Fat Mass Index Research Articles

A cross-sectional study in adiponectin, glucose metabolism, and body composition in cystic fibrosis

ObjectiveWe hypothesized that the insulin-sensitizing adipokine adiponectin (ADP) is upregulated in cystic fibrosis (CF) related diabetes (CFRD) and underweight adults with CF. We aimed to assess correlations between glucose metabolism, body composition and ADP in CF.MethodsWe performed a cross-sectional study among adults with CF at the Copenhagen CF Center. The study included a fasting level of ADP, an oral glucose tolerance test (OGTT), and a dual energy-x-ray absorptiometry scan.ResultsIn total, 115 patients were included of whom 104 had an OGTT performed. Glucose intolerance was not correlated with ADP in multivariable analysis, while increased hepatic insulin resistance (i.e., HOMA-IR) was correlated with reduced ADP levels. ADP declined by 4% (eβ 0.96, 95% CI: 0.94, 0.98), 5% (eβ 0.95, 95% CI: 0.93, 0.98), 9% (eβ 0.91, 95% CI: 0.87, 0.95), and 83% (eβ 0.17, 95% CI: 0.08, 0.37) for each one unit (kg/m2) increase in body mass index, fat mass index, muscle mass index, and bone mineral content index, respectively.ConclusionsIn CF, ADP was negatively correlated with hepatic insulin resistance as well as low fat, muscle, and bone mass, but not with glucose intolerance. This suggests that malnutrition leads to higher ADP levels in CF.

Association between bisphenol A exposure and cardiometabolic outcomes: a longitudinal approach

Abstract Background Increased cardiometabolic risk is associated with abnormalities in blood biomarkers profile and adiposity measurements. Some substances found in the food matrix or the environment, called endocrine-disrupting chemicals, may impair cardiometabolic health in the yearly and later stages of life. Bisphenol A (BPA) is a food contaminant that migrates from food contact materials and may act as an endocrine disruptor, negatively affecting human health. The present work aims to assess the longitudinal association between BPA exposure and cardiometabolic outcomes. Methods Data from the four waves of the Portuguese population-based birth cohort Generation XXI were used (n = 3138). Dietary data were collected by 3-d food diaries, using the FoodEx2 classification system to describe the reported foods. BPA daily exposure was estimated using a random forest model, combining dietary information with urinary BPA measured in 24-h urine from a subsample, used to predict the remaining sample’s BPA exposure. The generalised least squares model was used to test the associations between BPA and cardiometabolic outcomes. Results Blood insulin and HOMA-IR presented a significant longitudinal association with BPA daily exposure after adjustment for important variables and energy (0.06 SD(0.03, 0.09); 0.05 SD(0.02, 0.08) respectively). The same findings were observed for fat mass and waist circumference (0.03 SD(0.01, 0.06); 0.06 SD(0.04, 0.08), respectively). For z-BMI, a significant cross-sectional and longitudinal association was found (0.03 SD(0.01, 0.04); 0.02 SD(0.00, 0.04), respectively). Conclusions This was the first study assessing the association between BPA exposure and health outcomes from childhood to adolescence. We found an association between BPA exposure and an increased blood insulin level, insulin resistance, fat mass percentage, waist circumference and z-score of body mass index. Our results point to the need to reduce exposure to BPA in the early stages of life. Key messages • BPA exposure was estimated using direct and indirect methods. • BPA can impair cardiometabolic outcomes from the early stages of life, such as higher blood insulin level, insulin resistance, fat mass, waist circumference, and body mass index.

Muscle Mass and Muscle Strength in Non-Dialysis-Dependent Chronic Kidney Disease Patients

Background: Sarcopenia is a state with a progressive and generalized loss of skeletal muscle mass and strength. However, muscle strength and muscle mass are different features, which are usually not studied separately. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in chronic kidney disease (CKD). Methods: The study sample consisted of 84 patients with an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2. Muscle strength was estimated by measuring hand grip strength (HGS). Muscle quantity was measured with bioimpedance spectroscopy (BIS). Serum creatinine, urea, uric acid (UA), and albumin were measured as well. Results: Appendicular skeletal muscle mass (ASM) significantly and positively correlated with body mass, NH weight (normally hydrated weight), height, body mass index (BMI), lean tissue mass (LTM), lean tissue index (LTI), fat mass (FM), and fat tissue index (FTI), and was negatively associated with hydration status. HGS significantly and positively correlated with body mass, NH weight, height, LTM, LTI, and ASM, and was negatively associated with UA and urea. After adjustment for age, sex, and height, HGS remained significantly and negatively related with UA and hydration status. Conclusions: In CKD patients, ASM is determined by anthropometric parameters, but HGS is determined by both anthropometric and clinical variables specific for CKD. In order to study the determinants of HGS in CKD, relationships with HGS should be adjusted for anthropometric variables.

Anthropometric indices in older adults with and without Locomotive Syndrome

BackgroundLocomotive syndrome is a major challenge for older adults, and anthropometric indices can greatly affect the musculoskeletal system. This study aimed to compare the anthropometric indices between older adults with and without locomotive syndrome.MethodsThis descriptive-analytical study was performed on 211 older adults using random cluster sampling from a population of over-60 individuals covered by comprehensive health service centers in Sari in Autumn, 2021. Participants were divided into two groups: with and without locomotive syndrome. Locomotive syndrome was assessed via the 25-item Geriatric Locomotive Function Scale questionnaire, and the level of anthropometric indices was determined through the Bioelectrical Impedance Analysis device. Data were analyzed by independent t-test, Mann-Whitney U, Chi-Square, and Binary logistic regression in SPSS, Version 23 (P < 0.05).ResultsThe average age of older adult participants was 78.4 ± 6.6 years. In older adults with locomotive syndrome, the average percentage of fat-free mass (P < 0.001) was significantly lower while the average percentage of fat mass and fat mass index (P < 0.001) was significantly higher. Older adults with locomotive syndrome were shorter in height (P < 0.001) and had a higher body mass index (P < 0.05). Fat-free mass percentage (OR = 0.59) and body mass index (OR = 1.4) predicted the incidence of locomotive syndrome in the subjects. Significant differences such as chronic diseases, chronic pain, falls, age, and gender were observed between the two groups (P < 0.05).ConclusionAnthropometric indices can play an important role in the occurrence of locomotive syndrome in older adults. Evaluation of anthropometric indices and management of body composition can help prevent locomotive syndrome and improve the quality of life of older adults.

Associations of Urinary Cadmium with Body Composition and Fat Distribution in US Adults: Findings from NHANES 2011-2018.

The effects of cadmium (Cd) on metabolic physiology remain controversial. Given the varying metabolic impacts associated with different body compositions, investigating the relationship between Cd exposure and body composition may facilitate further research. Here, the associations of body composition and fat distribution with urine Cd (UCd) were evaluated. This analysis included 2979 adult participants from the 2011-2018 National Health and Demographic Survey (NHANES). UCd was measured using inductively coupled plasma mass spectrometry and adjusted for urinary creatinine. Body composition and fat distribution were estimated using dual-energy x-ray absorptiometry (DXA). The study results show that UCd was negatively associated with fat mass index (FMI) and percent fat mass (p for trend < 0.001), and the negative correlation between UCd and FMI was stronger in males and smokers (all p for interaction < 0.05). In terms of abdominal fat distribution, UCd was negatively associated with abdominal subcutaneous adipose tissue (SAT) mass (p for trend < 0.001), but with abdominal visceral adipose tissue (VAT) mass only in those with low percent fat mass (< 32.3%) (p for trend = 0.026 and p for interaction < 0.05). UCd was positively related to percent VAT (p for trend < 0.001) and visceral-to-subcutaneous (VAT/SAT) ratio (p for trend = 0.003). And there was a significant negative association between UCd and android-to-gynoid (A/G) ratio (p for trend = 0.001). Meanwhile, UCd was negatively correlated with fat-free mass index (FFMI) (p for trend < 0.001). And the negative correlation between UCd and FFMI was stronger in males, smokers, and individuals with < 32.3 percent fat mass (all p for interaction < 0.05). We found the association of UCd with body composition and fat distribution, with distinct patterns observed in different demographic groups. These findings underscore the importance of considering UCd exposure in the context of body composition and fat distribution.

Association between changes in body composition and progression of liver fibrosis in patients with type 2 diabetes mellitus

AimThe correlation between type 2 diabetes mellitus (T2DM) and the occurrence of liver fibrosis is well-established. However, the longitudinal association between body composition and liver fibrosis progression in patients with T2DM remains incompletely explored.MethodsTotal of 390 patients with T2DM underwent body composition assessments, followed by a median duration of 2.13 years. The calculated parameters included body mass index (BMI), fat mass index (FMI), trunk fat mass index (TFMI), appendicular skeletal muscle mass index (ASMI), muscle/fat mass ratio (M/F) and appendicular skeletal muscle mass/trunk fat mass ratio (A/T). Liver fibrosis was evaluated through liver stiffness measurement (LSM). Patients were classified according to BMI and body composition, followed by a comprehensive investigation into the impact of body composition changes on liver fibrosis outcomes.ResultsAmong 72 patients with incident advanced liver fibrosis at readmission, ΔBMI, ΔFMI and ΔTFMI increased, while ΔM/F and ΔA/T decreased. Individuals who kept obese had a dramatically elevated hazard of incident advanced liver fibrosis compared to those who kept non-obese, with an adjusted odds ratio of 3.464. When TFMI heightened, the hazard of incident advanced liver fibrosis was 3.601 times higher compared to the decreased group. Additionally, individuals in increased ASMI and A/T groups showed a slight advantage in preventing incident advanced liver fibrosis compared to the stable groups.ConclusionStable obesity was associated with a greater hazard of liver fibrosis advancement, and an increase in TFMI may promote the progression of liver fibrosis. Maintaining a balanced muscle/fat ratio appeared to help prevent the progression.

Assessment of Paraoxonase 1 and Arylesterase Activities and Lipid Profile in Bodybuilders: A Comparative Study of Physical Activity and Anthropometry on Atherosclerosis.

Background and Objectives: Atherosclerosis, driven by dyslipidaemia and oxidative stress, is a leading cause of cardiovascular morbidity and mortality. This study evaluates the effects of vigorous-intensity bodybuilding exercise (VIBBE) on atherosclerosis biomarkers-including paraoxonase-1 (PON1) and arylesterase (ARE) activities-and lipid profiles in male bodybuilders who do not use anabolic-androgenic steroids. Comparisons were made with individuals engaged in moderate-intensity aerobic exercise (MIAE), as well as overweight/obese sedentary (OOS) and normal-weight sedentary (NWS) individuals. Materials and Methods: A cross-sectional study was conducted involving 122 healthy male participants aged 18-45 years, divided into four groups: VIBBE (n = 31), OOS (n = 30), MIAE (n = 32), and NWS (n = 29). Anthropometric assessments were performed, and fasting blood samples were collected for biochemical analyses, including lipid profiles and PON1 and ARE activities. Statistical analyses compared the groups and evaluated correlations between adiposity measures and atherosclerosis biomarkers. Results: The VIBBE group exhibited significantly lower levels of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and logarithm of the TG to high-density lipoprotein cholesterol (HDL-C) ratio [log(TG/HDL-C)] compared to the OOS group (p < 0.05 for all), indicating improved lipid profiles. However, these improvements were not significant when compared to the NWS group (p > 0.05), suggesting that VIBBE may not provide additional lipid profile benefits beyond those associated with normal weight status. PON1 and ARE activities were significantly lower in the VIBBE group compared to the MIAE group (p < 0.05 for both), suggesting that VIBBE may not effectively enhance antioxidant defences. Correlation analyses revealed significant inverse relationships between PON1 and ARE activities and adiposity measures, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), fat mass index (FMI), and obesity degree (OD) (p < 0.05 for all). Positive correlations were observed between oxLDL and log(TG/HDL-C) and adiposity measures (p < 0.05 for all). Conclusions: Vigorous-intensity bodybuilding exercise improves certain lipid parameters compared to sedentary obese individuals but does not significantly enhance antioxidant enzyme activities or further improve lipid profiles beyond those observed in normal-weight sedentary men. Conversely, moderate-intensity aerobic exercise significantly enhances PON1 and ARE activities and improves lipid profiles, offering superior cardiovascular benefits. These findings underscore the importance of incorporating moderate-intensity aerobic exercise into physical activity guidelines to optimize cardiovascular health by balancing improvements in lipid metabolism with enhanced antioxidant defences.

Association Between Ultraprocessed Food Consumption and Metabolic Disorders in Children and Adolescents with Obesity.

We investigated the effects of ultraprocessed food (UPF) consumption on metabolic disorders (e.g., adiposity, metabolic associated steatotic liver disease [MASLD], and insulin resistance) in children and adolescents with obesity to improve dietary guidelines and public health strategies. The dietary intake of 149 participants (aged 8-17 years) was assessed with food diaries. The NOVA classification system was used to classify food according to the degree of processing. Metabolic outcomes, including the fat mass index (FMI), hepatic fat percentage, and insulin resistance, were measured via dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging proton density fat fraction (MRI-PDFF), and biochemical analysis, respectively. Greater UPF consumption from baseline to the 6-month follow-up was significantly associated with increased insulin and decreased total cholesterol and LDL-cholesterol. UPF consumption was positively associated with the prevalence of MASLD (liver MRI-PDFF ≥ 5%; odds ratio T3 vs. T1 = 1.75; 95% confidence interval [CI] 1.03, 3.00), moderate-to-severe MASLD (liver MRI-PDFF ≥ 10%; OR T3 vs. T1 = 4.19; 95% CI 1.72, 10.22), and insulin resistance (OR T3 vs. T1 = 2.44; 95% CI 1.33, 4.48), after adjusting for covariates. A linear dose-response relationship was observed between UPF consumption and the odds of moderate-to-severe MASLD and insulin resistance. Greater UPF consumption was strongly associated with MASLD and insulin resistance in children and adolescents with obesity, underscoring the importance of reducing UPF consumption through dietary guidelines and public health interventions to mitigate the risk of obesity-related metabolic conditions in young populations.

Accuracy of the international growth charts to diagnose obesity according to the body composition analysis in US children and adolescents.

This study verified the accuracy of the international BMI references and the allometric BMI reference to diagnose obesity in children and adolescents from the USA. Data from 17313 subjects were obtained from the National Health and Nutrition Examination Survey between the years 1999-2006 and 2011-2018. Fat Mass Index, Allometric Fat Mass Index and fat mass/fat-free mass were calculated. Receiver operating characteristic curve, AUC, sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were estimated to evaluate the accuracy of the growth references for diagnosing obesity. The International Obesity Task Force, MULT BMI 17 years, MULT BMI 18 years and allometric BMI 19 years achieved the best sensitivity-specificity trade-off for boys, with sensitivities ranging from 0·92 to 0·96 and specificities of 0·94, with positive likelihood ratio of 15·51, 16·17, 13·46 and 18·01, respectively. The negative likelihood ratios were notably low, ranging from 0·04 to 0·08. In girls, the International Obesity Task Force, MULT BMI 17 years and MULT allometric BMI 17 years also demonstrated high sensitivity (0·95-0·97) and specificity (0·92), with positive likelihood ratio values of 11·54, 11·82 and 11·77, respectively and low negative likelihood ratio values (0·03-0·05). In summary, these international growth references presented satisfactory performance to diagnose obesity. However, the MULT growth reference performed better, and the MULT allometric BMI was the only indicator capable of detecting that girls have a higher proportion of fat mass than boys for the same index values. These findings suggest that the MULT growth reference may be a better tool to assess the nutritional status of children and adolescents internationally.

Artificial intelligence-based assessment of pre-operative body composition is associated with early complications after radical cystectomy.

We aimed to use a validated artificial intelligence(AI) algorithm to extract muscle and adipose areas from CT images before radical cystectomy(RCx), and then correlate these measures with 90-day post-RCx complications. A tertiary referral center's cystectomy registry was queried for patients who underwent RCx between 2009-2017 for bladder cancer. 843 RCx patients with CT imaging within 90 days preceding surgery were included, to allow for extraction of body composition parameters by AI. We assessed complications within 90 days of surgery including: wound, infectious, major complications, re-admission, and death. Multivariable logistic regressions associated pre-RCx measures to post-RCx complications. Increasing subcutaneous adipose tissue(SAT) was associated with more wound complications while patients with increasing visceral adipose tissue(VAT) had greater odds of infectious related complications. After adjusting for patient characteristics, every 10 cm2 increases in fat mass index(FMI) were associated with more infectious (OR 1.04, p=0.002) and wound (OR 1.06, p<0.001) complications. On multivariable analysis, higher pre-operative skeletal muscle index(SMI) was associated with lower odds of major complications (OR 0.75 for every 10 cm2, p=0.008), while higher intramuscular adipose(IMA) was associated with higher odds of major complications (OR 1.93, p=0.008). Automated AI body composition measurements pre-operatively are associated with post-RCx complications. These measurements, in addition to patient (ECOG performance status, smoking status) and surgical (robotic approach, continent diversion) characteristics can then be utilized to individualize patient counseling and facilitate triage of nutritional and rehabilitation efforts.

Eating in the Absence of Hunger Is a Stable Predictor of Adiposity Gains in Middle Childhood

BackgroundEating in the absence of hunger (EAH) is a behavioral phenotype of pediatric obesity characterized by the consumption of palatable foods beyond hunger. Studies in children have identified EAH to be stable over time, but findings are unclear on whether it predicts the development of adiposity, particularly in middle childhood, a period of increased autonomy over food choices. ObjectivesWe hypothesized that EAH would remain stable and be associated with increased adiposity over a ≥1-y prospective study in 7–8-y old children without obesity. Secondary hypotheses tested whether physical activity moderated the impact of EAH on adiposity. MethodsChildren (n =72, age 7.8 ± 0.6 y; BMI% <90th), in a 7-visit longitudinal study, had EAH, adiposity, and physical activity assessed at baseline (time 1 – T1) and follow-up (time 2 – T2). EAH was determined by measuring children’s intake from 9 energy-dense (>3.9 kcal/g) sweet and savory foods during a 10-min access period after intake of a standard meal eaten to satiation. Adiposity was measured by dual-energy X-ray absorptiometry (DXA), with an outcome of fat mass index (FMI; fat mass/height in m2). Seven days of wrist-worn Actigraphy quantified moderate-to-vigorous-physical activity (MVPA) and sedentary time. ResultsEAH had moderate stability across time points (ICC = 0.54). ICCs were stronger for sweet (ICC = 0.53) than savory (ICC = 0.38) foods. Linear regression predicting 1-y change in FMI (adjusted for income, parent education, sex, time to follow-up, T2 Tanner stage, maternal weight status, and baseline adiposity) found that both total and sweet food EAH at baseline predicted increases in adiposity (P < 0.05 for both). EAH and adiposity were negatively correlated among children with high MVPA and low sedentary time. ConclusionsThese findings show that EAH is a stable predictive phenotype of increases in adiposity over 1 y among youth in middle childhood, although activity-related behaviors may moderate this effect. If replicated, targeting EAH as part of interventions may prevent excess adiposity gain. J Nutr 20xx;x:xx. Trial registration numberThe data was obtained from the Food and Brain study with registration number: NCT03341247.

12271 Differential Impacts Of Body Composition Indices On Cortisol Response And Hpa Axis Activity

Abstract Disclosure: S.G. Gonsalves: None. A. Ross: None. M.E. Steele: None. L.N. Saligan: None. Aim: The continued interest in the influence of muscle mass and fat distribution on stress stems from its implications on preventative healthcare. Fat mass index (FMI) and fat-free mass index (FFMI) were proposed as valuable indicators of body composition beyond body mass index (BMI). This study investigated correlations of FMI and FFMI with inflammatory stress markers, hypothesizing that these body composition indices identify inflammatory stress markers more distinctly than BMI. Methods: Skeletal muscle mass was assessed by Dual-Energy X-ray Absorptiometry, HPA axis response through an adrenocorticotropic hormone (ACTH) stimulation test, and markers of inflammation and stress response (e.g., dehydroepiandrosterone, DHEA) from peripheral blood of 104 healthy individuals aged 18-71 years, 52% female, with a mean BMI of 26.3 (+4.83). Perceived stress and fatigue were captured using patient-reported outcome questionnaires before the HPA procedure. Results: ACTH correlated with FFMI at baseline (ρ=0.299, p=0.009) and 60 minutes (ρ=0.254, p=0.041). Cortisol correlated with FFMI at 15 (ρ=–0.248, p≤0.025), 30 (ρ=–0.284, p≤0.010), and 60 minutes (ρ=–0.364, p≤0.001), and with BMI at 15 (ρ=–0.228, p=0.041). FMI and BMI did not correlate with ACTH and FMI with cortisol at any timepoint. With repeated measures ANOVA, FFMI at 50th percentile had large effect on cortisol (p=0.005, partial eta=0.094) at each timepoint, higher for the under lean than those with higher FFMI, compared to BMI at the same percentile (p=0.037, partial eta=0.054). None of the indices reached significance with ACTH. FMI correlated with Erythrocyte Sedimentation Rate (ESR) (ρ=0.521), C-reactive protein (CRP, ρ=0.493, both at p≤0.001), DHEA (ρ=0.252, p=0.030), and epinephrine (ρ=–0.246, p=0.045). FFMI was not correlated with ESR and CRP. BMI correlated only with albumin (ρ = –0.412, p ≤ 0.001 and CRP (ρ=0.342, p≤0.003). Discussion: The higher correlations of inflammatory stress markers with FMI and FFMI, as compared to BMI, supports our study hypothesis. These results hint that these body composition indices may detect subtle stress-related inflammatory changes than BMI. Future research should clarify underlying mechanisms driving these associations and explore the impact of targeted interventions on these indices and subsequent changes to inflammation and stress. Presentation: 6/1/2024

7522 Effects of Trikafta On Bone Mineral Density And Body Composition In Patients With Cystic Fibrosis

Abstract Disclosure: N. Mon: None. S.S. Krishnasamy: None. G. Bakeerathan: None. L. Healy: None. E. Favier: None. S. Foushee: None. Background: Cystic fibrosis related bone disease (CFBD) is a common complication of adult Cystic fibrosis (CF) patients due to calcium, vitamin D and K malabsorption from exocrine pancreatic insufficiency, increased inflammatory cytokines, glucocorticoid therapy, delayed puberty, physical inactivity, and hypogonadism. Newer CF transmembrane conductance regulator (CFTR) modulator therapy elexacaftor/tezacaftor/ivacaftor (Trikafta) has proven benefit in pulmonary and nutritional outcomes. There is limited data on effects of Trikafta on bone health and body composition. The aim is to examine the effects of Trikafta on bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN), and body composition in terms of fat free mass index (FFMI) and fat mass index (FMI) in our CF patients. Method: We conducted a cross sectional and retrospective review of 38 adults with CF (Ages 20-59, 28 males and 10 females) in our CF clinic. Body Mass Index (BMI), Body composition measured by bioelectric impedance analysis, BMD of LS and FN by Dual-energy X-ray absorptiometry, Vitamin D level, and forced expiratory volume in one second (FEV1 % predicted) in patients taking Trikafta were analyzed and compared with control CF group who were not on Trikafta. Results: 38 subjects on Trikafta, aged 33.29 ± 10.36 years with FEV1 % predicted 65.11± 28.14% were studied. Serum 25-hydroxyvitamin D level was 35.92 ± 18.52 ng/dL. Of the 38 study patients, 23 (60.53%) had a diagnosis of CF related diabetes (CFRD). Among the Trikafta cohort, 18 (50%) had low BMD with Z-scores ≤ -2.0 and 7 (19.44%) of them had Z score ≤ -1.0 and &amp;gt; -2.0. Compared with the control group, LS BMD 0.93 ± 0.16 g/cm2 and FN BMD 0.73± 0.13g/cm2 (p &amp;gt;0.05) were not improved significantly. BMI of study population 23.09 ± 4.21 kg/m2 (p &amp;lt;0.05) and FMI 6.11 ± 4.25 kg/m2 (p &amp;lt;0.05) increased significantly; however, there was a decrease in FFMI 9.60 ± 1.44 kg/m2 (p &amp;lt;0.05). Conclusion: Treatment with Trikafta in CF patients was associated with increases in BMI and fat mass index but decrease in fat free mass index. There was no statistically significant difference in BMD at LS and FN in our study cohort. This study has limitations in terms of gender differences within the study cohort, duration of Trikafta use in relation to bone mass, and also extent of glucocorticoid use among the study subjects. Larger prospective clinical trials are needed to study efficacy of Trikafta on CFBD. Presentation: 6/3/2024

7892 Longitudinal Changes in Bone Microarchitecture and Strength in Girls with Type 1 Diabetes

Abstract Disclosure: R. Dhaliwal: None. R.K. Saunders: None. M. Misra: None. M.L. Bouxsein: None. D.M. Mitchell: None. Introduction: Type 1 diabetes (T1D) confers an increased fracture risk, only partly explained by low areal bone mineral density (aBMD). We have previously shown in a cross-sectional study that bone microarchitecture is altered early in the course of T1D. The goal of this study is to evaluate how T1D influences longitudinal changes in volumetric BMD (vBMD) and microarchitecture. Methods: This is a 2-year prospective study of girls ages 10-16 years (62 with T1D and 59 controls). We used dual-energy x-ray absorptiometry (DXA) to measure aBMD, and high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius (7% site) and tibia (8% site) to measure vBMD and microarchitecture. We used linear mixed models to assess the effects of T1D on change in bone parameters over time, adjusting for bone age as an index of skeletal maturity, height, lean mass index (LMI), and fat mass index (FMI). Results: At baseline, mean duration of disease in T1D was 4.8 ± 3.2 years, and mean HbA1c was 8.6 ± 1.4%. The groups did not differ by age, bone age, and height, while T1D participants had higher LMI (p&amp;lt;0.001) and borderline higher FMI (p=0.107). Linear growth, weight gain, and changes in body composition over time did not differ between groups. Growth-mediated aBMD gains were observed in both groups at the subtotal body, total hip, femoral neck, and spine. While adjusted aBMD as well as trabecular bone score were lower in T1D, we did not observe between-group differences in changes in these endpoints over time. In both groups, at the distal radius, we observed significant increases over time in total and cortical vBMD, cortical thickness, trabecular (Tb) thickness, and estimated failure load, while cortical porosity decreased. While several microarchitectural parameters were altered in T1D participants, we did not observe significant between-group differences in changes in these measures over time. Of note, trabecular development was subtly altered, with T1D participants demonstrating a borderline significant decrease in Tb vBMD (-14.3 ± 9.0 mg HA/cm3, p=0.112) and Tb number (-0.14 ± 0.07 mm-[1], p=0.057), while control participants had no change in Tb vBMD or number, but a significant increase in Tb thickness (5.8 ± 2.5 µm, p=0.018). At the distal tibia, we observed similar overall detrimental effects of T1D at baseline. However, we did not observe between-group differences in microarchitectural change over time. Glycemic control as measured by HbA1c was not associated with changes in skeletal parameters among T1D participants. Conclusions: T1D leads to substantially altered areal and volumetric BMD as well as microarchitectural parameters in girls. While our data suggest that much of this deficit appears to occur early in the course of disease as prospective change is similar in T1D and controls, subtle changes in trabecular bone development at the radius may indicate ongoing impairment of bone accrual. Presentation: 6/3/2024

Assessing Static Balance, Balance Confidence, and Fall Rate in Patients with Heart Failure and Preserved Ejection Fraction: A Comprehensive Analysis.

Chronic heart failure (CHF) is a complex clinical syndrome, associated with frailty, higher fall rates, and frequent hospitalizations. Heart Failure (HF) and preserved ejection fraction (HFpEF) is defined as a condition where a patient with HF have a diagnosis of left ventricular ejection fraction (LVEF) of ≥ 50%. The risk of HFpEF increases with age and is related to higher non-cardiovascular mortality. The aim of this study was to evaluate static balance and examine the effect of task difficulty on the discriminating power of balance control between patients with HFpEF (Patients with HFpEF) and their healthy controls. Moreover, the associations between static balance parameters, balance confidence, falls, lean muscle mass, and strength were assessed. Seventy two patients with HFpEF (mean age: 66.0 ± 11.6 years) and seventy two age- and gender-matched healthy individuals (mean age: 65.3 ± 9.5 years) participated in this study. Participants underwent a 30 s bilateral stance (BS) test and a 20 s Tandem-Romberg stance (TRS) on a force platform, evaluating the Range and Standard Deviation of Center of Pressure (COP) displacement parameters in both axes. Balance confidence was evaluated by the Activities-Specific Balance Confidence (ABC) Scale, and the number of falls during the last year was recorded. Lower limb strength was measured using an isokinetic dynamometer, isometric leg strength, and a Sit-to-Stand test. Bioelectrical impedance analysis was conducted to assess lean fat mass, lean fat mass index, and lean%. Patients with HFpEF presented with lower static balance in BS and TRS compared to healthy controls (p < 0.05), lower balance confidence by 21.5% (p < 0.05), and a higher incidence of falls by 72.9% (p < 0.05). BS was a better descriptor of the between-group difference. Furthermore, static balance, assessed in controlled lab conditions, was found to have little if no relationship to falls, strength, lean muscle mass, and balance confidence. Although no correlation was noted between the static balance parameters and falls, the fall rate was related to balance confidence, age, muscle strength, and lean fat.

Excessive Gestational Weight Gain, independent of Body Mass Index, Is Associated With Child Fat Mass Index at Age 2 Years in the Growing life, Optimizing Wellness Study

BackgroundExcessive gestational weight gain (eGWG) increases risk for pregnancy complications and future obesity for pregnant persons and children. Yet, it is unclear whether eGWG leads to higher child adiposity at 2 years, independent of the pregnant person’s body mass index (BMI) while considering important covariates. Moreover, understanding the characteristics of pregnant persons experiencing eGWG will help design future targeted interventions. ObjectiveThe objectives of the analyses were to assess the association between eGWG and childhood adiposity at age 2 years, while controlling for pregnant persons’ BMI and other important covariates and to describe the characteristics of pregnant persons who experience eGWG during their second pregnancy. DesignThis is a secondary analysis of 221 pregnant persons and their children aged 2 years who were enrolled in the Growing life, Optimizing Wellness longitudinal observational study. Participants/settingParticipants were recruited between 2011 and 2014 in central Arkansas. Participants were secundigravida persons with BMI 18.5 to 35, older than age 20 years, and who conceived without assistance. Main outcome measuresThe main outcome measure was fat mass index of children aged 2 years measured by quantitative nuclear magnetic resonance imaging. Secondary outcomes included first pregnancy GWG, dietary and physical activity characteristics between pregnancies, second pregnancy nausea levels, and motivation level to adhere to the GWG guidelines. Statistical analysis performedMultivariable regression analyses were used to examine the associations between GWG and childhood fat mass index at age 2 years. Pearson correlations and Wilcoxon rank sum tests were used to identify the characteristics of pregnant persons who experienced eGWG. ResultsPregnant persons’ eGWG (β = .503; P = .03) was positively associated with child adiposity at age 2 years independent of maternal BMI (P = 0.3). Pregnant persons who experienced eGWG during their second pregnancy had greater odds of eGWG during first pregnancies (odds ratio 7.5; P < .001), dieting behavior (odds ratio 14.3; P = .02), and low motivation to adhere to the GWG guidelines (odds ratio 11.2; P = .009). Fewer participants had eGWG during their second pregnancy (52.5%) compared with their first pregnancy (66.8%), which was different by BMI groups (BMI 18.5 to 24.9: 23.6% decrease in participants who gained eGWG, BMI 25-29.9: 20.0% decrease, and BMI ≥ 30: 37.9% decrease). ConclusionseGWG among pregnant persons is associated with child adiposity at age 2 years. Pregnant persons who experienced eGWG during their second pregnancy reported low motivation to gain weight within guidelines, eGWG in first pregnancy, and reported prior dieting behavior. Future research focusing on patients with these characteristics may increase success of interventions designed to limit eGWG.

The Cross-Sectional Relation of Body Mass Index to Adiposity among 8- to 19-Year-Olds within Several Races and Ethnicities

To assess the screening ability of a high body mass index (BMI) for high adiposity among 8- to 19-year-olds. This cross-sectional study included 6454 National Health and Nutrition Survey participants from 2011 through 2018. Fat and lean mass were measured with dual-energy X-ray absorptiometry (DXA). We expressed adiposity as fat mass index (FMI, kg ÷ m2) and %fat. Based on the Centers for Disease Control and Prevention 95th percentile, a high BMI correctly classified a high FMI for about 95% of participants in each racial and ethnic group. About 81% (Blacks) to 90% (Hispanics) of participants with a high BMI also had a high FMI. Further, children with a high BMI were 17 (Hispanics) to 46 (Blacks) times more likely to have a high FMI than those with a "normal" BMI. The screening ability of high BMI for high %fat was weaker because levels of %fat are influenced by both fat mass (numerator) and lean mass (denominator). Despite differences in body composition, a high BMI is a very good screening tool for identifying high FMI not only among White 8- to 19-year-olds but also among Asians, Blacks, and Hispanics. Compared with %fat, FMI is likely a better adiposity metric among children and adolescents.

Study of malnutrition in patients with idiopathic pulmonary fibrosis

Background Although the interest in Idiopathic Pulmonary Fibrosis (IPF) has increased in recent years due to the appearance of new therapies however the interest has focused on pulmonary involvement with little concern for systemic manifestations such as the nutritional status abnormalities. Thus, our study assessed the malnutrition prevalence in patients with IPF and the best indicators for the assessment of malnutrition among them. Patients and methods This work was conducted on 110 stable IPF patients who attended the outpatient clinic of Ain Shams University Hospitals from October 2020 to July 2021. Data about the detailed history and nutritional assessment was collected. Results 22.7% and 20.9% were malnourished according to the definition of fat-free mass index (FFMI) and body mass index (BMI), respectively. Most malnourished patients according to low FFMI were female; not using PPI was a significant independent predictors of malnutrition. There was a statistically significant relation between low FFMI and low serum albumin, hemoglobin, and oxygen saturation. Our findings also revealed that measuring BMI and being less than or equal to 22.1 kg/m2 and mid-arm circumference (MAC) less than or equal 28.5 cm is significantly related to low free fat mass index (malnutrition) and increases that risk by 31.63 folds. Conclusion Nearly one-quarter of IPF patients were malnourished and it was found that measuring BMI less than or equal to 22.1 kg/m2 together with MAC less than or equal to 28.5 cm can predict low FFMI and that can be used in our clinical approach.

Variation of All-Cause Mortality with Fat-Free Mass Index (FFMI) and Fat Mass Index (FMI) in Individuals with Asthma: Results from the NHANES Database Retrospective Cohort Study.

The relationship between fat-free mass index (FFMI), fat mass index (FMI), and mortality in patients with asthma remains unknown. This study aimed to examine the associations between FFMI and FMI and all-cause mortality in a cohort of American adults diagnosed with asthma. This study included 15,200 adults from NHANES. To assess mortality, we linked participant records to the National Death Index. FMI and FFMI were measured and evaluated using dual-energy X-ray absorptiometry (DXA). Survival differences across quintiles of FFMI and FMI were explored using Kaplan-Meier plots and log-rank tests, with the proportional hazards assumption assessed using Schoenfeld residuals. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) for mortality associated with FFMI and FMI, adjusting for potential confounders including age, sex, smoking status, physical activity, and other relevant factors. Additionally, stratified analyses based on theoretical considerations were conducted to identify subgroups of individuals exhibiting an elevated risk of mortality. This study also examined the nonlinear relationships between FFMI, FMI, and mortality using restricted cubic splines (RCS). After a median follow-up of 184 months, 12.11% of individuals had died. Kaplan-Meier plots revealed significant differences in all-cause mortality among patients with asthma across the FFMI and FMI quintiles. Specifically, individuals in the lowest FFMI quintile (Q1, 10.4-16.0, representing the range of FFMI values) exhibited a significantly increased risk of all-cause mortality (HR: 4.63; 95% CI: 1.59, 13.5; p < 0.01). Similarly, elevated risks of all-cause mortality were observed in the upper three quintiles of FMI, with Q3 (4.8-6.1) having an HR of 2.9 (95% CI: 1.20, 7.00; p < 0.05), Q4 (6.2-8.3) having an HR of 3.37 (95% CI: 1.41, 8.03; p < 0.01), and Q5 (8.4-22.8) having an HR of 4.6 (95% CI: 1.31, 16.2; p < 0.05). Moreover, the risk of all-cause mortality increased with increasing FMI and decreasing FFMI (p for non-linearity < 0.001 in both cases). Subgroup analyses further elucidated these associations across different categories. In examining the association between FMI and all-cause mortality among asthma patients across various subgroups, a heightened mortality risk found among males, individuals with medium education levels, medium income levels, and those who consume alcohol. The study shows that both high FMI and low FFMI are associated with increased mortality in patients with asthma. These findings underscore the critical role of FMI and FFMI in the health management of asthma patients. Therefore, it is recommended that clinicians proactively monitor and adjust these indices to improve patient prognosis and enhance health outcomes for individuals with asthma..

Fat Mass Index Predicts the Effect of Weight Loss and Quality of Life Early After Laparoscopic Sleeve Gastrectomy.

Fat mass index (FMI) is a body composition indicator that reflects body fat content. Laparoscopic sleeve gastrectomy (LSG) is widely performed in patients with obesity. This study aimed to evaluate the value of the FMI in predicting weight loss effect and quality of life early after LSG. From January 2014 to July 2022, the clinical data and computed tomography (CT) images of patients who underwent LSG at a tertiary referral teaching hospital were analyzed. Body composition indicators were calculated using the SliceOmatic software. Achieving initial body mass index within 6months postoperatively was defined as early eligible weight loss (EEWL). The relationship between body composition and EEWL was analyzed. A total of 243 patients were included. Receiver operating characteristic (ROC) curve analysis showed that the predictive value of the FMI for EEWL in patients after LSG was higher than that of other indicators (all P < 0.05; area under the curve = 0.813). The best FMI cut-off point was 13.662. Accordingly, the patients were divided into the high-FMI group and low-FMI group. The %EWL and BMI of patients in the low-FMI group at 1, 3, 6, 9, 12, and 24months after surgery were better than those in the high-FMI group (all P < 0.001). Patients in the low-FMI group had higher BAROS (Bariatric Analysis and Reporting Outcome System) scores than those in the high-FMI group (P < 0.001). Compared with other body composition indicators, FMI can effectively predict the early effect of weight loss and quality of life after LSG.