Appendicular Muscle Mass Research Articles

MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis

BackgroundAlthough lumbar spinal stenosis (LSS) often coexists with other degenerative conditions, few studies have fully assessed possible contributing factors for low back pain (LBP) in patients with LSS. The purpose of this study was to identify factors associated with the severity of LBP in patients with LSS.MethodsThe patients with neurogenic claudication caused by LSS, which was confirmed by magnetic resonance imaging (MRI) were included in this cross-sectional study. Data included ratings of LBP, buttock and leg pain, and numbness on a numerical rating scale (NRS), 36-item Short-Form Survey (SF-36) scores, muscle mass measured by bioelectrical impedance analysis, and radiographic measurements including lumbopelvic alignment and slippage. The severity of LSS, endplate defects, Modic endplate changes, intervertebral disc degeneration, and facet joint osteoarthritis were evaluated on MRI. Spearman correlation and multivariate linear regression analyses were used to examine the factors associated with the severity of LBP (NRS score).ResultsA total of 293 patients (135 male and 158 female, average age 72.6 years) were analyzed. LBP was moderately correlated with buttock and leg pain, and buttock and leg numbness. Significant but weak correlations were observed between LBP and body mass index, appendicular and trunk muscle mass, all domains of SF-36, pelvic tilt, total number of endplate defects and Modic endplate changes, and summary score of disc degeneration grading, but not severity or number of spinal stenoses. In the multivariate regression analysis, age, female sex, trunk muscle mass, diabetes, NRS buttock and leg pain, NRS buttock and leg numbness, SF-36 vitality, pelvic tilt, and total number of endplate defects were associated with the severity of LBP.ConclusionsTrunk muscle mass, lumbopelvic alignment, and endplate defects, but not severity of stenosis are partly associated with severity of LBP, but buttock and leg pain and buttock and leg numbness have strongest relationships with LBP in patients with LSS.

Increased Carcinoembryonic Antigen (CEA) Level Is Highly Associated with Low Skeletal Muscle Mass in Asymptomatic Adults: A Population-Based Study.

We investigated the relationship between high carcinoembryonic antigen (CEA) levels and low skeletal muscle mass (LMM) in asymptomatic adults in a population-based study. A total of 202,602 adults (mean age 41.7 years) without malignancy, stroke, cardiovascular disease, or chronic lung/liver disease were included. A high CEA level was defined as ≥5 ng/mL. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)2. Participants were classified into three groups based on SMI: “normal”, “mild LMM”, and “severe LMM.” The prevalence of elevated CEA levels was the highest in subjects with severe LMM (4.2%), followed by those with mild LMM (1.6%) and normal muscle mass (1.1%) (p for trend < 0.001). In multivariate logistic regression analysis, high CEA was independently associated with having mild LMM (adjusted odds ratio, 1.139 [95% confidence interval, 1.092–1.188]) and severe LMM (2.611 [2.055–3.319]) compared to normal muscle mass. Furthermore, the association between high CEA and severe LMM was stronger in women than that in men (women, 5.373 [2.705–10.669]; men, 2.273 [1.762–2.933]). Elevated CEA levels were significantly associated with a higher prevalence of LMM. Therefore, increased CEA could be used as a biomarker for detecting LMM in adults without cancer.

The Validity of Ultrasonographic Measurements of the Rectus Femoris Muscle in Older Adults with Sarcopenia in Thai Population

PurposeThis study aimed to determine the validity of ultrasonographic measurement of the rectus femoris muscle (RFM) thickness as a screening tool for low appendicular muscle mass (ASM) to diagnose sarcopenia and to determine the cut-off point of RFM thickness in the Thai population.Patients and methodsWe enrolled 857 community-dwelling adults aged 60 years and older who were diagnosed with sarcopenia using the Asian Working Group for Sarcopenia-2019 algorithm. The RFM thickness was measured using ultrasonography and compared with bioelectrical impedance analysis (BIA) data. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated, and the area under the receiver operating curve (AUROC) was used to determine the accuracy of the test.ResultsA total of 857 participants were included in the study. Overall, when the cut-off values of RFM thickness of ≤1.1 cm were used for male and ≤1 cm for female, the highest sensitivity for sarcopenia diagnosis was 90.9% and specificity was 92.2%. The PPV was 76.6, and the NPV was the highest at 97.3. The highest sensitivity for the diagnosis of severe sarcopenia was 92.5% and specificity was 97.4%. The AUROC of the cut-off point of RFM thickness for the diagnosis of sarcopenia was 0.92 (95% confidence interval [CI], 0.89−0.94); for severe sarcopenia, it was 0.95 (95% CI, 0.92−0.98).ConclusionMeasuring RFM thickness using ultrasonography is a feasible and reliable screening test for sarcopenia, and the cut-off values of ≤1.1 cm for male and ≤1 cm for female showed the highest accuracy for confirming low ASM in the Thai population.

Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT

Background Angiotensin-converting enzyme inhibitors and leucine are promising potential treatments for sarcopenia. Neither has yet been tested in adequately powered randomised trials in patients with sarcopenia. Objectives To determine the efficacy of leucine and perindopril in improving physical function in older people with sarcopenia, to evaluate the effect of leucine and perindopril on muscle mass and to evaluate the predictive biomarkers of sarcopenia. Design A placebo-controlled, parallel group, double-blind, randomised 2 × 2 factorial trial. Setting Primary care and geriatric medicine secondary care departments in 14 UK centres. Participants Adults aged ≥ 70 years with low muscle strength and mass, without contraindications to angiotensin-converting enzyme inhibitors and without known diagnosis-specific skeletal myopathy. Interventions Eligible participants were randomised 1 : 1 to receive 4 mg of oral perindopril or a matching placebo and, separately, were randomised 1 : 1 to receive 2.5 g of oral leucine powder or a matching placebo powder taken thrice daily with meals. Randomisation was performed using an interactive web-based randomisation system run independently of the research team to preserve allocation concealment. Main outcome measures The primary outcome was the between-group difference in the Short Physical Performance Battery (SPPB) score over the 12-month follow-up period. Other outcome measures included appendicular muscle mass, EQ-5D (EuroQol-5 Dimensions) quality-of-life score, grip strength, quadriceps strength, 6-minute walk distance, activities of daily living, hip bone mineral density and insulin resistance. All adverse events and falls were recorded. Protein-, DNA (deoxyribonucleic acid)- and RNA (ribonucleic acid)-based biomarkers were collected at baseline and at 3 and 12 months. Results We screened 320 people and randomised 145 participants. Participants had a mean age of 79 (standard deviation 6) years, 78 (54%) were women and the mean SPPB was 7.0 (standard deviation 2.4). The median adherence was lower for perindopril than for placebo (76% vs. 96%; p &lt; 0.001). Perindopril did not improve the primary outcome (adjusted treatment effect –0.1 points, 95% confidence interval –1.2 to 1.0 points). Quality of life was worse in the perindopril group (treatment effect –12 points, 95% confidence interval –21 to –3 points) and more adverse events occurred in the perindopril group (n = 218 vs. n = 165). Falls rates between the groups were similar and other secondary outcomes showed no significant treatment effect. For leucine compared with placebo, median adherence was the same in both groups (76% vs. 76%; p = 0.99). Leucine did not improve the primary outcome (adjusted treatment effect 0.1 point, 95% confidence interval –1.0 to 1.1 points). No significant treatment effect was found for any secondary outcome. There were similar numbers of adverse events and falls in both groups. Limitations The trial did not reach its original recruitment target; this trial alone cannot confidently exclude clinically important effects of either perindopril or leucine. Future work Further exploration of biomarkers predicting response to sarcopenia interventions is warranted. Conclusions Neither perindopril nor leucine improved physical performance or muscle mass in this trial; meta-analysis confirmed the lack of efficacy of both treatments in improving physical performance. Study registration This trial is registered as ISRCTN90094835 and EudraCT 2014-003455-61. The systematic review is registered as PROSPERO CRD42014013398. Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and National Institute for Health and Care Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.

Nutritional status and osteoporotic phenotype of body composition in patients with rheumatoid arthritis

Aim. To evaluate the nutritional status and its relationship with osteoporotic phenotype of body composition in women with rheumatoid arthritis (RA).Material and methods. The study included 91 women aged 40 to 75 years with RA according to ACR/EULAR criteria (2010). A questionnaire, laboratory examination and dual X-ray absorptiometry of whole body, lumbar spine and proximal femur were conducted. Nutritional status was assessed using a MNA (Mini Nutricial Assessment) questionnaire.Results. Risk of malnutrition and malnutrition according to the MNA were detected in 42.9 % and 1.1 % of patients with RA, respectively. These patients differed from those with normal nutritional status with a higher risk of osteoporotic hip fracture according to FRAX (p = 0.035), lower appendicular muscle mass (AMM) (p = 0.048) and lower QOL according to VAS (p = 0.012). A positive correlation was established between the nutritional status by MNA and BMI (r = 0.280; p = 0.007), as well as total muscle mass (r = 0.280; p = 0.008), AMM (r = 0.320; p = 0.002) and AMM index (r = 0.280; p = 0.009). In multivariate logistic regression analysis, age above 55 years (OR = 7.76; 95 % CI: 2.17–27.69), nutritional status by MNA (OR = 0.68; 95 % CI: 0.51–0.92) and AMM index less than 6 kg/m2 (OR = 3.43; 95 % CI: 1.16–10.21) were independent factors associated with osteoporotic phenotype in RA patients.Conclusion. Malnutrition occurred in 44.0 % of RA patients. Women at risk of malnutrition had a higher 10-year probability of hip fracture according to FRAX. Age and AMM index were positively associated, while nutrition status according to MNA was negatively associated with osteoporotic phenotype of body composition.

Evaluation of Appendicular Muscle Mass in Sarcopenia in Older Adults Using Ultrasonography: A Systematic Review and Meta-Analysis

Background: The measurement of appendicular muscle mass is essential for the diagnosis of sarcopenia. Ultrasonography is an accurate and convenient method used to evaluate muscle mass. Objective: The aim of the study was to evaluate the diagnostic value of ultrasonography for appendicular muscle mass in sarcopenia in older adults and find out proper ultrasound parameters. Methods: Medline, Embase, Cochrane, and Web of Science databases were searched for relevant articles. Published studies on the validity and/or reliability of ultrasonography for quantifying muscle mass of the limbs in sarcopenia in the older population were included. A systematic review was conducted based on specific muscles and reference methods. A meta-analysis was conducted to assess the validity and reliability of the ultrasonography. Results: Forty articles were included in this review. There were nine, nine, nine, and four studies included in the qualitative synthesis for a diagnostic test, correlation coefficient, intra-class reliability, and inter-class reliability, respectively. The diagnostic value of rectus femoris (RF) or gastrocnemius (GM) thickness on ultrasonography for sarcopenia or low muscle mass was moderate (the area under summary receiver operating characteristic curve [SROC] = 0.76, 95% confidence interval [CI]: 0.72–0.79, SROC = 0.80, 95% CI: 0.76–0.83, respectively). The pooled correlation between muscle mass on dual-energy X-ray (DXA) or bioelectrical impedance analysis (BIA) and muscle thickness (MT) on ultrasound was moderate (r = 0.56, 95% CI: 0.49–0.62). There was a low-to-moderate correlation between muscle mass on DXA or BIA and cross-sectional area (CSA) on ultrasound (r = 0.267–0.584). The correlation was high to very high between muscle mass from DXA and the ultrasound-predicted formula (r = 0.85–0.963). The CSA from ultrasound had a high or very high correlation with that from computed tomography or magnetic resonance imaging (r = 0.826, intra (inter)-correlation coefficient [ICC] = 0.998–0.999). The respective meta-analyses showed good inter-rater and intra-rater reliabilities (ICC > 0.9). Conclusion: Ultrasonography is a reliable and valid diagnostic method for the quantitative assessment of appendicular muscle mass in sarcopenia in older people. The thickness and CSA of the RF or GM seem to be proper ultrasound parameters to predict muscle mass in sarcopenia. Multicenter studies with large samples and the application of new ultrasonic techniques will be the future research directions.

The frequency of sarcopenia and factors affecting appendicular muscle mass in patients with systemic sclerosis

Aim. To determine the frequency of sarcopenia (SP) and to identify factors associated with the muscle mass in women with systemic sclerosis (SSc).Materials and methods. The study included 64 women with SSc aged 40–70 years. Questionnaires, clinical, instrumental, laboratory examinations and absorptiometry. Linear regression analysis was performed to identify factors associat ed with appendicular muscle mass (AMM).Results. Probable SP was detected in 35 (54.7 %), and confirmed SP – 17 (26.5 %) women with SSc. The frequency of SP did not differ depending on the form of the disease. Univariate linear analysis revealed the relationship between the AMM and BMI, nutritional status; mid-upper arm, waist, hip and calf circumferences, skin Rodnan score, cumulative dose of glucocorticoids (GC) and BMD of the proximal hip. Multivariate linear analysis confirmed the presence of associations between the AMM index and BMI (b = 0.65; p &lt;0.001), the Rodnan skin score (b = –0.19; p = 0.047), the cumulative dose of GC (b = –0.22; p = 0.021).Conclusion. The study demonstrated that more than a quarter of patients with SSc had a confirmed SP. Although age is the main risk factor for SP in the general population, in our study it did not differ between patients with low and normal AMM. The cumulative dose of GC and the Rodnan skin score were negatively, and BMI was positively associated with the value of AMМ.

Efficacy of Exercise on Muscle Function and Physical Performance in Older Adults with Sarcopenia: An Updated Systematic Review and Meta-Analysis.

This study aimed to analyze the efficacy of exercise interventions on muscle strength, muscle mass, and physical performance in older adults with sarcopenia. Randomized controlled studies assessing exercise effects on sarcopenia were searched in Web of Science, PubMed, Cochrane Library, ProQuest, EBSCOhost, Scopus, EMBASE, and VIP and CNKI up to 31 March 2022. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. The initial search identified 5379 studies, and 23 studies involving 1252 participants met the inclusion criteria for further analysis. Results revealed that exercise interventions can significantly improve grip strength (MD = 2.38, 95%CI = 1.33–3.43), knee extension strength (SMD = 0.50, 95%CI = 0.36–0.64), muscle mass of lower extremities (MD = 0.28, 95%CI = 0.01–0.56), walking speed (SMD = 0.88, 95%CI = 0.49–1.27), and functional mobility (MD = −1.77, 95%CI = −2.11–−1.42) among older adults with sarcopenia. No significant exercise effects were found on fat-free muscle mass, appendicular muscle mass, skeletal muscle mass, and muscle mass of the upper extremities. The results of subgroup analysis indicated that both resistance training and multicomponent exercise could significantly increase the muscle strength, while aerobic exercise did not. The findings suggest that exercise intervention can effectively improve muscle function and physical performance in older adults with sarcopenia, but has limited effects on the muscle mass of the upper extremities. In addition, it is highly recommended to apply group-based and supervised resistance training and multicomponent exercise in the prevention and treatment of sarcopenia among the older population.

Prevalencia de sarcopenia en pacientes mayores de 75 años ingresados por fractura de cadera

IntroductionHip fracture in the population aged 75 years and older is one of the most disabling pathologies. Likewise, disease related malnutrition (DRM) and sarcopenia are two frequent diagnoses in this age group, whose prevalence may be increased in patients with hip fracture. AimTo determine the prevalence of malnutrition and/or sarcopenia in patients admitted for hip fracture and evaluate the existence of malnutrition related to disease and sarcopenia, and the differences between the sarcopenic and non-sarcopenic group. Methods186 patients aged 75 years or over, hospitalised for hip fracture from March 2018 to June 2019 were included. Demographic, nutritional and biochemical variables were collected. Nutritional screening was carried out with the Mini-Nutritional Assessment (MNA), the presence of DRM was established with The Global Leadership Initiative on Malnutrition (GLIM) criteria. For sarcopenia screening, the Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls (SARC-F) was used and the diagnosis of sarcopenia was made using the criteria from the European Working Group on Sarcopenia in Older People (EWGSOP) reviewed in 2019 (EWGSOP2). Muscle strength was determined by hand-grip strength, body composition by measurement of bioelectrical impedance. ResultsThe mean age was 86.2 years, most of the patients were women (81.7%). 37.1% of patients were at nutritional risk (MNA 17-23.5) and 16.7% were malnourished (MNA<17). 72.4% of women and 79,4% of men, were diagnosed with DRM. 77.6% of the women and 73.5% of the men had low muscle strength. The appendicular muscle mass index was below the cut-off points for sarcopenia in 72.4% of the women and 79.4% of the men. Patients with sarcopenia had a lower body mass index, older age, poorer previous functional status and higher disease burden. The relationship between weight loss and hand grip strength (HGS) was significant (p=0.007) Conclusions53.8% of patients admitted for hip fracture present malnutrition or are at risk after screening with MNA. Sarcopenia and DRM affects at least three out of four patients older than 75 years admitted for hip fracture. Older age, worse functional status, lower body mass index and high number of comorbidities, are associated with these two entities. There is a relationship between DRM and sarcopenia.

Interrelationship among thigh intermuscular adipose tissue, cross-sectional area, muscle strength, and functional mobility in older subjects.

The aim of this cross-sectional study was to investigate the association between lower limb strength, muscle mass and composition, and balance ability in elders.Thirthy-four older participants (Age: 65.6 ± 4.73 years; male = 10 and female = 24) were assessed for muscle strength (maximal isometric strength of knee extensors and one repetition maximum by leg press, the one repetition maximum [1RM]), balance and gait capacity (Mini-BESTest), body composition by whole-body dual energy x-ray absorptiometry (obtaining Appendicular Skeletal Muscle Mass Index, ASMMI), and magnetic resonance imaging of thigh to evaluate Intermuscular Adipose Tissue (IMAT) and muscle Cross Sectional Area (CSA).Positive correlations between 1RM and ASMMI (rs = 0.64, P < .0001) and thigh CSA (rs = 0.52, P = .0017), but not with thigh IMAT, were found. In addition, significant correlations between knee extensors strength and ASMMI (rs = 0.48, P = .004) and thigh CSA (rs = 0.49, P = .0033) and IMAT (rs = -0.35, P = .043) were observed, whereas no significant correlations between the Mini-BESTest with ASMMI, thigh CSA, and IMAT were observed.Lower limb strength positively correlated with appendicular muscle mass. Further, the maximal isometric strength of knee extensors negatively correlated with thigh IMAT in elderly patients, whereas the dynamic balance ability did not correlate with any of the morphological variables of the muscle (i.e., ASMMI, CSA, and IMAT). A reduced muscle size and strength could affect movement and reduce physical function in older patients. Improving the composition and size of muscle in elder subjects could reduce frailty and risk of falls.

Bone mineral density and muscle mass in adults with developmental skeletal discrepancies

BackgroundIt was aimed to investigate the musculoskeletal status in individuals diagnosed with skeletal discrepancies.MethodsThis case–control study was performed on 35 patients with developmental skeletal discrepancies listed for orthognathic surgery as a case group and 33 patients who were nominated for wisdom tooth removal as a control group. All participants were aged 18–40 years and the research was carried out in the period between May 2018 and May 2019. Dual X-ray absorptiometry (DEXA) was used to assess bone mass density at three bone sites: total hip, femoral neck, and the spinal lumbar vertebrae (L1-L4). The appendicular muscle mass index (ASMI) was measured based on the four limbs from the DEXA scan.ResultsOur data showed that 45.7% (16) of the case group were osteopenic or osteoporotic while in the control group only 21.2% (7) were osteopenic in at least one region (total hip, femoral neck, or lumbar) (p-value = 0.03).Regarding muscle mass, there was significantly lower SMI in subjects with skeletal discrepancies (case group) compared with the control group (median (IQR) 5.9 (2.5) vs. 6.8 (2.9) (kg/m2), respectively, p = 0.04).ConclusionsThere is an essential need for more studies to understand the exact interrelationship between musculoskeletal status and skeletal jaw discrepancies.

Associations of muscle mass, strength, and quality with all-cause mortality in China: a population-based cohort study.

BackgroundIt remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China.MethodsBased on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality.ResultsDuring a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08–1.51) for low appendicular muscle mass index, 1.38 (1.16–1.62) for low total muscle mass index, 1.68 (1.41–2.00) for low grip strength, and 1.41 (1.20–1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories.ConclusionLow muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.

1099-P: Truncal Fat–to–Leg Fat Ratio and Carotid Plaque Score in Patients with Type 2 Diabetes

High truncal fat is known to be a risk factor for cardiovascular disease (CVD) , but high leg fat has a protective effect on CVD. We investigated the association between truncal fat-to-leg fat ratio (TLR) and carotid plaque score PS) in patients with type 2 diabetes (T2D) . A total of 1966 participants aged over 30 years and having T2D were recruited. Truncal fat, leg fat, and appendicular muscle mass (ASM) were measured using dual-energy X-ray absorptiometry and Carotid intima-media thickness (CIMT) and PS were assessed using high-resolution B-mode ultrasonography. High PS was defined as PS ≥ 3. The prevalence of plaque and high PS were 72.0% and 40.0%, respectively. Patients with high PS were more likely to be old, male, and hypertensive and had higher systplic blood pressure (SBP) , diabetic duration (DD) , serum creatinine (Cr) , and TLR, but lower values of diastolic BP, truncal and leg fat, HDL, and estimated glomerular filtration rate (eGFR) than those without high PS. Participants in the highest TLR tertile group were older and more hypertensive and had higher DD, SBP, waist circumference (WC) , body mass index (BMI) , HOMA-IR, glycated A1c (HbA1c) , triglycerides (TG) , serum Cr, CIMT, and PS, but lower ASM/BMI, HDL, and eGFR than those in the lowest TLR tertile group. The prevalence of high PS progressively increased with increasing TLR tertiles (Lowest vs. Middle vs. Highest = 33.4 vs. 41.0 vs. 45.7%, respectively, p &amp;lt; 0.001) . After adjusting age and sex, the odd ratios (ORs) and 95% confidence intervals (CIs) for high PS were 1.39 (1.- 1.79, p = 0.01) in the middle and 1.65 (1.28 - 2.11, p = &amp;lt; 0.001) in the highest tertile groups. After further adjusting for hypertesnsion, WC, BMI, SBP, DD, HbA1c, HOMA-IR, HDL cholesterol, TG, and eGFR, the ORs and 95% CIs in the middle and highest tertile groups remained significant. In conclusion, higher TLR was independently associated with carotid PS in patients with T2D. Therefore, we suggest that high TLR may be a risk factor for early atherosclerosis in patients with T2D. Disclosure J.Shin: n/a.

Dietary Fiber Intake Is Related to Skeletal Muscle Mass, Body Fat Mass, and Muscle-to-Fat Ratio Among People With Type 2 Diabetes: A Cross-Sectional Study.

ObjectivesTo investigate the relationship between dietary fiber intake and skeletal muscle mass, body fat mass, and muscle-to-fat ratio (MFR) among men and women with type 2 diabetes (T2D).MethodsThis cross-sectional study involved 260 men and 200 women with T2D. Percent skeletal muscle mass (%) or percent body fat mass (%) was calculated as (appendicular muscle mass [kg] or body fat mass [kg]/body weight [kg]) × 100. MFR was calculated as appendicular muscle mass divided by body fat mass. Information about dietary fiber intake (g/day) was obtained from a brief-type self-administered diet history questionnaire.ResultsDietary fiber intake was correlated with percent body fat mass (r = –0.163, p = 0.021), percent skeletal muscle mass (r = 0.176, p = 0.013), and MFR (r = 0.157, p = 0.026) in women. However, dietary fiber intake was not correlated with percent body fat mass (r = –0.100, p = 0.108), percent skeletal muscle mass (r = 0.055, p = 0.376), and MFR (r = 0.065, p = 0.295) in men. After adjusting for covariates, dietary fiber intake was correlated with percent body fat mass (β = 0.229, p = 0.009), percent skeletal muscle mass (β = 0.364, p < 0.001), and MFR (β = 0.245, p = 0.006) in women. Further, dietary fiber intake was related to percent skeletal muscle mass (β = 0.221, p = 0.008) and tended to be correlated with percent body fat mass (β = 0.148, p = 0.071) in men.ConclusionDietary fiber intake was correlated with skeletal muscle mass, body fat mass, and MFR among women with T2D.

Diagnosis, management strategies and research horizons in sarcopenia.

Sarcopenia was first described by Rosenberg as the age-related loss of skeletal muscle mass. The early operational definitions of sarcopenia were based on low muscle mass alone. However, research has suggested a strong predictive relationship between measures of muscle quality i.e., strength and/or physical performance, and health outcomes. Therefore, the definition has been revised to "age-related loss of muscle mass and muscle function". The etiology of sarcopenia is multifactorial and diagnostic recommendations published to date have addressed the total or appendicular muscle mass. Measurement of anterior thigh muscle mass has better correlations with functional tests and all-cause mortality when compared with appendicular or total muscle mass measurements. The aim of this review is to highlight the importance of sarcopenia as an emerging public health issue, diagnostic evaluation with muscle mass and functional performance evaluations and appropriate interventions for management.

Abstract #1183822: The thigh is relevant to assess myosteatosis, through proton magnetic resonance spectroscopy, and lean mass in adults with metabolic risk factors

Fatty infiltration in the muscle, i.e., myosteatosis, is an undervalued parameter of muscle quality associated to cardiometabolic health. Appendicular muscle mass is also associated to cardiometabolic outcomes. Then, both muscle mass and quality should be evaluated in the same region. We explored the association of intramuscular lipids (IML) in the thigh, measured through proton magnetic resonance spectroscopy (1H-MRS), with body fat (BF), thigh lean mass, thigh fat mass and saturated free fatty acids (S-FFA) in a cohort of Colombian adults with metabolic risk factors.

Need of nutritional assessment and monitoring in a population with acquired brain injury: an analytical cross-sectional study

ABSTRACT Introduction Patients with acquired brain injury (ABI) may be at an increased risk of malnutrition due to the pathophysiology of their condition, which can affect their anthropometrical profile and therefore their quality of life. The present study analyzes the anthropometrical profile of these individuals, describes their dietary habits and nutrients intake and identifies the related risk factors influencing health status and quality of life. Methods Twenty-three volunteers with ABI from the province of Granada (Spain) were recruited for this cross-sectional study. Nutritional assessment was quantitatively and qualitatively performed using a 72-h dietary record and a food frequency questionnaire, respectively. Body composition parameters were evaluated by bioelectrical impedance. Results Low intakes of minerals related to bone health, extra virgin olive oil (EVOO) and fruits were reported. Moreover, women presented a poorer anthropometrical profile compared to men. With reference to age, a significant inverse correlation was observed with sarcopenic obesity, appendicular muscle mass index and Vitamin B6 intake [(r = −0.617, p < 0.01), (r = −0.475, p < 0.05) and (r = −0.498, p < 0.05), respectively]. Intake of EVOO was inversely correlated to body mass index (r = −0.767, p < 0.001). Lastly, a direct correlation was observed between the consumption of alcohol and sweets and snacks (r = 0.608, p < 0.01). Conclusion The main findings support the existence of poor dietary quality and anthropometrical profile. Interdisciplinary team assessment would be beneficial to enhance the quality of life and attenuate the development of comorbidities in subjects with ABI.

Muscular Ultrasonography in Morphofunctional Assessment of Patients with Oncological Pathology at Risk of Malnutrition.

Background: Muscular ultrasonography is a technique that allows assessing the amount and quality of muscle in a specific body region. The aim of the study was to compare the value of muscle ultrasonography in diagnosis of malnutrition with techniques such as anthropometry, handgrip strength and impedanciometry in patients with oncological pathology. Methods: Cross-sectional study in 43 patients with oncological pathology and high nutritional risk. Classical anthropometry (body mass index (BMI), arm circumference (AC), calf circumference (CC) and estimated appendicular muscle mass index (ASMI)) was performed. Body composition was measured with impedanciometry (BIA), phase angle (PA) and fat-free mass index (FFMI) and muscle ultrasonography of quadriceps rectus femoris (muscle area (MARA) and circumference (MCR) in section transverse). Malnutrition was diagnosed using the GLIM criteria and sarcopenia was assessed using EWGSOP2 criteria. Results: The mean age was 68.26 years (±11.88 years). In total, 23/20 of the patients were men/women. The BMI was 23.51 (4.75) kg/m2. The ASMI was 6.40 (1.86) kg/m2. The MARA was 3.31 cm2 in ultrasonography. In impedanciometry, phase angle was 4.91 (0.75)°; the FFMI was 17.01 kg/m2 (±2.65 kg/m2). A positive correlation was observed between the MARA with anthropometric measurements (AC: r = 0.39, p = 0.009; CC: r = 0.44, p < 0.01; ASMI: r = 0.47, p < 0.001); and with BIA (FFMI: r = 0.48, p < 0.01 and PA: r = 0.45, p < 0.001). Differences were observed when comparing the MARA based on the diagnosis of sarcopenia (Sarcopenia: 2.47 cm2 (±0.54 cm2); no sarcopenia: 3.65 cm2 (±1.34 cm2); p = 0.02). Conclusions: Muscle ultrasonography correlates with body composition measurement techniques such as BIA and anthropometry in patients with cancer.

Quantitative estimation of muscle mass in older adults at risk of sarcopenia using ultrasound: a cross-sectional study.

Sarcopenia is an age-associated syndrome of decreased skeletal muscle function and loss of muscle mass. This cross-sectional study was designed to investigate whether ultrasound can be used to quantitatively estimate muscle mass in older adults as an efficient assistive method for the diagnosis of sarcopenia. A cohort of 103 older adults older aged over 60 years who were at risk of sarcopenia, including 57 males and 46 females, was recruited. The participants underwent ultrasound to measure the muscle thickness (MT) of 11 sites across the whole body. Bioelectrical impedance analysis (BIA) was then used to estimate the appendicular muscle mass, and the correlation between skeletal muscle mass index (SMI) and MT at different sites was studied. Finally, muscle mass estimation algorithms for older adults were developed using multiple linear regression. Male participants had a significantly higher SMI (7.03±0.73 vs. 5.84±0.72 kg/m2, P<0.001) and higher MT than female participants at all 11 sites (all P<0.05). The MT of Site 7 (rectus femoris and intermedius femoris) in males had the strongest correlation with SMI (R=0.719, P<0.001). In females, the MT at Site 3 (flexor pollicis longus, flexor digitorum superficialis, and brachioradialis) had the strongest correlation with SMI (R=0.733, P<0.001). The MT of Site 7 was selected for a one-site algorithm; the R2 and standard error of estimate (SEE) values were 0.701 and 0.519 kg/m2, respectively. The MT of Site 3, Site 7, Site 1 (biceps and brachialis), and Site 9 (tibialis anterior) were selected for a four-site algorithm; the R2 and SEE values were 0.819 and 0.404 kg/m2, respectively. MT measured using ultrasound is correlated with SMI at some sites, and the correlations differ between men and women. When sex and age were included in the algorithm, the MT at Site 1, Site 3, Site 7, and Site 9 were valuable for estimating SMI, with Site 7 being the best parameter among them. Ultrasound-derived algorithms can achieve a satisfying fitting effect and provide new solutions for muscle mass estimation in older adults.

Sex-specific associations of fat mass and muscle mass with cardiovascular disease risk factors in adults with type 2 diabetes living with overweight and obesity: secondary analysis of the Look AHEAD trial

BackgroundDistinguishable sex differences exist in fat mass and muscle mass. High fat mass and low muscle mass are independently associated with cardiovascular disease (CVD) risk factors in people living with type 2 diabetes; however, it is unknown if the association between fat mass and CVD risk is modified by muscle mass, or vice versa. This study examined the sex-specific interplay between fat mass and muscle mass on CVD risk factors in adults with type 2 diabetes living with overweight and obesity.MethodsDual-energy X-ray absorptiometry (DXA) measures were used to compute fat mass index (FMI) and appendicular muscle mass index (ASMI), and participants were separated into high-fat mass vs. low-fat mass and high-muscle mass vs. low-muscle mass. A two-way analysis of covariance (ANCOVA: high-FMI vs. low-FMI by high-ASMI vs. low-ASMI) was performed on CVD risk factors (i.e., hemoglobin A1C [A1C]; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; triglycerides; systolic and diastolic blood pressure; cardiorespiratory fitness, depression and health related-quality of life [HR-QoL]) at baseline and following a 1-year intensive lifestyle intervention (ILI) for females and males separately, with a primary focus on the fat mass by muscle mass interaction effects.ResultsData from 1,369 participants (62.7% females) who completed baseline DXA were analyzed. In females, there was a fat mass by muscle mass interaction effect on A1C (p = 0.016) at baseline. Post-hoc analysis showed that, in the low-FMI group, A1C was significantly higher in low-ASMI when compared to high-ASMI (60.3 ± 14.1 vs. 55.5 ± 13.5 mmol/mol, p = 0.023). In the high-FMI group, there was no difference between high-ASMI and low-ASMI (56.4 ± 12.5 vs. 56.5 ± 12.8 mmol/mol, p = 0.610). In males, only high-FMI was associated with higher A1C when compared to low-FMI (57.1 ± 14.4 vs. 54.2 ± 12.0 mmol/mol, p = 0.008) at baseline. Following ILI, there were significant fat mass by muscle mass interaction effects on changes in the mental component of HR-QoL in males.ConclusionConsidering that A1C predicts future CVD, strategies to lower A1C may be especially important in females with low fat and low muscle mass living with type 2 diabetes. Our results highlight the complicated and sex-specific contribution of fat mass and muscle mass to CVD risk factors.