The Extracellular to Intracellular Water Ratio in Upper Legs is Negatively Associated With Skeletal Muscle Strength and Gait Speed in Older People

Yamada, Yosuke; Yoshida, Tsukasa; Yokoyama, Keiichi; Watanabe, Yuya; Miyake, M.; Yamagata, Emi; Yamada, Minoru; Kimura, Misaka; Study, Kyoto-Kameoka

doi:10.1093/gerona/glw125

Cited by 68 publications

(97 citation statements)

References 48 publications

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“…that included men and women with mean group ages in the seventh or eighth decades. Skeletal muscle mass or size was estimated in these studies using ultrasound or BIA prediction formulas . Phase angle was not specifically measured in these studies, rather quality indices calculated at different frequencies or predicted values for extracellular and intracellular water were derived from bioimpedance spectroscopy measurements .…”

Section: Discussionmentioning

confidence: 99%

“…Peak torque through extension was measured in Newton‐metres and taken as the maximum torque achieved during the three sets. We refer to this measurement as leg strength, although it has also been termed knee extension strength . The CV for leg strength measurements was 6.1%.…”

Section: Methodsmentioning

confidence: 99%

“…This loss of function is often attributed to changes in muscle ‘quality’ independent of ‘mass’ . Muscle quality is affected by changes in skeletal muscle composition with ageing including alterations in muscle fibre type, expansion of the extracellular space with relative reductions in myofiber diameter, and loss of mitochondrial mass and function …”

Section: Introductionmentioning

confidence: 99%

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Improved strength prediction combining clinically available measures of skeletal muscle mass and quality

Bourgeois

Fan

Johannsen

et al. 2018

J cachexia sarcopenia muscle

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Background Measures of skeletal muscle function decline at a faster rate with ageing than do indices of skeletal muscle mass. These observations have been attributed to age‐related changes in muscle quality, another functional determinant separate from skeletal muscle mass. This study tested the hypothesis that improved predictions of skeletal muscle strength can be accomplished by combining clinically available measures of skeletal muscle mass and quality. Methods The participants included 146 healthy adult (age ≥ 18 years, range 18–77 years; X ± SD 47 ± 17 years and body mass index 16.5–51.8 kg/m 2 ; 27.7 ± 6.2 kg/m 2 ) men ( n = 60) and women ( n = 86) in whom skeletal muscle mass was estimated as appendicular lean soft tissue (LST) measured by dual‐energy X‐ray absorptiometry and skeletal muscle quality as bioimpedance analysis‐derived phase angle and B‐mode‐evaluated echogenicity of mid‐thigh skeletal muscle. Strength of the right leg and both arms was quantified as knee isokinetic extension and handgrip strength using dynamometers. The statistical significance of adding phase angle or echogenicity to strength prediction multiple regression models that included extremity‐specific LST and other covariates (e.g. age and sex) was evaluated to test the study hypothesis. Results Right leg LST mass alone was significantly ( P < 0.0001) correlated with isokinetic right leg strength ( R 2 = 0.57). The addition of segmental phase angle measured in the right leg at 50 kHz increased the R 2 of this model to 0.66 ( P < 0.0001); other phase angle frequencies (5 and 250 kHz) did not contribute significantly to these models. Results were similar for both right and left arm handgrip strength prediction models. Adding age and sex as model covariates increased the R 2 values of these models further (e.g. right leg strength model R 2 increased to 0.71), but phase angle continued to remain a significant (all P < 0.01) predictor of extremity strength. Similarly, when predicting isokinetic right leg strength, mid‐thigh skeletal muscle echogenicity added significantly ( P < 0.0001) to right leg LST, increasing R 2 from 0.57 to 0.64; age was a significant ( P < 0.0001) covariate in this model, increasing R 2 further to 0.68. Conclusions The hypothesis of the current study was confirmed, strongly supporting and extending earlier reports by quantifying the combined independent effects of skeletal muscle mass and quality on lo...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improved strength prediction combining clinically available measures of skeletal muscle mass and quality

Bourgeois

Fan

Johannsen

et al. 2018

J cachexia sarcopenia muscle

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“…Resistance of intracellular water (R ICW ) and extracellular to intracellular water ratio (ECW/ICW) were calculated using the following equations (Yamada et al, 2017): Resistance of intracellular water (R ICW ) and extracellular to intracellular water ratio (ECW/ICW) were calculated using the following equations (Yamada et al, 2017):…”

Section: Measurement Of Bioelectrical Impedancementioning

confidence: 99%

Acute effect of wearing compression stockings on lower leg swelling and muscle stiffness in healthy young women

Sugahara

Doi

Nakayama

et al. 2018

Clin Physio Funct Imaging

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Compression stockings are known to be effective in reducing peripheral oedema or leg swelling by increasing tissue pressure and venous blood flow. While previous studies on compression stockings have focused on its prolonged, preventive effect on leg swelling, the aim of this study was to investigate an acute effect of wearing compression stockings on lower leg swelling and muscle stiffness. Twenty healthy women aged 18-23 years participated in the experiment conducted in the evening, in which they wore below-knee graduated compression stockings and rested in a seated position for 30 min. Before and after the application of stockings, maximum calf circumference, volume, extracellular water resistance (R ) and muscle stiffness of the right lower leg were determined by tape measure, water displacement volumetry, segmental bioelectrical impedance spectroscopy and ultrasound shear-wave elastography, respectively. The maximum calf circumference and the reciprocal of R (an index of extracellular fluid volume) significantly decreased after the application of stockings, whereas the total lower leg volume and the stiffness (shear modulus) of the medial gastrocnemius muscle tended to decrease. These changes, except for that in the medial gastrocnemius muscle stiffness, were opposite to those from morning to evening studied in the subgroup of participants (n = 8). However, partial correlation analysis failed to detect significant associations among these changes. These results suggest that even for a short period of application, compression stockings have some positive effects against lower leg swelling.

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“…One of the most wellknown equations for estimating muscle mass by BIA was developed by Janssen et al using MRI as follows: SMM (kg) = ((Ht 2 /R50 × 0.401) + (sex × 3.825) + (age × −0.071)) + 5.102 [30], and many BIA equations are age-dependent. Yamada et al indicated that expansion of ECW relative to ICW or total body water (TBW) is observed with aging, and may mask actual age-related decrease of muscle cell mass [32,34,[39][40][41]. The Z at low-frequency (≤50 kHz, for example, Z5 or Z50) currents mainly reflects ECW.…”

Section: Multi-frequency Bioelectrical Impedance Analysismentioning

confidence: 99%

Developing and Validating an Age-Independent Equation Using Multi-Frequency Bioelectrical Impedance Analysis for Estimation of Appendicular Skeletal Muscle Mass and Establishing a Cutoff for Sarcopenia

Yamada¹,

Nishizawa²,

Uchiyama³

et al. 2017

Preprint

Self Cite

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Abstract:Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated using dualenergy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable; thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were as follows: (1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) based on theoretical models, and (2) to establish sarcopenia cutoff values using the equation for the Japanese population. Methods: We measured height (Ht), weight, and ALM obtained using DXA and a standing-posture 8-electrode MF-BIA (5, 50, 250 kHz) in 756 Japanese individuals aged 18 to 86-years-old (222 men and 301 women as developing equation group and 97 men and 136 women as a cross validation group). The traditional impedance index (Ht 2 /Z50) and impedance ratio of high and low frequency (Z250/Z5) of hand to foot values were calculated. Multiple regression analyses were conducted with ALM as dependent variable in men and women separately. Results: We created the following equations: ALM = (0.6947 × (Ht 2 /Z50)) + (−55.24 × (Z250/Z5)) + (−10,940 × (1/Z50)) + 51.33 for men, and ALM = (0.6144 × (Ht 2 /Z50)) + (−36.61 × (Z250/Z5)) + (−9332 × (1/Z50)) + 37.91 for women. Additionally, we conducted measurements in 1624 men and 1368 women aged 18 to 40 years to establish sarcopenia cutoff values in the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht 2 ) in these participants were 6.8 and 5.7 kg/m 2 in men and women, respectively. Conclusion: The current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

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The Extracellular to Intracellular Water Ratio in Upper Legs is Negatively Associated With Skeletal Muscle Strength and Gait Speed in Older People

Cited by 68 publications

References 48 publications

Improved strength prediction combining clinically available measures of skeletal muscle mass and quality

Improved strength prediction combining clinically available measures of skeletal muscle mass and quality

Acute effect of wearing compression stockings on lower leg swelling and muscle stiffness in healthy young women

Developing and Validating an Age-Independent Equation Using Multi-Frequency Bioelectrical Impedance Analysis for Estimation of Appendicular Skeletal Muscle Mass and Establishing a Cutoff for Sarcopenia

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