Body Composition Changes with Long-term Pegvisomant Therapy of Acromegaly

Abstract Context In active acromegaly, the lipolytic and insulin antagonistic effects of growth hormone (GH) excess alter adipose tissue (AT) deposition, reduce body fat, and increase insulin resistance. This pattern reverses with surgical therapy. Pegvisomant treats acromegaly by blocking GH receptor (GHR) signal transduction and lowering insulin-like growth factor 1 (IGF-1) levels. The long-term effects of GHR antagonist treatment of acromegaly on body composition have not been studied. Methods We prospectively studied 21 patients with active acromegaly who were starting pegvisomant. Body composition was examined by whole body magnetic resonance imaging, proton magnetic resonance spectroscopy of liver and muscle and dual-energy x-ray absorptiometry, and endocrine and metabolic markers were measured before and serially during 1.0 to 13.4 years of pegvisomant therapy. The data of patients with acromegaly were compared with predicted and to matched controls. Results Mass of visceral AT (VAT) increased to a peak of 187% (1.56-229%) (P < .001) and subcutaneous AT (SAT) to 109% (–17% to 57%) (P = .04) of baseline. These remained persistently and stably increased, but did not differ from predicted during long-term pegvisomant therapy. Intrahepatic lipid rose from 1.75% to 3.04 % (P = .04). Although lean tissue mass decreased significantly, skeletal muscle (SM) did not change. IGF-1 levels normalized, and homeostasis model assessment insulin resistance and HbA1C were lowered. Conclusion Long-term pegvisomant therapy is accompanied by increases in VAT and SAT mass that do not differ from predicted, stable SM mass and improvements in glucose metabolism. Long-term pegvisomant therapy does not produce a GH deficiency-like pattern of body composition change.

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Increased intramyocellular lipid accumulation in HIV-infected women with fat redistribution

Journal of Applied Physiology ◽

10.1152/japplphysiol.00797.2005 ◽

2006 ◽

Vol 100 (2) ◽

pp. 609-614 ◽

Cited By ~ 32

Author(s):

Martin Torriani ◽

Bijoy J. Thomas ◽

Robert B. Barlow ◽

Jamie Librizzi ◽

Sara Dolan ◽

...

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Magnetic Resonance ◽

Subcutaneous Fat ◽

Abdominal Fat ◽

Whole Body ◽

Resonance Spectroscopy ◽

Intramyocellular Lipid ◽

Fat Redistribution ◽

Visceral Abdominal Fat

The human immunodeficiency virus (HIV)-lipodystrophy syndrome is associated with fat redistribution and metabolic abnormalities, including insulin resistance. Increased intramyocellular lipid (IMCL) concentrations are thought to contribute to insulin resistance, being linked to metabolic and body composition variables. We examined 46 women: HIV infected with fat redistribution ( n = 25), and age- and body mass index-matched HIV-negative controls ( n = 21). IMCL was measured by 1H-magnetic resonance spectroscopy, and body composition was assessed with computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging. Plasma lipid profile and markers of glucose homeostasis were obtained. IMCL was significantly increased in tibialis anterior [135.0 ± 11.5 vs. 85.1 ± 13.2 institutional units (IU); P = 0.007] and soleus [643.7 ± 61.0 vs. 443.6 ± 47.2 IU, P = 0.017] of HIV-infected subjects compared with controls. Among HIV-infected subjects, calf subcutaneous fat area (17.8 ± 2.3 vs. 35.0 ± 2.5 cm2, P < 0.0001) and extremity fat by DEXA (11.8 ± 1.1 vs. 15.6 ± 1.2 kg, P = 0.024) were reduced, whereas visceral abdominal fat (125.2 ± 11.3 vs. 74.4 ± 12.3 cm2, P = 0.004), triglycerides (131.1 ± 11.0 vs. 66.3 ± 12.3 mg/dl, P = 0.0003), and fasting insulin (10.8 ± 0.9 vs. 7.0 ± 0.9 μIU/ml, P = 0.004) were increased compared with control subjects. Triglycerides ( r = 0.39, P = 0.05) and extremity fat as percentage of whole body fat by DEXA ( r = −0.51, P = 0.01) correlated significantly with IMCL in the HIV but not the control group. Extremity fat (β = −633.53, P = 0.03) remained significantly associated with IMCL among HIV-infected patients, controlling for visceral abdominal fat, abdominal subcutaneous fat, and antiretroviral medications in a regression model. These data demonstrate increased IMCL in HIV-infected women with a mixed lipodystrophy pattern, being most significantly associated with reduced extremity fat. Further studies are necessary to determine the relationship between extremity fat loss and increased IMCL in HIV-infected women.

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Validation of whole-body magnetic resonance spectroscopy as a tool to assess murine body composition

International Journal of Obesity ◽

10.1038/sj.ijo.0801231 ◽

2000 ◽

Vol 24 (6) ◽

pp. 719-724 ◽

Cited By ~ 36

Author(s):

P Mystkowski ◽

E Shankland ◽

SA Schreyer ◽

RC LeBoeuf ◽

RS Schwartz ◽

...

Keyword(s):

Body Composition ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Whole Body ◽

Resonance Spectroscopy

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PSVIII-40 Late-Breaking Abstract: Variability in body composition is associated with insulin sensitivity in growing-finishing pigs

Journal of Animal Science ◽

10.1093/jas/skaa278.616 ◽

2020 ◽

Vol 98 (Supplement_4) ◽

pp. 350-351

Author(s):

Hector H Salgado ◽

Aline Remus ◽

Marie-Pierre Letourneau-Montminy ◽

Candido Pomar

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Insulin Sensitivity ◽

Growing Pigs ◽

The Body ◽

Whole Body ◽

Oral Glucose ◽

Sensitivity Index ◽

Model Assessment ◽

Glucose Ingestion

Abstract Growing pigs’ body composition variation can be associated with differences in insulin sensitivity given the insulin anabolic effect on protein and lipid synthesis. The objective of this study was to elucidate this association by relating the individual insulin response to the oral glucose tolerance test (OGTT) with the body composition of growing pigs. Thirty 95 kg jugular vein catheterized pigs received an oral dose of 1.75 g of glucose/kg of BW after 18 hours of fasting. Blood samples were collected at -20, -10, 5, 10, 15, 20, 25, 30, 45, 60, 90, 120, 150, 180, 210, 240, 300 and 360 min following glucose ingestion. Insulin sensitivity indexes were calculated and analyzed. Body lipids (LB, %) and protein (PB, %) composition were estimated by dual X-ray densitometry. Association between body composition and insulin sensitivity were studied by using partial least squares and correlations. Average LB and PB were 19.7% (CV = 7.6 %) and 16.2% (CV = 2.2%), respectively. Basal insulin blood concentration and area-under-the-curve (AUC) CV (51.9 % and 26.9 %, respectively) were larger than those for basal glucose and AUC (5.52 and 5.48 %, respectively). Additionally, insulin sensitivity (%S), steady-state beta cell function (%B), and insulin resistance (HOMA-IR) estimated with the Homeostasis Model Assessment (HOMA 2) and whole-body insulin sensitivity index (ISI) were highly variable between pigs which CV ranged from 30.1 % to 54.5 %. These results can indicate an early stage of insulin resistance in an important part of the studied pig population. LB and PB were affected by insulin sensitivity indexes (P < 0.05) which accounted, respectively, for 48% and 44% of the observed variation. In conclusion, lower insulin sensitivity was associated with higher body fat in growing pigs raised under similar conditions.

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The Effect of Weight-Loss Interventions on Cervical and Chin Subcutaneous Fat Depots; the CENTRAL Randomized Controlled Trial

Nutrients ◽

10.3390/nu13113827 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3827

Author(s):

Gal Tsaban ◽

Avital Bilitzky-Kopit ◽

Anat Yaskolka Meir ◽

Hila Zelicha ◽

Yftach Gepner ◽

...

Keyword(s):

Insulin Resistance ◽

Weight Loss ◽

Controlled Trial ◽

Subcutaneous Fat ◽

Whole Body ◽

Adherence Rate ◽

Model Assessment ◽

Weight Changes ◽

Fat Depots

Accumulation of cervical and chin subcutaneous adipose tissues (SAT) represent known phenotypes of obesity. We aimed to evaluate the sensitivity of these fat storages to long-term weight-loss directed lifestyle-intervention and to assess their relations to bodily-adiposity, insulin-resistance, and cardiometabolic risk; We randomly assigned 278 participants with abdominal-obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets +/− physical-activity. All participants underwent an 18 month whole-body magnetic resonance imaging follow-up, from which we assessed cervical and chin SAT-areas; Participants (age = 48 years; 90% men; body-mass-index = 30.9 kg/m2) had an 18-month adherence-rate of 86%. Cervical-SAT and chin-SAT decreased after 6-months (−13.1% and −5.3%, respectively, p < 0.001). After 18-months only cervical-SAT remained decreased compared to baseline (−5%, p < 0.001). Cervical and chin-SAT 18-month changes were associated with changes in weight (r = 0.70, r = 0.66 respectively; <0.001 for both) and visceral-adipose-tissue (VAT; r = 0.35, r = 0.42 respectively; <0.001 for both). After adjustment to VAT, waist-circumference, or weight-changes, chin-SAT 18-month reduction was associated with favorable changes in fasting-glucose (β = 0.10; p = 0.05), HbA1c (β = 0.12; p = 0.03), and homeostasis-model-assessment-of-insulin-resistance (β = 0.12; p = 0.03). Cervical-SAT 18-month reduction was associated with decreased triglycerides (β = 0.16; p = 0.02) and leptin (β = 0.19; p = 0.01) independent of VAT; Cervical and chin-SATs are dynamic fat depots that correspond with weight-loss and are associated with changes in cardiometabolic profile. In long-term, chin-SAT displays a larger rebound compared with cervical-SAT. Chin-SAT accumulation is associated with in insulin-resistance, independent of central obesity. (ClinicalTrials identifier NCT01530724)

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Increased intrahepatic triglyceride is associated with peripheral insulin resistance: in vivo MR imaging and spectroscopy studies

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00590.2006 ◽

2007 ◽

Vol 293 (6) ◽

pp. E1663-E1669 ◽

Cited By ~ 122

Author(s):

Jong-Hee Hwang ◽

Daniel T. Stein ◽

Nir Barzilai ◽

Min-Hui Cui ◽

Julia Tonelli ◽

...

Keyword(s):

Insulin Resistance ◽

Insulin Sensitivity ◽

Magnetic Resonance ◽

Subcutaneous Fat ◽

Liver Fat ◽

Whole Body ◽

Glucose Disposal ◽

Resonance Spectroscopy ◽

Euglycemic Hyperinsulinemic Clamp ◽

Triglyceride Accumulation

Recent studies have indicated that the mass/content of intramyocellular lipid (IMCL), intrahepatic triglyceride (IHTG), visceral fat (VF), and even deep abdominal subcutaneous fat (SF) may all be correlated with insulin resistance. Since simultaneous measurements of these parameters have not been reported, the relative strength of their associations with insulin action is not known. Therefore, the goals of this study were 1) to simultaneously measure IMCL, IHTG, VF, and abdominal SF in the same nondiabetic individuals using noninvasive 1H-magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) and 2) to examine how these fat stores are correlated with systemic insulin sensitivity as measured by whole body glucose disposal (Rd) during euglycemic-hyperinsulinemic clamp studies. Positive correlations were observed among IMCL, IHTG, and VF. There were significant inverse correlations between whole body Rd and both IMCL and VF. Notably, there was a particularly tight inverse correlation between IHTG and whole body Rd ( r = −0.86, P < 0.001), consistent with an association between liver fat and peripheral insulin sensitivity. This novel finding suggests that hepatic triglyceride accumulation has important systemic consequences that may adversely affect insulin sensitivity in other tissues.

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Monitoring long-term effects of mild traumatic brain injury with magnetic resonance spectroscopy

Neuroreport ◽

10.1097/wnr.0b013e3283637aa4 ◽

2013 ◽

Vol 24 (12) ◽

pp. 677-681 ◽

Cited By ~ 12

Author(s):

Philip J.A. Dean ◽

Maria C.G. Otaduy ◽

Lisa M. Harris ◽

Adam McNamara ◽

Ellen Seiss ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Mild Traumatic Brain Injury ◽

Resonance Spectroscopy ◽

Long Term Effects

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Long-term effects of temperature on growth, energy density, whole-body composition and aerobic scope of age-0 Lake sturgeon (A. fulvescens)

Aquaculture ◽

10.1016/j.aquaculture.2021.737505 ◽

2021 ◽

pp. 737505

Author(s):

GwangseokR. Yoon ◽

Laura Groening ◽

Cheryl N. Klassen ◽

Catherine Brandt ◽

W. Gary Anderson

Keyword(s):

Body Composition ◽

Energy Density ◽

Lake Sturgeon ◽

Whole Body ◽

Aerobic Scope ◽

Long Term Effects ◽

Effects Of Temperature ◽

Growth Energy

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Body Composition and Ectopic Lipid Changes With Biochemical Control of Acromegaly

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-01210 ◽

2017 ◽

Vol 102 (11) ◽

pp. 4218-4225 ◽

Cited By ~ 10

Author(s):

Miriam A Bredella ◽

Melanie Schorr ◽

Laura E Dichtel ◽

Anu V Gerweck ◽

Brian J Young ◽

...

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Magnetic Resonance ◽

Muscle Mass ◽

Glucose Homeostasis ◽

Gonadal Steroids ◽

Fasting Insulin ◽

Biochemical Control ◽

Ectopic Lipids ◽

Active Acromegaly

Abstract Context Acromegaly is characterized by growth hormone (GH) and insulinlike growth factor-1 (IGF-1) hypersecretion, and GH and IGF-1 play important roles in regulating body composition and glucose homeostasis. Objective The purpose of our study was to investigate body composition including ectopic lipids, measures of glucose homeostasis, and gonadal steroids in patients with active acromegaly compared with age-, body mass index (BMI)−, and sex-matched controls and to determine changes in these parameters after biochemical control of acromegaly. Design Cross-sectional study of 20 patients with active acromegaly and 20 healthy matched controls. Prospective study of 16 patients before and after biochemical control of acromegaly. Main Outcome Measures Body composition including ectopic lipids by magnetic resonance imaging/proton magnetic resonance spectroscopy; measures of glucose homeostasis by an oral glucose tolerance test; gonadal steroids. Results Patients with active acromegaly had lower mean intrahepatic lipid (IHL) and higher mean fasting insulin and insulin area under the curve (AUC) values than controls. Men with acromegaly had lower mean total testosterone, sex hormone−binding globulin, and estradiol values than male controls. After therapy, homeostasis model assessment of insulin resistance, fasting insulin level, and insulin AUC decreased despite an increase in IHL and abdominal and thigh adipose tissues and a decrease in muscle mass. Conclusions Patients with acromegaly were characterized by insulin resistance and hyperinsulinemia but lower IHL compared with age-, BMI-, and sex-matched healthy controls. Biochemical control of acromegaly improved insulin resistance but led to a less favorable anthropometric phenotype with increased IHL and abdominal adiposity and decreased muscle mass.

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