Appendicular Muscle Index Research Articles

Prospective Study to Evaluate Rectus Femoris Muscle Ultrasound for Body Composition Analysis in Patients Undergoing Bariatric Surgery.

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and consequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study was to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evaluation of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aimed to demonstrate how MUS of RFT correlates with quality of life (QoL) in this population, likely due to its ability to detect regional quadriceps muscle sarcopenia compared to the other mentioned methods. Methods: This was a prospective pilot study that included 77 participants (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA, and RFT was measured by MUS. Moreover, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was assessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p = 0.001). Firstly, we observed a positive correlation pre-surgery between HOMA and RFT (r = 0.27, p = 0.02), iFFM (r = 0.36, p = 0.001), AMI (r = 0.31, p = 0.01) and dynamometer readings (r = 0.26, p = 0.02). In addition, we found a correlation between RFT and iFFM (pre-surgery: r = 0.31, p = 0.01; post-surgery: r = 0.25, p = 0.05) and between RFT and lower-extremity AMI post-surgery (r = 0.27, p = 0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p = 0.001), but not in dynamometer readings (p = 0.94). Finally, a tendency to a positive correlation between QoL questionnaire and RFT post-surgery results (r = 0.23, p = 0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS is useful for evaluating SO and for the follow-up of these patients after BS. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.

Body composition and bone mineral density in postmenopausal women with rheumatoid arthritis

Aim – to study the relationship between body composition and bone mineral density (BMD) in postmenopausal women with rheumatoid arthritis (RA).Material and methods. 68 postmenopausal women, median age 59 [54; 63] years, with RA were included in the study. Bone mineral density (BMD) and body composition were assessed with dual energy X-ray absorptiometry.Results. 33 (48.5%) women had osteopenia, and 17 (25.0%) – osteoporosis (OP). Low lean muscle mass was found in 10 (14.7%) patients. There were positive correlations between different areal BMD and body weight, trunk fat, trunk lean muscle mass and total lean muscle mass. In the multivariate linear regression analysis total lean muscle mass was associated with BMD of lumbar spine (β=0.638; p=0.001) and total hip (β=0.473; p=0.008), and appendicular lean muscle mass, estimated using the appendicular muscle index, with femoral neck BMD (β=0.360; p=0.014).Conclusion. 73.5% of patients with RA had a reduced BMD, and 14.7% women – low muscle mass. The revealed significant association between the lean muscle mass and BMD of lumbar spine and proximal femur indicates the importance of detecting and correcting low lean muscle mass, as well as preventing its decline in order to prevent loss of BMD and osteoporotic fractures.

Bone mineral density and appendicular muscle mass in patients with rheumatoid arthritis

Objective. To study the bone mineral density (BMD) and appendicular muscle mass (AMM), their interrelation and relationship with calcium intake and vitamin D level in women with rheumatoid arthritis (RA).Material and methods. 43 women (mean age 57.5 ± 7.0 years) with confirmed RA were included. All patients were interviewed using a special questionnaire. Dual-energy X-ray absorptiometry (DXA) of lumbar spine, hip and total body was performed, and dietary calcium intake and vitamin D blood serum levels were assessed.Results. Reduced BMD was detected in 76.8% of patients, including osteoporosis (OP) – in 23.3%, and osteopenia – in 53.5% of women. Low AMM was found in 11.6%, and reduced appendicular muscle index (AMI) was found in 18.6% of the examined patients. Women with low BMD had significantly lower AMM and AMI scores than patients with normal BMD. The average calcium intake was 737 mg per day, while it was lower in patients with OP compared to those with normal BMD (p = 0.038). Among all women, 56% of individuals needed additional calcium supplementation. The average level of vitamin D in the blood serum was 20.8 ng/ml, with the incidence of insufficiency – 48.8%, and deficiency – 41.9% without significant differences between individuals with OP, osteopenia and normal BMD.Conclusion. In women with RA, reduced BMD was found in 76.8%, reduced AMM – in 11.6%, and low AMI – in 18.6% of cases. Patients with low BMD had lower AMM and AMI than women with normal BMD. Calcium intake was significantly lower in patients with OP compared to those with normal BMD.

Osteoporosis and sarcopenia in women with rheumatoid arthritis

Objective: to assess bone mineral density (BMD) and the incidence of osteoporosis (OP) and sarcopenia (SP) in women suffering from rheumatoid arthritis (RA).Patients and methods. Eighty-one women (mean age, 59.0±8.1 years) with a reliable diagnosis of RA were examined. The women underwent the following studies: a survey using a special questionnaire; tests to measure the functional status of muscles, including those to determine their strength; as well as dual-energy X-ray absorptiometry of the axial skeleton and whole body.Results and discussion. According to the EWGSOP2 criteria, 20 (24.7%) female patients were diagnosed with SP, 24 (29.6%) had OP, and 39 (48.2%) had osteopenia. OP in female patients with and without SP occurred in 35.0 and 27.9% of cases, respectively (p>0.05). BMD in the femoral neck and in the proximal femur as a whole was significantly lower in the presence of SP than in its absence (p=0.0006 and p=0.0061, respectively). The frequency of falls was significantly higher in the female patients with SP than in those without SP (p=0.028). The major osteoporotic and hip fracture probabilities calculated according to the FRAX ® algorithm was higher in the patients with SP than in those without SP (p=0.041 and p=0.033, respectively). There were positive correlations of BMD with body mass index, appendicular muscle mass, appendicular muscle index, hand strength, shoulder circumference, and the serum levels of calcium, creatinine and uric acid, as well as negative correlations with age, postmenopausal length, and RA duration.Conclusion. OP and SP are common RA complications that increase the risk of falls and fractures.