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Krumhansl KA, Brooks CM, Lowen JB, O’Brien JM, Wong MC, DiBacco C. Loss, resilience and recovery of kelp forests in a region of rapid ocean warming. Ann Bot 2024; 133:73-92. [PMID: 37952103 PMCID: PMC10921841 DOI: 10.1093/aob/mcad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND AIMS Changes in kelp abundances on regional scales have been highly variable over the past half-century owing to strong effects of local and regional drivers. Here, we assess patterns and dominant environmental variables causing spatial and interspecific variability in kelp persistence and resilience to change in Nova Scotia over the past 40 years. METHODS We conducted a survey of macrophyte abundance at 251 sites spanning the Atlantic coast of Nova Scotia from 2019 to 2022. We use this dataset to describe spatial variability in kelp species abundances, compare species occurrences to surveys conducted in 1982 and assess changes in kelp abundance over the past 22 years. We then relate spatial and temporal patterns in abundance and resilience to environmental metrics. KEY RESULTS Our results show losses of sea urchins and the cold-tolerant kelp species Alaria esculenta, Saccorhiza dermatodea and Agarum clathratum in Nova Scotia since 1982 in favour of the more warm-tolerant kelps Saccharina latissima and Laminaria digitata. Kelp abundances have increased slightly since 2000, and Saccharina latissima and L. digitata are widely abundant in the region today. The highest kelp cover occurs on wave-exposed shores and at sites where temperatures have remained below thresholds for growth (21 °C) and mortality (23 °C). Moreover, kelp has recovered from turf dominance following losses at some sites during a warm period from 2010 to 2012. CONCLUSIONS Our results indicate that dramatic changes in kelp community composition and a loss of sea urchin herbivory as a dominant driver of change in the system have occurred in Nova Scotia over the past 40 years. However, a broad-scale shift to turf-dominance has not occurred, as predicted, and our results suggest that resilience and persistence are still a feature of kelp forests in the region despite rapid warming over the past several decades.
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Affiliation(s)
- K A Krumhansl
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
| | - C M Brooks
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
| | - J B Lowen
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
| | - J M O’Brien
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
| | - M C Wong
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
| | - C DiBacco
- Fisheries and Oceans Canada, Bedford Institute of Oceanography, Dartmouth, Nova Scotia, B2Y 4A2, Canada
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Maskarinec G, Shvetsov Y, Wong MC, Cataldi D, Bennett J, Garber AK, Buchthal SD, Heymsfield SB, Shepherd JA. Predictors of visceral and subcutaneous adipose tissue and muscle density: The ShapeUp! Kids study. Nutr Metab Cardiovasc Dis 2024; 34:799-806. [PMID: 38218711 PMCID: PMC10922397 DOI: 10.1016/j.numecd.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/02/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Body fat distribution, i.e., visceral (VAT), subcutaneous adipose tissue (SAT) and intramuscular fat, is important for disease prevention, but sex and ethnic differences are not well understood. Our aim was to identify anthropometric, demographic, and lifestyle predictors for these outcomes. METHODS AND RESULTS The cross-sectional ShapeUp!Kids study was conducted among five ethnic groups aged 5-18 years. All participants completed questionnaires, anthropometric measurements, and abdominal MRI scans. VAT and SAT areas at four lumbar levels and muscle density were assessed manually. General linear models were applied to estimate coefficients of determination (R2) and to compare the fit of VAT and SAT prediction models. After exclusions, the study population had 133 male and 170 female participants. Girls had higher BMI-z scores, waist circumference (WC), and SAT than boys but lower VAT/SAT and muscle density. SAT, VAT, and VAT/SAT but not muscle density differed significantly by ethnicity. R2 values were higher for SAT than VAT across groups and improved slightly after adding WC. For SAT, R2 increased from 0.85 to 0.88 (girls) and 0.62 to 0.71 (boys) when WC was added while VAT models improved from 0.62 to 0.65 (girls) and 0.57 to 0.62 (boys). VAT values were significantly lower among Blacks than Whites with little difference for the other groups. CONCLUSION This analysis in a multiethnic population identified BMI-z scores and WC as the major predictors of MRI-derived SAT and VAT and highlights the important ethnic differences that need to be considered in diverse populations.
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Affiliation(s)
| | | | | | - Devon Cataldi
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Andrea K Garber
- University of California at San Francisco, San Francisco, CA, USA
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Leong LT, Wong MC, Liu YE, Glaser Y, Quon BK, Kelly NN, Cataldi D, Sadowski P, Heymsfield SB, Shepherd JA. Generative deep learning furthers the understanding of local distributions of fat and muscle on body shape and health using 3D surface scans. Commun Med (Lond) 2024; 4:13. [PMID: 38287144 PMCID: PMC10824755 DOI: 10.1038/s43856-024-00434-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Body shape, an intuitive health indicator, is deterministically driven by body composition. We developed and validated a deep learning model that generates accurate dual-energy X-ray absorptiometry (DXA) scans from three-dimensional optical body scans (3DO), enabling compositional analysis of the whole body and specified subregions. Previous works on generative medical imaging models lack quantitative validation and only report quality metrics. METHODS Our model was self-supervised pretrained on two large clinical DXA datasets and fine-tuned using the Shape Up! Adults study dataset. Model-predicted scans from a holdout test set were evaluated using clinical commercial DXA software for compositional accuracy. RESULTS Predicted DXA scans achieve R2 of 0.73, 0.89, and 0.99 and RMSEs of 5.32, 6.56, and 4.15 kg for total fat mass (FM), fat-free mass (FFM), and total mass, respectively. Custom subregion analysis results in R2s of 0.70-0.89 for left and right thigh composition. We demonstrate the ability of models to produce quantitatively accurate visualizations of soft tissue and bone, confirming a strong relationship between body shape and composition. CONCLUSIONS This work highlights the potential of generative models in medical imaging and reinforces the importance of quantitative validation for assessing their clinical utility.
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Affiliation(s)
- Lambert T Leong
- Molecular Bioscience and Bioengineering at University of Hawaii, Honolulu, HI, USA
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Michael C Wong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yong E Liu
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yannik Glaser
- Information and Computer Science at University of Hawaii, Honolulu, HI, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Devon Cataldi
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Peter Sadowski
- Information and Computer Science at University of Hawaii, Honolulu, HI, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LO, USA
| | - John A Shepherd
- Molecular Bioscience and Bioengineering at University of Hawaii, Honolulu, HI, USA.
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA.
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Cataldi D, Bennett JP, Wong MC, Quon BK, Liu YE, Kelly NN, Kelly T, Schoeller DA, Heymsfield SB, Shepherd JA. Accuracy and precision of multiple body composition methods and associations with muscle strength in athletes of varying hydration: The Da Kine Study. Clin Nutr 2024; 43:284-294. [PMID: 38104490 DOI: 10.1016/j.clnu.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Athletes vary in hydration status due to ongoing training regimes, diet demands, and extreme exertion. With water being one of the largest body composition compartments, its variation can cause misinterpretation of body composition assessments meant to monitor strength and training progress. In this study, we asked what accessible body composition approach could best quantify body composition in athletes with a variety of hydration levels. METHODS The Da Kine Study recruited collegiate and intramural athletes to undergo a variety of body composition assessments including air-displacement plethysmography (ADP), deuterium-oxide dilution (D2O), dual-energy X-ray absorptiometry (DXA), underwater-weighing (UWW), 3D-optical (3DO) imaging, and bioelectrical impedance (BIA). Each of these methods generated 2- or 3-compartment body composition estimates of fat mass (FM) and fat-free mass (FFM) and was compared to equivalent measures of the criterion 6-compartment model (6CM) that accounts for variance in hydration. Body composition by each method was used to predict abdominal and thigh strength, assessed by isokinetic/isometric dynamometry. RESULTS In total, 70 (35 female) athletes with a mean age of 21.8 ± 4.2 years were recruited. Percent hydration (Body Water6CM/FFM6CM) had substantial variation in both males (63-73 %) and females (58-78 %). ADP and DXA FM and FF M had moderate to substantial agreement with the 6C model (Lin's Concordance Coefficient [CCC] = 0.90-0.95) whereas the other measures had lesser agreement (CCC <0.90) with one exception of 3DO FFM in females (CCC = 0.91). All measures of FFM produced excellent precision with %CV < 1.0 %. However, FM measures in general had worse precision (% CV < 2.0 %). Increasing quartiles (significant p < 0.001 trend) of 6CM FFM resulted in increasing strength measures in males and females. Moreover, the stronger the agreement between the alternative methods to the 6CM, the more robust their correlation with strength, irrespective of hydration status. CONCLUSION The criterion 6CM showed the best association to strength regardless of the hydration status of the athletes for both males and females. Simpler methods showed high precision for both FM and FFM and those with the strongest agreement to the 6CM had the highest strength associations. SUMMARY BOX This study compared various body composition analysis methods in 70 athletes with varying states of hydration to the criterion 6-compartment model and assessed their relationship to muscle strength. The results showed that accurate and precise estimates of body composition can be determined in athletes, and a more accurate body composition measurement produces better strength estimates. The best laboratory-based techniques were air displacement plethysmography and dual-energy x-ray absorptiometry, while the commercial methods had moderate-poor agreement. Prioritizing accurate body composition assessment ensures better strength estimates in athletes.
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Affiliation(s)
- Devon Cataldi
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Jonathan P Bennett
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Michael C Wong
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Thomas Kelly
- Hologic Inc, 250 Campus Dr, Marlborough, MA 01752, USA
| | - Dale A Schoeller
- Isotope Ratio Core Biotech Center and Nutritional Sciences, Henry Mall Madison, WI 53706, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 7080, USA
| | - John A Shepherd
- Department of Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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Garber AK, Bennett JP, Wong MC, Tian IY, Maskarinec G, Kennedy SF, McCarthy C, Kelly NN, Liu YE, Machen VI, Heymsfield SB, Shepherd JA. Cross-sectional assessment of body composition and detection of malnutrition risk in participants with low body mass index and eating disorders using 3D optical surface scans. Am J Clin Nutr 2023; 118:812-821. [PMID: 37598747 PMCID: PMC10797509 DOI: 10.1016/j.ajcnut.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND New recommendations for the assessment of malnutrition and sarcopenia include body composition, specifically reduced muscle mass. Three-dimensional optical imaging (3DO) is a validated, accessible, and affordable alternative to dual X-ray absorptiometry (DXA). OBJECTIVE Identify strengths and weaknesses of 3DO for identification of malnutrition in participants with low body mass index (BMI) and eating disorders. DESIGN Participants were enrolled in the cross-sectional Shape Up! Adults and Kids studies of body shape, metabolic risk, and functional assessment and had BMI of <20 kg/m2 in adults or <85% of median BMI (mBMI) in children and adolescents. A subset was referred for eating disorders evaluation. Anthropometrics, scans, strength testing, and questionnaires were completed in clinical research centers. Lin's Concordance Correlation Coefficient (CCC) assessed agreement between 3DO and DXA; multivariate linear regression analysis examined associations between weight history and body composition. RESULTS Among 95 participants, mean ± SD BMI was 18.3 ± 1.4 kg/m2 in adult women (N = 56), 19.0 ± 0.6 in men (N = 14), and 84.2% ± 4.1% mBMI in children (N = 25). Concordance was excellent for fat-free mass (FFM, CCC = 0.97) and strong for appendicular lean mass (ALM, CCC = 0.86) and fat mass (FM, CCC = 0.87). By DXA, 80% of adults met the low FFM index criterion for malnutrition, and 44% met low ALM for sarcopenia; 52% of children and adolescents were <-2 z-score for FM. 3DO identified 95% of these cases. In the subset, greater weight loss predicted lower FFM, FM, and ALM by both methods; a greater percentage of weight regained predicted a higher percentage of body fat. CONCLUSIONS 3DO can accurately estimate body composition in participants with low BMI and identify criteria for malnutrition and sarcopenia. In a subset, 3DO detected changes in body composition expected with weight loss and regain secondary to eating disorders. These findings support the utility of 3DO for body composition assessment in patients with low BMI, including those with eating disorders. This trial was registered at clinicaltrials.gov as NCT03637855.
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Affiliation(s)
- Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, CA, United States.
| | - Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, HI, United States; University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Michael C Wong
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | | | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Nisa N Kelly
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Yong E Liu
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Vanessa I Machen
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - John A Shepherd
- University of Hawai'i Cancer Center, Honolulu, HI, United States
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Wong MC, Bennett JP, Quon B, Leong LT, Tian IY, Liu YE, Kelly NN, McCarthy C, Chow D, Pujades S, Garber AK, Maskarinec G, Heymsfield SB, Shepherd JA. Accuracy and Precision of 3-dimensional Optical Imaging for Body Composition by Age, BMI, and Ethnicity. Am J Clin Nutr 2023; 118:657-671. [PMID: 37474106 PMCID: PMC10517211 DOI: 10.1016/j.ajcnut.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The obesity epidemic brought a need for accessible methods to monitor body composition, as excess adiposity has been associated with cardiovascular disease, metabolic disorders, and some cancers. Recent 3-dimensional optical (3DO) imaging advancements have provided opportunities for assessing body composition. However, the accuracy and precision of an overall 3DO body composition model in specific subgroups are unknown. OBJECTIVES This study aimed to evaluate 3DO's accuracy and precision by subgroups of age, body mass index, and ethnicity. METHODS A cross-sectional analysis was performed using data from the Shape Up! Adults study. Each participant received duplicate 3DO and dual-energy X-ray absorptiometry (DXA) scans. 3DO meshes were digitally registered and reposed using Meshcapade. Principal component analysis was performed on 3DO meshes. The resulting principal components estimated DXA whole-body and regional body composition using stepwise forward linear regression with 5-fold cross-validation. Duplicate 3DO and DXA scans were used for test-retest precision. Student's t tests were performed between 3DO and DXA by subgroup to determine significant differences. RESULTS Six hundred thirty-four participants (females = 346) had completed the study at the time of the analysis. 3DO total fat mass in the entire sample achieved R2 of 0.94 with root mean squared error (RMSE) of 2.91 kg compared to DXA in females and similarly in males. 3DO total fat mass achieved a % coefficient of variation (RMSE) of 1.76% (0.44 kg), whereas DXA was 0.98% (0.24 kg) in females and similarly in males. There were no mean differences for total fat, fat-free, percent fat, or visceral adipose tissue by age group (P > 0.068). However, there were mean differences for underweight, Asian, and Black females as well as Native Hawaiian or other Pacific Islanders (P < 0.038). CONCLUSIONS A single 3DO body composition model produced accurate and precise body composition estimates that can be used on diverse populations. However, adjustments to specific subgroups may be warranted to improve the accuracy in those that had significant differences. This trial was registered at clinicaltrials.gov as NCT03637855 (Shape Up! Adults).
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Affiliation(s)
- Michael C Wong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Jonathan P Bennett
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Brandon Quon
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Lambert T Leong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | - Yong E Liu
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Dominic Chow
- John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Sergi Pujades
- Inria, Université Grenoble Alpes, CNRS, Grenoble INP, LJK, Grenoble, France
| | - Andrea K Garber
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States
| | - Gertraud Maskarinec
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | | | - John A Shepherd
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States.
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Tian IY, Wong MC, Nguyen WM, Kennedy S, McCarthy C, Kelly NN, Liu YE, Garber AK, Heymsfield SB, Curless B, Shepherd JA. Automated body composition estimation from device-agnostic 3D optical scans in pediatric populations. Clin Nutr 2023; 42:1619-1630. [PMID: 37481870 PMCID: PMC10528749 DOI: 10.1016/j.clnu.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/19/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Excess adiposity in children is strongly correlated with obesity-related metabolic disease in adulthood, including diabetes, cardiovascular disease, and 13 types of cancer. Despite the many long-term health risks of childhood obesity, body mass index (BMI) Z-score is typically the only adiposity marker used in pediatric studies and clinical applications. The effects of regional adiposity are not captured in a single scalar measurement, and their effects on short- and long-term metabolic health are largely unknown. However, clinicians and researchers rarely deploy gold-standard methods for measuring compartmental fat such as magnetic resonance imaging (MRI) and dual X-ray absorptiometry (DXA) on children and adolescents due to cost or radiation concerns. Three-dimensional optical (3DO) scans are relatively inexpensive to obtain and use non-invasive and radiation-free imaging techniques to capture the external surface geometry of a patient's body. This 3D shape contains cues about the body composition that can be learned from a structured correlation between 3D body shape parameters and reference DXA scans obtained on a sample population. STUDY AIM This study seeks to introduce a radiation-free, automated 3D optical imaging solution for monitoring body shape and composition in children aged 5-17. METHODS We introduce an automated, linear learning method to predict total and regional body composition of children aged 5-17 from 3DO scans. We collected 145 male and 206 female 3DO scans on children between the ages of 5 and 17 with three scanners from independent manufacturers. We used an automated shape templating method first introduced on an adult population to fit a topologically consistent 60,000 vertex (60 k) mesh to 3DO scans of arbitrary scanning source and mesh topology. We constructed a parameterized body shape space using principal component analysis (PCA) and estimated a regression matrix between the shape parameters and their associated DXA measurements. We automatically fit scans of 30 male and 38 female participants from a held-out test set and predicted 12 body composition measurements. RESULTS The coefficient of determination (R2) between 3DO predicted body composition and DXA measurements was at least 0.85 for all measurements with the exception of visceral fat on 3D scan predictions. Precision error was 1-4 times larger than that of DXA. No predicted variable was significantly different from DXA measurement except for male trunk lean mass. CONCLUSION Optical imaging can quickly, safely, and inexpensively estimate regional body composition in children aged 5-17. Frequent repeat measurements can be taken to chart changes in body adiposity over time without risk of radiation overexposure.
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Affiliation(s)
- Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, 98195, USA.
| | - Michael C Wong
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - William M Nguyen
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, 98195, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Nisa N Kelly
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - Yong E Liu
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - Andrea K Garber
- UCSF School of Medicine, University of California - San Francisco, San Francisco, CA, 94118, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Brian Curless
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, 98195, USA
| | - John A Shepherd
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wong MC, Bennett JP, Leong LT, Tian IY, Liu YE, Kelly NN, McCarthy C, Wong JMW, Ebbeling CB, Ludwig DS, Irving BA, Scott MC, Stampley J, Davis B, Johannsen N, Matthews R, Vincellette C, Garber AK, Maskarinec G, Weiss E, Rood J, Varanoske AN, Pasiakos SM, Heymsfield SB, Shepherd JA. Monitoring body composition change for intervention studies with advancing 3D optical imaging technology in comparison to dual-energy X-ray absorptiometry. Am J Clin Nutr 2023; 117:802-813. [PMID: 36796647 PMCID: PMC10315406 DOI: 10.1016/j.ajcnut.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Recent 3-dimensional optical (3DO) imaging advancements have provided more accessible, affordable, and self-operating opportunities for assessing body composition. 3DO is accurate and precise in clinical measures made by DXA. However, the sensitivity for monitoring body composition change over time with 3DO body shape imaging is unknown. OBJECTIVES This study aimed to evaluate the ability of 3DO in monitoring body composition changes across multiple intervention studies. METHODS A retrospective analysis was performed using intervention studies on healthy adults that were complimentary to the cross-sectional study, Shape Up! Adults. Each participant received a DXA (Hologic Discovery/A system) and 3DO (Fit3D ProScanner) scan at the baseline and follow-up. 3DO meshes were digitally registered and reposed using Meshcapade to standardize the vertices and pose. Using an established statistical shape model, each 3DO mesh was transformed into principal components, which were used to predict whole-body and regional body composition values using published equations. Body composition changes (follow-up minus the baseline) were compared with those of DXA using a linear regression analysis. RESULTS The analysis included 133 participants (45 females) in 6 studies. The mean (SD) length of follow-up was 13 (5) wk (range: 3-23 wk). Agreement between 3DO and DXA (R2) for changes in total FM, total FFM, and appendicular lean mass were 0.86, 0.73, and 0.70, with root mean squared errors (RMSEs) of 1.98 kg, 1.58 kg, and 0.37 kg, in females and 0.75, 0.75, and 0.52 with RMSEs of 2.31 kg, 1.77 kg, and 0.52 kg, in males, respectively. Further adjustment with demographic descriptors improved the 3DO change agreement to changes observed with DXA. CONCLUSIONS Compared with DXA, 3DO was highly sensitive in detecting body shape changes over time. The 3DO method was sensitive enough to detect even small changes in body composition during intervention studies. The safety and accessibility of 3DO allows users to self-monitor on a frequent basis throughout interventions. This trial was registered at clinicaltrials.gov as NCT03637855 (Shape Up! Adults; https://clinicaltrials.gov/ct2/show/NCT03637855); NCT03394664 (Macronutrients and Body Fat Accumulation: A Mechanistic Feeding Study; https://clinicaltrials.gov/ct2/show/NCT03394664); NCT03771417 (Resistance Exercise and Low-Intensity Physical Activity Breaks in Sedentary Time to Improve Muscle and Cardiometabolic Health; https://clinicaltrials.gov/ct2/show/NCT03771417); NCT03393195 (Time Restricted Eating on Weight Loss; https://clinicaltrials.gov/ct2/show/NCT03393195), and NCT04120363 (Trial of Testosterone Undecanoate for Optimizing Performance During Military Operations; https://clinicaltrials.gov/ct2/show/NCT04120363).
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Affiliation(s)
- Michael C Wong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Jonathan P Bennett
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Lambert T Leong
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | - Yong E Liu
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Julia M W Wong
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, United States
| | - Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, United States
| | - David S Ludwig
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, United States
| | - Brian A Irving
- Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Matthew C Scott
- Pennington Biomedical Research Center, Baton Rouge, LA, United States; Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - James Stampley
- Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Brett Davis
- Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Neil Johannsen
- Pennington Biomedical Research Center, Baton Rouge, LA, United States; Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Rachel Matthews
- Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Cullen Vincellette
- Louisiana State University, School of Kinesiology, Baton Rouge, LA, United States
| | - Andrea K Garber
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States
| | - Gertraud Maskarinec
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Ethan Weiss
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Alyssa N Varanoske
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, United States; Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, United States
| | | | - John A Shepherd
- Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, United States; Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, United States.
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Bennett JP, Liu YE, Kelly NN, Quon BK, Wong MC, McCarthy C, Heymsfield SB, Shepherd JA. Reply to Y Lu et al. Am J Clin Nutr 2023; 117:641-642. [PMID: 36872025 DOI: 10.1016/j.ajcnut.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Jonathan P Bennett
- From the Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, HI, USA; The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA.
| | - Yong En Liu
- The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Nisa N Kelly
- The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Brandon K Quon
- The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Michael C Wong
- From the Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, HI, USA; The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Cassidy McCarthy
- The Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Steven B Heymsfield
- The Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - John A Shepherd
- From the Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, HI, USA; The Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, HI, USA
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Tian IY, Wong MC, Kennedy S, Kelly NN, Liu YE, Garber AK, Heymsfield SB, Curless B, Shepherd JA. A device-agnostic shape model for automated body composition estimates from 3D optical scans. Med Phys 2022; 49:6395-6409. [PMID: 35837761 PMCID: PMC9990507 DOI: 10.1002/mp.15843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/18/2022] [Accepted: 06/01/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Many predictors of morbidity caused by metabolic disease are associated with body shape. 3D optical (3DO) scanning captures body shape and has been shown to accurately and precisely predict body composition variables associated with mortality risk. 3DO is safer, less expensive, and more accessible than criterion body composition assessment methods such as dual-energy X-ray absorptiometry (DXA). However, 3DO scanning has not been standardized across manufacturers for pose, mesh resolution, and post processing methods. PURPOSE We introduce a scanner-agnostic algorithm that automatically fits a topologically consistent human mesh to 3DO scanned point clouds and predicts clinically important body metrics using a standardized body shape model. Our models transform raw scans captured by any 3DO scanner into fixed topology meshes with anatomical consistency, standardizing the outputs of 3DO scans across manufacturers and allowing for the use of common prediction models across scanning devices. METHODS A fixed-topology body mesh template was automatically registered to 848 training scans from three different 3DO systems. Participants were between 18 and 89 years old with body mass index ranging from 14 to 52 kg/m2 . Scans were registered by first performing a coarse nearest neighbor alignment between the template and the input scan with an anatomically constrained principal component analysis (PCA) domain deformation using a device and gender specific bootstrap basis trained on 70 seed scans each. The template mesh was then optimized to fit the target with a smooth per-vertex surface-to-surface deformation. A combined unified PCA model was created from the superset of all automatically fit training scans including all three devices. Body composition predictions to DXA measurements were learned from the training mesh PCA coefficients using linear regression. Using this final unified model, we tested the accuracy of our body composition models on a withheld sample of 562 scans by fitting a PCA parameterized template mesh to each raw scan and predicting the expected body composition metrics from the principal components using the learned regression model. RESULTS We achieved coefficients of determination (R2 ) above 0.8 on all nine fat and lean predictions except female visceral fat (0.77). R2 was as high as 0.94 (total fat and lean, trunk fat), and all root-mean-squared errors were below 3.0 kg. All predicted body composition variables were not significantly different from reference DXA measurements except for visceral fat and female trunk fat. Repeatability precision as measured by the coefficient of variation (%CV) was around 2-3x worse than DXA precision, with visceral fat %CV below 2x DXA %CV and female total fat mass at 5x. CONCLUSIONS Our method provides an accurate, automated, and scanner agnostic framework for standardizing 3DO scans and a low cost, radiation-free alternative to criterion radiology imaging for body composition analysis. We published a web-app version of this work at https://shapeup.shepherdresearchlab.org/3do-bodycomp-analyzer/ that accepts mesh file uploads and returns templated meshes with body composition predictions for demo purposes.
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Affiliation(s)
- Isaac Y. Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, Washington, USA
| | - Michael C. Wong
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, Hawaii, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Nisa N. Kelly
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, Hawaii, USA
| | - Yong E. Liu
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, Hawaii, USA
| | - Andrea K. Garber
- UCSF School of Medicine, University of California - San Francisco, San Francisco, California, USA
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Brian Curless
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, Washington, USA
| | - John A. Shepherd
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, Hawaii, USA
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Bennett JP, Liu YE, Quon BK, Kelly NN, Leong LT, Wong MC, Kennedy SF, Chow DC, Garber AK, Weiss EJ, Heymsfield SB, Shepherd JA. Three-dimensional optical body shape and features improve prediction of metabolic disease risk in a diverse sample of adults. Obesity (Silver Spring) 2022; 30:1589-1598. [PMID: 35894079 PMCID: PMC9333197 DOI: 10.1002/oby.23470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study examined whether body shape and composition obtained by three-dimensional optical (3DO) scanning improved the prediction of metabolic syndrome (MetS) prevalence compared with BMI and demographics. METHODS A diverse ambulatory adult population underwent whole-body 3DO scanning, blood tests, manual anthropometrics, and blood pressure assessment in the Shape Up! Adults study. MetS prevalence was evaluated based on 2005 National Cholesterol Education Program criteria, and prediction of MetS involved logistic regression to assess (1) BMI, (2) demographics-adjusted BMI, (3) 85 3DO anthropometry and body composition measures, and (4) BMI + 3DO + demographics models. Receiver operating characteristic area under the curve (AUC) values were generated for each predictive model. RESULTS A total of 501 participants (280 female) were recruited, with 87 meeting the criteria for MetS. Compared with the BMI model (AUC = 0.819), inclusion of age, sex, and race increased the AUC to 0.861, and inclusion of 3DO measures further increased the AUC to 0.917. The overall integrated discrimination improvement between the 3DO + demographics and the BMI model was 0.290 (p < 0.0001) with a net reclassification improvement of 0.214 (p < 0.0001). CONCLUSIONS Body shape measures from an accessible 3DO scan, adjusted for demographics, predicted MetS better than demographics and/or BMI alone. Risk classification in this population increased by 29% when using 3DO scanning.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Lambert T Leong
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Dominic C Chow
- John A. Burns School of Medicine, University of Hawai'i Manoa, Honolulu, Hawaii, USA
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, California, USA
| | - Ethan J Weiss
- Division of Cardiology, University of California School of Medicine, San Francisco, California, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
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13
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Bennett JP, Liu YE, Kelly NN, Quon BK, Wong MC, McCarthy C, Heymsfield SB, Shepherd JA. Next generation smartwatches to estimate whole body composition using bioimpedance analysis: accuracy and precision in a diverse multiethnic sample. Am J Clin Nutr 2022; 116:1418-1429. [PMID: 35883219 DOI: 10.1093/ajcn/nqac200] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/07/2022] [Accepted: 07/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Novel advancements in wearable technologies include continuous measurement of body composition via smart watches. The accuracy and stability of devices are unknown. OBJECTIVES This study evaluated smart watches with integrated bioimpedance (BIA) sensors for their ability to measure and monitor change in body composition. DESIGN Participants recruited across body mass indexes received duplicate body composition measures using two wearable smart watch (W-BIA) models in sitting and standing positions and multiple versions of each watch were used to evaluate inter- and intra-model precision. Duplicate laboratory-grade octapolar bioimpedance (8-BIA) and criterion dual-energy X-ray absorptiometry (DXA) scans were acquired to compare estimates between the watches and laboratory methods. Test-retest precision and least significant changes assessed the ability to monitor change in body composition. RESULTS Of 109 participants recruited, 75 subjects completed the full manufacturer-recommended protocol. No significant differences were observed between W-BIA watches in position or between watch models. Significant fat-free mass (FFM) differences (p < 0.05) were observed between both W-BIA and 8-BIA when compared to DXA, though the systematic biases to the criterion were correctable. No significant difference was observed between the W-BIA and the laboratory-grade BIA technology for FFM (55.3 ± 14.5 kg for W-BIA versus 56.0 ± 13.8 kg for 8-BIA, p > 0.05, CCC = 0.97). FFM was less precise on the watches than DXA (CV = 0.7%, RMSE = 0.4 kg versus CV = 1.3%, RMSE = 0.7 kg for W-BIA), requiring more repeat measures to equal the same confidence in body composition change over time as DXA. CONCLUSIONS After systematic correction, smart watch BIA devices are capable of stable, reliable and accurate body composition with precision comparable but lower than laboratory measures. These devices allow for measurement in environments not accessible to laboratory systems such as the home, training centers, and geographically remote locations.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, Louisiana, 70808 USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, Louisiana, 70808 USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, Hawaii, 96822, USA.,Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, Hawaii, 96813 USA
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14
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Smith B, McCarthy C, Dechenaud ME, Wong MC, Shepherd J, Heymsfield SB. Anthropometric evaluation of a 3D scanning mobile application. Obesity (Silver Spring) 2022; 30:1181-1188. [PMID: 35491718 PMCID: PMC9177647 DOI: 10.1002/oby.23434] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Three-dimensional (3D) imaging systems are increasingly being used in health care settings for quantifying body size and shape. The potential exists to provide similar phenotyping capabilities outside of professional settings using smartphone applications (apps). The current study aim was to compare waist, hip, upper arm, and midthigh circumference measurements acquired by a free downloadable app (MeThreeSixty; Size Stream, Cary, North Carolina) and a conventional 20-camera 3D system (SS20; Size Stream) with those measured with a flexible tape at the same anatomic sites. METHODS Fifty-nine adults were scanned with the app and SS20; the same software was used to generate circumference estimates from device-acquired object files that were then compared with reference tape measurements. RESULTS The app and SS20 had similar coefficients of variation that were minimally larger than those by the tape (e.g., waist, 0.93%, 0.87%, and 0.06%). Correlations of the app and of SS20 with tape circumferences were all strong (p < 0.001) and similar in magnitude (R2 s: 0.72-0.93 and 0.78-0.95, respectively); minimally significant (p < 0.05 to p < 0.01) bias was present between both imaging approaches and some tape measurements. CONCLUSION These proof-of-concept observations combined with ubiquitous smartphone availability create the possibility of phenotyping adult body size and shape, with important clinical and research implications, on a global scale.
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Affiliation(s)
- Brooke Smith
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | | | | | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
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Bennett J, Wong MC, McCarthy C, Fearnbach N, Queen K, Shepherd J, Heymsfield SB. Emergence of the adolescent obesity epidemic in the United States: five-decade visualization with humanoid avatars. Int J Obes (Lond) 2022; 46:1587-1590. [PMID: 35610336 DOI: 10.1038/s41366-022-01153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Body size and shape have increased over the past several decades with one in five adolescents now having obesity according to objective anthropometric measures such as weight, height, and body mass index (BMI). The gradual physical changes and their consequences may not be fully appreciated upon visual inspection by those managing the long-term health of adolescents. This study aimed to develop humanoid avatars representing the gradual changes in adolescent body size and shape over the past five decades and to align avatars with key BMI percentile cut points for underweight, normal weight, overweight, and obesity. PARTICIPANTS/METHODS Participants included 223 children and adolescents between the ages of 5 and 18 years approximately representative of the race/ethnicity and BMI of the noninstitutionalized US population. Each participant completed a three-dimensional whole-body scan, and the collected data was used to develop manifold regression models for generating humanoid male and female avatars from specified ages, weights, and heights. Secular changes in the mean weights and heights of adolescents were acquired from six U.S. National Health and Nutrition Surveys beginning in 1971-1974 and ending in 2015-2018. Male and female avatars at two representative ages, 10 and 15 years, were developed for each survey and at the key BMI percentile cut points based on data from the 2015-2018 survey. RESULTS The subtle changes in adolescent Americans' body size and shape over the past five decades are represented by 24 male and female 10- and 15-year-old avatars and 8 corresponding BMI percentile cut points. CONCLUSIONS The current study, the first of its kind, aligns objective physical examination weights and heights with the visual appearance of adolescents. Aligning the biometric and visual information may help improve awareness and appropriate clinical management of adolescents with excess adiposity passing through health care systems. TRIAL REGISTRATION ClinicalTrials.Gov NCT03706612.
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Affiliation(s)
- Jonathan Bennett
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Michael C Wong
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Nicole Fearnbach
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Katie Queen
- Our Lady of the Lake Children's Health, Baton Rouge, LA, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
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Müller MJ, Bosy-Westphal A, Braun W, Wong MC, Shepherd JA, Heymsfield SB. What Is a 2021 Reference Body? Nutrients 2022; 14:nu14071526. [PMID: 35406138 PMCID: PMC9003358 DOI: 10.3390/nu14071526] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 01/25/2023] Open
Abstract
The historical 1975 Reference Man is a ‘model’ that had been used as a basis for the calculation of radiation doses, metabolism, pharmacokinetics, sizes for organ transplantation and ergonomic optimizations in the industry, e.g., to plan dimensions of seats and other formats. The 1975 Reference Man was not an average individual of a population; it was based on the multiple characteristics of body compositions that at that time were available, i.e., mainly from autopsy data. Faced with recent technological advances, new mathematical models and socio-demographic changes within populations characterized by an increase in elderly and overweight subjects a timely ‘state-of-the-art’ 2021 Reference Body are needed. To perform this, in vivo human body composition data bases in Kiel, Baton Rouge, San Francisco and Honolulu were analyzed and detailed 2021 Reference Bodies, and they were built for both sexes and two age groups (≤40 yrs and >40 yrs) at BMIs of 20, 25, 30 and 40 kg/m2. We have taken an integrative approach to address ‘structure−structure’ and ‘structure−function’ relationships at the whole-body level using in depth body composition analyses as assessed by gold standard methods, i.e., whole body Magnetic Resonance Imaging (MRI) and the 4-compartment (4C-) model (based on deuterium dilution, dual-energy X-ray absorptiometry and body densitometry). In addition, data obtained by a three-dimensional optical scanner were used to assess body shape. The future applications of the 2021 Reference Body relate to mathematical modeling to address complex metabolic processes and pharmacokinetics using a multi-level/multi-scale approach defining health within the contexts of neurohumoral and metabolic control.
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Affiliation(s)
- Manfred J. Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
- Correspondence: ; Tel.: +49-43188-05671; Fax: +49-43188-05679
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
| | - Michael C. Wong
- University of Hawaii Cancer Center, Shepherd Res. Lab, Honolulu, HI 96816, USA; (M.C.W.); (J.A.S.)
- Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - John A. Shepherd
- University of Hawaii Cancer Center, Shepherd Res. Lab, Honolulu, HI 96816, USA; (M.C.W.); (J.A.S.)
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Maskarinec G, Shvetsov YB, Wong MC, Garber A, Monroe K, Ernst TM, Buchthal SD, Lim U, Marchand LL, Heymsfield SB, Shepherd JA. Subcutaneous and visceral fat assessment by DXA and MRI in older adults and children. Obesity (Silver Spring) 2022; 30:920-930. [PMID: 35253409 PMCID: PMC10181882 DOI: 10.1002/oby.23381] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/16/2021] [Accepted: 12/30/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Given the importance of body fat distribution in chronic disease development, feasible methods to assess body fat are essential. This study compared dual-energy x-ray absorptiometry (DXA) in measuring visceral and subcutaneous adipose tissue (VAT and SAT) with magnetic resonance imaging (MRI). METHODS VAT and SAT were assessed using similar DXA and MRI protocols among 1,795 elderly participants of the Adiposity Phenotype Study (APS) and 309 children/adolescents in Shape Up! Kids (SKids). Spearman correlations, Bland-Altman plots, and coefficients of determination (R2 ) assessed agreement between DXA and MRI measures. RESULTS DXA overestimated SAT values in APS (315 vs. 229 cm2 ) and SKids (212 vs. 161 cm2 ), whereas DXA underestimated VAT measures (141 vs. 167 cm2 ) in adults only. The correlations between DXA and MRI values were stronger for SAT than VAT (APS: r = 0.92 vs. 0.88; SKids: 0.90 vs. 0.74). Bland-Altman plots confirmed better agreement for SAT than VAT despite differences by sex, ethnicity, and weight status with respective R2 values for SAT and VAT of 0.88 and 0.84 (APS) and 0.81 and 0.69 (SKids). CONCLUSION These findings indicate that SAT by DXA reflects MRI measures in children and older adults, whereas agreement for VAT is weaker for individuals with low VAT levels.
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Affiliation(s)
- Gertraud Maskarinec
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Yurii B. Shvetsov
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Michael C. Wong
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Andrea Garber
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Kristine Monroe
- Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Thomas M. Ernst
- Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Steven D. Buchthal
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Unhee Lim
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Loïc Le Marchand
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | | | - John A. Shepherd
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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Wong MC, McCarthy C, Fearnbach N, Yang S, Shepherd J, Heymsfield SB. Emergence of the obesity epidemic: 6-decade visualization with humanoid avatars. Am J Clin Nutr 2022; 115:1189-1193. [PMID: 35030235 PMCID: PMC8971009 DOI: 10.1093/ajcn/nqac005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/10/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Visualizations of the emerging obesity epidemic, such as with serial US color prevalence maps, provide graphic images that extend informative public health messages beyond those in written communications. Advances in low-cost 3D optical technology now allow for development of large image databases that include participants varying in race/ethnicity, body mass, height, age, and circumferences. When combined with contemporary statistical methods, these data sets can be used to create humanoid avatar images with prespecified anthropometric features. OBJECTIVES The current study aimed to develop a humanoid avatar series with characteristics of representative US adults extending over the past 6 decades. METHODS 3D optical scans were conducted on a demographically diverse sample of 570 healthy adults. Image data were converted to principal components and manifold regression equations were then developed with body mass, height, age, and waist circumference as covariates. Humanoid avatars were generated for representative adults with these 4 characteristics as reported in CDC surveys beginning in 1960-1962 up to 2015-2018. RESULTS There was a curvilinear increase in adult US population body mass, waist circumference, and BMI in males and females across the 9 surveys spanning 6 decades. A small increase in average adult population age was present between 1960 and 2018; height changes were inconsistent. A series of 4 avatars developed at ∼20-y intervals for representative males and females reveal the changes in body size and shape consistent with the emergence of the obesity epidemic. An additional series of developed avatars portray the shapes and sizes of males and females at key BMI cutoffs. CONCLUSIONS New mathematical approaches and accessible 3D optical technology combined with increasingly available large and diverse data sets across the life span now make unique visualization of body size and shape possible on a previously unattainable scale. This study is registered at https://clinicaltrials.gov/ct2/show/NCT03637855 as NCT03637855.
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Affiliation(s)
- Michael C Wong
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Nicole Fearnbach
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
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19
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Bennett JP, Liu YE, Quon BK, Kelly NN, Wong MC, Kennedy SF, Chow DC, Garber AK, Weiss EJ, Heymsfield SB, Shepherd JA. Assessment of clinical measures of total and regional body composition from a commercial 3-dimensional optical body scanner. Clin Nutr 2022; 41:211-218. [PMID: 34915272 PMCID: PMC8727542 DOI: 10.1016/j.clnu.2021.11.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The accurate assessment of total body and regional body circumferences, volumes, and compositions are critical to monitor physical activity and dietary interventions, as well as accurate disease classifications including obesity, metabolic syndrome, sarcopenia, and lymphedema. We assessed body composition and anthropometry estimates provided by a commercial 3-dimensional optical (3DO) imaging system compared to criterion measures. METHODS Participants of the Shape Up! Adults study were recruited for similar sized stratifications by sex, age (18-40, 40-60, >60 years), BMI (under, normal, overweight, obese), and across five ethnicities (non-Hispanic [NH] Black, NH White, Hispanic, Asian, Native Hawaiian/Pacific Islander). All participants received manual anthropometry assessments, duplicate whole-body 3DO (Styku S100), and dual-energy X-ray absorptiometry (DXA) scans. 3DO estimates provided by the manufacturer for anthropometry and body composition were compared to the criterion measures using concordance correlation coefficient (CCC) and Bland-Altman analysis. Test-retest precision was assessed by root mean square error (RMSE) and coefficient of variation. RESULTS A total of 188 (102 female) participants were included. The overall fat free mass (FFM) as measured by DXA (54.1 ± 15.2 kg) and 3DO (55.3 ± 15.0 kg) showed a small mean difference of 1.2 ± 3.4 kg (95% limits of agreement -7.0 to +5.6) and the CCC was 0.97 (95% CI: 0.96-0.98). The CCC for FM was 0.95 (95% CI: 0.94-0.97) and the mean difference of 1.3 ± 3.4 kg (95% CI: -5.5 to +8.1) reflected the difference in FFM measures. 3DO anthropometry and body composition measurements showed high test-retest precision for whole body volume (1.1 L), fat mass (0.41 kg), percent fat (0.60%), arm and leg volumes, (0.11 and 0.21 L, respectively), and waist and hip circumferences (all <0.60 cm). No group differences were observed when stratified by body mass index, sex, or race/ethnicity. CONCLUSIONS The anthropometric and body composition estimates provided by the 3DO scanner are precise and accurate to criterion methods if offsets are considered. This method offers a rapid, broadly available, and automated method of body composition assessment regardless of body size. Further studies are recommended to examine the relationship between measurements obtained by 3DO scans and metabolic health in healthy and clinical populations.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA.
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - Dominic C Chow
- John A. Burns School of Medicine, University of Hawaii, 651 Ilalo St, Honolulu, HI, 96813, USA
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, 3333 California Street, Suite 245, CA, 94118, USA
| | - Ethan J Weiss
- University of California School of Medicine, 555 Mission Bay Blvd South, San Francisco, CA, 94158, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
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20
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Wong MC, Ng BK, Tian I, Sobhiyeh S, Pagano I, Dechenaud M, Kennedy SF, Liu YE, Kelly NN, Chow D, Garber AK, Maskarinec G, Pujades S, Black MJ, Curless B, Heymsfield SB, Shepherd JA. A pose-independent method for accurate and precise body composition from 3D optical scans. Obesity (Silver Spring) 2021; 29:1835-1847. [PMID: 34549543 PMCID: PMC8570991 DOI: 10.1002/oby.23256] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether digitally re-posing three-dimensional optical (3DO) whole-body scans to a standardized pose would improve body composition accuracy and precision regardless of the initial pose. METHODS Healthy adults (n = 540), stratified by sex, BMI, and age, completed whole-body 3DO and dual-energy X-ray absorptiometry (DXA) scans in the Shape Up! Adults study. The 3DO mesh vertices were represented with standardized templates and a low-dimensional space by principal component analysis (stratified by sex). The total sample was split into a training (80%) and test (20%) set for both males and females. Stepwise linear regression was used to build prediction models for body composition and anthropometry outputs using 3DO principal components (PCs). RESULTS The analysis included 472 participants after exclusions. After re-posing, three PCs described 95% of the shape variance in the male and female training sets. 3DO body composition accuracy compared with DXA was as follows: fat mass R2 = 0.91 male, 0.94 female; fat-free mass R2 = 0.95 male, 0.92 female; visceral fat mass R2 = 0.77 male, 0.79 female. CONCLUSIONS Re-posed 3DO body shape PCs produced more accurate and precise body composition models that may be used in clinical or nonclinical settings when DXA is unavailable or when frequent ionizing radiation exposure is unwanted.
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Affiliation(s)
- Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Bennett K Ng
- Department of Emerging Growth and Incubation, Intel Corp., Santa Clara, California, USA
| | - Isaac Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, Washington, USA
| | - Sima Sobhiyeh
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ian Pagano
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Marcelline Dechenaud
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Yong E Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Dominic Chow
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Andrea K Garber
- School of Medicine, University of California, San Francisco, California, USA
| | - Gertraud Maskarinec
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Sergi Pujades
- Inria, Université Grenoble Alpes, CNRS, Grenoble INP, LJK, Grenoble, France
| | - Michael J Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Brian Curless
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, Washington, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
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21
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Maskarinec G, Garber AK, Wong MC, Kelly N, Kazemi L, Buchthal SD, Fearnbach N, Heymsfield SB, Shepherd JA. Predictors of liver fat among children and adolescents from five different ethnic groups. Obes Sci Pract 2020; 7:53-62. [PMID: 33680492 PMCID: PMC7909587 DOI: 10.1002/osp4.459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives As rates of obesity around the world have increased, so has the detection of high level of liver fat in children and adolescents. This may put them at risk for cardiovascular disease later in life. This analysis of a cross‐sectional population‐based study of children and adolescents evaluated demographic and lifestyle determinants of percent liver fat. Methods Healthy participants (123 girls and 99 boys aged 5–17 years) recruited by convenience sampling in three locations completed questionnaires, anthropometric measurements, and dual X‐ray absorptiometry and magnetic resonance imaging (MRI) assessment. General linear models were applied to estimate the association of demographic, anthropometric, and dietary factors as well as physical activity with MRI‐based percent liver fat. Results The strongest predictor of liver fat was body mass index (BMI; p < 0.0001); overweight and obesity were associated with 0.5% and 1% higher liver fat levels. The respective adjusted mean percent values were 2.9 (95% CI 2.7, 3.1) and 3.4 (95% CI 3.2, 3.6) as compared to normal weight (2.4; 95% CI 2.3, 2.6). Mean percent liver fat was highest in Whites and African Americans, intermediate in Hispanic, and lowest among Asians and Native Hawaiians/Pacific Islanders (p < 0.0001). Age (p = 0.67), sex (p = 0.28), physical activity (p = 0.74), and diet quality (p = 0.70) were not significantly related with liver fat. Conclusions This study in multiethnic children and adolescents confirms the strong relationship of BMI with percent liver fat even in a population with low liver fat levels without detecting an association with age, sex, and dietary or physical activity patterns.
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Affiliation(s)
| | - Andrea K Garber
- University of California at San Francisco San Francisco California USA
| | | | - Nisa Kelly
- University of Hawaii Cancer Center Honolulu Hawaii USA
| | - Leila Kazemi
- University of Hawaii Cancer Center Honolulu Hawaii USA
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22
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Tian IY, Ng BK, Wong MC, Kennedy S, Hwaung P, Kelly N, Liu E, Garber AK, Curless B, Heymsfield SB, Shepherd JA. Predicting 3D body shape and body composition from conventional 2D photography. Med Phys 2020; 47:6232-6245. [PMID: 32978970 DOI: 10.1002/mp.14492] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Total and regional body composition are important indicators of health and mortality risk, but their measurement is usually restricted to controlled environments in clinical settings with expensive and specialized equipment. A method that approaches the accuracy of the current gold standard method, dual-energy x-ray absorptiometry (DXA), while only requiring input from widely available consumer grade equipment, would enable the measurement of these important biometrics in the wild, enabling data collection at a scale that would have previously been prohibitive in time and expense. We describe an algorithm for predicting three-dimensional (3D) body shape and composition from a single frontal 2-dimensional image acquired with a digital consumer camera. METHODS Duplicate 3D optical scans, two-dimensional (2D) optical images, and DXA whole-body scans were available for 183 men and 233 women from the Shape Up! Adults Study. A principal component analysis vector basis was fit to 3D point clouds of a training subset of 152 men and 194 women. The relationship between this vector space and DXA-derived body composition was modeled with linear regression. The principal component 3D shape was then fitted to match a silhouette extracted from a 2D photograph of a novel body. Body composition was predicted from the resulting 3D shape match using the linear mapping between the principal component parameters and the DXA metrics. Accuracy of body composition estimates from the silhouette method was evaluated against a simple model using height and weight as a baseline, and against DXA measurements as ground truth. Test-retest precision of the silhouette method was evaluated using the duplicate 2D optical images and compared against precision of the duplicate DXA scans. Paired t-tests were performed to detect significant differences between the sets. RESULTS Results were reported on a held-out set. Body composition prediction achieved R2 s of 0.81 and 0.74 for percent fat prediction of males and females, respectively, on a held-out test set consisting of 31 males and 39 females. Precision estimates for fat mass were 2.31% and 2.06% for males and females, respectively, compared to 1.26% and 0.68% for DXA scans. The t-tests revealed no statistically significant differences between the silhouette method measurements and DXA measurements, or between retests. CONCLUSION Total and regional body composition measures can be estimated from a single frontal photograph of a human body. Body composition prediction using consumer level photography can enable early screening and monitoring of possible physiological indicators of metabolic disease in regions where medical imagery or clinical assessment is inaccessible.
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Affiliation(s)
- Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, 98195, USA
| | | | - Michael C Wong
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Phoenix Hwaung
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - Nisa Kelly
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - En Liu
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
| | - Andrea K Garber
- UCSF School of Medicine, University of California - San Francisco, San Francisco, CA, 94118, USA
| | - Brian Curless
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, 98195, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- University of Hawaii Cancer Center, University of Hawaii - Manoa, Honolulu, HI, 96813, USA
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23
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Panizza CE, Wong MC, Kelly N, Liu YE, Shvetsov YB, Lowe DA, Weiss EJ, Heymsfield SB, Kennedy S, Boushey CJ, Maskarinec G, Shepherd JA. Diet Quality and Visceral Adiposity among a Multiethnic Population of Young, Middle, and Older Aged Adults. Curr Dev Nutr 2020; 4:nzaa090. [PMID: 33959689 PMCID: PMC8082229 DOI: 10.1093/cdn/nzaa090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/30/2020] [Accepted: 05/20/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Visceral adiposity, more so than overall adiposity, is associated with chronic disease and mortality. There has been, to our knowledge, little research exploring the association between diet quality and visceral adipose tissue (VAT) among a mulitethnic population aged 18-80 y. OBJECTIVE The primary objective of this cross-sectional analysis was to examine the association between diet quality [Healthy Eating Index-2010 (HEI-2010) scores] and VAT among a multiethnic population of young, middle, and older aged adults in the United States. Secondary objectives were to repeat these analyses with overall adiposity and blood-based biomarkers for type 2 diabetes and cardiovascular disease risk as outcome measures. METHODS A total of 540 adults (dropped out: n = 4; age: 18-40 y, n = 220; 40-60 y, n = 183; 60-80 y, n = 133) were recruited across 3 sites (Honolulu County, San Francisco, and Baton Rouge) for the Shape Up! Adults study. Whole-body DXA, anthropometry, fasting blood draw, and questionnaires (food frequency, physical activity, and demographic characteristics) were completed. Linear regression was used to assess the associations between HEI-2010 tertiles and VAT and secondary outcome measures among all participants and age-specific strata, while adjusting for known confounders. RESULTS VAT, BMI (kg/m2), body fat percentage, total body fat, trunk fat, insulin, and insulin resistance were inversely related to diet quality (all P values < 0.004). When stratified by age, diet quality was inversely associated with VAT among participants aged 60-80 y (P < 0.006) and VAT/subcutaneous adipose tissue (SAT) among participants aged 40-60 y (P < 0.008). CONCLUSIONS Higher-quality diet was associated with lower VAT, overall adiposity, and insulin resistance among this multiethnic population of young, middle, and older aged adults with ages ranging from 18 to 80 y. More specifically, adherence to a high-quality diet may minimize VAT accumulation in adults aged 60-80 y and preferentially promote storage of SAT compared with VAT in adults aged 40-60 y.This study was registered at clinicaltrials.gov as NCT03637855.
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Affiliation(s)
| | | | - Nisa Kelly
- University of Hawaii Cancer Center, Honolulu, HI
| | - Yong En Liu
- University of Hawaii Cancer Center, Honolulu, HI
| | | | - Dylan A Lowe
- University of California-San Francisco, School of Medicine, San Francisco, CA
| | - Ethan J Weiss
- University of California-San Francisco, School of Medicine, San Francisco, CA
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24
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Ng BK, Sommer MJ, Wong MC, Pagano I, Nie Y, Fan B, Kennedy S, Bourgeois B, Kelly N, Liu YE, Hwaung P, Garber AK, Chow D, Vaisse C, Curless B, Heymsfield SB, Shepherd JA. Detailed 3-dimensional body shape features predict body composition, blood metabolites, and functional strength: the Shape Up! studies. Am J Clin Nutr 2019; 110:1316-1326. [PMID: 31553429 PMCID: PMC6885475 DOI: 10.1093/ajcn/nqz218] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/07/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Three-dimensional optical (3DO) body scanning has been proposed for automatic anthropometry. However, conventional measurements fail to capture detailed body shape. More sophisticated shape features could better indicate health status. OBJECTIVES The objectives were to predict DXA total and regional body composition, serum lipid and diabetes markers, and functional strength from 3DO body scans using statistical shape modeling. METHODS Healthy adults underwent whole-body 3DO and DXA scans, blood tests, and strength assessments in the Shape Up! Adults cross-sectional observational study. Principal component analysis was performed on registered 3DO scans. Stepwise linear regressions were performed to estimate body composition, serum biomarkers, and strength using 3DO principal components (PCs). 3DO model accuracy was compared with simple anthropometric models and precision was compared with DXA. RESULTS This analysis included 407 subjects. Eleven PCs for each sex captured 95% of body shape variance. 3DO body composition accuracy to DXA was: fat mass R2 = 0.88 male, 0.93 female; visceral fat mass R2 = 0.67 male, 0.75 female. 3DO body fat test-retest precision was: root mean squared error = 0.81 kg male, 0.66 kg female. 3DO visceral fat was as precise (%CV = 7.4 for males, 6.8 for females) as DXA (%CV = 6.8 for males, 7.4 for females). Multiple 3DO PCs were significantly correlated with serum HDL cholesterol, triglycerides, glucose, insulin, and HOMA-IR, independent of simple anthropometrics. 3DO PCs improved prediction of isometric knee strength (combined model R2 = 0.67 male, 0.59 female; anthropometrics-only model R2 = 0.34 male, 0.24 female). CONCLUSIONS 3DO body shape PCs predict body composition with good accuracy and precision comparable to existing methods. 3DO PCs improve prediction of serum lipid and diabetes markers, and functional strength measurements. The safety and accessibility of 3DO scanning make it appropriate for monitoring individual body composition, and metabolic health and functional strength in epidemiological settings.This trial was registered at clinicaltrials.gov as NCT03637855.
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Affiliation(s)
- Bennett K Ng
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Markus J Sommer
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Ian Pagano
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yilin Nie
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Bo Fan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Brianna Bourgeois
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Nisa Kelly
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Yong E Liu
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Phoenix Hwaung
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Andrea K Garber
- School of Medicine, University of California, San Francisco, CA, USA
| | - Dominic Chow
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Christian Vaisse
- Diabetes Center, University of California, San Francisco, CA, USA
| | - Brian Curless
- Paul G Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - John A Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Miller VE, Loring M, Morris SN, Isaacson KB, Wong MC. Intra-operative Factors Identified During Laparoscopy Hysterectomy are Correlated With Increased Post-operative Pain and Opioid Use. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wong MC, Ng BK, Kennedy SF, Hwaung P, Liu EY, Kelly NN, Pagano IS, Garber AK, Chow DC, Heymsfield SB, Shepherd JA. Children and Adolescents' Anthropometrics Body Composition from 3-D Optical Surface Scans. Obesity (Silver Spring) 2019; 27:1738-1749. [PMID: 31689009 PMCID: PMC7883773 DOI: 10.1002/oby.22637] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/13/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to explore the accuracy and precision of three-dimensional optical (3DO) whole-body scanning for automated anthropometry and estimating total and regional body composition. METHODS Healthy children and adolescents (n = 181, ages 5-17 years) were recruited for the Shape Up! Kids study. Each participant underwent whole-body dual-energy x-ray absorptiometry and 3DO scans; multisite conventional tape measurements served as the anthropometric criterion measure. 3DO body shape was described using automated body circumference, length, and volume measures. 3DO estimates were compared with criterion measures using simple linear regression by the stepwise selection method. RESULTS Of the 181 participants, 112 were used for the training set, 49 were used for the test set, and 20 were excluded for technical reasons. 3DO body composition estimates were strongly associated with dual-energy x-ray absorptiometry measures for percent body fat, fat mass, and fat-free mass (R2 : 0.83, 0.96, and 0.98, respectively). 3DO provided reliable measurements of fat mass (coefficient of variation, 3.30; root mean square error [RMSE], 0.53), fat-free mass (coefficient of variation, 1.34; RMSE, 0.53 kg), and percent body fat (RMSE = 1.2%). CONCLUSIONS 3DO surface scanning provides accurate and precise anthropometric and body composition estimates in children and adolescents with high precision. 3DO is a safe, accessible, and practical method for evaluating body shape and composition in research and clinical settings.
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Affiliation(s)
- Michael C. Wong
- Graduate Program in Human Nutrition, University of Hawai’i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Bennett K. Ng
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Samantha F. Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Phoenix Hwaung
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - En Y. Liu
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N. Kelly
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Ian S. Pagano
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Andrea K. Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, California, USA
| | - Dominic C. Chow
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, Hawaii, USA
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A. Shepherd
- Graduate Program in Human Nutrition, University of Hawai’i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
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Lee AP, Yang F, Fan YT, Wong MC, Wong RH. P1822Pocket-size mobile echocardiographic device screening for thoracic aortic aneurysm in asymptomatic hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with hypertension may develop thoracic aortic aneurysm (TAA) that can be asymptomatic but potentially life-threatening. We sought to assess the prevalence of asymptomatic TAA among hypertensive patients and define the effectiveness of a TAA point-of-care screening program using pocket-size mobile echocardiographic (PME) devices.
Methods
We prospectively performed transthoracic echocardiography for TAA screening using a PME device on 1529 hypertensive patients (age, 62y [30y to 85y], 824 men) who attended our hypertension specialist clinic between June 2016 and July 2018. Measurement of the dimensions of the aortic sinus, sinotubular junction, ascending aorta, aortic arch, and descending thoracic aorta were obtained through multiple standard echo views.
Results
The prevalence of TAA (defined as maximum aortic diameter of ≥4.5cm and/or >50% diameter of the adjacent aorta) in our study population was 7.3% (111/1529), with distal ascending aorta as the most frequent location (Figure). Multiple logistic regression analysis identified male gender, older age, and presence of heart valve disease as independent factors associated with TAA (all p<0.05).
Figure 1
Conclusions
Asymptomatic TAA is common among asymptomatic hypertensive patients. Point-of-care use of PME device is effective in detecting TAA in a clinic setting. Such approach may be useful for early detection of TAA among at-risk patients allowing aggressive blood pressure control and early surgical intervention to prevent catastrophic complications such as aortic dissection or rupture.
Acknowledgement/Funding
Health and Medical Research Fund of the Hong Kong Government
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Affiliation(s)
- A P Lee
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - F Yang
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Y T Fan
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M C Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - R H Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
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Terveer EM, Fallon M, Kraakman MEM, Ormond A, Fitzpatrick M, Caljouw MAA, Martin A, van Dorp SM, Wong MC, Kuijper EJ, Fitzpatrick F. Spread of ESBL-producing Escherichia coli in nursing home residents in Ireland and the Netherlands may reflect infrastructural differences. J Hosp Infect 2019; 103:160-164. [PMID: 31077778 DOI: 10.1016/j.jhin.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/01/2019] [Indexed: 12/29/2022]
Abstract
A prevalence study in two nursing homes (one each in the Netherlands and Ireland) found four (11%) Dutch and six (9%) Irish residents colonized with 11 extended-spectrum beta-lactamase-producing Escherichia coli, 10 of which contained CTX-M-15. Four Dutch isolates, from three residents of the same ward, belonged to E. coli O25:H4, sequence type (ST) 131 and were part of the same cluster type by whole-genome sequencing. Four Irish residents on three different wards were colonized with an identical E. coli O89:H9, ST131, complex type 1478. Cross-transmission between three Irish wards may reflect differences in nursing home infrastructure, specifically communal areas and multi-bedded resident rooms.
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Affiliation(s)
- E M Terveer
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - M Fallon
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M E M Kraakman
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - A Ormond
- Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - M Fitzpatrick
- Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - M A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - A Martin
- Department of Geriatric and Stroke Medicine, Beaumont Hospital, Dublin, Ireland; Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S M van Dorp
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M C Wong
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - E J Kuijper
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - F Fitzpatrick
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
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Chang WC, Lee HC, Chan SI, Chiu SY, Lee HM, Chan KW, Wong MC, Chan KL, Yeung WS, Choy LW, Chong SY, Siu MW, Lo TL, Yan WC, Ng MK, Poon LT, Pang PF, Lam WC, Wong YC, Chung WS, Mo YM, Lui SY, Hui LM, Chen EYH. Negative symptom dimensions differentially impact on functioning in individuals at-risk for psychosis. Schizophr Res 2018; 202:310-315. [PMID: 29935882 DOI: 10.1016/j.schres.2018.06.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/20/2018] [Accepted: 06/14/2018] [Indexed: 12/24/2022]
Affiliation(s)
- W C Chang
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
| | - H C Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S I Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S Y Chiu
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - H M Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - K W Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - M C Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - K L Chan
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - W S Yeung
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - L W Choy
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - S Y Chong
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - M W Siu
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - T L Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - W C Yan
- Department of Psychiatry, Kowloon Hospital, Hong Kong
| | - M K Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong
| | - L T Poon
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - P F Pang
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - W C Lam
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - Y C Wong
- Department of Psychiatry, Tai Po Hospital, Hong Kong
| | - W S Chung
- Department of Psychiatry, Tai Po Hospital, Hong Kong
| | - Y M Mo
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - S Y Lui
- Department of Psychiatry, Castle Peak Hospital, Hong Kong
| | - L M Hui
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - E Y H Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Koshy AN, Sajeev JK, Negishi K, Wong MC, Pham CB, Cooray SP, Khavar Y, Roberts L, Cooke JC, Teh AW. Accuracy of blinded clinician interpretation of single-lead smartphone electrocardiograms and a proposed clinical workflow. Am Heart J 2018; 205:149-153. [PMID: 30195576 DOI: 10.1016/j.ahj.2018.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022]
Abstract
Despite the appeal of smartphone-based electrocardiograms (ECGs) for arrhythmia screening, a paucity of data exists on the accuracy of primary care physicians' and cardiologists' interpretation of tracings compared with the device's automated diagnosis. Using 408 ECGs in 51 patients, we demonstrate a variable accuracy in clinician interpretation of smartphone-based ECGs, with only cardiologists demonstrating satisfactory agreement when referenced against a 12-lead ECG. Combining the device automated diagnostic algorithm with cardiologist interpretation of only uninterpretable traces yielded excellent results and provides an efficient, cost-effective workflow for the utilization of a smartphone-based ECG in clinical practice.
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Affiliation(s)
- Anoop N Koshy
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia; The University of Melbourne Clinical School, Austin Health Department of Cardiology, Melbourne, Victoria, Australia
| | - Jithin K Sajeev
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Kazuaki Negishi
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Michael C Wong
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Christopher B Pham
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Sumudu P Cooray
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Yeganeh Khavar
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Louise Roberts
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Jennifer C Cooke
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Andrew W Teh
- Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia; The University of Melbourne Clinical School, Austin Health Department of Cardiology, Melbourne, Victoria, Australia; Reprint requests: Andrew W Teh MBBS, PhD, Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, 5 Arnold St, Box Hill 3128; Melbourne, Victoria, Australia..
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Koshy AN, Sajeev JK, Nerlekar N, Brown AJ, Rajakariar K, Zureik M, Wong MC, Roberts L, Street M, Cooke J, Teh AW. Utility of photoplethysmography for heart rate estimation among inpatients. Intern Med J 2018; 48:587-591. [PMID: 29722189 DOI: 10.1111/imj.13777] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/02/2017] [Accepted: 11/20/2017] [Indexed: 12/23/2022]
Abstract
The accuracy of photoplethysmography (PPG) for heart rate (HR) estimation in cardiac arrhythmia is unknown. PPG-HR was evaluated in 112 hospitalised inpatients (cardiac arrhythmias (n = 60), sinus rhythm (n = 52)) using a continuous electrocardiogram monitoring as a reference standard. Strong agreement was observed in sinus rhythm HR < 100 and atrial flutter (bias 1 beat), modest agreement in sinus tachycardia (bias 24 beats) and complete heart block (bias -6 beats) and weak agreement with significant HR underestimation was seen in atrial fibrillation (bias 23 beats). Routine utilisation of PPG for HR estimation may delay early recognition of clinical deterioration in certain arrhythmias and sinus tachycardia.
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Affiliation(s)
- Anoop N Koshy
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Jithin K Sajeev
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Department of Medicine, Monash University and Monash Heart, Monash Health, Melbourne, Victoria, Australia
| | - Adam J Brown
- Monash Cardiovascular Research Centre, Department of Medicine, Monash University and Monash Heart, Monash Health, Melbourne, Victoria, Australia
| | - Kevin Rajakariar
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Mark Zureik
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Michael C Wong
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Louise Roberts
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Maryann Street
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia.,Deakin University, Geelong, Victoria, Australia
| | - Jennifer Cooke
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Andrew W Teh
- Department of Cardiology, Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia.,Department of Cardiology, The University of Melbourne, Austin Hospital Clinical School, Melbourne, Victoria, Australia
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Jiang ZD, Ajami NJ, Petrosino JF, Jun G, Hanis CL, Shah M, Hochman L, Ankoma-Sey V, DuPont AW, Wong MC, Alexander A, Ke S, DuPont HL. Randomised clinical trial: faecal microbiota transplantation for recurrent Clostridum difficile infection - fresh, or frozen, or lyophilised microbiota from a small pool of healthy donors delivered by colonoscopy. Aliment Pharmacol Ther 2017; 45:899-908. [PMID: 28220514 DOI: 10.1111/apt.13969] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 12/29/2016] [Accepted: 01/14/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Faecal microbiota transplantation (FMT) has become routine in managing recurrent C. difficile infection (CDI) refractory to antibiotics. AIM To compare clinical response and improvements in colonic microbiota diversity in subjects with recurrent CDI using different donor product. METHODS Seventy-two subjects with ≥3 bouts of CDI were randomised in a double-blind study to receive fresh, frozen or lyophilised FMT product via colonoscopy from 50 g of stool per treatment from eight healthy donors. Recipients provided stools pre- and 7, 14 and 30 days post-FMT for C. difficile toxin and, in a subset, microbiome composition by 16S rRNA gene profiling. RESULTS Overall resolution of CDI was 87% during 2 months of follow-up after FMT. Stool samples before FMT had significantly decreased bacterial diversity with a high proportion of Proteobacteria compared to donors. Cure rates were highest for the group receiving fresh product seen in 25/25 (100%), lowest for the lyophilised product 16/23 (78%; P = 0.022 vs. fresh and 0.255 vs. frozen) and intermediate for frozen product 20/24 (P = 0.233 vs. fresh). Microbial diversity was reconstituted by day 7 in the subjects receiving fresh or frozen product. Improvement in diversity was seen by day 7 in those randomised to lyophilised material with reconstitution by 30 days. CONCLUSIONS Comparative efficacy in faecal microbiota transplantation was observed in subjects receiving fresh or frozen faecal product from the same donors. The lyophilised product had a slightly lowered efficacy compared with fresh product, but it resembled other treatments in microbial restoration 1 month after faecal microbiota transplantation.
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Affiliation(s)
- Z D Jiang
- University of Texas School of Public Health, Houston, TX, USA
| | - N J Ajami
- Baylor College of Medicine, Houston, TX, USA
| | | | - G Jun
- University of Texas School of Public Health, Houston, TX, USA
| | - C L Hanis
- University of Texas School of Public Health, Houston, TX, USA
| | - M Shah
- University of Texas School of Public Health, Houston, TX, USA
| | - L Hochman
- Baylor St Luke's Medical Center, Houston, TX, USA
| | - V Ankoma-Sey
- Baylor St Luke's Medical Center, Houston, TX, USA
| | - A W DuPont
- University of Texas Medical School, Houston, TX, USA
| | - M C Wong
- Baylor College of Medicine, Houston, TX, USA
| | - A Alexander
- Baylor St Luke's Medical Center, Houston, TX, USA
| | - S Ke
- University of Texas School of Public Health, Houston, TX, USA
| | - H L DuPont
- University of Texas School of Public Health, Houston, TX, USA.,Baylor College of Medicine, Houston, TX, USA.,Baylor St Luke's Medical Center, Houston, TX, USA.,Kelsey Research Foundation, Houston, TX, USA
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Mclellan AJ, Ling LH, Wong MC, Walters TE, Nisbet A, Shetty AK, Taylor AJ, Morton JB, Kalman JM, Kistler PM. PT003 Pulmonary vein isolation: the impact of pulmonary venous anatomy on long term outcome of catheter ablation for paroxysmal atrial fibrillation. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.1814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
The overall goal of this project is the development of a new methodology for translating advances in molecular level understanding of toxicological responses into a predictive tool for dose response in whole animals and humans exposed to single compounds or mixtures of compounds. The methodology incorporates a mechanistic cellular level model into a PBPK (physiologically based pharmacokinetic) model which simultaneously guides the development of an in vitro cell culture analog (CCA) to the PBPK. Where the PBPK specifies an organ, (e.g., liver) the in vitro or CCA system contains a compartment with the appropriate cell or cell population (e.g., hepatocytes for the liver). The CCA has significant advantages over other in vitro systems and PBPK systems used independently for evaluating metabolic responses to drugs or potentially toxic chemicals where the exchange of metabolites between organs is likely to be important. The CCA system is superior to a PBPK because an a priori description of complete metabolism is not required and secondary, unexpected interactions can be detected. The CCA system, unlike other in vitro systems, gives a dynamic response that realistically simulates in vivo interactions between organs. Furthermore, the CCA allows dosing on the same basis as animal tests (e.g., milligrams per kilogram of body mass equivalent). Because the construction of a CCA is guided by a PBPK, this approach allows extrapolation to low doses and across species, including extrapolation to humans. We have constructed a prototype system and have conducted proof-of-concept experiments using naphthalene as a test chemical. These experiments clearly demonstrate the ability to generate a reactive metabolite in one compartment and detect its effects (on LDH release and glutathione depletion) in a second compartment. However, this prototype device would be expensive to replicate and requires nearly constant supervision from a trained investigator. For this concept to replace animals an inexpensive, self-regulating device is needed. An initial design to accomplish this goal is described as well as the corresponding model using naphthalene as a test compound. (c) 1996 John Wiley & Sons, Inc.
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Affiliation(s)
- M L Shuler
- School of Chemical Engineering, Cornell University, Ithaca, New York 14853-5201
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Moe KT, Yin NO, Naylynn TM, Khairunnisa K, Wutyi MA, Gu Y, Atan MSM, Wong MC, Koh TH, Wong P. Nox2 and Nox4 mediate tumour necrosis factor-α-induced ventricular remodelling in mice. J Cell Mol Med 2012; 15:2601-13. [PMID: 21251215 PMCID: PMC4373429 DOI: 10.1111/j.1582-4934.2011.01261.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Reactive oxygen species (ROS) and pro-inflammatory cytokines are crucial in ventricular remodelling, such as inflammation-associated myocarditis. We previously reported that tumour necrosis factor-α (TNF-α)-induced ROS in human aortic smooth muscle cells is mediated by NADPH oxidase subunit Nox4. In this study, we investigated whether TNF-α-induced ventricular remodelling was mediated by Nox2 and/or Nox4. An intravenous injection of murine TNF-α was administered to a group of mice and saline injection was administered to controls. Echocardiography was performed on days 1, 7 and 28 post-injection. Ventricular tissue was used to determine gene and protein expression of Nox2, Nox4, ANP, interleukin (IL)-1β, IL-2, IL-6, TNF-α and to measure ROS. Nox2 and Nox4 siRNA were used to determine whether or not Nox2 and Nox4 mediated TNF-α-induced ROS and upregulation of IL-1β and IL-6 in adult human cardiomyocytes. Echocardiography showed a significant increase in left ventricular end-diastolic and left ventricular end-systolic diameters, and a significant decrease in the ejection fraction and fractional shortening in mice 7 and 28 days after TNF-α injection. These two groups of mice showed a significant increase in ventricular ROS, ANP, IL-1β, IL-2, IL-6 and TNF-α proteins. Nox2 and Nox4 mRNA and protein levels were also sequentially increased. ROS was significantly decreased by inhibitors of NADPH oxidase, but not by inhibitors of other ROS production systems. Nox2 and Nox4 siRNA significantly attenuated TNF-α-induced ROS and upregulation of IL-1β and IL-6 in cardiomyocytes. Our study highlights a novel TNF-α-induced chronic ventricular remodelling mechanism mediated by sequential regulation of Nox2 and Nox4 subunits.
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Affiliation(s)
- K T Moe
- Research and Development Unit, National Heart Centre Singapore, Singapore.
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Narasimhalu K, Effendy S, Sim CH, Lee JM, Chen I, Hia SB, Xue HL, Corrales MP, Chang HM, Wong MC, Chen CP, Tan EK. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease. Acta Neurol Scand 2010; 121:217-24. [PMID: 19951274 DOI: 10.1111/j.1600-0404.2009.01263.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The safety and efficacy of early acetylcholinesterase inhibitors therapy in patients with cognitive impairment no dementia (CIND) after a cerebrovascular accident have not been examined. In this study, we investigated the safety and efficacy of rivastigmine in cognition, particularly executive function in patients with CIND because of cerebrovascular disease. METHODS This study was a 24-week, double-blind, randomized, placebo-controlled trial of ischemic stroke patients seen at a tertiary hospital who had cognitive impairment no dementia because of cerebrovascular disease. The intervention was either rivastigmine or placebo up to 9 mg/day. The primary outcome of interest was mean change from baseline in the Ten-Point Clock Drawing and Color Trails 1 and 2. RESULTS Fifty patients were randomized into rivastigmine (n = 25) and placebo (n = 25) arms. Patients in the rivastigmine group showed statistically significant improvement (1.70 vs 0.13, P = 0.02) on the animal subtask of the verbal fluency measure compared with placebo. There was also a trend (non-significant) towards improvement in Color Trails II. CONCLUSIONS In this pilot study, we demonstrated that rivastigmine was well tolerated in patients with CIND because of cerebrovascular disease and may potentially improve executive functioning.
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Affiliation(s)
- K Narasimhalu
- Center for Molecular Epidemiology, National University of Singapore, Singapore
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Tan EK, Lee J, Chen CP, Wong MC, Zhao Y. Case control analysis of LRRK2 Gly2385Arg in Alzheimer's disease. Neurobiol Aging 2009; 30:501-2. [PMID: 17720280 DOI: 10.1016/j.neurobiolaging.2007.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Revised: 07/10/2007] [Accepted: 07/18/2007] [Indexed: 10/22/2022]
Abstract
Alzheimer's disease (AD) pathology has been described in Parkinson's disease (PD) patients with leucine-rich repeat kinase-2 (LRRK2) mutations. A common LRRK2 Gly2385Arg variant has been widely shown to be associated with a twofold increased risk of PD in various Asian populations. In a case control study, the frequency of the heterozygous Gly2385Arg genotype was demonstrated in 4.3% of AD compared to 4.5% in controls (odds ratio=0.94, 95% CI 0.37-2.42, p=1.0). The Gly2385Arg variant does not appear to modulate the risk of AD in our population.
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Affiliation(s)
- E K Tan
- Department of Neurology, Singapore General Hospital, Singapore.
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Hankey GJ, Algra A, Chen C, Wong MC, Cheung R, Wong L, Divjak I, Ferro J, de Freitas G, Gommans J, Groppa S, Hill M, Spence D, Lees K, Lisheng L, Navarro J, Ranawaka U, Ricci S, Schmidt R, Slivka A, Tan K, Tsiskaridze A, Uddin W, Vanhooren G, Xavier D, Armitage J, Hobbs M, Le M, Sudlow C, Wheatley K, Yi Q, Bulder M, Eikelboom JW, Hankey GJ, Ho WK, Jamrozik K, Klijn K, Koedam E, Langton P, Nijboer E, Tuch P, Pizzi J, Tang M, Antenucci M, Chew Y, Chinnery D, Cockayne C, Loh K, McMullin L, Smith F, Schmidt R, Chen C, Wong MC, de Freitas G, Hankey GJ, Loh K, Song S. VITATOPS, the VITAmins TO prevent stroke trial: rationale and design of a randomised trial of B-vitamin therapy in patients with recent transient ischaemic attack or stroke (NCT00097669) (ISRCTN74743444). Int J Stroke 2008; 2:144-50. [PMID: 18705976 DOI: 10.1111/j.1747-4949.2007.00111.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epidemiological studies suggest that raised plasma concentrations of total homocysteine (tHcy) may be a common, causal and treatable risk factor for atherothromboembolic ischaemic stroke, dementia and depression. Although tHcy can be lowered effectively with small doses of folic acid, vitamin B(12) and vitamin B(6), it is not known whether lowering tHcy, by means of B vitamin therapy, can prevent stroke and other major atherothromboembolic vascular events. AIM To determine whether the addition of B-vitamin supplements (folic acid 2 mg, B(6) 25 mg, B(12) 500 microg) to best medical and surgical management will reduce the combined incidence of stroke, myocardial infarction (MI) and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye. DESIGN A prospective, international, multicentre, randomised, double blind, placebo-controlled clinical trial. SETTING One hundred and four medical centres in 20 countries on five continents. SUBJECTS Eight thousand (6600 recruited as of 5 January, 2006) patients with recent (<7 months) stroke (ischaemic or haemorrhagic) or TIA (brain or eye). RANDOMISATION Randomisation and data collection are performed by means of a central telephone service or secure internet site. INTERVENTION One tablet daily of either placebo or B vitamins (folic acid 2 mg, B(6) 25 mg, B(12) 500 mug). PRIMARY OUTCOME The composite of stroke, MI or death from any vascular cause, whichever occurs first. Outcome and serious adverse events are adjudicated blinded to treatment allocation. SECONDARY OUTCOMES TIA, unstable angina, revascularisation procedures, dementia, depression. STATISTICAL POWER: With 8000 patients followed up for a median of 2 years and an annual incidence of the primary outcome of 8% among patients assigned placebo, the study will have at least 80% power to detect a relative reduction of 15% in the incidence of the primary outcome among patients assigned B vitamins (to 6.8%/year), applying a two-tailed level of significance of 5%. CONCLUSION VITATOPS aims to recruit and follow-up 8000 patients between 1998 and 2008, and provide a reliable estimate of the safety and effectiveness of folic acid, vitamin B(12), and vitamin B(6) supplementation in reducing recurrent serious vascular events among a wide range of patients with TIA and stroke throughout the world.
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Affiliation(s)
- E-K Tan
- Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608.
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Clark DJ, Wong MC, Chan RK, Oliver LE, Ajani AE. Very late drug-eluting stent thrombosis. Cardiovascular Revascularization Medicine 2007; 8:72-5. [PMID: 17293273 DOI: 10.1016/j.carrev.2006.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022]
Affiliation(s)
- David J Clark
- Department of Cardiology, Austin Hospital, Heidelberg, Victoria, Australia.
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Moe KT, Lim ST, Wong P, Chua T, DeSilva DA, Koh TH, Wong MC, Chin-Dusting J. Association analysis of endothelial nitric oxide synthase gene polymorphism with primary hypertension in a Singapore population. J Hum Hypertens 2006; 20:956-63. [PMID: 17024134 DOI: 10.1038/sj.jhh.1002096] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Vascular endothelial cells produce nitric oxide (NO), which contributes to the regulation of blood pressure and regional blood flow. Endothelial nitric oxide synthase (eNOS) gene polymorphisms are associated with coronary artery disease, but their linkage with primary hypertension is controversial. A total of 103 individuals with primary hypertension and 104 normotensive control subjects were studied in Singapore. The specific genotypes for G894T missense variant in exon 7, variable number tandem repeats (VNTR) in intron 4 (eNOS 4A/B/C) and T-786C in the promoter were isolated using allele-specific gene amplification and restriction fragment length polymorphism to examine the association of genotype and allelic frequency in both groups. Logistic regression analysis was also used to detect the association between genotypes and hypertension. Five genotypes of intron 4 VNTR (AA, AB, BB, AC and BC) were observed. Intron 4 B/B genotype was significantly associated with the hypertension group (P = 0.035), but disequilibrium of G894T and T-786C was absent between the two groups (P = 0.419 and P = 0.227), respectively. The overall distribution of allelic frequency differed significantly between the two groups, with four-repeat allele (4A) of intron 4 more frequent in the normotensive group than the hypertensive group (P = 0.019). Logistic regression analysis showed that intron 4 B/B genotype was significantly associated with systolic blood pressure of individuals with body mass index greater than 25 kg/m2 (P = 0.04). In conclusion, the eNOS 4 B/B genotype is a genetic susceptibility factor for primary hypertension in a Singapore population.
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Affiliation(s)
- K T Moe
- Research and Development Unit, National Heart Centre, Singapore, Singapore
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Tan EK, Zhao Y, Skipper L, Tan MG, Di Fonzo A, Sun L, Fook-Chong S, Tang S, Chua E, Yuen Y, Tan L, Pavanni R, Wong MC, Kolatkar P, Lu CS, Bonifati V, Liu JJ. The LRRK2 Gly2385Arg variant is associated with Parkinson’s disease: genetic and functional evidence. Hum Genet 2006; 120:857-63. [PMID: 17019612 DOI: 10.1007/s00439-006-0268-0] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 09/11/2006] [Indexed: 10/24/2022]
Abstract
Evidence of LRRK2 haplotypes associated with Parkinson's disease (PD) risk was recently found in the Chinese population from Singapore, and a common LRRK2 missense variant, Gly2385Arg, was independently detected as a putative risk factor for PD in the Chinese population from Taiwan. To test the association between the Gly2385Arg variant in a large case-control sample of Chinese ethnicity from Singapore, and to perform functional studies of the wild type and Gly2385Arg LRRK2 protein in human cell lines. In a case-control study involving 989 Chinese subjects, the frequency of the heterozygous Gly2385Arg genotype was higher in PD compared to controls (7.3 vs. 3.6%, odds ratio = 2.1, 95% CI: 1.1-3.9, P = 0.014); these values yield an estimated population attributable risk (PAR) of approximately 4%. In a multivariate logistic regression analysis with the disease group (PD vs. controls) as the dependent variable and the genotype as an independent factor with adjustments made for the effect of age and gender, the heterozygous Gly2385Arg genotype remained associated with an increased risk of PD compared to wild type genotype (odds ratio = 2.67, 95% CI: 1.43-4.99, P = 0.002). The glycine at position 2385 is a candidate site for N-myristoylation, and the Gly2385Arg variant replaces the hydrophobic glycine with the hydrophilic arginine, and increases the net positive charge of the LRRK2 WD40 domain. In transfection studies, we demonstrated that both the wild type and Gly2385Arg variant LRRK2 protein localize to the cytoplasm and form aggregates. However, under condition of oxidative stress, the Gly2385Arg variant was more toxic and associated with a higher rate of apoptosis. Our study lends support to the contention that the Gly2385Arg is a common risk factor for PD in the Chinese population. Our bioinformatics and in-vitro studies also suggest that the Gly2385Arg variant is biologically relevant and it might act through pro-apoptotic mechanisms.
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Affiliation(s)
- E K Tan
- Department of Neurology, Singapore General Hospital, Outram Road, Singapore, Singapore
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Moe KT, Aulia S, Jiang F, Chua YL, Koh TH, Wong MC, Dusting GJ. Differential upregulation of Nox homologues of NADPH oxidase by tumor necrosis factor-alpha in human aortic smooth muscle and embryonic kidney cells. J Cell Mol Med 2006; 10:231-9. [PMID: 16563235 PMCID: PMC3933115 DOI: 10.1111/j.1582-4934.2006.tb00304.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
NADPH oxidases are important sources of vascular superoxide, which has been linked to the pathogenesis of atherosclerosis. Previously we demonstrated that the Nox4 subunit of NADPH oxidase is a critical catalytic component for superoxide production in quiescent vascular smooth muscle cells. In this study we sought to determine the role of Nox4 in superoxide production in human aortic smooth muscle cells (AoSMC) and embryonic kidney (HEK293) cells under proinflammatory conditions. Incubation with tumor necrosis factor-α (TNF-α, 10 ng/ml) for 12h increased superoxide production in both cell types, whereas angiotensin II, platelet-derived growth factor or interleukin-1β had little effects. Superoxide production was completely abolished by the NADPH oxidase inhibitors diphenyline iodonium and apocynin, but not by inhibitors of xanthine oxidase, nitric oxide synthase or mitochondrial electron transport. TNF-α upregulated the expression of Nox4 in AoSMC at both message and protein levels, while Nox1 and Nox2 were unchanged. In contrast, upregulation of Nox2 appeared to mediate the enhanced superoxide production by TNF-α in HEK293 cells. We suggest that Nox4 may be involved in increased superoxide generation in vascular smooth muscle cells under proinflammatory conditions.
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Affiliation(s)
- K T Moe
- Research and Development Unit, National Heart CentreSingapore
| | - S Aulia
- Research and Development Unit, National Heart CentreSingapore
| | - F Jiang
- Research and Development Unit, National Heart CentreSingapore
- Bernard O'Brien Institute of Microsurgery, St. Vincent's Hospital, The University of MelbourneVictoria, Australia
| | - Y L Chua
- Cardiothoracic Surgery Department, National Heart CentreSingapore
| | - T H Koh
- Cardiology Department, National Heart CenterSingapore
| | - M C Wong
- National Neuroscience Institute, Singapore General Hospital CampusSingapore
| | - G J Dusting
- Howard Florey Institute, University of Melbourne, VictoriaAustralia
- Bernard O'Brien Institute of Microsurgery, St. Vincent's Hospital, The University of MelbourneVictoria, Australia
- * Correspondence to: Professor Gregory J. DUSTING Bernard O'Brien Institute of Microsurgery, the University of Melbourne, 42 Fitzroy Street, Fitzroy, Victoria 3065, Australia Tel.: +61-3-9288 4062; Fax:+61-3-9416 0926 E-mail:
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Sharma V, Ong Benjamin KC, Wong MC, Wilder-Smith E. Headache characteristics in episodic ataxia. Eur J Neurol 2006; 13:e8. [PMID: 16879285 DOI: 10.1111/j.1468-1331.2006.01343.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lim SW, Zhao Y, Chua E, Law HY, Yuen Y, Pavanni R, Wong MC, Ng IS, Yoon CS, Puong KY, Lim SH, Tan EK. Genetic analysis of SCA2, 3 and 17 in idiopathic Parkinson's disease. Neurosci Lett 2006; 403:11-4. [PMID: 16687213 DOI: 10.1016/j.neulet.2006.04.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2006] [Revised: 03/31/2006] [Accepted: 04/14/2006] [Indexed: 10/24/2022]
Abstract
Recent reports of SCA2 and SCA3 patients who presented with levodopa responsive parkinsonism have generated considerable interest as they have implications for genetic testing. It is unclear whether ethnic race alone or founder effects within certain geographical region explain such an association. In this study, we conducted genetic analysis of SCA2, 3, 17 in an ethnic Chinese cohort with early onset and familial Parkinson's disease (PD) and healthy controls. A total of 191 subjects comprising of 91 PD and 100 healthy controls were examined. We identified one positive case of SCA2 in an early-onset sporadic PD patient who had CAG 36 repeats, yielding a prevalence of 2.2% in early-onset sporadic PD patients and less than 1.0% in our study PD population. The size of the repeats was lower than the expanded repeats (38-57) in SCA2 patients with ataxia in our population. All the children of the patient were physically normal even though some of them carried the repeat expansion of similar size. No cases and controls were positive for SCA3 and SCA17. We do not think routine screening of SCA2, SCA3 and SCA17 for all idiopathic PD patients is cost-effective in our ethnic Chinese population. However, SCA2 should be a differential diagnosis in young onset sporadic PD when genetic mutations of other known PD genes have been excluded.
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Affiliation(s)
- S W Lim
- Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
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Abstract
The authors propose "decreased-dose-intensity" PCV (procarbazine, lomustine [CCNU], and vincristine) chemotherapy for Asian patients with oligodendroglial tumors. In this study, all seven patients with oligodendroglioma (OD) and eight with anaplastic oligodendroglioma (AO) had objective responses or stable disease. Median progression-free survival was greater than 29 months (OD) and 36.5 months or greater (AO); 86% of patients with OD and 63% with AO remain progression-free. Twenty-four Common Toxicity Criteria Grade 3/4 adverse events were noted.
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Affiliation(s)
- A U Ty
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital Campus, Singapore
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Tan EK, Yew K, Chua E, Shen H, Jamora RD, Lee E, Puong KY, Zhao Y, Pavanni R, Wong MC, Puvan K, Yih Y, Tan LCS. Analysis of PINK1 in Asian patients with familial parkinsonism. Clin Genet 2005; 68:468-70. [PMID: 16207217 DOI: 10.1111/j.1399-0004.2005.00500.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Skipper L, Shen H, Chua E, Bonnard C, Kolatkar P, Tan LCS, Jamora RD, Puvan K, Puong KY, Zhao Y, Pavanni R, Wong MC, Yuen Y, Farrer M, Liu JJ, Tan EK. Analysis of LRRK2 functional domains in nondominant Parkinson disease. Neurology 2005; 65:1319-21. [PMID: 16247070 DOI: 10.1212/01.wnl.0000180517.70572.37] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A comprehensive sequence analysis of 29 exons that code for the functional domains of LRRK2 in 160 nondominant Parkinson disease (PD) patients was performed. Novel variant screening in a further 470 sporadic PD patients and 630 controls revealed two novel variants (R1067Q and IVS33 + 6 T>A), which are likely to be pathogenic in five patients. One patient presented initially with a typical essential tremor phenotype, expanding the phenotypic spectrum of LRRK2 mutations.
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Affiliation(s)
- L Skipper
- Department of Population Genetics, Genome Institute of Singapore, Singapore
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Tan EK, Puong KY, Chan DKY, Yew K, Fook-Chong S, Shen H, Ng PW, Woo J, Yuen Y, Pavanni R, Wong MC, Puvan K, Zhao Y. Impaired transcriptional upregulation of Parkin promoter variant under oxidative stress and proteasomal inhibition: clinical association. Hum Genet 2005; 118:484-8. [PMID: 16244875 DOI: 10.1007/s00439-005-0038-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Accepted: 07/12/2005] [Indexed: 12/01/2022]
Abstract
We provided data to show that the transcriptional activity of wildtype -258T in the parkin promoter region was significantly higher than the -258G variant in human cell lines. The transcriptional activity of wildtype -258T was significantly increased under oxidative stress by hydrogen peroxide, but this was not observed for the -258G variant. The transcriptional upregulation was significantly higher for wildtype -258T compared to -258G variant at 0.1, 0.2 and 0.4 mM of hydrogen peroxide. Similar results were obtained when the cells were treated with a proteasome inhibitor, MG132.Furthermore, in a case control study involving 753 subjects, we demonstrated that the parkin promoter -258G variant was associated with an increased risk of sporadic Parkinson's disease (PD) in the elderly ethnic Chinese population. Our clinical and laboratory data provide corroborative evidence that some older individuals who have the -258G variant may have a higher risk of developing PD.
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Affiliation(s)
- E K Tan
- Department of Neurology, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore.
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