Increase In Body Cell Mass Research Articles

Changes in body composition depending on the rs1801282 PPARG polymorphism in patients with different variants of treatment of early carbohydrate metabolism disorders

Objective: To study the effect of the rs1801282 PPARG polymorphism on changes in the body composition of patients with early carbohydrate metabolism disorders in groups with different variants of treatment.Materials and Methods: The study involved 64 patients (8 men and 56 women) with early carbohydrate metabolism disorders. At baseline, all patients underwent genotyping for the rs1801282 PPARG polymorphism and body composition determination with bioelectrical impedance analysis (BIA). Then, the patients were divided into two groups depending on the type of therapy. The patients from Group 1 (40 subjects, mean age 45.2±15.4 years) kept a generally accepted diet with the exclusion of simple carbohydrates and limitation of complex carbohydrates and fats. The patients from Group 2 (24 subjects, mean age 51.2±14.5 years) took metformin in addition to the diet therapy. The effects of different types of treatment on body composition changes were assessed with follow-up BIA 3 months after the start of treatment.Results: Carriers of the mutant G allele of rs1801282 PPARG in the metformin and diet therapy group showed a significant increase in the content of body cell mass (1.28±0.51% vs 0.36±0.37%; P = 0.021) compared with CC homozygotes in the absence of differences in body weight changes (P > 0.05).Conclusions: The presence of the mutant allele G of rs1801282 PPARG promotes the increase in body cell mass in case of adding metformin to the diet therapy in patients with early carbohydrate metabolism disorders.

The effect of long-term gymnastic exercises on body composition changes in women after mastectomy

This study describes the effects of regular 4-year-long rehabilitation exercises based on a 45 min exercise session 3 times/w, on changes in body composition of 23 postmenopausal women (experimental group - E) following mastectomy. Anthropometric measurements and body composition (BIA method) were compared between the E women and a control (C) group of non-exercising women (N = 20) who underwent the same surgical procedure. Following four years of regular exercise, significant increase in body cell mass (BCM) (kg, %) and intracellular water (ICW) (1) was observed ( P< 0.05), whereas the content of extracellular water (ECW) (%) and extracellular mass (ECM) (kg) decreased ( P< 0.05). Body mass, body mass index (BMI) and fat mass (FM) (kg, %), did not change significantly. Central fat deposition measured by waist-to-hip ratio (WHR) and the waist circumference increased ( P< 0.05), whereas hip circumference did not change. Compared to the C group the E group had a lower BCM, BMI, FM (kg, %), ECW (l, %) and ECM (kg) ( P< 0.05), and a higher total body water (TBW) (%), fat-free mass (FFM) (%) and BCM (%) content ( P< 0.05). Hence, regular exercise may have a positive effect on the abovementioned factors which are considered among breast cancer risk factors after mastectomy.

IMPACT OF RENAL TRANSPLANTATION ON BODY COMPOSITION

The aim of the study was to analyse the impact of renal transplantation on body composition (Body Cell Mass) in adult kidney transplant recipients.Body Cell Mass (BCM) was calculated from total body potassium (TBK), determined from K-40 in a whole body counter. Patients were measured before transplantation and 3 months, 1 year and 2 years after transplantation. Patients were encouraged to take part in physical exercise, but supervised physical training was not included in the study Out of 50 included patients, 44 have had a kidney transplant (9 F, 35 M). Mean age at transplantation was 49 (23-72) years. Before transplantation, mean BW was 80 (SD 13 ) kg and mean BMI 25,6 (SD 4) kg/m 2 . Mean TBK was 3162 (SD 690) mmol, corresponding to 90 % of predicted value. In the 1 year follow up, no significant changes in TBK (n=42) were found, nor in patients examined 2-3 years after transplantation (n=35). To examine whether post transplantation improvement of BCM will appear later, as has been seen in Liver Transplant recipients, patients were invited to a follow up measurement. So far, 11 patients have repeated the measurement 6 (4½-7½) years after transplantation. TBK improvements of >10% were seen in 4 patients, decreases of >10% in 2 patients, and changes of a lower magnitude in remaining patients. In conclusion, no increase in Body Cell Mass was seen in this unselected group of kidney transplant recipients during the first 2-3 years after transplantation. Pro catabolic events and low physical activity may explain this lack ofimprovement.

Changes in adipokines after transjugular intrahepatic porto-systemic shunt indicate an anabolic shift in metabolism

Decompressing the portal hypertension by inserting a transjugular intrahepatic porto-systemic shunt (TIPS) in undernourished liver cirrhosis patients results in gains in body weight. It is important to understand whether this reflects an advantageous or unfavourable shift in nutrition status. This to some extent can be judged from the changes in the patients' adipokine patterns. We, therefore, examined the circulating levels of the most important adipokines before and after the TIPS procedure. Twenty-five liver cirrhosis patients were examined before TIPS insertion and followed for six months after the procedure. Their body composition was determined by the bioimpedance technique. The serum concentrations of adiponectin, retinol binding protein 4 (RBP4), and leptin were measured. The TIPS procedure induced a 12% increase in body cell mass (P=0.03) but did not change the body fat mass. At six months, serum adiponectin was increased by 60% (mean±SD, 10.7±6.1 vs. 16.9±8.9mg/L; P=0.001), serum RBP4 was decreased by 45% (28.6±20.0 vs. 16.3±9.6mg/L; P=0.01), and the leptin levels remained unchanged. The TIPS-related tissue build up was accompanied by increased adiponectin and decreased RBP4. Such changes are associated with an anabolic condition where the adipose tissue possesses residual capacity for energy storage. TIPS, therefore, can be considered to be nutritionally beneficial to cirrhosis patients.

The IGF system after insertion of a transjugular intrahepatic porto-systemic shunt in patients with liver cirrhosis

Insertion of a transjugular intrahepatic porto-systemic shunt (TIPS) into patients with liver cirrhosis usually induces a gain in body cell mass. Changes in the IGF system in favor of anabolism may be involved. We, therefore measured blood concentrations of the components of the IGF system in cirrhosis patients before and after elective TIPS. The study comprised 17 patients and 11 healthy controls. Patients were examined before and 1, 4, 12, and 52 weeks after TIPS. Biochemical analyses of the IGF system were compared with changes in body composition (bioimpedance analysis), glucose and insulin, and metabolic liver function (galactose elimination capacity). After TIPS, body cell mass rose by 3.2 kg (95% confidence interval (CI): 1.0-5.5) at 52 weeks, in correlation with baseline liver function (r(2)=0.22; P=0.03). Peripheral blood concentrations of total IGF1 and 2, bioactive IGF1, and the IGF-binding proteins (IGFBP-1, -2, and -3) remained unchanged throughout the study period. There was no change in fasting glucose, whereas fasting insulin rose by 40% (CI: 11-77%) and glucagon by 58% (CI: 11-132%) from baseline to 52 weeks after TIPS. Our data confirm that TIPS was associated with an increase in body cell mass in patients with liver cirrhosis, but without any change in the circulating IGF system. Thus, the results do not support the notion that effects on the circulating IGF system are involved in the anabolic effects of TIPS insertion.

BODY COMPOSITION AND MUSCULAR STRENGTH CHANGES AFTER MODERATE ACTIVITY: ASSOCIATION WITH MATRIX METALLOPROTEINASE POLYMORPHISMS

Remodeling of skeletal muscles is regulated by matrix metalloproteinases (MMPs). Functional genetic polymorphism (PM), modulating the expression of some MMPs, might be associated to different body composition and muscular strength improvement after exercise. Genetic PM of MMP-1 (G+/− at −1607), MMP-3 (5A/6A at −1171) and MMP-9 (Cytosine-Adenine microsatellite = 13-27CA) repeats, around −90), body cell mass (BCM), extracellular water (ECW) and isometric maximal extensor strength (MES) of both legs were determined in 17 old sedentary women at the beginning and at the end of a 24 week physical exercise program. A 12 and 72% increase in BCM and MES, respectively, and 11% reduction in ECW were observed at the end of the program. Carriers of G-insertion in MMP-1, PM increased their BCM (7 kg vs. −1.5, p = 0.007) and lost ECW (9% of total body water vs. 0.1%, p = 0.004) more than the non-carriers; homozygote for 21 or less CA repeats/allele in MMP-9 PM gained more MES (115 N, interquartile range = IQR = 63–132) than carriers of longer microsatellites (63 N, IQR = 40−86, p = 0.028). MMP-3 did not show any association with body composition and exercise-related strength changes. Exercise in elderly women increases BCM and strength, these changes are associate to specific MMP genotypes.

Increase in Body Cell Mass and Decrease in Wasting Are Associated with Increasing Potency of Antiretroviral Therapy for HIV Infection

With the advent of potent combination antiretroviral therapy (ART), there has been a reduction in the incidence of wasting. However, few studies have investigated specific body composition changes associated with these treatments. This study aimed to investigate longitudinally the association of increasingly potent ART with changes in body cell mass and wasting utilizing bioelectric impedance analysis (BIA). In this longitudinal cohort study, 159 HIV-positive men were assessed semiannually from 1995 to 1997 for body composition utilizing BIA, CD4 lymphocyte count, HIV viral load, medical and depressive symptoms. Wasting was defined as body cell mass/height below the 90th percentile based on HIV positive norms. ART potency at each visit was scored utilizing published clinical guidelines, ranging from 1 (0-1 antiretrovirals) to 5 (3 or more antiretrovirals including a potent protease inhibitor). Viral resistance testing was not used. The mixed-effects model and the generalized estimating equations approaches were used to determine longitudinal correlates of body cell mass and of wasting, respectively. Over the 2 years of follow-up, potent combination ART use increased from 6% to 79%. Concurrently, a significant increase in mean body cell mass and a reduction in prevalence of wasting were seen, while total body weight, fat mass, and total body water did not change. Increasingly potent ART was associated with significant increases in body cell mass and reduction in wasting. Other significant correlates of increased body cell mass included higher CD4 count and decreased severity of HIV-related symptoms, fatigue and depression. The current study found that higher potency ART taken for relatively short term (2 years) was associated with an increase in body cell mass and a reduction in wasting and that these changes were associated with both medical (CD4, HIV symptoms) and behavioral (fatigue, depression) improvements. One caveat is this study did not distinguish among types of potent ART regimens. Given only some antiretrovirals appear linked to many body composition changes, regardless of their effect on viral load, it may be the type of regimen used that accounted for the relationship seen between viral load and body composition changes.

Reversal of COPD-Associated Weight Loss Using the Anabolic Agent Oxandrolone

Weight loss is a common complication of COPD, associated with negative outcomes. Weight restoration has been associated with improved outcomes. The effects of oxandrolone, an adjunct to help restore weight, were evaluated in patients with COPD. Prospective, open-label, 4-month clinical trial. Twenty-five community-based pulmonary practices throughout the United States. A primary pulmonary diagnosis of moderate-to-severe COPD as defined by FEV1 < 50% of predicted and FEV1/FVC ratio < 0.7, along with significant involuntary weight loss (weight < or = 90% ideal body weight). Oral oxandrolone, 10 mg bid. Body weight, body composition (bioelectric impedance analysis), spirometry, and 6-min walking distance were measured. Data for 82 patients at 2 months and 55 patients at 4 months are presented. At month 2, 88% of patients had gained a mean +/- SD of 6.0 +/- 4.36 lb (p < 0.05) and 12% had lost a mean of 1.7 +/- 2.15 lb (not statistically significant [NS]). At month 4, 84% had gained a mean of 6.0 +/- 5.83 lb (p < 0.05) and 16% had lost a mean of 1.8 +/- 1.74 lb (NS). Month 4 bioelectric impedance analysis showed the weight to be primarily lean tissue, with a mean increase in body cell mass of 3 +/- 2.6 lb (p < 0.05), and a mean increase in fat of 1.2 +/- 4.6 lb (NS). Oxandrolone is an effective adjunct to facilitate weight restoration in patients with COPD-associated weight loss. Weight gain is primarily lean body mass. Oxandrolone was relatively well tolerated and, therefore, should be a consideration in the comprehensive management of patients with COPD and weight loss.

Clinical Observations: Arginine vs Protein Supplementation in HIV‐infected Men

Background: The enhancement of immune function and nutritional status is a challenge in the care of HIV‐infected persons. The semiessential amino acid, L‐arginine, has been shown to enhance immune function by promoting T‐cell proliferation and nitrogen retention in animal and human models. Objective: We studied the effect of three levels of arginine supplementation in isonitrogenous doses on immune function and parameters commonly used to assess nutritional status. The side effect profile of oral arginine in HIV‐infected male volunteers was also assessed. Design: The study design was experimental double‐blinded with 19 HIV patients from an outpatient clinic randomized to consume 20 g (n = 7), 10 g (n = 6), or 0 g (n = 6) of arginine per day for four weeks. Protein powder was added to 0 g and 10 g arginine doses to make them isonitrogenous with the 20 g arginine dose. To assess immune function, peripheral blood CD4 T‐cell numbers and viral loads were obtained at week 0, 4, and 8. The parameters used to assess nutritional status included weight, body mass index (BMI), body cell mass (BCM), albumin, and body fat at week 0, week 4, and week 8. A series of weekly (weeks 0 to 4) 3‐day diet records was collected from each patient, and dietary protein, energy, and dietary arginine were determined. Results: Three‐day diet records collected from each patient indicated that compliance was good, and the side‐effect profile of the oral arginine supplement was favorable during the one‐month period. In the three groups, the following were identified: weight gain was 1.1 kg at week 4 for the 20 g arginine group, ‐0.09 kg in the 10 g arginine group, and ‐0.45 kg in the 0 g arginine group (p &gt; .05). There was an increase in BCM at week 4 in all three supplemented groups with a larger increase (1% vs 0.5%) in BCM from baseline to week 4 for the patients treated with protease inhibitors vs other antiretroviral agents (p &gt; .05). Viral load and CD4 lymphocyte counts were not changed in the three groups with supplementation, Conclusions: The study findings suggest that enrichment of a diet with protein or arginine may improve BCM and supplementation with arginine 20 g per day may safely increase body weight. However, arginine or protein supplementation did not significantly changes analyzed nutritional or immunological parameters in this population. Further study needs to consider a larger sample and a longer study duration to determine if changes are statistically significant.

Testosterone therapy for clinical symptoms of hypogonadism in eugonadal men with AIDS.

We conducted a small exploratory study to assess whether testosterone therapy is an effective treatment for clinical symptoms characteristic of hypogonadism in eugonadal men with AIDS. Treatment consisted of 12 weeks of bi-weekly intramuscular injections of testosterone cypionate. Twenty-three men enrolled in the study; mean age was 37 and 44% were ethnic minorities. All had an AIDS diagnosis and the mean CD4 cell count was 150 cells/mm3. All baseline serum testosterone levels were within the laboratory reference range and above 500 ng/dl. Diminished libido was an inclusion criterion, plus each patient had at least one additional symptom (low mood, low energy, loss of appetite and/or weight). Nineteen men completed the trial and a majority of patients responded with regard to libido (89%), mood (67%), energy (71%), and appetite (67%) as rated by the Clinical Global Impressions Scale. With the exception of appetite, self and clinician rated measures showed significant improvement in all symptom domains. Among the 14 study completers with significant weight loss, the average weight gain was 2.3 kg, with a 1.8 kg increase in body cell mass and no change in body fat. These results suggest that testosterone is as effective in treating these symptoms in eugonadal men with AIDS as we have found in our research with hypogonadal HIV+men.

Exercise as a mediator of psychological and nutritional effects of testosterone therapy in HIV+ men.

The purpose of this study was to determine whether exercise mediates the psychological and nutritional effects of testosterone therapy in men with symptomatic HIV illness, low serum testosterone, and clinical symptoms of hypogonadism. A 12-wk open trial of biweekly intramuscular testosterone injections was conducted, with 54 men completing the trial and exercise assessments. Most (71%) men were diagnosed with AIDS; 41% had a CD4 < 50. One-third of the men were diagnosed with major depression, and nearly half had some evidence of wasting. Twenty-nine men (54%) engaged in exercise (predominantly resistance training) during the trial. Exercisers did not differ from nonexercisers on any measure of psychological well being or nutritional status at baseline. After 12 wk of testosterone treatment, those who exercised showed significant improvement in mood (Hamilton Rating Scale for Depression; HAM-D) and overall distress (Brief Symptom Inventory; BSI) (P < 0.000 for both), as well as a significant increase in body cell mass (P < 0.01) and lean body mass (mean increase of 2.6 kg; P < 0.000) as measured by bioelectric impedance analysis. In contrast, nonexercisers showed improvement on the HAM-D (P < 0.000), but not the BSI or measures of nutritional status. These findings indicate that exercise may be an important adjunct to testosterone therapy in the treatment of psychological distress and wasting symptoms in men with symptomatic HIV illness.

Testosterone therapy for clinical symptoms of hypogonadism in eugonadal men with AIDS

Summary: We conducted a small exploratory study to assess whether testosterone therapy is an effective treatment for clinical symptoms characteristic of hypogonadism in eugonadal men with AIDS. Treatment consisted of 12 weeks of bi-weekly intramuscular injections of testosterone cypionate. Twenty-three men enrolled in the study; mean age was 37 and 44% were ethnic minorities. All had an AIDS diagnosis and the mean CD4 cell count was 150 cells/mm 3. All baseline serum testosterone levels were within the laboratory reference range and above 500 ng/dl. Diminished libido was an inclusion criterion, plus each patient had at least one additional symptom (low mood, low energy, loss of appetite and/or weight). Nineteen men completed the trial and a majority of patients responded with regard to libido (89%), mood (67%), energy (71%), and appetite (67%) as rated by the Clinical Global Impressions Scale. With the exception of appetite, self and clinician rated measures showed significant improvement in all symptom domains. Among the 14 study completers with significant weight loss, the average weight gain was 2.3 kg, with a 1.8 kg increase in body cell mass and no change in body fat. These results suggest that testosterone is as effective in treating these symptoms in eugonadal men with AIDS as we have found in our research with hypogonadal HIV+men.

Body composition in acromegaly.

Total body water (TBW) and potassium (TBK) were measured in untreated acromegalic patients seen between 1956 and 1984 and the results were compared to values predicted from height (BH), weight (BW), age and sex, using data from a large number of healthy subjects (n = 476). Normal body weight for each patient (BWnorm) was predicted from BH and sex, the regression equations being derived from a representative population sample (n = 4017). The BH for each patient was compared with data on BH in 15,000 Swedes. The patients were significantly taller than the control population (P less than 0.001). In 107 (70%) of the 156 patients BH was above the median. Patients with an early onset of the disease were taller than those with a later onset. TBK and TBW were significantly higher than predicted from observed BW (P less than 0.001) and so was the quotient extracellular water (ECW)/intracellular water (ICW). Body fat (BF), on the other hand, was lower than predicted (P less than 0.001). Observed BW in male acromegalics was 8.1 kg higher than predicted from healthy subjects of the same BH (BWnorm), a difference explained by an average increase of 4.7 kg in body cell mass (BCM) (P less than 0.001) and 7.1 kg in extracellular water (P less than 0.001) simultaneously with a mean decrease of 3.7 kg in BF (P less than 0.01). Female acromegalics weighed on average 6.4 kg more than healthy women, a difference explained by an increase in BCM of 3.3 kg (P less than 0.001) and in ECW of 4.6 kg (P less than 0.001) concomitantly with a decrease in BF of 1.5 kg. Mean hGH concentration at diagnosis correlated inversely with the quotients observed/predicted BF (P less than 0.01) and BW/BWnorm (P less than 0.05) but not with the quotients observed/predicted TBK, TBW or ECW/ICW.

Body composition and adipose cellularity in human obesity.

Abstract. Body composition, age at onset of obesity, adipose tissue cellularity and metabolic variables have been determined in 137 obese subjects and controls. Weight stability in 34 of the patients could also be judged by a repeated examination after about 10 months. Fat cell number correlated strongly with body fat, while fat cell size increased only within the control range of body fat. Above approximately 30 kg body fat, the fat cell enlargement was equally pronounced at all degrees of obesity. A cross‐sectional analysis of the obese men and women indicated that fat cell size was larger at 30–40 years of age than before and after this age. Cell number was elevated but did not increase with age in the obese group. Groups of younger and older obese women did not differ in adipose tissue cellularity factors. This had the consequence that, in comparisons with age‐ and sex‐matched control groups, obesity depending primarily on enlargement of fat cells seemed to be more frequent in the younger age groups, while in older obese subjects cell number seemed to be a more important factor for contribution to obesity. Fat cell number correlated positively with body cell mass. The earlier the onset of obesity the more fat cells, particularly when obesity could be traced to infancy. Obesity starting at adult age was characterized by larger fat cells. Two types of obesity can be distinguished. One is a hypercellular severe obesity with an early onset and an elevated body cell mass. The fat cells may be enlarged or not. The other type of obesity is characterized by fat cell hypertrophy, moderately increased body fat and a later onset. There is no increase in body cell mass. Plasma insulin was dependent on weight stability. Hypertriglyceridemia in obesity was associated with a decreased glucose tolerance, somewhat elevated insulin values, and elevated serum uric acid.

The effect of physical training on insulin production in obesity

Ten obese patients were subjected to physical training, which resulted in an increased maximal oxygen consumption and an increased isometric muscle strength. Body weight increased, due primarily to an increase in body fat, but also, in some cases, to an increase in body cell mass, determined by isotope dilution techniques. Fat cell diameter was unchanged. Peroral glucose tolerance test with plasma radioimmuochemically determined insulin in these patients showed no changes in blood glucose values after training but a marked decrease in insulin values. This was interpreted to be due to an increased insulin sensitivity of tissues. Since the body fat mass was not decreased it was not considered likely that the increased insulin sensitivity was due to adipose tissue factors. This augmentation of insulin sensitivity was furthermore not related to the increase in body cell mass and therefore probably not to an increase in muscle mass. It was concluded that muscle probably is an important determinant for insulin sensitivity in obesity.

Body cell mass during long-term treatment with cortisone and anabolic steroids in asthmatic subjects.

ABSTRACT Thirty-six patients (17 males and 19 females) with severe bronchial asthma were treated for more than two years with cortisone and norandrolone. The patients were followed by repeated estimations of the body cell mass (BCM) using total exchangeable potassium (Ke) as a parameter of cell mass. In ten of the female patients, determinations of total body water (TBW) were also performed at the end of anabolic treatment. BCM increased significantly in both male (3.3 kg) and female (4.5 kg) patients. The relative increase in BCM was more pronounced in the female (25%) than in the male patients (13%). After one year of anabolic therapy, no further increase in BCM was demonstrated in either sex. The male patients did not increase more than was seen in male patients on cortisone only and previously reported. The average body weight was unchanged during the study, indicating a decrease in body fat. In the female patients, the final relative body cell mass was higher than in normal women and similar to that of normal men. TBW also increased in proportion to Ke and at the end of treatment the quotient TBW/B.W. was not different from that of normal men. The regression of Ke on TBW was normal. The significance of these findings are discussed. During treatment, one woman developed radiological signs of osteoporosis and two males showed progression of bone atrophy, which was diagnosed before the study.

Changes in body composition after therapeutically induced remission in 12 cases of Cushing's syndrome.

ABSTRACT Exchangeable potassium (Ke) and total body water (TBW) were determined before treatment and 5–46 months after therapeutically induced remission in 12 cases of Cushing's syndrome. In six patients, Ke was determined repeatedly after treatment. From these measurements changes in body cell mass (BCM), body fat and in the volume of extracellular water (ECW) were estimated. BCM increased in all cases but two and this increase was most marked in the patients who showed muscular wasting. This increase often developed slowly and was probably related to physical activity. In six patients suffering from severe Cushing's syndrome, the increase in BCM varied between 1.7–6.9 kg (mean 3.5 kg). Body fat decreased on an average by 6.1 kg. Before treatment, the patients looked obese but the overweight was moderate in relation to height. The calculated ECW did not change significantly in most cases. Only in one case was considerable overhydration present in the absence of heart disease. Significant intracellular deficit of potassium was probably not present in this series of patients.