scholarly journals Body Composition and Incident Heart Failure in Older Adults: Results From 2 Prospective Cohorts

Author(s):  
Lili Zhang ◽  
Traci M. Bartz ◽  
Adam Santanasto ◽  
Luc Djoussé ◽  
Kenneth J. Mukamal ◽  
...  

Background Aging is associated with central fat redistribution and skeletal muscle decline, yet the relationships of tissue compartments with heart failure (HF) remain incompletely characterized. We assessed the contribution of body composition to incident HF in elders. Methods and Results Participants from 2 older cohorts who completed dual‐energy X‐ray absorptiometry (DEXA) and, in one cohort, computed tomography were included. We evaluated associations with incident HF for DEXA principal components (PCs) and total lean, appendicular lean, total fat and trunk fat mass; and for computed tomography measures of abdominal visceral and subcutaneous fat, thigh muscle, intermuscular fat area and thigh muscle density. DEXA analysis included 3621, and computed tomography analysis 2332 participants. During median follow‐up of 11.8 years, 927 participants developed HF. DEXA principal components showed no relationship with HF. After adjustment for height, weight, and cardiovascular risk factors, total lean mass was near significantly associated with higher HF (hazard ratio [HR], 1.25 per SD [1.00–1.56]), whereas total fat mass and thigh muscle density were significantly related to lower HF (HR, 0.82 [0.68–0.99] and HR, 0.87 [0.78–0.97], respectively). Patterns were similar for HF subtypes. The relationships with HF for total lean and fat mass were attenuated after adjusting for intercurrent atrial fibrillation or excluding high natriuretic peptide levels. Conclusions Total lean mass was positively associated, while total fat mass and thigh muscle density were inversely associated, with incident HF. These findings highlight the limitations of DEXA for assessment of HF risk in elders and support the preeminence of computed tomography–measured skeletal muscle quality over mass as a determinant of HF incidence.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1568-1568
Author(s):  
Pritesh S Karia ◽  
Corinne Joshu ◽  
Kala Visvanathan

1568 Background: Prior studies suggest that bilateral oophorectomy (BO), a common cancer prevention strategy, may be associated with adiposity. However, the impact of BO on lean mass, a potential marker of healthy aging, and whole-body composition is not known. Declines in lean mass have been linked to physical disability and mortality. We examined the association between BO and total and regional distribution of fat and lean mass in a cross-sectional study. Methods: The study population included women 35-70 years who underwent dual-energy x-ray absorptiometry (DXA) scans at enrollment as part of the National Health and Nutrition Examination Survey 1999-2006 (N = 3,764). Multinomial logistic regression models were used to examine the relationship between prior BO and tertiles of fat and lean mass. Models were adjusted for age, race, education, BMI at age 25, physical activity, smoking, alcohol use, parity, oral contraceptive use and hormone replacement therapy use. Results: Women with prior BO < 45 years (n = 346) had 2.9-times higher odds than women without BO (n = 3,212) of being in the highest compared to the lowest tertile of total fat mass (OR, 2.91; 95% CI, 1.93-4.38) and 2.7-times higher odds of being in the lowest compared to the highest tertile of total lean mass (OR, 2.67; 95% CI, 1.81-3.95). Results were similar when stratified by age at enrollment ( < 45, 45-54, and ≥55). Similarly, among women with normal BMI at enrollment, those with prior BO < 45 years (n = 74) had higher odds of being in the highest tertile of total fat mass (OR, 9.88, 95% CI, 2.21-44.00) and the lowest tertile of total lean mass (OR, 10.09; 95% CI, 2.72-37.46). These differences in body composition were most pronounced in the trunk region. No difference was observed in women with BO ≥45 years compared to women without BO. Conclusions: Women with a history of early BO experience significant changes in body composition, including increased fat mass and decreased lean mass, even while maintaining a normal BMI. If validated in future prospective studies, our results suggest that a comprehensive evaluation of body composition may be warranted in young women who undergo BO.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1627-1627
Author(s):  
Rosemary DeLuccia ◽  
May Cheung ◽  
Asma Altasan ◽  
Sumer Al-Ani ◽  
Rushali Parekh ◽  
...  

Abstract Objectives The objectives of this study were to determine if body composition and nutrient status are dependent on serumosteocalcin concentrations in healthy adults. Methods Adults 20 to 70 years of age completed fasting blood sampling to measure serum ionized calcium concentrations, serum ionized magnesium concentrations, and serum total osteocalcin concentrations. Dual Energy X-Ray Absorptiometry was also completed to measure body composition variables including body mass index (BMI), total fat mass, total fat freemass, total lean mass, android fat, gynoid fat, trunk fat, and visceral adipose tissue. Results A sample of 60 women and 78 men with a median age of 33.0 (21.0) years were categorized into two groups accordingto the median osteocalcin concentration measured: low osteocalcin (12.11 ± 2.72 ng/mL), and high osteocalcin (26.80 ± 9.72 ng/mL). Means, standard deviations, medians and interquartile ranges were calculated and independent t-tests, and Mann Whitney U tests were conducted to determine differences between groups in body composition variables. Total fat mass, total fat percentage, android fat, trunk fat, and trunk fat percentage were all significantly higher, and totalfat free mass, fat free mass percentage, total lean mass, lean mass percentage, serum ionized calcium concentrations, and serum ionized magnesium concentrations were all significantly lower (P &lt; 0.05) in the low osteocalcin groupcompared to the high osteocalcin group. There were no differences (P &gt;0.05) between groups in weight, gynoid fat, visceral adiposity tissue, or visceral adiposity tissue percentage. Conclusions The results of this study provide preliminary evidence that serum osteocalcin concentrations can predict bodycomposition. Interventional studies should consider methods to alter osteocalcin concentrations through vitamin ormineral supplementation as a means to improve body composition in adults. Funding Sources American Heart Association; Drexel University.


Author(s):  
Erica Roelofs ◽  
April Bockin ◽  
Tyler Bosch ◽  
Jonathan Oliver ◽  
Christopher W. Bach ◽  
...  

AbstractThe purpose of this study was to examine body composition of National Collegiate Athletic Association Division I female soccer players by position and season. One hundred seventy-five female athletes were categorized by positions of forward (n=47), midfielder (n=51), defender (n=57), and goalkeeper (n=20). A dual X-ray absorptiometry scan assessed percent body fat, total lean mass, total fat mass, arm and leg lean mass and fat mass, and visceral adipose tissue. Goalkeepers had significantly higher total, arm, and leg lean mass and fat mass compared to all other positions (p<0.05). For seasonal changes, body fat percentage was significantly higher in winter off-season (26.7%) compared to summer off-season (25.7%) and pre-season (25.8%; p<0.01) for all positions. Total and leg lean mass was significantly lower in winter off-season compared to all other seasons, and total lean mass was significantly higher in summer off-season than pre-season (p<0.01). Overall, goalkeepers were significantly different than all other positions. Body fat percentage increased and lean mass decreased in winter off-season indicating potential undesired changes in training and/or nutrition over the break whereas lean mass was the highest in summer off-season potentially reflecting the emphasis on resistance training and increased volume of training.


Diabetologia ◽  
2020 ◽  
Vol 63 (3) ◽  
pp. 473-485 ◽  
Author(s):  
Rory J. McCrimmon ◽  
Andrei-Mircea Catarig ◽  
Juan P. Frias ◽  
Nanna L. Lausvig ◽  
Carel W. le Roux ◽  
...  

Abstract Aims/hypothesis Intra-abdominal or visceral obesity is associated with insulin resistance and an increased risk for cardiovascular disease. This study aimed to compare the effects of semaglutide 1.0 mg and canagliflozin 300 mg on body composition in a subset of participants from the SUSTAIN 8 Phase IIIB, randomised double-blind trial who underwent whole-body dual-energy x-ray absorptiometry (DXA) scanning. Methods Adults (age ≥18 years) with type 2 diabetes, HbA1c 53–91 mmol/mol (7.0–10.5%), on a stable daily dose of metformin (≥1500 mg or maximum tolerated dose) and with an eGFR ≥60 ml min−1 [1.73 m]−2 were randomised 1:1 to semaglutide 1.0 mg once weekly and canagliflozin placebo once daily, or canagliflozin 300 mg once daily and semaglutide placebo once weekly. Body composition was assessed using whole-body DXA scans. The study participants and investigator remained blinded throughout the trial, and quality of DXA scans was evaluated in a blinded manner. Change from baseline to week 52 in total fat mass (kg) was the confirmatory efficacy endpoint. Results A subset of 178 participants (semaglutide, n = 88; canagliflozin, n = 90) underwent DXA scanning at screening and were randomised into the substudy. Of these, 114 (semaglutide, n = 53; canagliflozin, n = 61) participants had observed end-of-treatment data included in the confirmatory efficacy analysis. Of the 178 participants in the substudy, numerical improvements in body composition (including fat mass, lean mass and visceral fat mass) were observed after 52 weeks with both treatments. Total fat mass (baseline 33.2 kg) was reduced by 3.4 kg and 2.6 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: –0.79 [95% CI −2.10, 0.51]). Although total lean mass (baseline 51.3 kg) was also reduced by 2.3 kg and 1.5 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: −0.78 [−1.61, 0.04]), the proportion of lean mass (baseline 59.4%) increased by 1.2%- and 1.1%-point, respectively (estimated treatment difference 0.14 [−0.89, 1.17]). Changes in visceral fat mass and overall changes in body composition (assessed by the fat to lean mass ratio) were comparable between the two treatment groups. Conclusions/interpretation In individuals with uncontrolled type 2 diabetes on stable-dose metformin therapy, the changes in body composition with semaglutide and canagliflozin were not significantly different. Although numerical improvements in body composition were observed following treatment in both treatment arms, the specific impact of both treatments on body composition in the absence of a placebo arm is speculative at this stage. Trial registration ClinicalTrials.gov NCT03136484. Funding This trial was supported by Novo Nordisk A/S, Denmark.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Ambarish Pandey ◽  
Matthew W Segar ◽  
Ian J Neeland ◽  
Kershaw Patel

Introduction: Higher body mass index and obesity are associated with a higher risk of diabetes and heart failure (HF) development. However, the contribution of measures of body composition such as fat mass (FM), lean mass (LM), and central adiposity (waist circumference, WC) towards the risk of HF, and if these relationships are modified by diabetes status (DM) is unknown. Methods: Adults from visit 5 of the Atherosclerosis Risk in Communities Study without prevalent HF were included. FM and LM were measured using bioelectric impedance. Multivariable adjusted Cox proportional hazards models were created to evaluate the associations of FM, LM, and WC with the risk of HF after adjustment for potential confounders ( see Fig legend ). Multiplicative interaction testing and stratified analysis by DM status were performed using adjusted Cox models and restricted cubic splines to evaluate whether the association of body composition parameters and risk of HF were modified by DM status. Results: The present study included 5,555 participants (58.3% women, 79.3% white). Over a median follow-up of 4.6 years, there were 254 HF events (4.6%). In the overall cohort, higher LM was significantly associated with higher risk of HF (aHR [95% CI] per 1 SD higher LM: 1.34 [1.13-1.60]) with no interaction by DM status. However, the associations of FM and WC with risk of HF were modified by DM status (p-interaction: FM*diabetes = 0.03, WC*diabetes = 0.008). Higher FM and WC were each significantly associated with higher risk of HF in adults with DM (aHR [95% CI] per 1-SD higher FM: 1.23 [1.01-1.49], per 1SD higher WC: 1.57 [1.31 - 1.89]) but not among those without DM at baseline (aHR [95% CI] FM: 0.99 [0.80 - 1.23], WC: 1.06 [0.87 - 1.30]) ( Figure ). Conclusions: Higher LM was significantly associated with a higher risk of HF irrespective of diabetes status. In contrast, the association of FM and WC with the risk of HF was modified by the presence of DM such that higher FM and WC were associated with a higher risk of HF among adults with DM but not those without DM.


2020 ◽  
Vol 30 (6) ◽  
pp. 386-395
Author(s):  
Giuseppe delli Paoli ◽  
Denise van de Laarschot ◽  
Edith C.H. Friesema ◽  
Remco Verkaik ◽  
Antonia Giacco ◽  
...  

Fasting enhances the beneficial metabolic outcomes of exercise; however, it is unknown whether body composition is favorably modified on the short term. A baseline–follow-up study was carried out to assess the effect of an established protocol involving short-term combined exercise with fasting on body composition. One hundred seven recreationally exercising males underwent a 10-day intervention across 15 fitness centers in the Netherlands involving a 3-day gradual decrease of food intake, a 3-day period with extremely low caloric intake, and a gradual 4-day increase to initial caloric intake, with daily 30-min submaximal cycling. Using dual-energy X-ray absorptiometry analysis, all subjects substantially lost total body mass (−3.9 ± 1.9 kg; p < .001) and fat mass (−3.3 ± 1.3 kg; p < .001). Average lean mass was lost (−0.6 ± 1.5 kg; p < .001), but lean mass as a percentage of total body mass was not reduced. The authors observed a loss of −3.9 ± 1.9% android fat over total fat mass (p < .001), a loss of −2.2 ± 1.9% gynoid over total fat mass (p < .001), and reduced android/gynoid ratios (−0.05 ± 0.1; p < .001). Analyzing 15 preselected single-nucleotide polymorphisms in 13 metabolism-related genes revealed trending associations for thyroid state–related single-nucleotide polymorphisms rs225014 (deiodinase 2) and rs35767 (insulin-like growth factor1), and rs1053049 (PPARD). In conclusion, a short period of combined fasting and exercise leads to a substantial loss of body and fat mass without a loss of lean mass as a percentage of total mass.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 239-239
Author(s):  
Samaneh Farsijani ◽  
Lingshu Xue ◽  
Robert Boudreau ◽  
Adam Santanasto ◽  
Stephen Kritchevsky ◽  
...  

Abstract Background: Early work in the Health ABC cohort found that strength, but not muscle size predicted mortality. Recent literature suggests that body composition by computerized tomography (CT) and magnetic resonance imaging (MRI) predicts adverse health outcomes in diverse populations, but has not been directly compared to dual-energy X-ray absorptiometry (DXA) for predicting mortality. Objective: With long term follow-up, we reexamined body composition and mortality in Health ABC, comparing DXA and CT measures of muscle and fat. Methods: The Health ABC study assessed body composition in 2911 older adults (age 73.6±2.9 years) in 1996-97. Mid-thigh CTs were read for muscle area, inter-muscular, subcutaneous-fat areas and muscle density (HU). DXAs were read for whole body fat mass and appendicular lean mass (ALM). Mortality was assessed every 6-months through 2014 (maximum 17.4 years). Cox proportional hazards models, adjusting for age, sex, race, height, weight, physical activity, smoking and comorbidities were used to assess mortality risk. Results: Strong correlations were observed between mid-thigh muscle and subcutaneous fat areas by CT and leg lean and fat mass by DXA (P&lt;0.05). Lower mortality rates, per SD, were associated with higher CT muscle area (HR-men=0.76 [95%CI: 0.68-0.86]; HR-women=0.84 [0.75-0.94]), muscle density (HR-men=0.86 [0.79-0.93]; HR-women=0.89 [0.81-0.97]) and higher subcutaneous-fat (HR-men=0.90 [0.81-0.99]; HR-women=0.87 [0.77-0.98]), adjusting for covariates. Similarly for DXA, greater ALM (HR-men=0.56 [0.44-0.71]; HR-women=0.77 [0.59-1.01]) and higher total fat mass (HR-men=0.53 [0.40-0.72]; HR-women=0.58 [0.37-0.90]) were associated with lower risk of death. Conclusion: With long term follow-up, both CT and DXA assessments of body composition predicted all-cause mortality risk.


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 309
Author(s):  
Kun-Yun Yeh ◽  
Hang Huong Ling ◽  
Shu-Hang Ng ◽  
Cheng-Hsu Wang ◽  
Pei-Hung Chang ◽  
...  

Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.


2015 ◽  
Vol 228 (3) ◽  
pp. 127-134 ◽  
Author(s):  
Amanda E Brandon ◽  
Ella Stuart ◽  
Simon J Leslie ◽  
Kyle L Hoehn ◽  
David E James ◽  
...  

An important regulator of fatty acid oxidation (FAO) is the allosteric inhibition of CPT-1 by malonyl-CoA produced by the enzyme acetyl-CoA carboxylase 2 (ACC2). Initial studies suggested that deletion of Acc2 (Acacb) increased fat oxidation and reduced adipose tissue mass but in an independently generated strain of Acc2 knockout mice we observed increased whole-body and skeletal muscle FAO and a compensatory increase in muscle glycogen stores without changes in glucose tolerance, energy expenditure or fat mass in young mice (12–16 weeks). The aim of the present study was to determine whether there was any effect of age or housing at thermoneutrality (29 °C; which reduces total energy expenditure) on the phenotype of Acc2 knockout mice. At 42–54 weeks of age, male WT and Acc2−/− mice had similar body weight, fat mass, muscle triglyceride content and glucose tolerance. Consistent with younger Acc2−/− mice, aged Acc2−/− mice showed increased whole-body FAO (24 h average respiratory exchange ratio=0.95±0.02 and 0.92±0.02 for WT and Acc2−/− mice respectively, P<0.05) and skeletal muscle glycogen content (+60%, P<0.05) without any detectable change in whole-body energy expenditure. Hyperinsulinaemic–euglycaemic clamp studies revealed no difference in insulin action between groups with similar glucose infusion rates and tissue glucose uptake. Housing Acc2−/− mice at 29 °C did not alter body composition, glucose tolerance or the effects of fat feeding compared with WT mice. These results confirm that manipulation of Acc2 may alter FAO in mice, but this has little impact on body composition or insulin action.


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