Body Composition Measurements Research Articles

Body weight and composition endpoints in cancer cachexia clinical trials: Systematic Review 4 of the cachexia endpoints series.

Significant variation exists in the outcomes used in cancer cachexia trials, including measures of body composition, which are often selected as primary or secondary endpoints. To date, there has been no review of the most commonly selected measures or their potential sensitivity to detect changes resulting from the interventions being examined. The aim of this systematic review is to assess the frequency and diversity of body composition measures that have been used in cancer cachexia trials. MEDLINE, Embase and Cochrane Library databases were systematically searched between January 1990 and June 2021. Eligible trials examined adults (≥18years) who had received an intervention aiming to treat or attenuate the effects of cancer cachexia for >14days. Trials were also of a prospective controlled design and included body weight or at least one anthropometric, bioelectrical or radiological endpoint pertaining to body composition, irrespective of the modality of intervention (e.g., pharmacological, nutritional, physical exercise and behavioural) or comparator. Trials with a sample size of <40 patients were excluded. Data extraction used Covidence software, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. This review was prospectively registered (PROSPERO: CRD42022276710). A total of 84 clinical trials, comprising 13016 patients, were eligible for inclusion. Non-small-cell lung cancer and pancreatic cancer were studied most frequently. The majority of trial interventions were pharmacological (52%) or nutritional (34%) in nature. The most frequently reported endpoints were assessments of body weight (68 trials, n=11561) followed by bioimpedance analysis (BIA)-based estimates (23 trials, n=3140). Sixteen trials (n=3052) included dual-energy X-ray absorptiometry (DEXA)-based endpoints, and computed tomography (CT) body composition was included in eight trials (n=841). Discrepancies were evident when comparing the efficacy of interventions using BIA-based estimates of lean tissue mass against radiological assessment modalities. Body weight, BIA and DEXA-based endpoints have been most frequently used in cancer cachexia trials. Although the optimal endpoints cannot be determined from this review, body weight, alongside measurements from radiological body composition analysis, would seem appropriate. The choice of radiological modality is likely to be dependent on the trial setting, population and intervention in question. CT and magnetic resonance imaging, which have the ability to accurately discriminate tissue types, are likely to be more sensitive and provide greater detail. Endpoints are of particular importance when aligned with the intervention's mechanism of action and/or intended patient benefit.

Association of low muscle mass with cognitive function and mortality in USA seniors: results from NHANES 1999–2002

BackgroundSarcopenia and cognitive impairment have been linked in prior research, and both are linked to an increased risk of mortality in the general population. Muscle mass is a key factor in the diagnosis of sarcopenia. The relationship between low muscle mass and cognitive function in the aged population, and their combined impact on the risk of death in older adults, is currently unknown. This study aimed to explore the correlation between low muscle mass and cognitive function in the older population, and the relationship between the two and mortality in older people.MethodsData were from the National Health and Nutrition Examination Survey 1999–2002. A total of 2540 older adults aged 60 and older with body composition measures were included. Specifically, 17–21 years of follow-up were conducted on every participant. Low muscle mass was defined using the Foundation for the National Institute of Health and the Asian Working Group for Sarcopenia definitions: appendicular lean mass (ALM) (< 19.75 kg for males; <15.02 kg for females); or ALM divided by body mass index (BMI) (ALM: BMI, < 0.789 for males; <0.512 for females); or appendicular skeletal muscle mass index (ASMI) (< 7.0 kg/m2 for males; <5.4 kg/m2 for females). Cognitive functioning was assessed by the Digit Symbol Substitution Test (DSST). The follow-up period was calculated from the NHANES interview date to the date of death or censoring (December 31, 2019).ResultsWe identified 2540 subjects. The mean age was 70.43 years (43.3% male). Age-related declines in DSST scores were observed. People with low muscle mass showed lower DSST scores than people with normal muscle mass across all age groups, especially in the group with low muscle mass characterized by ALM: BMI (60–69 years: p < 0.001; 70–79 years: p < 0.001; 80 + years: p = 0.009). Low muscle mass was significantly associated with lower DSST scores after adjusting for covariates (ALM: 43.56 ± 18.36 vs. 47.56 ± 17.44, p < 0.001; ALM: BMI: 39.88 ± 17.51 vs. 47.70 ± 17.51, p < 0.001; ASMI: 41.07 ± 17.89 vs. 47.42 ± 17.55, p < 0.001). At a mean long-term follow-up of 157.8 months, those with low muscle mass were associated with higher all-cause mortality (ALM: OR 1.460, 95% CI 1.456–1.463; ALM: BMI: OR 1.452, 95% CI 1.448–1.457); ASMI: OR 3.075, 95% CI 3.063–3.088). In the ALM: BMI and ASMI-defined low muscle mass groups, participants with low muscle mass and lower DSST scores were more likely to incur all-cause mortality ( ALM: BMI: OR 0.972, 95% CI 0.972–0.972; ASMI: OR 0.957, 95% CI 0.956–0.957).ConclusionsLow muscle mass and cognitive function impairment are significantly correlated in the older population. Additionally, low muscle mass and low DSST score, alone or in combination, could be risk factors for mortality in older adults.

The milk study protocol: A longitudinal, prospective cohort study of the relationship between human milk metabolic hormone concentration, maternal body composition, and early growth and satiety development in Samoan infants aged 1-4 months.

Current research suggests that energy transfer through human milk influences infant nutritional development and initiates metabolic programming, influencing eating patterns into adulthood. To date, this research has predominantly been conducted among women in high income settings and/or among undernourished women. We will investigate the relationship between maternal body composition, metabolic hormones in human milk, and infant satiety to explore mechanisms of developmental satiety programming and implications for early infant growth and body composition in Samoans; a population at high risk and prevalence for overweight and obesity. Our aims are (1) to examine how maternal body composition influences metabolic hormone transfer from mother to infant through human milk, and (2) to examine the influences of maternal metabolic hormone transfer and infant feeding patterns on early infant growth and satiety. We will examine temporal changes in hormone transfers to infants through human milk in a prospective longitudinal cohort of n = 80 Samoan mother-infant dyads. Data will be collected at three time points (1, 3, & 4 months postpartum). At each study visit we will collect human milk and fingerpick blood samples from breastfeeding mother-infant dyads to measure the hormones leptin, ghrelin, and adiponectin. Additionally, we will obtain body composition measurements from the dyad, observe breastfeeding behavior, conduct semi-structured interviews, and use questionnaires to document infant hunger and feeding cues and satiety responsiveness. Descriptive statistics, univariate and multivariate analyses will be conducted to address each aim. This research is designed to advance our understanding of variation in the developmental programming of satiety and implications for early infant growth and body composition. The use of a prospective longitudinal cohort alongside data collection that utilizes a mixed methods approach will allow us to capture a more accurate representation on both biological and cultural variables at play in a population at high risk of overweight and obesity.

The Role of Subcutaneous Fat Composition on Blood Pressure: A Study on Students Aged 15-18 at Kalam Kudus II Senior High School Jakarta, Indonesia

Background: Hypertension is one of the leading causes of death worldwide. There was an increase in the prevalence of hypertension in children and adolescents ≤19 years of age from 2000 to 2015. Body mass index (BMI) and subcutaneous fat distribution are linked to blood pressure variations. Methods: The cross-sectional study was carried out at Kalam Kudus II Senior High School Jakarta from June – August 2023. The inclusion criteria in this study included students of Kalam Kudus II Senior High School Jakarta, aged 15-18 years, registered as active students at the time the study was conducted, physically and spiritually healthy, and willing to participate in the study. The exclusion criteria for this study include students who refused participation, did not obtain permission from their parents, or students with medical disorders that affect anthropometric results and blood pressure. Data was taken from direct measurement and performed multivariate testing using the double linear regression test enter method in SPSS. The statistical significance is 0.05. Results: An analysis of 102 students found that only BMI had a significant relationship with systolic blood pressure, and no anthropometric variable had a meaningful relationship with diastolic pressure. Conclusion: There are many ways and factors for measuring body composition. It is important to test the body composition and BMI of adolescents to reduce the risk of hypertension later in the day.

Profile of Nagasaki Islands Study (NaIS): A Population-based Prospective Cohort Study on Multi-disease.

In an aging society, it is important to visualize the conditions of people living with diseases or disabilities, such as frailty and sarcopenia, and determine the environmental and genetic factors underlying such conditions. Atherosclerosis and arterial stiffness are key conditions between these factors and noncommunicable diseases. In 2014, we launched a population-based prospective open-cohort study, the Nagasaki Islands Study (NaIS), which was conducted in Goto City, located in the remote islands of Nagasaki Prefecture, Japan, mostly involving middle-aged and older residents. We conducted our own health checkups along with the annual standardized checkups organized by the municipality; recruited study participants; and started to follow them for vital status (death), migration, and occurrence of diseases, such as myocardial infarction, stroke, fracture, and human T-cell leukemia virus type 1 (HTLV-1)-associated uveitis. Our checkups were conducted as baseline surveys in different areas of Goto City during the fiscal years 2014-2016, secondary surveys during 2017-2019, and tertiary surveys since 2021, consisting of medical interviews, physical examinations, blood and urine tests, body composition measurements, osteoporosis screening, arterial stiffness measurements, carotid ultrasonography, and dental examination. A total of 4,957 residents participated in either the baseline or secondary surveys and were followed; 3,594 and 3,364 residents (aged 27-96 and 28-98 years) participated in the baseline and secondary surveys, respectively. In conclusion, the NaIS has been undertaken to reveal the influence of aging and risk factors of noncommunicable diseases and disabilities, with an aim to contribute towards better healthcare in the future.

PSI-8 Impact of feeding level on boars from selection to entering the boar stud on trainability and growth measurements

Abstract The objective of this study was to determine if restricting feed in boars at selection impacts growth of boars or training for semen collection. Duroc boars (n = 25) randomly allotted at 6 mo of age to receive one of two levels of restricted feeding (1.8 kg/d, n = 12 or 2.72 kg/d, n = 13) of a corn-soybean meal-based diet formulated to meet NRC (2012) requirements. Diets were fed for 9 wk before training for semen collection where body weight (BW), body condition score (BCS), flank-flank tape measurements, Knauer sow caliper, loin muscle depth, backfat depth, and scrotal width and length were collected every 3 wk. Training for semen collection was conducted 5 d/wk for 2 wk. Boars were given 10 min in the collection pen to successfully mount the dummy and start collection each training session. Training was scored on a scale of 1-5, 1 = no interest and 5 = successful collection. After three successful collections in a row, boars were considered fully trained. All boars had their first production collection on wk 12. Data were analyzed using PROC MIXED and PROC FREQ chi-square in SAS 9.4 with boar serving as experimental unit. Weeks were analyzed individually and overall changes were evaluated. Significance was determined at P &amp;lt; 0.05 and a trend was observed at 0.05 &amp;lt; P ≤ 0.10. Boars fed 2.72 kg/d had increased BW on wk 9 (P &amp;lt; 0.05) and wk 12 (163.6 kg vs 149.8 kg, SE = 2.17; P &amp;lt; 0.001), increased BW gain wk 1-9 (P &amp;lt; 0.01), wk 9-12 (P &amp;lt; 0.001), and overall (49.8 kg vs 34.4 kg, SE = 1.60; P &amp;lt; 0.0001). The 2.72 kg/d boars also had increased backfat depth on wk 9 (P &amp;lt; 0.01) and wk 12 (8.4 mm vs 7.5 mm, SE = 0.17; P &amp;lt; 0.001), larger caliper scores on wk 12 (P &amp;lt; 0.01), greater flank-flank distance on wk 9 (P &amp;lt; 0.01), and increased BCS on wk 12 (3.2 vs 2.7, SE = 0.14; P &amp;lt; 0.01). No differences were observed for loin muscle depth, or scrotal width and length. Feeding level did not affect trainability with approximately 92% of boars being trained at the end of the two-week period in both feeding levels. Boars fed 2.72 kg/d had increased semen volume (128 mL vs 81 mL, SE = 12.1; P &amp;lt; 0.01) on their first production collection on wk 12 with no effects on other semen quality parameters. Overall, feeding boars 1.8 kg/d for 12 weeks following selection resulted in lower body weight and composition measures indicating limit feeding boars at selection could be used to slow growth rates, potentially decreasing structural issues, and increasing longevity of growing boars in the boar stud, with no effects on training for semen collection. Future research is needed to investigate the long-term impacts of the degree of limit feeding growing boars following selection on lifetime semen quality and quantity. Keywords boar, management, nutrition

Abstract PO1-11-09: Body composition correlates with BMI and menopausal status in patients with breast cancer

Abstract Background: Obesity is associated with higher risk of breast cancer (BC)-related death, all-cause mortality, and recurrence. While used to estimate body fat, body mass index (BMI) is insensitive to body fat distribution and lean muscle mass. We hypothesized that BMI categories (BMI 18.5-24.9 [healthy], 25-29.9 [overweight], and ≥30 kg/m2 [obesity]) would not correlate with CT-derived body composition. Methods: We retrospectively identified 180 patients diagnosed with new or recurrent Stage I-IV BC who presented to Johns Hopkins from 2015-2018 and were part of an institutional database. We extracted demographics, diagnosis date, cancer characteristics, BMI, and CT abdomen pelvis scans from the medical record. Baseline BMI was defined as the closest measurement to diagnosis between 1 year prior and 1 month after diagnosis. Baseline CT was within 6 months of and closest to the baseline BMI date. Fully automated deep-learning algorithms identified L1 and performed muscle and adipose tissue segmentation and quantification. Body composition data included: cross-sectional areas (CSA) of subcutaneous, visceral, and total adipose tissue; the mean, median, and standard deviation of the average of the muscle attenuation (density); and the body wall musculature CSA. ANOVA tests assessed associations between body composition, BMI, and menopausal status. Results: Among 180 patients, 136 (76%) had early-stage BC, and 44 (24%) had metastatic BC. Most patients were women (98%) and non-Hispanic (94%). Patients identified as White (57%), Black (29%), Asian (6%), and Other Race (8%). Sixty percent were post-menopausal. Hormone receptor-positive, HER2-positive, and triple negative subtypes were 56%, 19% and 22%, respectively. At diagnosis, 24% had a healthy BMI while 36% and 41% had overweight and obesity, respectively. All body composition measures were significantly associated with BMI (Table 1). As BMI increased, the average body wall musculature and subcutaneous, visceral, and total adipose tissue CSAs increased while the average muscle attenuation decreased. Specifically, the average visceral adipose tissue CSAs were 2.7 and 4.0-fold larger for overweight and obesity compared to that of the healthy BMI group, respectively, while their average muscle attenuations were 62.4% and 40.6% of the healthy BMI group. Postmenopausal women had 1.5-fold higher visceral adipose tissue CSA and 44.7% less average muscle attenuation compared to premenopausal women. Conclusion: Body composition correlates with all BMI categories in primarily white, non-Hispanic women with breast cancer. As BMI increases, body composition changes reliably, with increased subcutaneous and visceral adipose tissue, increased muscle area, and decreased muscle density. Muscle density, not size/area, is more associated with muscle performance, which can relate to functional status and outcomes. Despite validity concerns, BMI is an accessible and economical surrogate for body adiposity in patients with breast cancer. Postmenopausal status was also associated with greater visceral and total adiposity and lower muscle density. Further investigation is needed to confirm these findings. Table 1: Correlation between body composition, BMI, and menopausal status in patients with breast cancer All measures of body composition were significantly associated with BMI. Visceral adipose tissue increased and muscle density decreased as BMI increased and with post-menopausal status. Citation Format: Terrence Tsou, Tingchang Wang, Amanda Blackford, Ronald Summers, Vered Stearns, Jennifer Sheng. Body composition correlates with BMI and menopausal status in patients with breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-09.

Abstract PO1-11-11: A Novel Body Composition Risk Score (B-Score) and Overall Survival among Patients with Early-Stage Breast Cancer

Abstract Background: Measurements (amount, distribution, and radiodensity) of muscle and adipose tissue were reported to be individually associated with overall survival in breast cancer survivors, but they were not typically combined to develop an overall risk score. Such a score can identify patients at high risk of death and prioritize patients in need of lifestyle interventions. Objectives: We developed a novel body composition risk score (B-Score) by combining multiple tissue measurements. Methods: We included 3105 patients with stage II or III breast cancer (diagnosed from 2000 to 2013) at Kaiser Permanente Northern California and Dana Farber Cancer Institute. From CT scans at diagnosis, we used the third lumber vertebrae as the landmark to assess areas (cm2) and radiodensity (HU) of muscle and adipose tissue. We divided the area by height2 (m2) to derive the index and measured the average HU of the tissue area as the radiodensity, which acts as a marker of tissue 'quality' to be indicative of lipid content, inflammation, and angiogenesis. Out of all tissue measurements, we considered skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI) and SAT radiodensity as they were independent predictors for overall survival. Each measurement was dichotomized using optimal stratification, with low SMI (&amp;lt; 40.1cm2/m2), high SATI (≥75.7cm2/m2), and high SAT radiodensity (≥ -97.2HU) considered risk factors. We calculated B-Score as the sum of these factors and estimated its association with overall survival using Cox proportional hazards regression with adjustment for clinicopathologic factors. Results: Mean (standard deviation) age at diagnosis was 53.9 (11.8) years, 2161 (70.1%) were Non-Hispanic White, 1880 (60.5%) were stage II, and 919 (29.6%) died over a median follow-up of 10.7 years. Most patients (60.6%) had only one body composition risk factor (B-Score = 1). Compared to those with no body composition risk factors (B-Score = 0), the risk of death increased with more body composition risk factors: the adjusted hazard ratios were 1.10 (95% CI: 0.85, 1.42), 1.47 (95% CI: 1.12, 1.92), and 2.11 (95% CI: 1.26, 3.53) for B-Scores of 1, 2, and 3, respectively (Ptrend &amp;lt; 0.001). Conclusions: More unfavorable body composition characteristics were associated with increased risks of overall mortality in a dose-response manner. Considering body composition measurements together as a composite score (B-Score) may prove a useful tool to identify patients at high risk of death following breast cancer diagnosis. Table. Adjusted Associations of the Body Composition Risk Score (B-Score) with Overall Mortality Among Patients with Early-Stage Breast Cancer Abbreviations: HR, hazard ratio. a Areas (cm2) and radiodensity (HU) of skeletal muscle and subcutaneous adipose tissue (SAT) were extracted from the single axial CT slice at the third lumbar vertebra. The body composition risk score was defined as the sum of three risk factors: low skeletal muscle index (SMI; &amp;lt;40.1cm2/m2), high SAT index (SATI; ≥75.7cm2/m2), and high SAT radiodensity (≥ -97.2HU). b Adjusted for age (years), race and ethnicity (Asian, Black, Hispanic, Non-Hispanic White, and Others), stage (II, III), ER (ER+, ER-), PR (PR+, PR-), HER2 (HER2+, HER2-, unknown), smoking (current, former, never), Charlson comorbidity index (0, 1-2, ≥3), and BMI (&amp;lt;18.5, 28.5-24.9, 25-29.9, and ≥30 kg/m2). For the trend test, B-Score was considered as a continuous variable with adjustment for the above covariates. Citation Format: En Cheng, Bette Caan, Wendy Chen, Carla Prado, Elizabeth Cespedes Feliciano. A Novel Body Composition Risk Score (B-Score) and Overall Survival among Patients with Early-Stage Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-11.

Replacing sedentary time for physical activity: Does intensity matter for body composition in oldest-old adults?

ABSTRACT To assess the independent and combined relationships among objectively measured sedentary time (ST), light intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA) with muscle mass and fat mass (FM) and how theoretical displacement of these inter-dependent behaviours relates to body composition in oldest-old men. A total of 1046 men participating in the year 14 visit of the prospective Osteoporotic Fractures in Men (MrOS) cohort study with complete data for accelerometry, dual x-ray absorptiometry, and deuterated creatine dilution (D3Cr) muscle mass were included in the analysis (84.0 ± 3.8 yrs.). Single, partition, and isotemporal substitution models were used to assess the interrelationships between PA intensities and ST with body composition measures, while controlling for relevant confounders. Replacing 30-min of ST with 30-min of MVPA was associated with lower FM (β =-0.17, p < 0.001) and higher D3Cr muscle mass, although this was of borderline significance (β = 0.07, p = 0.05). Replacing 30-min of ST for LPA was associated with lower FM (β =-0.15, p < 0.001), but there was no effect on D3Cr muscle mass (p > 0.05). Exchanging ST with any intensity of PA is associated with benefits for FM in oldest-old adult men, although substitution with MVPA may be more beneficial than LPA for maintaining/improving skeletal muscle mass.

Health professional attitudes and perceptions of prehabilitation and nutrition before haematopoietic cell transplantation.

Nutritional prehabilitation may improve haematopoietic cell transplantation (HCT) outcomes, although little evidence exists. The present study aimed to understand healthcare professional (HCP) perceptions of prehabilitation and nutritional care pre-HCT in UK centres. An anonymous online survey (developed and refined via content experts and piloting) was administered via email to multidisciplinary HCPs in 39 UK adult centres, between July 2021 and June 2022. Data are presented as proportions of responses. Routine provision denotes that care was provided >70% of time. Seventy-seven percent (n = 66) of HCPs, representing 61.5% (n = 24) of UK adult HCT centres, responded. All HCPs supported prehabilitation, proposing feasible implementation between induction chemotherapy (60.4%; n = 40) and first HCT clinic (83.3%; n = 55). Only 12.5% (n = 3) of centres had a dedicated prehabilitation service. Nutrition (87.9%; n = 58), emotional wellbeing (92.4%; n = 61) and exercise (81.8%; n = 54) were considered very important constituents. HCPs within half of the HCT centres (n = 12 centres) reported routine use of nutrition screening pre-HCT with a validated tool; 66.7% of HCPs (n = 36) reported using the malnutrition universal screening tool (MUST). Sixty-two percent (n = 41) of HCPs reported those at risk, received nutritional assessments, predominantly by dietitians (91.6%; n = 22) using the dietetic care process (58.3%; n = 14). Body mass index (BMI) was the most frequently reported body composition measure used by HCPs (70.2%, n = 33). Of 59 respondents, non-dietitians most routinely provided dietary advice pre-HCT (82.4%; n = 28 vs. 68%; n = 17, p = 0.2); including high-energy/protein/fat and neutropenic diet advice. Prophylactic enteral feeding pre-HCT was rare, indicated by low BMI and significant unintentional weight loss. Just under half (n = 25 of 59, 42.4%) HCPs reported exercise advice was given routinely pre-HCT. Nutrition and prehabilitation pre-HCT are considered important and deliverable by HCPs, but current provision in UK centres is limited and inconsistent.

Functional and Combined Training Promote Body Recomposition and Lower Limb Strength in Postmenopausal Women: A Randomized Clinical Trial and a Time Course Analysis.

Encouraging healthy aging in postmenopausal women involves advocating for lifestyle modifications, including regular physical exercise like combined training (CT) and functional training (FT). Regarding this population, age-related alterations in body composition, such as decreased muscle mass and heightened adipose tissue, impact health. The aim of this study was to analyze the effects of FT and CT on body recomposition in postmenopausal women. About the methods, we randomly allocated 96 post-menopausal women to the FT, CT, or control group (CG). We measured body composition by bioimpedance and lower limb muscle strength by sit-to-stand test in five repetitions, respectively. The training protocol lasted 16 weeks, and we measured body composition and lower limb muscle strength every 4 weeks, totaling five assessments. Regarding results, we notice that both training groups increased lean mass from the 8th week of training. In addition, a reduction was observed in total fat percentage and an increase in appendicular lean mass from the 12th week of intervention. No differences were found for body mass. Furthermore, only the experimental groups increase muscle strength, starting from the 4th week of training. The conclusion was that FT and CT promote similar adaptations in body recomposition without affecting body mass in postmenopausal women.

Effect of contrast phase upon quantitative analysis of skeletal muscle and adipose tissue by computed tomography

ObjectiveSignificant variability exists in the contrast phases applied during computed tomography (CT) studies when assessing morphometric measurements of muscle area (CT-assessed sarcopenia), density (CT-assessed myosteatosis), and visceral adipose tissue area (CT-assessed visceral obesity). This study explored the impact of contrast phase timing on changes in morphometric measurements of body composition. Research Methods & ProceduresThis single-center retrospective cohort study included 459 patients undergoing a multiphase CT scan. Morphometric measurements were obtained at the third lumbar vertebra level. Patients were classified as sarcopenic, myosteatotic, or visceral obese using pre-defined cutoff values. The intra-class correlation coefficient was used to assess correlations across different enhancement phases, and Cohen's κ measured the inter-enhancement agreement for sarcopenia, myosteatosis, and visceral obesity. ResultsSignificant differences were observed in mean visceral adipose tissue area, muscle density, and muscle area (p<0.001). The intra-class correlation coefficient between unenhanced and arterial phases was 0.987 (95% confidence interval [CI], 0.759-0.996) for adipose tissue, 0.995 (95% CI, 0.989-0.997) for muscle area, and 0.850 (95% CI, 0.000-0.956) for muscle density. However, when morphometric measurements were categorized using predefined cutoffs, the κ agreement was considerably lower, particularly for CT-assessed myosteatosis, ranging from 0.635 (unenhanced to arterial) to 0.331 (unenhanced to late venous phase). ConclusionDifferent CT contrast phases induce small, but clinically significant, alterations in the measurements of muscle area, density, and visceral fat. Such minor changes can result in misclassification issues when fixed cutoff values are used to diagnose myosteatosis with computed tomography. This underscores the importance of reporting absolute values and the specific contrast phase used in future studies.

Association of the oxidative balance score with obesity and body composition among young and middle-aged adults

ObjectiveThe oxidative balance score (OBS) is important for determining the cause of obesity and its complications. We aimed to evaluate the association between OBS and obesity and other segmental body composition parameters among young and middle-aged U.S. adults.Methods9,998 participants from the National Health and Nutrition Examination Survey 2011–2018 were included. Lean mass percentage (LM%) and FM% were evaluated by dual-energy x-ray absorptiometry. Obesity was defined as body FM% ≥25% in men and ≥ 35% in women. The OBS was scored by 5 pro-oxidant and 21 antioxidant factors. Associations of quartiles of OBS with obesity risk were estimated using multivariable logistic regression models. Multivariable linear regression was conducted to estimate the association between OBS and segmental body composition measures including the arm LM%, leg LM%, torso LM%, whole LM%, arm FM%, leg FM%, torso FM% and total FM%.ResultsCompared to participants in the lowest quartile of OBS, those in the highest quartile of OBS were associated with a lower risk of BMI-defined obesity BMI-defined obesity [0.43 (0.36, 0.50)] and FM%-related obesity [0.43 (0.35, 0.52)]. Additionally, OBS was negatively associated with FM% of the limb and torso but positively associated with the percentage of lean mass (LM%) of the limb and trunk.ConclusionOBS was negatively associated with the risk of obesity and segmental FM%, but was positively associated with segmental LM% among US adults, indicating that adhering to an anti-oxidative diet and lifestyle management may be beneficial for preventing segmental obesity.

Predictive factors of bone strength variation in adolescent girls according to body composition.

This study examined correlations among anthropometric parameters, body composition, bone parameters and predictive factors of bone mass in adolescent girls with different body fat percentages (%fat). A total of 129 females aged 15-18 years were categorized into 3 groups using %fat-for-age at the 50th and 95th percentiles as cutoff points (normal, over, and excess %fat groups). We recorded anthropometric data and measured the speed of sound at the tibia and radius using quantitative ultrasound. Dual-energy x-ray absorptiometry (DXA) was used to measure body composition and bone parameters, including bone mineral density (BMD), bone mineral content (BMC), and the BMD-z-score (z-score) in the lumbar spine (LS) and whole body (WB). These parameters were compared among the 3 groups using bivariate and multivariate correlation analyses. There were strong correlations among all anthropometric parameters, body composition, and DXA in the over %fat group. Lean parameters strongly correlated with LS and WB in the normal %fat group, whereas both lean mass (LM) and fat mass (FM) were positively correlated with BMC in the excess %fat group. The predictive factors of bone mass differed among the groups, as follows: lean body mass was predictive of BMD and BMC at both sites in the normal and over %fat groups; LM and body weight were predictive of LS-BMC and WB-bones, respectively, in the over %fat group; and FM was predictive of WB-bones in the excess %fat group. Body fat and waist circumference were negative predictors of bone mass. Predictive factors of bone strength appear to depend on the amount of body fat in adolescent girls.

Causal analysis of body composition measurements in osteoarthritis knee: a two-sample mendelian randomization study

BackgroundTo analyse the causal associations of different physical measures with osteoarthritis knee (KOA).MethodsExposure factors (weight, body mass index (BMI), body fat percentage, waist circumference, hip circumference, waist–hip ratio (WHR), and basal metabolic rate (BMR)), and outcome factor KOA were analyzed by inverse-variance weighted (IVW) method, along with heterogeneity test, sensitivity and pleiotropy analyses. Meta-analysis was used to combine the effect values of IVW methods in different data sources.ResultsWeight, BMI, body fat percentage, waist circumference, hip circumference and BMR analyses showed causal association with increased KOA risk, while WHR analysis indicated a reduction of the incidence of KOA. P-value for all the results was less than 0.05 and F-value large than 20. All results were negative for heterogeneity tests and sensitivity analyses, and there was pleiotropy in weight and BMR. Meta-analysis results showed that the results of Odds Ratios (95% Confidence Intervals) for Weight (1.43(1.35–1.51)), BMI (1.40(1.10–1.78)), body fat percentage (1.56(1.44–1.68)), waist circumference (1.40(1.10–1.78)), hip circumference (1.37(1.30–1.44)), WHR (0.86(0.71–1.04)) and BMR (1.36(1.27–1.46) were consistent with the ones by Mendelian randomization analyses.ConclusionsBody fat percentage may be a better indicator of KOA than BMI. In addition, weight and BMR may have a causal effect in KOA, but WHR does not have a causal relationship. BMI, body fat percentage, waist circumference, and hip circumference has a causal effect on KOA.

Biological sex does not independently influence time-dependent changes in core temperature and sweating of children exercising in uncompensable heat stress.

To investigate the influence of biological sex, independent of differences in aerobic fitness and body fatness, on the change in gastro-intestinal temperature (∆Tgi) and whole-body sweat rate (WBSR) of children exercising under uncompensable heat stress. Seventeen boys (mean±SD; 13.7±1.3 years) and 18 girls (13.7±1.4) years) walked for 45 min at a fixed rate of metabolic heat production per kg body mass (8 W·kg-1) in 40°C and 30% relative humidity. Sex and V̇O2peak were entered into a Bayesian hierarchical general additive model (HGAM) for Tgi. Sex, V̇O2peak and the evaporative requirement for heat balance (Ereq) were entered into a Bayesian hierarchical linear regression for WBSR. For 26 (12 M, 14 F) of the 35 children with measured body composition, body fat percentage was entered in a separate HGAM and hierarchical linear regression for Tgi and WBSR respectively. Conditional on sex-specific mean V̇O2peak, ∆Tgi was 1.00°C [90% credible intervals: 0.84, 1.16] for boys and 1.17°C [1.01, 1.33] for girls, with a difference of 0.17°C [-0.39, 0.06]. When sex differences in V̇O2peak were accounted for, the difference in ∆Tgi between boys and girls was 0.01°C [-0.25, 0.22]. The difference in WBSR between boys and girls was 0.03 L·h-1 [-0.02, 0.07], when isolated from differences in Ereq. The difference in ∆Tgi between boys and girls was -0.10°C [-0.38, 0.17] when sex differences in body fat (%) were accounted for. Biological sex did not independently influence the ∆Tgi and WBSR of children exercising under uncompensable heat stress.

Assessment of body composition in breast cancer patients: concordance between transverse computed tomography analysis at the fourth thoracic and third lumbar vertebrae.

Specific body composition markers derived from L3 axial computed tomography (CT) images predict clinical cancer outcomes, including chemotherapy toxicity and survival. However, this method is only applicable to those undergoing lumbar (L3) CT scanning, which is not universally conducted in early breast cancer cases. This study aimed to evaluate CT analysis at T4 as a feasible alternative marker of body composition in breast cancer. All patients participated in the Investigating Outcomes from Breast Cancer: Correlating Genetic, Immunological, and Nutritional (BeGIN) Predictors observational cohort study (REC reference number: 14/EE/1297). Staging chest-abdomen-pelvic CT scan images from 24 women diagnosed with early breast cancer at University Hospital Southampton were analysed. Adipose tissue, skeletal muscle, and muscle attenuation were measured from the transverse CT slices' cross-sectional area (CSA) at T4 and L3. Adipose tissue and skeletal muscle area measurements were adjusted for height. Spearman's rank correlation coefficient analysis was used to determine concordance between body composition measurements using CT analysis at L3 and T4 regions. Derived estimates for total adipose tissue, subcutaneous adipose tissue, and intramuscular adipose tissue mass following adjustment for height were highly concordant when determined from CSAs of CT slices at T4 and L3 (Rs = 0.821, p < 0.001; Rs = 0.816, p < 0.001; and Rs = 0.830, p < 0.001). In this cohort, visceral adipose tissue (VAT) and skeletal muscle estimates following height adjustment were less concordant when measured by CT at T4 and L3 (Rs = 0.477, p = 0.039 and Rs = 0.578, p = 0.003). The assessment of muscle attenuation was also highly concordant when measured by CT at T4 and L3 (Rs = 0.840, p < 0.001). These results suggest that the CT analysis at T4 and L3 provides highly concordant markers for total adipose, subcutaneous adipose, and intramuscular adipose estimation, but not VAT, in this breast cancer population. High concordance between T4 and L3 was also found when assessing skeletal muscle attenuation. Lower concordance was observed for the estimates of skeletal muscle area, potentially explained by differences in the quantity and proportions of axial and appendicular muscle between the thorax and abdomen. Future studies will determine the value of T4 metrics as predictive tools for clinical outcomes in breast cancer.

Advances in body composition: a 100-year journey.

Knowledge of human body composition at the dawn of the twentieth century was based largely on cadaver studies and chemical analyses of isolated organs and tissues. Matters soon changed by the nineteen twenties when the Czech anthropologist Jindřich Matiegka introduced an influential new anthropometric method of fractionating body mass into subcutaneous adipose tissue and other major body components. Today, one century later, investigators can not only quantify every major body component in vivo at the atomic, molecular, cellular, tissue-organ, and whole-body organizational levels, but go far beyond to organ and tissue-specific composition and metabolite estimates. These advances are leading to an improved understanding of adiposity structure-function relations, discovery of new obesity phenotypes, and a mechanistic basis of some weight-related pathophysiological processes and adverse clinical outcomes. What factors over the past one hundred years combined to generate these profound new body composition measurement capabilities in living humans? This perspective tracks the origins of these scientific innovations with the aim of providing insights on current methodology gaps and future research needs.

Opportunistic CT for Prediction of Adverse Postoperative Events in Patients with Spinal Metastases.

The purpose of this study was to assess the value of body composition measures obtained from opportunistic abdominal computed tomography (CT) in order to predict hospital length of stay (LOS), 30-day postoperative complications, and reoperations in patients undergoing surgery for spinal metastases. 196 patients underwent CT of the abdomen within three months of surgery for spinal metastases. Automated body composition segmentation and quantifications of the cross-sectional areas (CSA) of abdominal visceral and subcutaneous adipose tissue and abdominal skeletal muscle was performed. From this, 31% (61) of patients had postoperative complications within 30 days, and 16% (31) of patients underwent reoperation. Lower muscle CSA was associated with increased postoperative complications within 30 days (OR [95% CI] = 0.99 [0.98-0.99], p = 0.03). Through multivariate analysis, it was found that lower muscle CSA was also associated with an increased postoperative complication rate after controlling for the albumin, ASIA score, previous systemic therapy, and thoracic metastases (OR [95% CI] = 0.99 [0.98-0.99], p = 0.047). LOS and reoperations were not associated with any body composition measures. Low muscle mass may serve as a biomarker for the prediction of complications in patients with spinal metastases. The routine assessment of muscle mass on opportunistic CTs may help to predict outcomes in these patients.

Development of New Predictive Equations for the Resting Metabolic Rate (RMR) of Women with Lipedema.

This study aimed to develop a novel predictive equation for calculating resting metabolic rate (RMR) in women with lipedema. We recruited 119 women diagnosed with lipedema from the Angiology Outpatient Clinic at Wroclaw Medical University, Poland. RMR was assessed using indirect calorimetry, while body composition and anthropometric measurements were conducted using standardized protocols. Due to multicollinearity among predictors, classical multiple regression was deemed inadequate for developing the new equation. Therefore, we employed machine learning techniques, utilizing principal component analysis (PCA) for dimensionality reduction and predictor selection. Regression models, including support vector regression (SVR), random forest regression (RFR), and k-nearest neighbor (kNN) were evaluated in Python's scikit-learn framework, with hyperparameter tuning via GridSearchCV. Model performance was assessed through mean absolute percentage error (MAPE) and cross-validation, complemented by Bland-Altman plots for method comparison. A novel equation incorporating body composition parameters was developed, addressing a gap in accurate RMR prediction methods. By incorporating measurements of body circumference and body composition parameters alongside traditional predictors, the model's accuracy was improved. The segmented regression model outperformed others, achieving an MAPE of 10.78%. The proposed predictive equation for RMR offers a practical tool for personalized treatment planning in patients with lipedema.