Influence of probe position in the measurement of muscle thickness and its association with lean mass: an ultrasound study / Influencia de la posición de la sonda en la medición del grosor muscular y su asociación con la masa magra: un estudio ecográfico

SUMMARY: Skeletal muscles play a fundamental role in people's lives and their evaluation provides significant information on health. Different tools have been used to evaluate muscle mass, and the evaluation of muscle thickness (MT) using ultrasound has been included as an alternative, which can be performed with the probe in different positions; however, these could present differences. The objectives of this study were to determine whether there are differences in the measurement of MT in the vastus lateralis (VL) muscle using the probe in the longitudinal or transverse position, and to determine its association with the lean mass of the lower limbs. The results indicated no significant differences between MT measurements with the probe in the longitudinal and transverse positions (p =0.084). However, when associating these measurements with lower limb lean mass, it was found that transverse measurements had a strong association (r =0.547; p < 0.001), while longitudinal measurements had a moderate association (r =0.351; p =0.007). This suggests that measurements with the probe positioned transversely to measure the MT would be the best option. Therefore, it could be useful as an indicator of lower limb lean mass in the absence of tools, such as bioelectrical bioimpedance or magnetic nuclear resonance.

El músculo esquelético cumple un rol fundamental en la vida de las personas, y su evaluación entrega mucha información de la salud. Se han utilizado diferentes herramientas para evaluar la masa muscular, y el último tiempo se ha incluido la evaluación del grosor muscular (MT) a través de la ecografía como una alternativa para estimarla, las cuales se pueden realizar con la sonda en distintas posiciones, sin embargo, estas podrían presentar diferencias. Los objetivos del estudio fueron determinar si existen diferencias en la medición de MT en el músculo vasto lateral (VL) utilizando la sonda en posición longitudinal o transversal y determinar su asociación con la masa magra de los miembros inferiores. Los resultados indican que no existen diferencias significativas entre las mediciones de MT con la sonda en posición longitudinal y transversal (valor p: 0.084). Sin embargo, al asociar estas mediciones con la masa magra de los miembros inferiores, se encontró que las mediciones transversales poseen una asociación fuerte (r: 0.547; valor p < 0.001), mientras que las mediciones longitudinales presentan una asociación moderada (r: 0.351; valor p: 0.007). Esto sugiere que las mediciones con la sonda posicionada transversal para medir MT serían la mejor opción. Por lo tanto, podría ser de utilidad como un indicador de masa magra de los miembros inferiores en caso de no contar con herramientas como la bioimpedancia bioeléctrica o resonancia nuclear magnética.

Official Position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry—part II (clinical aspects): interpretation, reporting, and special situations

Abstract Objective: To present an updated and evidence-based guideline for the use of dual-energy x-ray absorptiometry (DXA) to assess body composition in clinical practice. Materials and methods: This Official Position was developed by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism ( Associação Brasileira de Avaliação Óssea e Osteometabolismo , ABRASSO) and experts in the field who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications in the area of body composition assessment. In this second part of the Official Position, the authors discuss the interpretation and reporting of body composition parameters assessed by DXA and the use of DXA for body composition evaluation in special situations, including evaluation of children, persons with HIV, and animals. Conclusion: This document offers recommendations for the use of DXA in body composition evaluation, including indications, interpretation, and applications, to serve as a guiding tool in clinical practice and research for health care professionals in Brazil.

Cambios en la composición corporal y ángulo de fase durante la pretemporada en jugadores de fútbol profesional / Changes in body composition and phase angle during pre-season in professional soccer players

RESUMEN: El análisis y el control de la composición corporal son claves en el fútbol por su implicación en el rendimiento. El objetivo de este estudio fue identificar, en jugadores de futbol profesional, el ángulo de fase (PhA) de miembros inferiores con los posibles patrones de mejora del componente magro en los mismos medido por DEXA. Al mismo tiempo, se estudió mediante BIA la evolución de parámetros hídricos de los jugadores, sometidos a un entrenamiento intenso y a un control nutricional de su alimentación y suplementación. Se evaluaron a 18 jugadores (26,28 ± 5,1 años; 85,09 ± 9,16 kg; 185,5 ± 4,32 cm) de un equipo de la primera división de fútbol italiana. Se llevó a cabo el estudio durante cuatro semanas, entre el 11 de julio (pre-test) y el 11 de agosto de 2021 (post-test). La intervención se llevó a cabo en su totalidad en pretemporada, con un confinamiento en modalidad de aislamiento o burbuja total por prevención al contagio del COVID-19, dónde se monitorizaba en un alto porcentaje la vida del jugador, incluyendo factores como la alimentación, el entrenamiento y el descanso. La suplementación estuvo basada en antioxidantes, multivitamínicos, minerales y ácidos grasos poliinsaturados y dos productos en polvo (uno a base de creatina, glutamina y leucina, y otro, a base de aminoácidos esenciales). Los jugadores presentaron una mejora del PhA y del componente magro en los miembros inferiores, con una moderada correlación (r = 0,6). Con respecto al agua intracelular y extracelular, señalar que, a pesar de la alta intensidad del ejercicio durante cuatro semanas, éstas se han mantenido constantes sin presentar variaciones significativas durante el periodo de estudio, lo que indica que no se ha producido un proceso de deshidratación del jugador.

SUMMARY: The analysis and control of body composition is essential in soccer due to its implication in performance. The aim of this study was to identify, in professional soccer players, the phase angle (PhA) of the lower limbs with possible patterns of improvement of the lean component measured by DEXA. At the same time, the evolution of hydric parameters of the players, subjected to intense training and nutritional control of their diet and supplementation, was studied by means of BIA. Eighteen players (26.28 ± 5.1 years; 85.09 ± 9.16 kg; 185.5 ± 4.32 cm) from an Italian first division football team were evaluated. The study was conducted for four weeks, between 11th July (pre- test) and 11th August of 2021 (post-test). The intervention was carried out entirely in pre-season, with confinement in isolation or total bubble mode for prevention of COVID-19 infection, where a high percentage of the player's life was monitored, including factors such as diet, training and rest. Supplementation was based on antioxidants, multivitamins, minerals and polyunsaturated fatty acids and two powdered products (one based on creatine, glutamine and leucine, and the other one, on essential amino acids). The players showed an improvement in PhA and in the lean component in the lower limbs, with a moderate correlation (r = 0.6). With regard to intracellular and extracellular water, it should be noted that, despite the high intensity of exercise during four weeks, these have remained constant without significant variations during the study period, indicating that there has not been a process of dehydration of the player.

Índice de asimetría bilateral morfológica de extremidades inferiores y superiores en jugadores de baloncesto universitario / The upper and lower limb bilateral morphological asymmetry index in university basketball players

Introducción: El baloncesto es objeto de múltiples estudios que incluye la valoración mediante tecnologías actuales como la bioimpedancia. Objetivo: Comparar los índices de asimetría (IA) de las extremidades superiores e inferiores en jugadores de baloncesto universitario por nivel deportivo. Método: Se evaluaron 24 jugadores de baloncesto de diferente nivel competitivo, representativo 1) universitario (n = 12) y 2) facultad (n = 12). Se determinó la circunferencia de brazos y piernas, además de masa magra y grasa por bioimpedancia. Se determinó el índice de asimetría de los miembros inferiores y superiores y se compararon por nivel deportivo. Resultados: La comparación de los índices de asimetría entre brazos y piernas en el grupo total identificó diferencias estadísticamente significativas (p < 0,05) en lo referente a la masa grasa, con mayor adiposidad en extremidades superiores, y un índice de asimetría de -10,8. Cuando se compararon las mismas variables en función del nivel deportivo, los jugadores representantes de la universidad mostraron mayores valores (p < 0,05) en el índice de asimetría de la masa total, circunferencias, masa magra y masa grasa. Las comparaciones intergrupales señalan diferencias en los índices de asimetría del brazo vs. la pierna en masa magra para ambos grupos (p < 0,05) mientras que los de la facultad mostraron diferencia también para grasa con índice de asimetría de 18,3 (p < 0,05). Conclusiones: Indistintamente del nivel deportivo, existen diferentes niveles del índice de asimetría entre extremidades superiores e inferiores en el componente de masa grasa, aunque menores valores del índice de asimetría fueron característicos de los individuos de mayor nivel deportivo(AU)

Introduction: Basketball has been the object of many studies, including assessments based on current technologies such as bioimpedance. Objective: Compare the asymmetry indices (AI) for upper and lower limbs in university basketball players. Methods: An evaluation was conducted of 24 basketball players from different competitive levels, representing 1) the university (n = 12) and 2) the school (n = 12). Determination was made of arm and leg circumference, as well as lean mass and fat by bioimpedance. The lower and upper limb asymmetry index was estimated and compared between the competitive levels. Results: Comparison of the arms and legs asymmetry indices in the total group revealed statistically significant differences (p < 0.05) as to fat mass, with greater adiposity in the upper limbs and an asymmetry index of 10.8. Comparison of the same variables between the sports levels found that players representing the university displayed higher values (p < 0.05) in the asymmetry index for total mass, circumferences, lean mass and fat mass. Comparison between the groups found differences in the arm vs. leg asymmetry indices for lean mass in both groups (p < 0.05), whereas the school players also showed differences for fat, with an asymmetry index of 18.3 (p < 0.05). Conclusions: Regardless of the sports level, different asymmetry indices are found between upper and lower limbs as to fat mass, though smaller asymmetry index values were characteristic of individuals from a higher sports level(AU)

Cambios en el agua corporal, grasa y masa magra de personas con y sin disfunción renal en sus diversos estadios de enfermedad renal crónica / Changes in body water, fat and lean mass of people with and without kidney dysfunction in their various stages of chronic kidney disease

Resumen Objetivo: Estudiar los cambios en el agua corporal, grasa y masa magra de personas sanas y enfermas (20-80 años) categorizadas según tasa de filtración glomerular (TFG). Material y métodos: Estudio descriptivo y analítico de 198 sujetos (sanos, con enfermedades crónicas sin azoemia y con diferentes estados de enfermedad renal crónica normalizados por sexo) según categorías: Categoría 1 (TFG >140 ml/min/1,73 m2SC); Categoría 2 (TFG 90-140); Categoría 3 (TFG 60-89); Categoría 4 (TFG 30-59); Categoría 5 (TFG<30) y Categoría 6 (diálisis). Se midió peso, talla, agua corporal, grasa y masa magra con balanza de bioimpedancia; aclaramiento de creatinina (TFG), aclaramiento de urea y sodio y potasio en orina de 24 horas. Con estos datos se calculó la masa corporal, agua corporal, grasa y masa magra, la ingesta de sal sódica, potasio y proteínas. Se relacionaron las diversas variables según categorías propuestas con ANOVA y eta cuadrado. Se correlacionó con la TFG y la masa magra mediante regresión bivariada y el resto de variables mediante regresión múltiple lineal, para definir las relevantes. Resultados: Las variables relevantes asociadas con pérdida de TFG fueron la masa magra y el agua corporal: ANOVA (p=0,000 ambas) y eta cuadrado (0,178 y 0,165), respectivamente. El análisis multivariado solo relacionó la TFG con la edad (r=-0,34; p=0,000) y la masa magra mostró correlación bivariada relevante con el agua (r=0,861; p=0,000). Conclusión: La pérdida de TFG implica fundamentalmente pérdida de masa magra y agua corporal en la estructura corporal.

SUMMARY Objective : Study changes in body water, fat and lean mass of healthy and sick people (20-80 years) categorized according to glomerular filtration rate (GFR). Material and Methods: Descriptive and analytical study of 198 subjects (healthy, with chronic disease without azotemia and with different stages of chronic kidney disease standardized by sex) according to stages: Stage 1 (GFR> 140 ml / min / 1.73 m2SC); Stage 2 (TFG 90-140); Stage 3 (TFG 60-89); Stage 4 (TFG 30-59); Stage 5 (TFG <30) and Stage 6 (dialysis). We measured weight, height, body water, fat and lean (with bio impedance scales); creatinine clearance (GFR) and urea clearance. In 24-hour urine: sodium and potassium. With these data, body mass, body water, fat and lean mass, sodium salt intake, potassium and proteins were calculated. The analysis was descriptive and analytical, relating the various variables according to the proposed categories with ANOVA and eta squared. The rest of the variables were correlated with the TFG and lean mass by bivariate regression and linear multiple regression to define the relevant ones. Results: The relevant variables associated with loss of GFR were lean body mass and water: ANOVA (p = 0.000 both) and eta squared (0.178 and 0,165) respectively. The multivariate analysis only related the GFR with age (r = -0.34, p = 0.000) and the lean mass showed significant bivariate correlation with water (r = 0.861, p = 0.000). Conclusion: The loss of TFG mainly involves loss of lean body mass and water in the body structure.

Efecto de intervenciones con ejercicio y/o suplementación sobre la masa muscular de personas mayores con sarcopenia: un metaanálisis / Effect of interventions with exercise and/or supplementation on muscle mass of elderly people with sarcopenia: a meta-analysis / Efeito das intervenções com o exercício e / ou a suplementação na massa muscular de idosos com sarcopenia: uma meta-análise

Resumen Solano-García, W. & Carazo-Vargas, P. (2019). Efecto de intervenciones con ejercicio y/o suplementación sobre la masa muscular de personas mayores con sarcopenia: Un metaanálisis. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 17(1), 1-22. La sarcopenia se caracteriza por la pérdida de la masa muscular y la fuerza. El objetivo fue determinar el tamaño del efecto global del tratamiento con ejercicio y/o suplementación sobre la masa muscular de personas adultas mayores diagnosticadas con sarcopenia, así como identificar las variables que moderan el efecto del tratamiento. Con respecto al método, se realizó una búsqueda de literatura en las bases de datos EBSCOhost, Ovid, ProQuest, PubMed, ScienceDirect, SpringerLink, Embase. De 4770 estudios recuperados, se incluyeron los 14 que cumplieron los criterios de inclusión: analizar la masa muscular, emplear diseños experimentales, aportar la estadística descriptiva, administrar un programa de ejercicio, suplementación o combinado de estas intervenciones e incluir personas mayores de 60 años diagnosticadas con sarcopenia. Los estudios debían estar publicados en texto completo en inglés o español. El cálculo del tamaño de efecto global se siguió utilizando el modelo de efectos aleatorios. En los resultados, fueron analizados 818 sujetos pertenecientes al grupo experimental y 284 al grupo control. Se obtuvo un tamaño de efecto global de 0.16 (p=0.005), procedente de 38 tamaños de efecto. El gráfico de funnel plot y la prueba de Egger no evidenciaron la presencia de sesgo general, ni publicación. Se necesitan 23 estudios para que el tamaño de efecto global sea no significativo. En la conclusión, se evidencia un cambio significativo en la masa muscular de personas adultas mayores diagnosticadas con sarcopenia, utilizando el tipo de intervención de ejercicio contra-resistencia con o sin suplementación; asimismo, se establece una guía de recomendaciones sobre prescripción de ejercicio y suplementación.

Abstract Solano-García, W. & Carazo-Vargas, P. (2019). Effect of interventions with exercise and/or supplementation on muscle mass of elderly people with sarcopenia: a meta-analysis. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 17(1), 1-22. Sarcopenia is characterized by the loss of muscle mass and strength. The objective of this paper was to determine the size of the overall effect of a treatment based on exercise and/or supplementation on muscle mass in elderly adults diagnosed with Sarcopenia, as well as identify the variables that can moderate the effect of the treatment. Regarding the method used, the EBSCOhost, Ovid, ProQuest, PubMed, ScienceDirect, SpringerLink, and Embase databases were consulted. Out of the 4770 studies recovered, 14 met the following criteria: analysis of muscle mass; use of experimental designs; use of descriptive statistics; administration of a program based on exercise, supplementation, or both; and subjects being over 60 diagnosed with sarcopenia. The studies were also required to be published completely in English or Spanish. The size of the global effect was calculated following the random effects model. A total of 818 and 284 subjects were analyzed in the experimental group and in the control group, respectively. An overall effect size of 0.16 (p = 0.005) was obtained from 38 effect sizes. The Funnel Plot graph and the Egger test did not reveal any evidence of presence of general bias or publication. A total of 23 studies are needed for the global effect size not to be significant. In conclusion, a significant change in the muscle mass of elderly adults diagnosed with sarcopenia was evident when having a resistance exercise intervention, with or without supplementation. A guide of recommendations on supplementation and exercise prescription was also established in the paper.

Resumo Solano-García, W. & Carazo-Vargas, P. (2019). Efeito das intervenções com o exercício e / ou a suplementação na massa muscular de idosos com sarcopenia: Uma meta-análise. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 17(1), 1-22. A sarcopenia é caracterizada pela perda de massa e força muscular. O objetivo foi determinar o tamanho do efeito global sobre a massa muscular no tratamento com exercício e/ou suplementação em idosos diagnosticados com sarcopenia e identificar as variáveis que moderam o efeito do tratamento. Com relação ao método, foi realizada uma pesquisa bibliográfica nas bases de dados EBSCOhost, Ovid, ProQuest, PubMed, ScienceDirect, SpringerLink, Embase. Dentre os 4770 estudos recuperados foram incluídos 14 que preencheram os critérios de inclusão, ou seja, analisar a massa muscular, usar desenhos experimentais, fornecer estatísticas descritivas, administrar um programa de exercício, suplementação ou a combinação dessas intervenções e incluir pessoas com mais de 60 anos de idade diagnosticadas com sarcopenia. Os estudos deveriam ter sido publicados em texto completo em inglês ou espanhol. Para o cálculo do tamanho do efeito global continuou-se usando o modelo de efeitos aleatórios. Nos resultados, 818 indivíduos pertencentes ao grupo experimental e 284 ao grupo controle foram analisados. Obteve-se um tamanho de efeito global de 0,16 (p = 0,005), a partir de 38 tamanhos de efeito. O gráfico de funnel plot e o teste de Egger não mostraram a presença de viés geral ou publicação. São necessários 23 estudos para que o tamanho do efeito global não seja significativo. Na conclusão, há uma mudança significativa na massa muscular de idosos diagnosticados com sarcopenia, utilizando o tipo de intervenção do exercício contrarresistência com ou sem suplementação; igualmente, fica estabelecido um guia de recomendações sobre prescrição de exercícios e suplementação.

Composición corporal y factores relacionados en pacientes con hiperplasia adrenal congénita / Body composition and factors-related in patients diagnosed with congenital adrenal hyperplasia

Introducción: Existen discrepancias en relación con la composición corporal de los pacientes con hiperplasia adrenal congénita (HAC) y la influencia de factores clínicos, hormonales y relacionados con el tratamiento esteroideo. Objetivo: Describir variables clínicas, antropométricas y de composición corporal de pacientes con hiperplasia adrenal congénita y determinar si existe relación entre esta y las variables antes mencionadas. Método: Estudio descriptivo transversal que incluyó a todos los pacientes con hiperplasia adrenal congénita y tratamiento esteroideo sustitutivo, atendidos en endocrinología pediátrica del Instituto Nacional de Endocrinología desde el 2000-2015. Se estudiaron variables clínicas y hormonales. Para las variables cualitativas se calcularon frecuencias absolutas y porcentajes, media y desviación estándar para las variables cuantitativas. Se evaluaron asociaciones utilizando el coeficiente de correlación de Spearman y la prueba chi cuadrado para evaluar la significación estadística de la posible asociación. Resultados: Fueron estudiados 29 pacientes, de las cuales 24 (82,8 por ciento) mujeres. La edad promedio fue 10,9 ± 6,27 años, diagnóstico de 1,9 años ± 2,7 años y edad de inicio del tratamiento 2,03 ± 2,7 años. Predominó el color de la piel blanca: 19 (65,5 por ciento). En la mayoría de los pacientes predominaron altos porcentajes de masa magra y parámetros bioquímicos normales. El uso de mayores dosis de esteroides se correlacionó positivamente con mayor porcentaje de masa grasa, lo mismo sucedió desde el punto de vista clínico (no estadístico), con el mayor tiempo de tratamiento. Los niveles de testosterona plasmáticas no se relacionaron de manera significativa con las características de la composición corporal(AU)

Introduction: There is disagreement with respect to the body composition of patients with congenital adrenal hyperplasia (CAH) and the influence of clinical, hormonal and other factors involved in steroid therapy. Objective: Describe the clinical, anthropometric and body composition variables of patients with congenital adrenal hyperplasia and determine whether there is a relationship between this condition and the aforementioned variables. Method: A descriptive cross-sectional study was conducted of all congenital adrenal hyperplasia patients under replacement steroid therapy cared for at the pediatric endocrinology service of the National Institute of Endocrinology from 2000 to 2015. Clinical and hormonal variables were analyzed. Absolute frequencies and percentages were estimated for qualitative variables, whereas mean and standard deviation were used for quantitative variables. Associations were evaluated with Spearman's rank correlation coefficient, and the chi-square test was applied to evaluate the statistical significance of the possible association. Results: A total 29 patients were studied, of whom 24 (82.8 percent) were women. Mean age was 10.9 ± 6.27 years, diagnosis 1.9 ± 2.7 years and age at the start of therapy 2.03 ± 2.7 years. White skin color prevailed with 19 (65.5 percent). In most patients there was a predominance of high lean mass percentages and normal biochemical parameters. A positive correlation was found between the use of higher steroid doses and a higher lean mass percentage. The same occurred from a clinical (non-statistical) point of view with a longer therapy time. Plasma testosterone levels did not show a significant relationship to body composition characteristics(AU)

Increased trunk fat along with decreased peripheral fat as an important predictor of hypertriglyceridaemia & hypercholesterolaemia in Indians with HIV infection

Background & objectives: Dyslipidaemia is a major contributor to cardiovascular morbidity, which is increased in HIV. Data on dyslipidaemia in Indians with HIV are scant. This study was undertaken to determine the predictors of dyslipidaemia and lipoatrophy in Indians with HIV infection and their relation with body composition parameters. Methods: A total of 382 consecutive patients with HIV infection were screened, of whom 257 clinically stable patients, without any acute comorbidity, having at least one year follow up underwent biochemical and DEXA analysis. Results: The most common dyslipidaemia was hypertriglyceridaemia (47.08%), followed by hypercholesterolaemia [total cholesterol (TC)] (38.91%) and low high-density lipoprotein (HDL) cholesterol (38.52%), in patients having median age 37 (32-42) yr and HIV duration 57 (33-101) months. Patients with at least one dyslipidaemia (78.99%) had significantly higher insulin resistance (IR), per cent body fat, per cent trunk fat (PTF) and trunk limb fat ratio (TLFR). Baseline CD4 count and delta CD4 count (change in CD4 count 6-12 months following ART) had significant inverse correlation with triglycerides and TC. Patients with highest triglycerides and cholesterol quartiles had significantly higher immune reconstitution, metabolic syndrome, IR, trunk fat mass (FM), PTF and TLFR, with comparable total FM. Logistic regression revealed that body mass index, HIV duration and PTF were independent predictors of hypertriglyceridaemia, with only PTF being significant predictor of hypercholesterolaemia. Every unit increase in PTF was associated with 13 and 4.1 per cent increased hypertriglyceridaemia and hypercholesterolaemia. Lipoatrophy was present in 8.57 per cent patients and was a poor predictor of dyslipidaemia. Interpretation & conclusions: High occurrence of dyslipidaemia was observed in patients with HIV on anti retroviral therapy. Central adiposity (TFM) was the most important predictor of dyslipidaemia in these patients.

Occurrence & predictors of osteoporosis & impact of body composition alterations on bone mineral health in asymptomatic pre-menopausal women with HIV infection

Background & objectives: Data on bone mineral density (BMD) and sarcopenia are scant from young females with HIV. This study was conducted to determine occurrence, predictors and impact of body composition alterations on osteoporosis in pre-menopausal women with HIV. Methods: A total of 214 females with serologically documented HIV infection were screened, of whom 103 pre-menopausal women, 25-45 yr age, clinically stable, having at least one year follow up data, underwent hormonal and dual-energy X-ray absorptiometry analysis for BMD and body composition. Seventy five matched controls were also evaluated. Results: Females with HIV had significantly lower BMD and Z-score at lumbar spine (LS), total femur, neck of femur (NOF), and radius ultra-distal (UD) compared to controls. Osteoporosis at least at one site was observed in 34.95 per cent patients, compared to eight per cent in controls (P<0.001). Most common site of osteoporosis in females with HIV was radius UD (24.27%), followed by radius 33 per cent (17.48%), radius total (15.53%) and greater trochanter, NOF and LS (6.80% each). HIV patients had significantly lower bone mineral content, lean mass (LM), fat per cent, android (A) fat, gynoid (G) fat, and A/G ratio. LM and fat mass (FM) were ?15.65 and ?11.54 per cent lower in HIV patients, respectively. Osteoporosis patients had significantly higher use of antiretroviral therapy and lower LM, FM and fat per cent. On logistic regression, LM followed by A/G ratio and BMI were the best predictors of osteoporosis. Sarcopenia was observed in 17.5 per cent patients. Interpretation & conclusions: Our results showed that osteoporosis and sarcopenia were significant problems in young women with HIV. HIV was associated with greater LM loss, which was critical for bone health. Sarcopenia may predict low BMD in HIV.

Relationship between handgrip strength and appendicular lean mass in patients with stable chronic obstructive pulmonary disease / 医学研究生学报

Objective At present no deep investigation has been done on the relationship between handgrip strength and appendicular lean mass (ALM) in patients with chronic obstructive pulmonary disease (COPD). The study aimed to explore the present situation of handgrip strength in patients with stable COPD and relationship between handgrip strength and ALM.Methods A total of 93 patients with stable COPD who hospitalized in our department from August 2016 to July 2017 were selected for the study. All the patients underwent handgrip strength test, body composition analysis, as well as the analysis of the relationship between handgrip strength and ALM.Results Multivariate linear regression analysis showed age(X1), education(X2), smoking(X3), course of disease(X4) and lower limb lean mass(X5) could be taken as predictive factors for the variation degree of handgrip strength (R2=50.5%), and multiple linear regression equation was Y=9.959-4.315X1+1.397X2+2.679X3-1.526X4+1.538X5. The variation degree decreased to 48.1% when the course of disease was removed from the model, 28.3% when the limb lean mass was removed, 26.5% when two variables were removed. The correlation coefficients of ALM, upper limb, lower limb and torso lean mass (\[22.32±3.25\]kg, \[6.48±1.05\]kg, \[15.83±2.26\]kg, \[22.27±3.22\]kg) with handgrip strength (\[32.27±7.27\]kgf) were respectively 0.484, 0.436, 0.496 and 0.496 (P＜0.01).Conclusion The handgrip strength in patients with stable COPD is closely associated with ALM, and the course of disease and the lower limb lean mass greatly affect the handgrip strength. Clinical workers should pay extra attention to the relationship in order to give timely clinical intervention.

The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study / 가정의학회지

BACKGROUND: We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea. METHODS: A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed. RESULTS: In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women. CONCLUSION: Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.

Uma breve revisão: a utilização da suplementação de creatina no treinamento de força / A brief review: the use of creatine supplementation on strength training

O presente estudo tem como objetivo verificar a eficácia da suplementação de creatina no treinamento de força. A creatina é uma substância não essencial encontrada no organismo, derivada de três aminoácidos: glicina L-arginina e metionina. Foi realizada uma pesquisa bibliográfica, a partir de artigos publicados junto ao banco de dados Google acadêmico, Bireme e Scielo. A creatina é produzida de forma endógena pelo fígado, rins e pâncreas, podendo também ser adquirida através da alimentação. A suplementação de creatina vem sendo utilizada por atletas com características de força máxima, explosiva e velocidade. A suplementação de creatina durante um curto período não aumenta e nem altera a taxa de filtração glomerular, portanto conclui-se que a creatina, quando suplementada de forma adequada promove uma melhoria no desempenho do treinamento de força e não provoca efeitos colaterais graves(AU)

This study has the aims to determine the effectiveness of creatine supplementation on strength training. The creatine is not essential substance found in the body derived from three amino acids: glycine, L-arginine and methionine. A bibliographic search was carried out basea on articles published by the Academic Google, Bireme and Scielo. Creatine is produced endogenously by the liver, kidneys and pancreas and can also be acquired through diet. Creatine supplementation has been used by athletes with maximum strength characteristics, and explosive speed. Creatine supplementation for a short period and does not increase or change glomerular filtration rate, so it follows that creatine when supplemented appropriately promotes an improvement in the performance of strength training and do not cause serious side effects(AU)

Changes in Body Composition According to Age and Sex among Young Non-Diabetic Korean Adults: the Kangbuk Samsung Health Study

BACKGROUND: Age-related decreases in lean mass represent a serious health problem. We aimed to analyze the risks of rapid decreases in lean mass by age and sex in relatively young Korean adults during a 4-year follow-up study. METHODS: A total of 65,856 non-diabetic participants (59.5% men, mean age 39.1 years) in a health screening program were subjected to bioimpedance body composition analyses and metabolic parameter analyses at baseline and after 4 years. The participants were sub-divided according to age, and additionally to six groups by age and the degree of body weight change over the 4-year period. The actual changes in body weight, lean mass, and fat mass and the percent changes over the 4-year period were assessed. RESULTS: The percent change in lean mass decreased and the percent change of fat mass increased with increasing age in every age and sex group. However, the annual percent decrease in lean mass and percent increase in fat mass were significantly higher among women than among men (−0.26% vs. −0.15% and 0.34% vs. 0.42%, respectively; P<0.01). Participants who were older than 50 years and had a weight loss <−5% during the 4 years had significantly greater decreases in lean mass and smaller decreases in fat mass, compared to those who were younger than 50 years. An odds ratio analysis to determine the lowest quartile of the percent change in lean mass according to age group revealed that participants older than 60 years had a significantly increased risk of a rapid decrease in the lean mass percentage (2.081; 95% confidence interval, 1.678 to 2.581). CONCLUSION: Even in this relatively young study population, the lean mass decreased significantly with age, and the risk of a rapid decrease in lean mass was higher among women than among men. Furthermore, the elderly exhibited a significantly more rapid decrease in lean mass, compared with younger participants.

Change in Dietary Intake and Nutritional Status Using Mealworms as Hospital Meal in Postoperative Patients

The purpose of this study was to verify the validity of Mealworms as a hospital meal with increased nutrition density. We provided a meal for postoperative patients and conducted analysis of dietary intake and nutritional status of patients and assessment of acceptability of the meal. This study was carried out as a randomized control trial. Patients were supplied either a hospital meal using Mealworms (Experimental group) or a regular hospital meal (Control group). We investigated the administration amounts of parenteral nutrition (PN) and food intake of patients after surgery and measured anthropometry, body composition, and blood tests before surgery and at hospital discharge. We included 34 postoperative patients who were admitted to Gangnam Severance Hospital from March to September. In the groups of patients not supplied with PN, the experimental group (964.68±284.6 kcal, 38.82±12.9 g) had significantly higher dietary calorie and protein intake than the control group (666.62±153.7 kcal, 24.47±4.9 g)(P<0.05). Additionally in the group of patients not supplied with PN, the experimental group (1.37%) showed a significantly higher increase in fat free mass index than the control group (−3.46%)(P<0.05). In all subjects, calorie density and protein density were significantly higher in the experimental group (P<0.001), and acceptability of calorie (P=0.036) and protein (P=0.001) was also significantly higher in the experimental group. Therefore, the results of this study support the validity of the introduction of hospital meals using Mealworms.

Sarcopenia in Korea: Prevalence and Clinical Aspects

Sarcopenia has been defined as the considerable loss of skeletal muscle mass and strength that results in frailty in the elderly. Because muscle tissue plays diverse important roles in human, sarcopenia presents many negative health-related consequences including impaired energy homeostasis, falls and cardiovascular disease, and subsequently higher mortality. It is becoming evident that sarcopenia has a negative impact on the healthy life of the elderly. The European Working Group on Sarcopenia, the International Working Group on Sarcopenia and the Asian Working Group on Sarcopenia have released position statement regarding sarcopenia, and more recently the Foundation for the National Institutes of Health Sarcopenia Project has provided a new guideline for assessment of sarcopenia. At this time, there have been several data delineating the status of sarcopenia in Korea. This review focuses on largescale cohorts that assessed sarcopenia and highlights the controversies surrounding the clinical definition and prevalence of sarcopenia in Korea.

The relationship between men hip geometric structure and body composition in Shanghai area / 中华内分泌代谢杂志

correlation with cross-sectional area and negative correlation with bucking ratio. The effect of fat mass on hip geometric parameters at the three regions was inconsistent. (3) Fat mass and percentage of body fat ( Fat%) showed negative correlation with cross-sectional area and average cortical thickness and positive correlation with bucking ratio in young group. However, the negative contribution produced by fat mass and Fat% to hip geometric structure became weaker gradually in middle-aged and older groups. ( 4 ) Limb lean mass yielded the largest positive contribution to cross-sectional area and average cortical thickness at all three regions in young group. However, the contribution produced by trunk lean mass became the largest positive contribution to cross-sectional area and average cortical thickness in older group. Conclusions Among all the body composition parameters, hip BMD has showed the most marked correlation with hip geometric structure. Lean mass is ranked the second in the correlation. The impacts of fat mass and lean mass on hip geometry are changing with aging and their different tissue distributions.

Weight and Bone Mineral Density: The Summary of Epidemiological Evidence / 가정의학회지

Not only bone mineral density (BMD) is strongly associated with body weight, but also weight change infl uences BMD change. The weight change related bone change is more marked in women especially after menopause, in the elderly, in the underweight and in persons who have the history of weight cycling. Because of the health impacts of obesity, weight reduction has been often recommended in practices. Therefore various intervention methods have been tried to reduce the weight change related bone change such as hormone therapy, raloxifene, exercise, and calcium supplementation. This review summarizes the epidemiological evidences of the weight change related bone change and the associated factors.