Association of Abdominal Muscle Area and Density with Glucose Regulation: The Multi‐Ethnic Study of Atherosclerosis (MESA)

Introduction: Quality and quantity of skeletal muscle decrease with age, largely due to adipose tissue infiltration, and are important determinants of metabolic health. To inform efforts to slow aging-related decline in muscle mass and prevent myosteatosis, a better understanding of the biological determinants of muscle atrophy and quality is needed. We used targeted lipidomics to identify, with a greater specificity, lipoproteins associated with muscle and intermuscular adipose tissue (IMAT) area (quantity) and density (quality) of the total abdominal, locomotion, and stabilization muscles in the Multi-Ethnic Study of Atherosclerosis. Hypothesis: Lower density lipoproteins will be positively associated with muscle and IMAT quantity, but negatively associated with quality. Methods: At visit one, 105 serum lipoproteins were measured by Bruker lipoprotein subclass analysis with 1 H-Nuclear Magnetic Resonance spectroscopy. Muscle and IMAT area (cm 2 ) and density (Hounsfield units) were estimated 2.6 years, on average, after visit 1 for the total abdominal, locomotion (psoas), and stabilization (paraspinal, oblique, and rectus abdominis) muscles from computed-tomography scans at the L4/L5 spinal junction. We identified lipoproteins associated with body composition using linear regression adjusting for age, gender, race, diet, physical activity, lipid-lowering medication, and multiple comparisons using a 1% false discovery rate. Results: Participants (N=947) were 44-84 years old (mean: 63), 51% men, 40% White, 16% Black, 16% Chinese American, and 27% Hispanic American. Among 105 lipoproteins, 24 were associated with total muscle area, whereas none were associated with muscle density. When examining specific muscle groups, 25 lipoproteins were associated with stabilization muscle area, driven by the oblique muscles. As for total IMAT area, there were 27 associations with lipoproteins. Specifically, 27 lipoproteins were associated with stabilization muscle IMAT area, driven by oblique and rectus abdominis muscles. Last, 39 lipoproteins were associated with total IMAT density, with 28 and 33 associated with locomotion and stabilization (driven by obliques) IMAT density, respectively. Higher VLDL: cholesterols, free cholesterols, phospholipids, and triglycerides and lower HDL: cholesterols and free cholesterols were associated with higher muscle area and IMAT area, but lower IMAT density (

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Abstract MP047: Abdominal Skeletal Muscle Density is Significantly Associated With Selected Measures of Adiposity Associated Inflammation: the Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.135.suppl_1.mp047 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Rachel Van Hollebeke ◽

Mary Cushman ◽

Matthew A Allison

Keyword(s):

Skeletal Muscle ◽

Interleukin 6 ◽

Subcutaneous Fat ◽

Psoas Muscle ◽

Abdominal Muscle ◽

Muscle Area ◽

Muscle Density ◽

Ethnic Study ◽

The Mean ◽

Muscle Groups

Background: Excess adiposity is associated with higher levels of certain inflammatory markers that have been linked to cardiometabolic disease. Lean skeletal muscle is the largest regulator of glucose metabolism but few population-based studies have examined the associations between muscle and inflammation. Therefore, we studied the relationships between abdominal muscle mass [area] and density with selected measures of adiposity-associated inflammation. Methods: Nearly 2,000 subjects enrolled in the Multi-Ethnic Study of Atherosclerosis underwent computed tomography (CT) of the abdomen and had venous fasting blood drawn concomitantly. The CT scans were interrogated for visceral and subcutaneous fat, as well as lean muscle areas and densities in the rectus abdominus, obliques, paraspinus and psoas muscle groups. We then categorized the muscle in locomotion (psoas) and stabilization groups (rectus, obliques and paraspinus). The blood samples were assayed for interleukin-6, resistin, C-reactive protein, and tumor necrosis factor - alpha. Multivariable linear regression was used to determine the independent associations between muscle area and density with each of the aforementioned adipokines. Results: The mean age was 64.7 years and 49% were female. Forty percent were non-Hispanic White, 26% were Hispanic/ Latino American, 21% were African American, 13% were Chinese American. The mean BMI was 28.0 kg/m 2 and 30% were obese (BMI > 30 kg/m 2 ). With adjustment for age, gender, race, dyslipidemia, diabetes, hypertension, eGFR, coronary artery calcium, physical activity, sedentary behavior, selected adipokines and both subcutaneous and visceral fat, a 1-SD increment in the mean densities for total abdominal muscle, total stabilization muscle and total locomotive muscle were each significantly associated with lower levels of interleukin-6 (-15%, -15% and -9%, p < 0.01 for all) and resistin (-0.11, -0.11 and -0.07 ng/mL, p < 0.02 for all), but not CRP or TNF-alpha. These associations remained significant after additional adjustment for muscle area in the corresponding muscle group. Conversely, the areas of the muscle variables were not independently associated with any of the adipokines, especially after adjustment for muscle density. There were no significant interactions between ethnicity and both muscle area and density for any of the adipokines. Conclusions: Higher densities of several muscle groups in the abdomen are significantly associated with lower interleukin-6 and resistin levels, independent of the muscle area in these groups. Techniques that either enhance or maintain muscle density levels may reduce the risk of cardiometabolic diseases linked to adverse levels of inflammation.

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Associations of abdominal muscle area and density with coronary artery calcium volume and density: The multi-ethnic study of atherosclerosis

Metabolism ◽

10.1016/j.metabol.2020.154230 ◽

2020 ◽

Vol 107 ◽

pp. 154230

Author(s):

Margaret A. Crawford ◽

Michael H. Criqui ◽

Nketi Forbang ◽

Jonathan T. Unkart ◽

Matthew A. Allison ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Calcium ◽

Abdominal Muscle ◽

Muscle Area ◽

Ethnic Study

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Associations of Sedentary Behavior and Abdominal Muscle Density: The Multi-Ethnic Study of Atherosclerosis

Journal of Physical Activity and Health ◽

10.1123/jpah.2018-0028 ◽

2018 ◽

Vol 15 (11) ◽

pp. 827-833 ◽

Cited By ~ 2

Author(s):

Chantal A. Vella ◽

Erin D. Michos ◽

Dorothy D. Sears ◽

Mary Cushman ◽

Rachel B. Van Hollebeke ◽

...

Keyword(s):

Physical Activity ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Abdominal Muscle ◽

Muscle Quality ◽

Sedentary Behaviors ◽

Muscle Area ◽

Metabolic Equivalent ◽

Muscle Density ◽

Ethnic Study

Background: Sedentary behaviors (SB) may exacerbate loss of muscle mass and function, independent of physical activity levels. This study examined the associations of SB with abdominal muscle area and density, a marker of muscle quality, in adults. Methods: A total of 1895 participants from the Multi-Ethnic Study of Atherosclerosis completed detailed health history, physical activity and SB questionnaires, computed tomography to quantify body composition, and measurements of inflammatory markers. Analyses included linear and nonlinear regression. Results: The mean age and body mass index were 64.6 years and 28 kg·m−2, respectively, and 50% were women. On average, participants engaged in 28 metabolic equivalent hours·week−1 of SB. With adjustment for age, sex, race/ethnicity, physical activity, cardiovascular disease risk factors, and inflammation, multivariable regression modeling revealed a nonlinear (quadratic) relationship between SB and locomotor, stability, and total abdominal muscle density (P < .01) but not muscle area. The SB inflection point at which locomotor, stability, and total abdominal muscle density began to decrease was 38.2, 39.6, and 39.2 metabolic equivalent hours·week−1 of SB, respectively. Conclusions: SB is associated with reduced muscle density when practiced as little as 5.5 metabolic equivalent hours·day−1. These findings may have important implications for SB guidelines for targeting skeletal muscle health in older adults.

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Skeletal muscle area and density are associated with lipid and lipoprotein cholesterol levels: The Multi-Ethnic Study of Atherosclerosis

Journal of Clinical Lipidology ◽

10.1016/j.jacl.2020.01.002 ◽

2020 ◽

Vol 14 (1) ◽

pp. 143-153 ◽

Cited By ~ 2

Author(s):

Chantal A. Vella ◽

Megan C. Nelson ◽

Jonathan T. Unkart ◽

Iva Miljkovic ◽

Matthew A. Allison

Keyword(s):

Skeletal Muscle ◽

Lipoprotein Cholesterol ◽

Muscle Area ◽

Ethnic Study ◽

Cholesterol Levels ◽

Skeletal Muscle Area

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Muscle area and density and risk of all-cause mortality: The Multi-Ethnic Study of Atherosclerosis

Metabolism ◽

10.1016/j.metabol.2020.154321 ◽

2020 ◽

Vol 111 ◽

pp. 154321

Author(s):

Britta Larsen ◽

John Bellettiere ◽

Matthew Allison ◽

Robyn L. McClelland ◽

Iva Miljkovic ◽

...

Keyword(s):

Muscle Area ◽

Ethnic Study ◽

All Cause Mortality

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Null association between abdominal muscle and calcified atherosclerosis in community-living persons without clinical cardiovascular disease: The multi-ethnic study of atherosclerosis

Metabolism ◽

10.1016/j.metabol.2013.06.001 ◽

2013 ◽

Vol 62 (11) ◽

pp. 1562-1569 ◽

Cited By ~ 7

Author(s):

Nicole E. Jensky ◽

Matthew A. Allison ◽

Rohit Loomba ◽

Mercedes R. Carnethon ◽

Ian H. de Boer ◽

...

Keyword(s):

Cardiovascular Disease ◽

Abdominal Muscle ◽

Community Living ◽

Ethnic Study

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Association Between Muscle Quality Measured by Abdominal Computed Tomography and Subclinical Coronary Atherosclerosis

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.120.315054 ◽

2020 ◽

Author(s):

Min Jung Lee ◽

Hong-Kyu Kim ◽

Eun Hee Kim ◽

Sung Jin Bae ◽

Kyung Won Kim ◽

...

Keyword(s):

Computed Tomography ◽

Skeletal Muscle ◽

Adipose Tissue ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Coronary Atherosclerosis ◽

Abdominal Muscle ◽

Muscle Quality ◽

Muscle Area ◽

Cross Sectional

Objective: Low muscle mass was known to be associated with cardiovascular diseases. However, only few studies investigated the association between muscle quality and subclinical coronary atherosclerosis. Thus, we evaluated whether muscle quality measured by abdominal computed tomography is associated with the risk of coronary artery calcification. Approach and Results: We conducted a cross-sectional study on 4068 subjects without cardiovascular disease who underwent abdominal and coronary computed tomography between 2012 and 2013 during health examinations. The cross-sectional area of the skeletal muscle was measured at the L3 level (total abdominal muscle area, total abdominal muscle area) and segmented into normal attenuation muscle area, low attenuation muscle area, and intramuscular adipose tissue. We calculated the normal attenuation muscle area/total abdominal muscle area index, of which a higher value reflected a higher proportion of good quality muscle (normal attenuation muscle area) and a lower proportion of myosteatosis (low attenuation muscle area and intramuscular adipose tissue). In women, as the normal attenuation muscle area/total abdominal muscle area quartiles increased, the odds ratios (95% CIs) for significant coronary artery calcification (>100) consistently decreased (0.44 [0.24–0.80], 0.39 [0.19–0.81], 0.34 [0.12–0.98]; P =0.003) after adjusting for cardiovascular risk factors including visceral fat area and insulin resistance. In men, the odds ratios in the Q2 group were significantly lower than those in the Q1, but the association was attenuated in Q3–4 after adjustment. Conclusions: A higher proportion of good quality muscle was strongly associated with a lower prevalence of significant coronary artery calcification after adjustment, especially in women. Poor skeletal muscle quality may be an important risk factor for subclinical coronary atherosclerosis.

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Associations of Abdominal Muscle Area and Radiodensity with Adiponectin and Leptin: The Multiethnic Study of Atherosclerosis

Obesity ◽

10.1002/oby.22208 ◽

2018 ◽

Vol 26 (7) ◽

pp. 1234-1241 ◽

Cited By ~ 3

Author(s):

Chantal A. Vella ◽

Mary Cushman ◽

Rachel B. Van Hollebeke ◽

Matthew A. Allison

Keyword(s):

Abdominal Muscle ◽

Muscle Area

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Abdominal Muscles and Metabolic Syndrome According to Patient Sex: A Retrospective Cross-Sectional Study

Healthcare ◽

10.3390/healthcare9091197 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1197

Author(s):

Tae Young Lee ◽

Young-Jee Jeon ◽

Chung Reen Kim ◽

Byung Ju Kang ◽

Gyung-Min Park

Keyword(s):

Skeletal Muscle ◽

Metabolic Syndrome ◽

Lumbar Vertebrae ◽

Cross Sectional Study ◽

Abdominal Muscle ◽

Muscle Quality ◽

Abdominal Muscles ◽

Sectional Study ◽

Muscle Area ◽

Cross Sectional

Computed tomography (CT) is a reference method for measuring skeletal muscle mass, and the amount of fat in the skeletal muscle can be calculated based on CT attenuation. This study aimed to comprehensively investigate the effect of muscle quality and quantity on metabolic syndrome (MetS) according to sex. This retrospective cross-sectional study enrolled 8081 individuals aged ≥20 years who underwent self-referral abdominopelvic CT at our hospital. The total abdominal muscle area (TAMA), low-attenuation abdominal muscle area (LAMA), normal-attenuation abdominal muscle area (NAMA), and extramyocellular lipid area (EMCLA) were measured using cross-sectional CT data of the L3 lumbar vertebrae. The TAMA and NAMA showed negative correlations with risk factors for MetS and a positive correlation with high-density lipoprotein cholesterol, whereas the LAMA and EMCLA showed an inverse trend in both the sexes (p < 0.001). After adjusting for various factors, a higher LAMA index and the ratio of LAMA to TAMA were associated with a higher prevalence of MetS. High TAMA indices were associated with a lower prevalence of MetS. Furthermore, muscle quality and quantity were associated with the prevalence of MetS in both males and females. However, the LAMA showed a stronger association with MetS in males than in females.

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