Total Lean Mass Research Articles

Impact of whole-body and skeletal muscle composition on peak oxygen uptake in heart failure: a systematic review and meta-analysis.

Heart failure (HF) has a major impact on exercise tolerance that may (in part) be due to abnormalities in body and skeletal muscle composition. This systematic review and meta-analysis aims to assess how differences in whole-body and skeletal muscle composition between patients with HF and non-HF controls (CON) contribute to reduced peak oxygen uptake (VO2peak). The PubMed database was searched from 1975 to May 2024 for eligible studies. Cross-sectional studies with measures of VO2peak, body composition, or muscle biopsies in HF and CON were considered. Out of 709 articles, 27 studies were included in this analysis. Compared with CON, VO2peak [weighted mean difference (WMD): -9.96 mL/kg/min, 95% confidence interval (CI): -11.71 to -8.21), total body lean mass (WMD: -1.63 kg, 95% CI: -3.05 to -0.21), leg lean mass (WMD: -1.38 kg, 95% CI: -2.18 to -0.59), thigh skeletal muscle area (WMD: -10.88 cm2 , 95% CI: -21.40 to -0.37), Type I fibres (WMD: -7.76%, 95% CI: -14.81 to -0.71), and capillary-to-fibre ratio (WMD: -0.27, 95% CI: -0.50 to -0.03) were significantly lower in HF. Total body fat mass (WMD: 3.34 kg, 95% CI: 0.35-6.34), leg fat mass (WMD: 1.37 kg, 95% CI: 0.37-2.37), and Type IIx fibres (WMD: 7.72%, 95% CI: 1.52-13.91) were significantly higher in HF compared with CON. Absolute VO2peak was significantly associated with total body and leg lean mass, thigh skeletal muscle area, and capillary-to-fibre ratio. Individuals with HF display abnormalities in body and skeletal muscle composition including reduced lean mass, oxidative Type I fibres, and capillary-to-fibre ratio that negatively impact VO2peak.

Abstract P142: Cross Sex Steroid Therapy and Cardiac Function in a Rodent Model of Gender Affirming Hormone Therapy in the Male Rat.

Transgender females ( TGF ) are individuals born biologically male, but identify as female. Gender-Affirming Hormone Therapy ( GAHT ) consists of 17β-Estradiol ( E2 ) supplementation with androgen suppression or a surgical intervention in order to match physical characteristics with perceived gender. Whether the prevalence of cardiovascular ( CV ) disease is enhanced in TGFs on GAHT is not clear. We previously reported that baseline cardiac morphology and function is not altered in a rat model of cross sex hormone therapy ( CSHT ) that mimics GAHT in the TGF. This study tested the hypothesis that myocardial ischemia will result in enhanced cardiac susceptibility in the male rat on CSHT. Adult male Sprague Dawley rats (13 weeks of age) were randomly assigned to either Control or E2+CTX ; E2 at 5 mg/day, pellet sc, replaced every 3 weeks with castration ( CTX ) performed at 15 weeks of age. At 25 weeks of age, rats in each group were randomly subdivided into Sham (n=8) or myocardial ischemia/reperfusion ( MIR ) , 1 hour occlusion, n=6-7. Statistics: Two-way ANOVA with Tukey’s post-hoc test. *Denotes significance vs. Control Sham. Results ( Table ): At 27 weeks of age, total lean mass (EchoMRI) was significantly decreased in Sham and I/R E2+CTX (p<0.05). At one week post I/R, stroke volume and cardiac output (echocardiogram, VEVO 3100) were significantly decreased in E2+CTX Sham vs. Control Sham (p<0.05); yet, ejection fraction, end-diastolic volume, and end-systolic volume did not differ. Thus, these data suggest that the biological effects of CSHT in the male does not enhance susceptibility to cardiac ischemia in young adulthood; yet, the long-term effect of CSHT on CV health remains unknown.

Effects of Hormonal Contraception and the Menstrual Cycle on Maximal Strength and Power Performance.

To evaluate the effects of oral contraceptive (OC) and hormonal intrauterine device (H-IUD) use, compared to an eumenorrheic (EUM) cycle, on maximal strength and power between hormone phases. One repetition max (1RM) leg press and bench press, peak force (PF) from knee extension and upright row isometric dynamometry, and power from vertical jump height (VJH) and reactive strength index (RSI; cm/s) were measured in 60 healthy, active women (mean ± standard deviation [SD]; Age: 26.5 ± 7.0 yrs, BMI: 22.5 ± 3.7 kg/m2) who were monophasic OC users for ≥6 months (n = 21), had a H-IUD for ≥6 months (n = 20), or had regularly naturally occurring menstrual cycle for ≥3 months or were using a non-hormonal IUD (EUM; n = 19). Participants were randomly assigned to begin in the follicular phase/placebo pill (low hormone phase; LHP) or in the luteal phase/active pill (high hormone phase; HHP) and were tested once in each phase. Estimates of total lean mass (LM), leg LM, and arm LM were measured via dual energy x-ray absorptiometry. Separate univariate ANCOVAs were used to assess the change from HHP to LHP between groups, with LM and progesterone as covariates. Leg press 1RM was significantly different across phases between groups (p = 0.027), with higher leg press 1RM in the HHP for the OC group (mean difference[∆HHP-LHP] ± standard error: ∆7.4 ± 15.9 kg; p = 0.043) compared to the H-IUD group (∆-8.9 ± 23.8 kg; p = 0.043). All groups demonstrated similar bench press 1RM, PF, VJH, and RSI between phases (p > 0.05). Lower body strength was greater in the HHP for OC users (5.6% increase) suggesting lower body maximal strength outcomes may be influenced by hormonal contraception type.

Semaglutide as a promising treatment for hypothalamic obesity: a six-month case series on four females with craniopharyngioma

PurposePatients with hypothalamic pathology often develop hypothalamic obesity, causing severe metabolic alterations resulting in increased morbidity and mortality. Treatments for hypothalamic obesity have not proven very effective, although the glucagon-like peptide-1 receptor agonist semaglutide has been shown to have positive effects. We examined semaglutide’s effect on weight loss in a sample of patients with hypothalamic obesity.MethodsFour female patients with hypothalamic obesity resulting from treatment of craniopharyngiomas were treated with semaglutide for six months. Whole Body Dual-energy x-ray absorptiometry scans were performed, and blood samples drawn at baseline and after six months. Semaglutide dosages were increased monthly along with tracking of body weight and eating behavior (Three Factor Eating Questionnaire, TFEQ-R18).ResultsBMI was reduced in all cases, with an average of 7.9 BMI (range: 6.7 to 10.1) corresponding to a weight loss of 17.0% (range: 11.3–22.4%) or 20.2 kg (range 16.2 kg to 23.4 kg). We found a comparable reduction in total fat mass (17.2%, p = 0.006) and lean mass (16.0%, p = 0.05), whereas bone mass was unchanged (2.6%, p = 0.12). All cases reported an increase in energy levels, improved mobility and physical activity. Unfavorable eating behaviors were reduced after 1 month of treatment (emotional eating − 41 points, p = 0.02, uncontrolled eating − 23 points, p = 0.11). HbA1c and total cholesterol were significantly reduced (p = 0.014 for both).ConclusionSemaglutide is a promising and safe treatment option for HO, that improves eating behavior, reduces weight, and improves metabolic markers.

Difference in Body Composition Patterns between Age Groups in Italian Individuals with Overweight and Obesity: When BMI Becomes a Misleading Tool in Nutritional Settings.

Little is known about the changes in body composition (BC) in people with overweight or obesity. The aim of this study was to assess the differences in BC patterns in this population based on gender and age. A total of 2844 Italian adults of mixed gender and a body mass index (BMI) of ≥25 kg/m2 underwent a BC assessment by means of dual-energy X-ray absorptiometry (DXA). The sample was categorized into three age groups: 'young' (20-39 years), 'middle' (40-59 years), and 'older' (60-80 years) adults, after being matched by body weight and BMI. Males showed higher total body fat percentage (BF%) and a lower total lean mass (LM), progressively from the young to the middle to the older age groups, while females showed similar values for these total compartments between the three age groups. However, in both genders, participants in the middle and older groups were more likely to have a higher trunk fat percentage by +1.23% to +4.21%, and lower appendicular lean mass (ALM) by -0.81 kg to -2.63 kg with respect to the young group, indicating expression of major central adiposity and sarcopenia. While our findings underscore the limitations of BMI to detect these differences between age groups, the identification of new tools suitable for this aim is greatly needed in this population. Moreover, further investigation that clarifies the impact of these differences in BC patterns between gender and age groups on health outcomes is also required.

Muscle-to-Bone Ratio in NCAA Division I Collegiate Football Players by Position.

Dengel, DR, Studee, HR, Juckett, WT, Bosch, TA, Carbuhn, AF, Stanforth, PR, and Evanoff, NG. Muscle-to-bone ratio in NCAA Division I collegiate football players by position. J Strength Cond Res 38(9): 1607-1612, 2024-The purpose of this study was to compare the muscle-to-bone ratio (MBR) in National Collegiate Athletic Association Division I football players (collegiate football players [CFP]) to healthy, age-matched controls. In addition, we examined MBR in CFP by position. A total of 553 CFP and 261 controls had their total and regional lean mass (LM), fat mass (FM), and bone mineral content (BMC) determined by dual x-ray absorptiometry (DXA). College football players were categorized by positions defined as offensive linemen (OL), defensive linemen (DL), tight end, linebacker (LB), running back (RB), punter or kicker, quarterback (QB), defensive back (DB), and wide receiver (WR). There were significant differences between CFP and controls for total LM (80.1 ± 10.0 vs. 56.9 ± 7.8 kg), FM (22.2 ± 12.5 vs. 15.2 ± 7.1 kg), and BMC (4.3 ± 0.5 vs. 3.1 ± 0.5 kg). Although there were significant differences in body composition between CFP and controls, there was no significant differences in total MBR between CFP and controls (18.6 ± 1.4 vs. 18.8 ± 1.7). Regionally, CFP had significantly lower trunk MBR than controls (26.7 ± 2.7 vs. 28.7 ± 4.2), but no difference was seen in leg or arm MBR. Positional differences in CFP were noted as total MBR being significantly higher in DL (19.0 ± 1.4) than in DB (18.1 ± 1.3), WR (18.1 ± 1.3), and LB (18.2 ± 1.3). OL had a significantly higher total MBR (19.2 ± 1.3) than DB (18.1 ± 1.3), LB (18.2 ± 1.3), QB (18.1 ± 1.0), and WR (18.1 ± 1.3). In addition, RB had significantly higher total MBR (18.8 ± 1.3) than DB (18.1 ± 1.3) and WR (18.1 ± 1.3). This study may provide athletes and training staff with normative values when evaluating total and regional MBR with DXA.

Effects of a physical exercise programme on bodyweight, body condition score and chest, abdominal and thigh circumferences in dogs

BackgroundResearch on the effects of physical exercise on canine body composition is limited. The aim of this study was to investigate the effects of a physical exercise programme on bodyweight, body condition score (BCS) and chest, abdominal and thigh circumferences in dogs. Twenty-one healthy dogs of different breeds exercised together with their owners during an eight-week programme consisting of jogging and strength exercises. Standardised measurements were performed in triplicates with a measuring tape on standing dogs. Chest circumference was measured at three anatomical locations, abdomen at two and thigh at one. Data on bodyweight, BCS (9-point scale) and circumferences were analysed with mixed model repeated measures analyses to evaluate changes after the programme and effects of target distance.ResultsSeven dog owners choose a target distance of 2 km and 14 owners choose 5–10 km. Mean BCS decreased (P = 0.007) after the programme (5.1 ± 0.9 vs. 4.7 ± 0.6) but there was no effect of target distance. Almost all chest and abdominal circumference measurements decreased (P ≤ 0.007) with the 2 km group driving the reduction in chest circumference and the 5–10 km group driving the reduction in abdominal circumference. In contrast, thigh circumference (28.8 ± 0.4 vs. 30.2 ± 0.4) increased (P = 0.007) while bodyweight was maintained. There were positive correlations between BCS and abdominal/chest ratios before and after the programme (Pearson correlation; R square ≤ 0.43, P ≤ 0.0012) but the mean ratio remained constant.ConclusionsResults indicated a redistribution between total body fat and muscle mass in body composition of normal weight to slightly overweight dogs after the physical exercise programme. The use of bodyweight alone was not a reliable evaluation method to complement the BCS assessment. However, repeated measurements of chest, abdominal and thigh circumference might aid in the assessment of body composition in dogs performing physical exercise. Further research should include a control group and objective evaluations of total body fat and lean mass, in order to investigate the effectiveness of physical exercise as a freestanding method for decreasing BCS and increasing muscle mass in overweight dogs.

Physiological characteristics predictive of passing military physical employment standard tasks for ground close combat occupations in men and women.

Challenges for some women meeting the physical employment standards (PES) for ground close combat (GCC) roles stem from physical fitness and anthropometric characteristics. The purpose of this study was to identify the modifiable and nonmodifiable characteristics predictive of passing GCC-based PES tasks and determine the modifiable characteristics suitable to overcome nonmodifiable limitations. 107 adults (46 women) underwent multiday testing assessing regional and total lean mass (LM), percent body fat (BF%), aerobic capacity (V̇O2peak), strength, power, and PES performance. Predictors with p-value <0.200 were included in stepwise logistic regression analysis or binary logistic regression when outcomes among sexes were insufficient. Relative and absolute arm LM (OR: 4.617-8.522,p<0.05), leg LM (OR: 2.463, p<0.05), and upper body power (OR: 2.061, p<0.05) predicted medicine ball chest throw success. Relative and absolute arm LM (OR: 3.734-11.694, p<0.05), absolute trunk LM (OR: 2.576, p<0.05), and leg LM (OR: 2.088, p<0.05) predicted casualty drag success. Upper body power (OR: 3.910, p<0.05), absolute trunk LM (OR: 2.387, p<0.05), leg LM (OR: 2.290, p<0.05), and total LM (OR: 1.830, p<0.05) predicted maximum single lift success. Relative and absolute arm LM (OR: 3.488-7.377, p<0.05), leg LM (OR: 1.965, p<0.05), and upper body power (OR: 1.957, p<0.05) predicted water can carry success. %BF (OR: 0.814, p=0.007), V̇O2peak (OR: 1.160, p=0.031), and lower body strength (OR: 1.059, p<0.001) predicted repeated lift and carry success. V̇O2peak (OR: 1.540, p<0.001) predicted 2-km ruck march success. Modifiable characteristics were the strongest predictors for GCC-based PES task success to warrant their improvement for enhancing PES performance for women.

Poster 391: Injury Risk Cut-offs for Bone Density and Body Composition in Professional Female Ballet Dancers

Objectives: Female professional ballet performers are a unique population that undergo substantial physiologic stresses related to training, performance, and, at times, reduced energy availability that can result in elevated incidences of injury relative to their male counterparts and, even more so, the general population. However, there are currently no population-specific cut-offs based on dual energy X-ray absorptiometry (DEXA), bone mineral density (BMD), bone mineral content (BMC), and body composition (lean mass, LM; fat mass, FM) in relation to injury risk for appropriate screening and identification of those who might benefit from nutritional or activity-based interventions for injury prevention. The objective of this investigation was to develop population-specific DEXA cut-offs for BMD and body composition in professional female ballet performers based on injury risk. Methods: All procedures for this investigation were approved by the IRB. A total of 132 DEXA scans among 48 female professional ballet dancers from a single dance company taken during yearly physicals between 2017-2022 were collected for BMD and body composition (body mass, lean mass, fat mass). The electronic hospital record (EHR) was reviewed for each performer. The year of injury, level of injury, anatomic location, and diagnosis were collected if an injury was identified for the year following DEXA and physical. Level of injury was recorded. The data was de-identified and categorized by gender and year of injury. A female ballet population-matched Z-score was generated for total and regional BMD and body composition measures whereby Zb = (Measure – Ballet Population Measure) / SD of the ballet population. Logistic regression was used to determine Zb-score cut-offs whereby a significant increase in injury metrics (frequency &amp; severity) would occur. Next, a T-test was used to compare injury severity scores between those above and below the cut-off. Chi-square analysis was then used to compare injury level frequencies between those above and below the cut-off. Significance was set at p&lt;0.05 for all analyses. Corresponding BMD and body composition measures to each established Zb cut-off were also calculated. Results: Results are presented in Figure 1. Analysis revealed a strong association between Zb-scores for body mass index (BMI, kg/m2) and increased incidence of level 1 injuries. Weaker associations for Zb-scores for total BMD and total lean mass index (LMI, kgLM/m2) with all-cause injury severity and frequency rates (P&lt;0.05) were also found. For total BMD, a Zb-score threshold of -0.5 was observed to be the point at which injury severity (P=0.039) and frequency of higher-level injuries (Level 2&amp; 3, P&lt;0.05) was observed to significantly increase. This cut-off corresponded to a total BMD value of 1.100 g/cm2. For total LMI, a Zb-score threshold of -0.5 was observed to be the point at which injury severity (P=0.046) and overall injury frequency (P=0.023) was observed to increase. This cut-off corresponded to a total LMI value of 13.86 kgLM/m2. For BMI, a Zb-score threshold of -0.4 was observed to be the point at which injury severity (P=0.047) and frequency of level higher level injuries (&gt;Level 1, P=0.002) was observed to significantly increase. No significant injury cut-offs for % body fat or fat mass index were observed. This cut-off corresponded to a BMI value of 18.40 kg/m2. Conclusions: Reduced total bone density (BMD &lt;1.100 g/cm2), lean mass (LMI &lt; 13.86 kgLM/m2), and body mass (BMI &lt; 18.40 kg/m2) may increase injury risk in elite professional female ballet performers. The cut-offs identified here may be used to better evaluate injury risk (as it pertains to DEXA assessment) in a manner that is specific to this population as opposed to generalizing to general population norms. Investigation remains ongoing regarding male dancers as well as how regional DEXA measures may relate to specific injury locations. The methods used here may also be utilized to find similar body composition and BMD injury risk cut-offs among other athlete populations and may greatly enhance the value of densitometry-based screening.

Body composition and body mass index are independently associated with widespread pain and experimental pain sensitivity in older adults: a pilot investigation.

Chronic musculoskeletal (MSK) pain is prevalent in older adults and confers significant risk for loss of independence and low quality of life. While obesity is considered a risk factor for developing chronic MSK pain, both high and low body mass index (BMI) have been associated with greater pain reporting in older adults. Measures of body composition that distinguish between fat mass and lean mass may help to clarify the seemingly contradictory associations between BMI and MSK pain in this at-risk group. Twenty-four older adults (mean age: 78.08 ± 5.1 years) completed dual-energy x-ray absorptiometry (DEXA), and pain measures (Graded Chronic Pain Scale, number of anatomical pain sites, pressure pain threshold, mechanical temporal summation). Pearson correlations and multiple liner regression examined associations between body mass index (BMI), body composition indices, and pain. Significant positive associations were found between number of pain sites and BMI (b = 0.37) and total fat mass (b = 0.42), accounting for age and sex. Total body lean mass was associated with pressure pain sensitivity (b = 0.65), suggesting greater lean mass is associated with less mechanical pain sensitivity. The results from this exploratory pilot study indicate lean mass may provide additional resilience to maladaptive changes in pain processing in older adults, and highlights the importance of distinguishing body composition indices from overall body mass index to better understand the complex relationship between obesity and MSK pain in older adults.

Force magnitude and distribution during impacts to the hip are affected differentially by body size and body composition

Hip fractures are a severe health concern among older adults. While anthropometric factors have been shown to influence hip fracture risk, the low fidelity of common body composition metrics (e.g. body mass index) reduces our ability to infer underlying mechanisms. While simulation approaches can be used to explore how body composition influences impact dynamics, there is value in experimental data with human volunteers to support the advancement of computational modeling efforts. Accordingly, the goal of this study was to use a novel combination of subject-specific clinical imaging and laboratory-based impact paradigms to assess potential relationships between high-fidelity body composition and impact dynamics metrics (including load magnitude and distribution and pelvis deflection) during sideways falls on the hip in human volunteers.Nineteen females (<35 years) participated. Body composition was assessed via DXA and ultrasound. Participants underwent low-energy (but clinically relevant) sideways falls on the hip during which impact kinetics (total peak force, contract area, peak pressure) and pelvis deformation were measured. Pearson correlations assessed potential relationships between body composition and impact characteristics.Peak force was more strongly correlated with total mass (r = 0.712) and lean mass indices (r = 0.510–0.713) than fat mass indices (r = 0.401–0.592). Peak deflection was positively correlated with indices of adiposity (all r > 0.7), but not of lean mass. Contact area and peak pressure were positively and negatively associated, respectively, with indices of adiposity (all r > 0.49). Trochanteric soft tissue thickness predicted 59 % of the variance in both variables, and was the single strongest correlate with peak pressure. In five-of-eight comparisons, hip-local (vs. whole body) anthropometrics were more highly associated with impact dynamics.In summary, fall-related impact dynamics were strongly associated with body composition, providing support for subject-specific lateral pelvis load prediction models that incorporate soft tissue characteristics. Integrating soft and skeletal tissue properties may have important implications for improving the biomechanical effectiveness of engineering-based protective products.

Changes in body composition in early breast cancer patients treated with aromatase inhibitors

PurposeThe aim of the study was to analyze the modification of total and regional body composition in early breast cancer patients treated with aromatase inhibitors (AIs).MethodsThis is a prospective, single-center, observational, longitudinal study. Four-hundred and twenty-eight patients treated with adjuvant aromatase inhibitors were enrolled at the Medical Oncology and Breast Unit of Spedali Civili Hospital in Brescia from September 2014 to June 2022. Several body composition parameters including total and regional fat and lean body mass were investigated with dual-energy X-ray absorptiometry (DXA) scan at baseline and after 18 months of treatment with aromatase inhibitors.ResultsA significant increase in fat body mass (mean + 7.2%, 95% confidence interval [CI]: 5.5;8.9%) and a reduction in lean body mass (mean −3.1%, 95% CI −3.9; −2.4) were documented in this population. The changes in fat and lean body mass varied considerably according to different body districts ranging between + 3.2% to + 10.9% and from−1.3% to −3.9%, respectively.ConclusionAromatase inhibitor adjuvant therapy in early breast cancer is associated with changes in body composition, with a wide variability among different body districts, leading to a risk of sarcopenic obesity. Supervised physical exercise that focuses on single body parts that may display detrimental variations may be beneficial for AIs treated patients.

The Effect of Palmitoylethanolamide (PEA) on Skeletal Muscle Hypertrophy, Strength, and Power in Response to Resistance Training in Healthy Active Adults: A Double-Blind Randomized Control Trial

BackgroundPalmitoylethanolamide (PEA) has analgesic/anti-inflammatory properties that may be a suitable alternative to over-the-counter (OTC) non-steroidal analgesics/anti-inflammatories. While OTC pain medications can impair strength training adaptations, the mechanism of action of PEA is distinct from these and it may not negatively affect skeletal muscle adaptations to strength training.MethodsThe primary aim of this study was to investigate the effects of daily PEA supplementation (350 mg Levagen + equivalent to 300 mg PEA) combined with 8-weeks of resistance training on lean body mass with secondary aims addressing strength, power, sleep, and wellbeing compared to placebo (PLA) in young, healthy, active adults. In a randomized, controlled, double-blinded trial, 52 untrained, recreationally active participants aged 18–35 y were allocated to either the PEA or PLA groups. Participants consumed either 2 × 175 mg Levagen + PEA or identically matched maltodextrin capsules during an 8-week period of whole-body resistance training. This trial assessed the pre- to post- changes in total and regional lean body mass, muscular strength (1-RM bench, isometric mid-thigh pull), muscular power [countermovement jump (CMJ), bench throw], pain associated with exercise training, sleep, and wellbeing compared with the PEA or PLA condition.Results48 Participants were included in the final intention to treat (ITT) analysis and we also conducted per protocol (PP) analysis (n = 42). There were no significant between-group differences for total or regional lean muscle mass post-intervention. There was a significantly higher jump height (CMJ) at week 10 in the PEA group compared to the PLA (Adjusted mean difference [95% CI] p-value; ITT: − 2.94 cm [− 5.15, − 0.74] p = 0.010; PP: − 2.93 cm [− 5.31, − 0.55] p = 0.017). The PLA group had higher 1-RM bench press post-intervention compared with the PEA group (ITT: 2.24 kg [0.12, 4.37] p = 0.039; PP: 2.73 kg [0.40, 5.06] p = 0.023). No significant treatment effects were noted for any of the other outcomes.ConclusionPEA supplementation, when combined with 8 weeks of strength training, did not impair lean mass gains and it resulted in significantly higher dynamic lower-body power when compared with the PLA condition.Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12621001726842p).

Evaluation of kidney function and body composition in adult survivors of unilateral, non-metastatic, non-syndromic Wilms tumor: A report from the St. Jude Lifetime Cohort Study.

10064 Background: The relationships among treatment exposures, body composition and estimated glomerular filtration rate (eGFR) in adult survivors of childhood have not been well studied. Methods: We evaluated body composition with dual energy x-ray absorptiometry (DXA) and eGFR with the Kidney Disease International Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in 149 adults previously treated for non-syndromic, non-metastatic, unilateral Wilms tumor at St. Jude Children’s Research Hospital between 1964 and 2004 with chemotherapy and with [(whole abdomen (WA) radiation therapy (RT) – 41 patients; median dose 12.5 Gray (Gy), Interquartile Range (IQR) 12.5 – 20.0 Gy); (hemiabdomen (HA) RT – 30 patients; median dose 12.0 Gy, IQR 10.8 – 20.1 Gy)] or without (78 patients) RT. z-scores for DXA variables were calculated using data from the National Health and Nutrition Survey (1). Results: The study population [56 males (37.6%), 109 whites (73.2%)] was a median of 3.1 years of age at diagnosis (IQR: 1.7-4.3) and 23.4 years at evaluation (IQR: 23.4-35.5). Relative total and relative trunk lean mass, and eGFR were significantly decreased among those who received WART compared to unirradiated patients. Linear regression demonstrated that WART was significantly associated with a lower eGFR (p = 0.012) and higher value of creatinine (p = 0.013). Conclusions: Relative total and relative trunk lean mass, and eGFR are decreased in survivors of unilateral, non-metastatic, non-syndromic WT following WART. Although eGFR was in the normal range, eGFR may be inaccurate due to loss of lean mass. Assessments using non-secreted molecules may more accurately measure the magnitude of kidney function loss among WART treated WT survivors. 1. PLoS ONE 2009;4(9):e7038. [Table: see text]

Unintentional weight loss, body composition, and all-cause mortality among United States adults with cancer.

e22527 Background: While unintentional weight loss (UWL) is a common presenting symptom of malignancy, weight changes also occur regularly in patients with diagnosed cancer.UWL is often characterized by considerable muscle and fat loss and can lead to cachexia, which may increase risk of mortality. This nationally representative study aims to assess the association between UWL and mortality among adults with history of cancer and characterize differences in body composition. Methods: This was a retrospective cohort study of the National Health and Nutrition Examination Survey 1999-2018 linked to the 2019 National Death Index. We identified adults with self-reported history of cancer, excluding non-melanoma skin cancer. Weight change was determined as the difference between current weight and self-reported weight 1 year prior to interview. We categorized weight change into: UWL (unintentionally losing &gt; 5% of weight), intention weight loss (IWL) (intentional loss &gt; 5% weight), no weight change (NWC) (≤5% weight change), weight gain (WG) ( &gt; 5% weight gain). We estimated risk of all-cause mortality using gender-stratified multivariable Cox regression, adjusting for demographics (age, race, income, education, insurance status), sociobehavioral factors (smoking, alcohol, nutrition, physical activity, self-reported health), comorbidities, and albumin. We additionally identified participants with cancer who had whole-body dual x-ray absorptiometry scans (2011-2018) and assessed body composition measurements including total lean mass, lean-to-fat ratio, subcutaneous fat mass, and visceral fat mass by weight change category using multivariable linear regression. Results: Among 3,153 participants (mean age 62 years, 55% women, 82% non-Hispanic White), the top four primary cancers were breast (21%), prostate (14%), melanoma (11%), and cervical (11%). Approximately 9% of men and 11% of women experienced UWL. Adults with UWL were more likely to have lower socioeconomic status, more functional limitations, and higher comorbidity burden. Across a median 7 years (IQR, 3-11y) follow-up, 22% of females and 34% of men died. Both men and women experiencing UWL had more than 2 times the risk of all-cause mortality compared to NWC (adjusted HR [95% CI]; men: 2.02 [1.47, 2.78]), women: 2.43 [1.78, 3.34]). Participants with UWL had less subcutaneous fat mass (-113g, 95% CI [-242, 16]) and visceral fat mass (-65g, 95% CI [-146, 16]) compared to NWC, though not statistically significance. Conclusions: UWL in patients with history of cancer is independently associated with more than 2 times the risk of all-cause mortality in both men and women. UWL was associated with proportional loss of both subcutaneous and visceral fat mass. Further longitudinal studies examining UWL’s impact on body composition changes and downstream outcomes by cancer type and stage are needed.

Comparison of resistance training using barbell half squats and trap bar deadlifts on maximal strength, power performance, and lean mass in recreationally active females: an eight-week randomised trial

BackgroundThe aim of this study was to investigate the effect of high load resistance training using barbell half squats compared with trap bar deadlifts on maximal strength, power performance, and lean mass in recreationally active females.MethodsTwenty-two recreationally active female participants (age: 26.9 ± 7.7 yrs.; height: 166.0 ± 5.1 cm; weight: 68.6 ± 9.9 kg) were randomly assigned to either a barbell half squat group (SG: n = 10) or trap bar deadlift group (DG: n = 12). Training consisted of twice-weekly sessions for eight weeks. Both groups completed one-repetition maximum (1RM) testing for both barbell half squat and trap bar deadlift groups. Countermovement jump (CMJ) and sprint performance were also assessed. Total body (TBLM) and leg lean mass (LLM) were measured with dual-energy x-ray absorptiometry. Between-group differences were analysed using analysis of covariance.ResultsSG tended to improve 1RM half squat (21.0 ± 11.5 kg vs. 13.1 ± 7.5 kg) more than DG (mean difference (MD): 8.0 kg, 95% CI: -0.36 – 16.3 kg). A similar pattern in favour of DG (18.4 ± 11.2 vs. 11.7 ± 8.1 kg) compared to SG was observed (MD: 6.5 kg, 95% CI: -2.5 – 15.6 kg). No between-group differences for sprint, jump or lean body mass changes was observed. For groups combined, the following changes in CMJ (2.0 ± 2.4 cm), 5-m sprint (-0.020 ± 0.039 s), 15-m sprint (-0.055 ± 0.230 s), TBLM (0.84 ± 1.12 kg), and LLM (0.27 ± 0.59 kg) was observed.ConclusionsAn exercise intervention consisting of half squats or trap bar deadlift were associated with improved muscle strength, power, and lean mass. Our findings suggests that in recreationally active females, exercise selection is less of a concern provided that heavy loads are applied, and relevant muscle groups are targeted.

Association between insulin sensitivity and lean mass loss during weight loss.

The study objective was to assess the relationship between insulin sensitivity and changes in total lean mass (LM) and appendicular LM (ALM) during weight loss. Individuals were randomly assigned to either a standard or a moderately reduced carbohydrate diet for 16 weeks. Body composition was assessed using dual-energy x-ray absorptiometry and insulin sensitivity index (SI) using an intravenous glucose tolerance test. Multiple linear regression was used to determine whether baseline SI was predictive of changes in total LM and ALM. Participants (n = 57; baseline BMI 32.1 ± 3.8 kg/m2) lost an average of 6.8 ± 3.2 kg of body weight (p < 0.001), with 1.5 ± 2.6 kg coming from LM (p < 0.05) and 0.5 ± 0.73 kg from ALM (p < 0.05). Multiple regression analysis demonstrated that SI was inversely associated with changes in total LM (kilograms; β = 0.481, p < 0.001), after adjusting for baseline LM, fat mass, acute insulin response to glucose, and weight loss. Similar results were seen when assessing ALM loss (β = 0.359, p < 0.05). Identifying individuals with low insulin sensitivity prior to weight loss interventions may allow for a personalized approach aiming at minimizing LM loss.

Associations of serum vitamin B12 and its biomarkers with musculoskeletal health in middle-aged and older adults.

The effects of vitamin B12 metabolism on musculoskeletal health and the exact mechanism have not been fully determined. Our study aimed to assess the association of vitamin B12 and its biomarkers with musculoskeletal health in middle-aged and older adults. The data from the National Health and Nutrition Examination Survey 2001-2002 were used to investigate the effects of serum vitamin B12 and its biomarkers (homocysteine and methylmalonic acid) on skeletal muscle health. Bone mineral density (BMD), lean mass, gait speed and knee extensor strength were used as indicators for musculoskeletal health. Serum vitamin B12 level was positively correlated with the total and appendicular lean mass (β = 584.83, P = 0.044; β = 291.65, P = 0.043) in older adults over 65 years of age. In the full population, plasma homocysteine was associated with total lean mass, appendicular lean mass, gait speed, and knee extensor strength (all P < 0.05). Among older adults over 65 years of age, homocysteine level was significantly negatively correlated with gait speed and knee extensor strength (β = -12.75, P = 0.019; β = -0.06, P <0.001). Plasma methylmalonic acid was negatively associated with total BMD and femur BMD in the full population (β = -0.01, P = 0.018; β = -0.01, P = 0.004). In older adults, methylmalonic acid significantly affected total BMD, femur BMD and knee extensor strength (β = -0.01, P = 0.048; β = -0.01, P = 0.025; β = -7.53, P = 0.015). Vitamin B12 and its biomarkers are closely related to BMD, body composition, muscle strength and physical function in middle-aged and older adults. Vitamin B12 may be an important indicator of musculoskeletal health in the elderly.

Abstract PO2-08-10: Effect of 6 months of bazedoxifene + conjugated estrogens on body composition and insulin resistance

Abstract Menopause transition is often marked by an acceleration of visceral fat accumulation. Excess visceral fat is associated with insulin resistance and increased risk for breast cancer as well as heart disease and diabetes. We measured change in body composition (via iDXA), fasting insulin and glucose as part of an ongoing, Phase IIB trial (NCT04821141) of 6 months of bazedoxifene (BZA) + conjugated estrogen (CE) vs control with primary endpoints of change in mammographic density and breast tissue Ki-67. Participants are women ages 45-60 with vasomotor symptoms at increased risk for development of breast cancer. Methods: Visceral and total fat, lean, and total mass, were measured with iDXA (GE CoreScan™). Fasting plasma was assayed same day as drawn for total insulin using a chemiluminescence assay and glucose using a hexokinase method. Values generated were used to calculate HOMA IR (as a measure of insulin resistance) using the formula insulin µl/ml x glucose mg/dl/405. HOMA %S was calculated as 1/HOMA IR X100 as a measure of insulin sensitivity. Optimal HOMA IR is considered as ≤1; HOMA IR &amp;gt;1.5 is considered abnormal with &amp;gt;2.0 as evidence of insulin resistance. Optimal HOMA %S is 100%. Results: 24 women (12 BZA+CE, 12 Control) have completed baseline and 6-month body composition and insulin resistance assessments. Women randomized to BZA+CE were more likely to experience reduction in insulin resistance and improved insulin sensitivity despite a small weight gain over the initial 6 months. 7/12 randomized to BZA+CE had ≥15% reduction in HOMA IR vs only 2/12 controls. Three participants had HOMA IR &amp;gt;2 at baseline. Of these, one was randomized to BZA+CE and had a normal HOMA IR value at 6 months. The remaining two women were in the control group and saw no improvement in HOMA IR at 6 months. In addition, one woman randomized to control with normal HOMA-IR at baseline had HOMA IR &amp;gt; 2 at 6 months. Next Steps: The improvements in insulin resistance parameters with BZA+CE are similar to those observed in our rodent studies, supporting this combination as promising for use in breast cancer risk reduction in women with vasomotor symptoms at high-risk for metabolic disease. Citation Format: Carol Fabian, Adrian Zelenchuk, Kandy Powers, Amy Kreutzjans, Krystal Pittman, Bill Hendry, Christy Altman, Erin Giles, Katherine L. Cook, Stephen Hursting, Bruce Kimler. Effect of 6 months of bazedoxifene + conjugated estrogens on body composition and insulin resistance [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 PO2-08-10.

Relationships between Body Composition Measurements and Insulin-Stimulated Plasma Lipoprotein Lipase Activity in Individuals with Varying Degrees of Body Adiposity

Lipoprotein Lipase (LPL) hydrolyzes plasma triglycerides into free fatty acids in the circulation for use and/or storage in tissues (i.e., adipose tissue, skeletal muscle). Impaired LPL activity (LPLa) is associated with unfavorable health outcomes, such as elevated plasma triglyceride concentrations. We sought to determine how plasma LPLa relates to body composition measurements in individuals with varying degrees of adiposity. Eighteen subjects (ages 19 to 45 years) with body mass index (BMI) between 18 and 45 kg/m2 had their body composition measured by dual-energy X-ray absorptiometry (DEXA) and insulin sensitivity estimated from an oral glucose tolerance test by using the Matsuda Index (MI). Subjects ingested a bolus of 5g fat (i.e., whipping cream, 0.2 g fat/kg fat free mass), followed by small boluses of fat over the course of a 3-hour experimental period. This experimental protocol allows for the induction of a postprandial state without perturbation of the plasma triglyceride or insulin concentrations. LPLa was measured in the presence of increased plasma insulin induced by intravenous insulin infusion during the last 30 mins of the 3-hour experimental protocol. Insulin was infused at a rate of 0.5 mU/kg/min for subjects with MI-determined insulin sensitivity &lt; 4 and 1 mU/kg/min for those with MI-determined insulin sensitivity &gt; 4, in order to produce comparable levels of plasma insulin concentrations across subjects. To release endothelial-bound LPL, subjects received an injection of intravenous heparin (75 UI/kg) at the end of the plasma insulin infusion. Plasma samples were collected 10 minutes after the heparin infusion and analyzed for LPL concentration (LPLc) and LPLa using commercially available ELISA kits. Person’s correlation was used to evaluate relationships between several body composition parameters and LPLc as well as LPLa. LPLc was not correlated (P &gt;0.05) with BMI (r = 0.03), total lean body mass (r = -0.20), total body fat (r = -0.02), or android fat (r = - 0.08). However, LPLa was positively correlated (P &lt;0.05) with BMI (r = 0.49) and total lean body mass (r = 0.58), as well as total body fat (r = 0.54, P = 0.02) and android fat (r = 0.58, P = 0.01). In conclusion, increased body fat, including android fat, are associated with increased intravascular LPLa in the presence of insulin. Greater insulin-stimulated intravascular LPLa can enhance the release of triglyceride-associated free fatty acids and their uptake by tissues, resulting in insulin resistance as documented in individuals with increased android fat distribution. American Diabetes Association Grant #7-12-CT-40. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.