scholarly journals Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population

2020 ◽  
Vol 9 (5) ◽  
pp. 1580
Author(s):  
Mateu Serra-Prat ◽  
Isabel Lorenzo ◽  
Mònica Papiol ◽  
Elisabet Palomera ◽  
Maria Bartolomé ◽  
...  

Background: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people. Objectives: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality. Methodology: Design: cross-sectional study. Population: persons aged 65–75 years with a body mass index of 30–39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria. Results: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty. Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM). With this last definition, sarcopenia was related to frailty, gait speed and the TUG test. Conclusions: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 755 ◽  
Author(s):  
Carina O. Walowski ◽  
Wiebke Braun ◽  
Michael J. Maisch ◽  
Björn Jensen ◽  
Sven Peine ◽  
...  

Assessment of a low skeletal muscle mass (SM) is important for diagnosis of ageing and disease-associated sarcopenia and is hindered by heterogeneous methods and terminologies that lead to differences in diagnostic criteria among studies and even among consensus definitions. The aim of this review was to analyze and summarize previously published cut-offs for SM applied in clinical and research settings and to facilitate comparison of results between studies. Multiple published reference values for discrepant parameters of SM were identified from 64 studies and the underlying methodological assumptions and limitations are compared including different concepts for normalization of SM for body size and fat mass (FM). Single computed tomography or magnetic resonance imaging images and appendicular lean soft tissue by dual X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) are taken as a valid substitute of total SM because they show a high correlation with results from whole body imaging in cross-sectional and longitudinal analyses. However, the random error of these methods limits the applicability of these substitutes in the assessment of individual cases and together with the systematic error limits the accurate detection of changes in SM. Adverse effects of obesity on muscle quality and function may lead to an underestimation of sarcopenia in obesity and may justify normalization of SM for FM. In conclusion, results for SM can only be compared with reference values using the same method, BIA- or DXA-device and an appropriate reference population. Limitations of proxies for total SM as well as normalization of SM for FM are important content-related issues that need to be considered in longitudinal studies, populations with obesity or older subjects.


2020 ◽  
Author(s):  
Hiroki Oba ◽  
Yasumoto Matsui ◽  
Hidenori Arai ◽  
Tsuyoshi Watanabe ◽  
Hiroki Iida ◽  
...  

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength, and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We compared computed tomography (CT) with various motor function tests to determine the validity of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups: normal, low muscle mass (low mass), poor muscle function/strength (poor function), and sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. CSA was significantly reduced both in men and women with low mass and sarcopenia group (p < 0.01), whereas CTV was significantly lower in men with sarcopenia group and in women with poor function and sarcopenia group (p < 0.01).ConclusionsCSA mostly reflects muscle strength, whereas CTV mostly reflects physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. Thus, CT is thought to be useful for the assessment of motor function and diagnosis of sarcopenia.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250439
Author(s):  
Anne N. Hiol ◽  
Pamela R. von Hurst ◽  
Cathryn A. Conlon ◽  
Owen Mugridge ◽  
Kathryn L. Beck

Background Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. Methods Adults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). Results Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength. Conclusions Body fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.


2021 ◽  
Author(s):  
Hiroki Oba ◽  
Yasumoto Matsui ◽  
Hidenori Arai ◽  
Tsuyoshi Watanabe ◽  
Hiroki Iida ◽  
...  

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We investigated the correlation between computed tomography (CT) and various motor function tests to assess the utility of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01); furthermore, the CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01).ConclusionsCSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.


2017 ◽  
Vol 7 (3) ◽  
pp. 454-462 ◽  
Author(s):  
Akito Tsugawa ◽  
Yusuke Ogawa ◽  
Naoto Takenoshita ◽  
Yoshitsugu Kaneko ◽  
Hirokuni Hatanaka ◽  
...  

Background/Aims: Diabetes-related dementia (DrD), a dementia subgroup associated with specific diabetes mellitus (DM)-related metabolic abnormalities, is clinically and pathophysiologically different from Alzheimer disease (AD) and vascular dementia. We determined whether skeletal muscle strength, quality, and mass decrease in individuals with DrD. Methods: We evaluated grip and knee extension strength, muscle mass, and gait speed in 106 patients with probable AD and without type 2 DM (AD[–DM] group), 74 patients with probable AD and with DM (AD[+DM] group), and 36 patients with DrD (DrD group). Muscle quality was defined as the ratio of muscle strength to muscle mass. Results: Both female and male subjects with DrD showed significantly decreased muscle strength and quality in the upper extremities compared with the subjects with AD[–DM] or AD[+DM]. Female subjects with DrD showed significantly decreased muscle quality in the lower extremities compared with the subjects with AD[–DM]. Both female and male subjects with DrD had a significantly lower gait speed compared with the subjects with AD[–DM]. However, there were no significant differences in muscle mass and the prevalence of sarcopenia between the groups. Conclusion: Subjects with DrD showed decreased muscle strength and quality, but not muscle mass, and had a low gait speed.


2020 ◽  
Author(s):  
Kenneth M Madden ◽  
Boris Feldman ◽  
Shane Arishenkoff ◽  
Graydon S Meneilly

Abstract Background/Objectives Sarcopenia is defined as the gradual age-associated loss of both muscle quantity and strength in older adults, and is associated with increased mortality, falls, fractures and hospitalisations. Current sarcopenia criteria use dual-energy X-ray absorptiometry (DXA) measures of muscle mass, a test that cannot be performed at the bedside, unlike point-of-care ultrasound (PoCUS). We examined the association between ultrasonic measures of muscle thickness (MT, vastus medialis muscle thickness) and measures of muscle quantity and strength in older adults. Methods A total of 150 older adults (age ≥ 65; mean age 80.0 ± 0.5 years, 66 women, 84 men) were recruited sequentially from geriatric medicine clinics. Each subject had lean body mass (LBM, by bioimpedance assay), grip strength, mid-arm biceps circumference (MABC), gait speed and MT measured. All initial models were adjusted for biological sex. Results In our final parsimonious models, MT showed a strong significant correlation with all measures of muscle mass, including LBM (Standardised β = 0.204 ± 0.058, R2 = 0.577, P &lt; 0.001) and MABC (Standardised β = 0.141 ± 0.067, R2 = 0.417, P = 0.038). With respect to measures of muscle quality, there was a strong significant correlation with grip strength (Standardised β = 0.118 ± 0.115, R2 = 0.511, P &lt; 0.001) but not with subject performance (gait speed). Conclusions MT showed strong correlations with both measures of muscle mass (LBM and MABC) and with muscle strength (grip strength). Although more work needs to be done, PoCUS shows potential as a screening tool for sarcopenia in older adults.


Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 661 ◽  
Author(s):  
Mateu Serra-Prat ◽  
Isabel Lorenzo ◽  
Elisabet Palomera ◽  
Juan Yébenes ◽  
Lluís Campins ◽  
...  

High intracellular water (ICW) content has been associated with better functional performance and a lower frailty risk in elderly people. However, it is not clear if the protective effect of high ICW is due to greater muscle mass or better muscle quality and cell hydration. We aimed to assess the relationship between ICW content in lean mass (LM) and muscle strength, functional performance, frailty, and other clinical characteristics in elderly people. In an observational cross-sectional study of community-dwelling subjects aged ≥75 years, ICW and LM were estimated by bioelectrical impedance, and the ICW/LM ratio (mL/kg) calculated. Muscle strength was measured as hand grip, frailty status was assessed according to Fried criteria, and functional status was assessed by Barthel score. For 324 recruited subjects (mean age 80 years), mean (SD) ICW/LM ratio was 408 (29.3) mL/kg. The ICW/LM ratio was negatively correlated with age (rs = −0.249; p < 0.001). A higher ICW/LM ratio was associated with greater muscle strength, better functional capacity, and a lower frailty risk, even when adjusted by age, sex, nº of co-morbidities, and LM. ICW content in LM (including the muscle) may influence muscle strength, functional capacity and frailty. However, further studies are needed to confirm this hypothesis.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hiroshi Irisawa ◽  
Takashi Mizushima

Introduction: After stroke, paralysis reduces muscle strength on the affected side. The lost muscle strength can be partially restored through stroke rehabilitation. However, even if muscle strength is restored, it is not clear whether muscle mass and quality improve. In recent years, it has become possible to measure muscle mass noninvasively using bioelectrical impedance analysis. Additionally, it is known that the phase angle measured by bioelectrical impedance analysis reflects muscle quality. We measured changes in muscle strength, mass, and quality using a hand dynamometer and bioelectrical impedance analysis in patients undergoing rehabilitation after stroke and examined their relationships with activities of daily living (ADLs) improvement. Hypothesis: Post-stroke rehabilitation improves muscle strength, mass, and quality, as well as ADLs. Methods: This retrospective study was performed at two stroke rehabilitation units from January 2017 to March 2019. Muscle mass and quality were assessed using bioelectrical impedance analysis. ADLs were assessed using the functional independence measure (FIM). We measured the grip strength of the non-affected and affected sides as muscle strength. Each measurement was performed at admission and 4 weeks later. We assessed changes in motor FIM items and examined relationships among data. Results and Conclusions: This study included 179 patients (mean age, 75.5±13.0 years; male/female, 89/90; mean duration after stroke, 27.6±8.7 days). Patients received stroke rehabilitation (159.8±21.6 min/day) 7 days a week individually. Muscle strength and quality significantly increased after 4 weeks on both the non-affected and affected sides. Muscle mass decreased, but there was no significant difference. The results were similar when analyzed by sex. Changes in muscle strength and quality were significantly correlated with ADLs improvement (r=0.56 and 0.43, respectively), but muscle mass was not correlated with ADLs improvement. Thus, post-stroke rehabilitation improves muscle strength and quality, as well as ADLs. Muscle mass is not appropriate to measure the effects of stroke rehabilitation, and it is desirable to instead use muscle strength and quality to assess stroke rehabilitation.


2019 ◽  
Vol 8 (2) ◽  
pp. 145 ◽  
Author(s):  
Jakub Mesinovic ◽  
Lachlan McMillan ◽  
Catherine Shore-Lorenti ◽  
Barbora De Courten ◽  
Peter Ebeling ◽  
...  

Ageing, obesity and the metabolic syndrome (MetS) may all contribute to poor muscle health (sarcopenia). This study aimed to determine the cross-sectional associations between MetS (International Diabetes Federation classification) and sarcopenia (revised European Working Group on Sarcopenia in Older People definition) in 84 overweight and obese older adults. Components of sarcopenia included muscle strength (hand grip and leg extension), physical performance (stair climb test and short physical performance battery (SPPB), including gait speed and repeated chair stands time), muscle mass (appendicular lean mass (ALM), dual-energy X-ray absorptiometry), muscle size (peripheral quantitative computed tomography-determined calf and forearm cross-sectional area (CSA)) and muscle quality (muscle density and strength normalised to lean mass). Waist circumference was associated with greater muscle size, but poorer leg extension strength, chair stands and stair climb time, gait speed, SPPB scores and muscle quality measures (all p < 0.05). MetS was positively associated with ALM and forearm muscle CSA, and negatively associated with muscle quality measures and chair stands time (all p < 0.05). MetS is associated with larger muscle size, yet poorer muscle quality in overweight and obese older adults. Assessments of muscle function and quality should be considered for obese older adults and those with MetS.


2021 ◽  
pp. 1-10
Author(s):  
Ryo Miyachi ◽  
Nana Koike ◽  
Suzu Kodama ◽  
Junya Miyazaki

BACKGROUND: Although trunk muscles are involved in many important functions, evaluating trunk muscle strength is not an easy task. If trunk muscle mass and thickness could be used as indicators of trunk muscle strength, the burden of measurement would be reduced, but the relationship between trunk muscle strength and trunk muscle mass and thickness has not been clarified. OBJECTIVE: The purpose of this study was to clarify the relationship between trunk muscle strength and trunk muscle mass by bioelectrical impedance analysis and trunk muscle thickness by ultrasound imaging in healthy adults. METHODS: One hundred and twenty-one healthy university students were included in this study. Trunk flexion/extension muscle strength and trunk muscle mass by bioelectrical impedance analysis, and trunk muscle thickness by ultrasound imaging were measured. RESULTS: Both trunk flexion strength and trunk extension strength were significantly correlated with trunk muscle mass and oblique and rectus abdominis muscle thickness. Multiple regression analysis showed that trunk extension muscle strength had an independent relationship with trunk muscle mass. CONCLUSIONS: This study demonstrated that trunk muscle mass or trunk muscle thickness can be used as an alternative means for evaluating trunk muscle strength, making the evaluation of trunk muscles less burdensome.


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