip strength cutoff values were tailored for Mexican older adults. Muscle mass was estimated by a formula, which uses simple anthropometry and demographic characteristics. RESULTS From the total of 1,238 older adults included in our study, sarcopenia prevalence was 11% (n = 137). When categorizing sarcopenia, 39.1% (n = 484) had pre-sarcopenia, 8.3% (n = 103) moderate sarcopenia, and 2.75% (n = 34) had severe sarcopenia. CONCLUSIONS Sarcopenia is a common problem in Mexican older adults, and its frequency along with its severity increases with age. Tailored cutoff values could help in identifying those subjects that could have benefited from intervention.
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Affiliation(s)
- M.U. Pérez-Zepeda
- Geriatric Epidemiologic Research Department, National Institute of Geriatrics, Mexico City, Mexico
| | - N. Sánchez-Garrido
- Geriatric Epidemiologic Research Department, National Institute of Geriatrics, Mexico City, Mexico
| | - M. González-Lara
- Postgraduate Division, Medicine Faculty, Mexican National Autonomous University, Mexico City, Mexico
| | - L.M. Gutiérrez-Robledo
- Geriatric Epidemiologic Research Department, National Institute of Geriatrics, Mexico City, Mexico
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