Inter-muscular adipose tissue is associated with adipose tissue inflammation and poorer functional performance in central adiposity

Lim, Jun Pei; Chong, Mei Sian; Tay, Laura; Yang, Yu; Leung, Bernard P.; Yeo, Audrey; Yew, Suzanne; Tan, Cher Heng; Lim, Wee Shiong

doi:10.1016/j.archger.2018.11.006

Cited by 34 publications

(45 citation statements)

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“…This hypothesis is strengthened by three observations. First, the accumulation of the IMAT within the muscles happens earlier than losing the muscle volume in the course of the disease and is independently associated with longitudinal lower muscle strengths (26)(27)(28). Second, compared with the SAT, the IMAT index is less affected by weight loss or weight gain in the clinical setting, making it a better imaging-derived marker for body composition in these conditions (28).…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Adipose Depots by Using Chest CT and Associations with All-Cause Mortality in Chronic Obstructive Pulmonary Disease: Longitudinal Analysis from MESArthritis Ancillary Study

et al. 2021

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Excessive adipose depots and sarcopenia are associated with poor prognosis and mortality in several chronic conditions including chronic obstructive pulmonary disease (COPD) (1,2). Obesity is associated with lower mortality in patients with COPD, referred to as the obesity paradox (3). Sarcopenia is the clinical syndrome of diminished muscle mass and strength and has an estimated prevalence of 22% in patients with COPD (2,4). In contradistinction to obesity, sarcopenia is associated with higher risks of mortality in COPD and impaired functional status (4,5).CT is the reference standard for the quantitative study of adipose depots (including the subcutaneous adipose tissue [SAT] and intermuscular adipose tissue [IMAT]).Background: Obesity and sarcopenia are associated with mortality in chronic obstructive pulmonary disease (COPD). Routine chest CT examinations may allow assessment of obesity and sarcopenia by soft-tissue markers for predicting risks of mortality.Purpose: To investigate associations between soft-tissue markers subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and pectoralis muscle (PM) index from chest CT with mortality in participants with COPD. Materials and Methods:In this secondary analysis of a prospectively enrolled cohort from the Multi-Ethnic Study of Atherosclerosis, participants with available chest CT in 2010-2012 were included. CT examinations were analyzed to determine SAT, IMAT (within PM), and PM areas. The spirometry evaluations were used to establish COPD diagnosis. Mortality data were extracted from the National Death Index (April 2010 to December 2017). The correlations of the soft-tissue markers with fat mass index were studied. The associations of these markers and risks of mortality in participants with COPD were assessed by using Cox proportional-hazard models adjusted for confounders.Results: Among 2994 participants who were included (mean age, 69 years  9 [standard deviation]; 1551 women), 265 had COPD (9%; mean age, 72 years  9; 162 men) and 49 participants with COPD (18%) died during follow-up. The SAT, IMAT, and PM areas had moderate-to-excellent reliabilities (intraclass correlation coefficient, 0.88-0.99). In the 2994 participants, the SAT ( = 0.80; 95% CI: 0.78, 0.81; P  .001) and IMAT indexes ( = 0.37; 95% CI: 0.34, 0.41; P  .001) were correlated with fat mass index. Those with COPD and higher SAT index had lower risks of mortality (hazard ratio, 0.2; 95% CI: 0.1, 0.4; P  .001, per doubling), whereas a higher IMAT index was associated with a higher risk of mortality (hazard ratio, 1.4; 95% CI: 1.0, 1.9; P = .04, per doubling). Conclusion:Soft-tissue markers were reliably obtained by using chest CT performed for lung assessment. In participants with chronic obstructive pulmonary disease, a high intermuscular adipose tissue index was associated with a higher risk of mortality than was a high subcutaneous adipose tissue index.

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Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Adipose Depots by Using Chest CT and Associations with All-Cause Mortality in Chronic Obstructive Pulmonary Disease: Longitudinal Analysis from MESArthritis Ancillary Study

et al. 2021

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“…Both sarcopenia and osteoporosis contribute to frailty through common pathways, including chronic inflammation, which exacerbates muscle [ 27 ] and bone loss [ 28 ]. Mechanisms include the accumulation and altered distribution of body fat into intra- and intermuscular adipose tissue [ 29 ], altering lipid metabolism and promoting the accumulation of macrophages and other immune cells, and increasing the secretion of proinflammatory cytokines [ 30 ]. Together, these contribute to a state of chronic, low-grade inflammation favoring the development and progression of sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis

et al. 2020

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Osteosarcopenia is associated with increased risk of adverse outcomes such as falls and fractures. Its association with frailty is less well-described, particularly in independent community-dwelling older adults. Although nutrition plays a crucial role in maintaining bone and muscle health, the complex relationship between osteosarcopenia and nutrition in the pathogenesis of frailty remains to be elucidated. In this cross-sectional analysis of 230 independent, community-dwelling individuals (mean age 67.2 ± 7.4 years), we examined the associations between osteosarcopenia with nutritional status and frailty, and the mediating role of nutrition in the association between osteosarcopenia and frailty. Osteosarcopenia was defined as fulfilling both the Asian Working Group for Sarcopenia 2019 consensus definition (low relative appendicular skeletal muscle mass adjusted for height, in the presence of either of either low handgrip strength or slow gait speed) and T-score ≤ −2.5 SD on bone mineral densitometry. We assessed frailty using the modified Fried criteria and nutrition using the Mini-Nutritional Assessment. We performed multiple linear regression, followed by pathway analysis to ascertain whether nutrition mediates the relationship between osteosarcopenia and frailty. Our study population comprised: 27 (11.7%) osteosarcopenic, 35 (15.2%) sarcopenic, 36 (15.7%) osteoporotic and 132 (57.4%) normal (neither osteosarcopenic, sarcopenic nor osteoporotic). Osteosarcopenia (β = 1.1, 95% CI 0.86–1.4) and sarcopenia (β = 1.1, 95% CI 0.90–1.4) were significantly associated with frailty, but not osteoporosis. Nutrition mediated the association between osteosarcopenia and frailty (indirect effect estimate 0.09, bootstrap 95% CI 0.01–0.22). In conclusion, osteosarcopenia is associated with frailty and poorer nutritional status, with nutrition mediating the association between osteosarcopenia and frailty. Our findings support early nutritional assessment and intervention in osteosarcopenia to mitigate the risk of frailty.

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“…Each one-standard deviation increase in IMAT (~6.8% greater IMAT) is associated with a 40% greater mortality risk over a 10-year period 7 . IMAT volume is higher in individuals with obesity and type 2 diabetes 8,9 and is associated with high levels of inflammation, insulin resistance, obesity, sarcopenia, and lower physical performance in adults and the elderly population 10,11 . Recently, Bergia et al showed that greater IMAT in the thigh is a better predictor of cardiometabolic risk than greater IMAT in the calf in adults who are overweight and obese 11 .…”

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confidence: 99%

Neck circumference is associated with adipose tissue content in thigh skeletal muscle in overweight and obese premenopausal women

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Silva

Ruiz

et al. 2020

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Neck circumference (NC) has been proposed as a simple and practical tool, independently associated with cardiometabolic risk factors. However, the association of NC with inter-muscular adipose tissue (IMAT) is still to be determined. We aimed to examine the association of NC with thigh IMAT, and visceral adipose tissue (VAT) measured with computed tomography (CT) in overweight/obese women. 142 premenopausal overweight and obese Caucasian women participated in this crosssectional study. NC was measured with an inextensible metallic tape above the thyroid cartilage according to International Society for Advancement of Kinanthropometry protocol. Thigh IMAT and VAT volumes were measured with a single cross-sectional CT. Regarding the covariates, fat mass (FM) was assessed with dual-energy x-ray absorptiometry and physical activity was objectively measured with accelerometry. NC was positively associated with thigh IMAT and VAT volumes (standardized β coefficient: β = 0.45, P-value = ≤0.001, β = 0.60, P = ≤ 0.001; respectively), which persisted after adjusting for age, height, overall FM or moderate-to-vigorous physical activity. Our findings show that NC is associated with thigh IMAT volume in overweight and obese premenopausal Caucasian women, regardless of the amount of lower-body fatness. These results suggest underscoring the relevance of NC as a marker of adipose tissue content in thigh skeletal muscle.

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Inter-muscular adipose tissue is associated with adipose tissue inflammation and poorer functional performance in central adiposity

Cited by 34 publications

References 34 publications

Quantitative Analysis of Adipose Depots by Using Chest CT and Associations with All-Cause Mortality in Chronic Obstructive Pulmonary Disease: Longitudinal Analysis from MESArthritis Ancillary Study

Quantitative Analysis of Adipose Depots by Using Chest CT and Associations with All-Cause Mortality in Chronic Obstructive Pulmonary Disease: Longitudinal Analysis from MESArthritis Ancillary Study

Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis

Neck circumference is associated with adipose tissue content in thigh skeletal muscle in overweight and obese premenopausal women

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