Estimation of appendicular muscle mass and fat mass by near infrared spectroscopy in older persons

Aim: Near infrared spectroscopy has been reported to have a high reliability and accuracy in assessing the percentage of body fat. However, whether muscle mass can be accurately estimated using this method has not been established. This study examined whether a near infrared spectroscopy method could estimate appendicular muscle mass and fat mass, with dual‐energy X‐ray absorptiometry as the standard method for comparison. Methods: A total of 20 orthopedic inpatients (mean age 73.2 ± 6.8 years) were recruited for this study. Their body composition was assessed using near infrared spectroscopy and dual‐energy X‐ray absorptiometry. Appendicular muscle mass and fat mass were estimated from height, weight and optical densities. Results: The optical densities for the upper arm (biceps, triceps) and forearm (flexor carpi radialis) were significantly correlated with appendicular muscle mass (r = 0.534 to 0.623) or fat mass (r = ?0.483 to ?0.827). Estimated appendicular muscle mass and fat mass explained 89% and 80% of the variance in the dual‐energy X‐ray absorptiometry‐derived muscle mass and fat mass estimates using height, weight and optical density values of the proximal flexor carpi radialis. Conclusions: Near infrared spectroscopy is a useful method to assess not only fat mass, but also muscle mass in older adults. Geriatr Gerontol Int 2012; ??: ??–?? .     

The magnitude and progress of lean body mass,fat-free mass,and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis

Postbariatric loss of muscle tissue could negatively affect long-term health due to its role in various bodily processes, such as metabolism and functional capacity. This meta-analysis aimed to unravel time-dependent changes in the magnitude and progress of lean body mass (LBM), fat-free mass (FFM), and skeletal muscle mass (SMM) loss following bariatric surgery. A systematic literature search was conducted in Pubmed, Embase, and Web of Science. Fifty-nine studies assessed LBM (n = 37), FFM (n = 20), or SMM (n = 3) preoperatively and ≥1 time points postsurgery. Random-effects meta-analyses were performed to determine pooled loss per outcome parameter and follow-up time point. At 12-month postsurgery, pooled LBM loss was ?8.13 kg [95%CI ?9.01; ?7.26]. FFM loss and SMM loss were ?8.23 kg [95%CI ?10.74; ?5.73] and ?3.18 kg [95%CI ?5.64; ?0.71], respectively. About 55% of 12-month LBM loss occurred within 3-month postsurgery, followed by a more gradual decrease up to 12 months. Similar patterns were seen for FFM and SMM. In conclusion, >8 kg of LBM and FFM loss was observed within 1-year postsurgery. LBM, FFM, and SMM were predominantly lost within 3-month postsurgery, highlighting that interventions to mitigate such losses should be implemented perioperatively.     

Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III

OBJECTIVES: To assess the association between functional limitations and body composition indices, including percentage of body fat, muscle mass, and body mass index (BMI). DESIGN: A cross-sectional, population-representative sample. SETTING: All noninstitutionalized people living in the United States (National Health and Nutrition Examination Survey). Data were collected between 1988 and 1994. PARTICIPANTS: One thousand five hundred twenty-six women and 1,391 men aged 70 and older. MEASUREMENTS: Independent variables included BMI, muscle mass, and percentage of body fat; the latter two were assessed using predictive equations. The dependent variable, functional limitations, was defined as difficulty in performing at least three of five functional living tasks, such as carrying a 10-pound bag of groceries. RESULTS: Women in the highest quintile for percentage of body fat and women with a BMI of 30 or greater were two times more likely to report functional limitations than women in the comparison groups. Similar, but weaker, relationships were found among men; men in the highest quintile for body fat and men with a BMI of 35 or greater were 1.5 times more likely to report limitations. Low muscle mass (sarcopenia) and sarcopenia in combination with high percentage of body fat (sarcopenic obesity) were not associated with a greater likelihood of reporting functional limitations. CONCLUSIONS: Prevention of excessive accumulation of body fat and maintenance of a BMI in the normal range may reduce the likelihood of functional limitations in old age.     

Ability of fat and fat-free mass percentages to predict functional disability in older men and women

OBJECTIVES: Previous studies suggest an association between body composition and declining functional ability in older people. This study examined the relation between functional disability and percentage of fat mass (FM) and percentage of fat-free mass (FFM) in older men and women. DESIGN: Cross-sectional and prospective. SETTING: Rancho Bernardo, California. PARTICIPANTS: Subjects consisted of 1,051 ambulatory, community-dwelling Caucasian men and women, age 55 to 92, who attended a clinic visit between 1988 and 1992 and a subsequent clinic visit between 1992 and 1996. MEASUREMENTS: Measured at both visits, percentage of fat mass and percentage of lean body mass were estimated by bioelectric impedance analysis and functional disability was ascertained by self-administered questionnaire. Functional disability was dichotomized into those having any difficulty with a set of tasks versus those having no difficulty with the tasks. Two measures of functional disability were used: "lower body" disability, consisting of two lower motor tasks (walking 2-3 blocks and climbing up 10 stairs) and "overall" disability, consisting of nine tasks representing upper and lower body function and mobility. RESULTS: Compared with men, women were more likely to report both lower body and overall functional disability (P=.001). Cross-sectionally, a significant positive association was shown between fat mass and overall functional disability and a significant negative association was shown between FFM and overall functional disability in both men and women. Prospectively, increased percentage of body fat and decreased percentage of FFM were significantly associated with decreased functional ability in both women and men. All results were adjusted for age, smoking, alcohol use, physical activity, current estrogen use, depression, chronic disease, and education. CONCLUSION: Increased percentage of fat mass and decreased percentage of FFM are associated with greater functional disability in older men and women. Further research is needed to assess the relative importance of decreasing fat percentage or increasing fat-free percentage to preserve or improve functional ability in older people.     

Prediction of fat-free body mass from bioelectrical impedance among 9- to 11-year-old Swedish children

AIM: Predictive equations for estimating body composition from bioelectrical impedance analysis (BIA) among Scandinavian children are lacking. In the present study, equations for estimation of fat-free body mass (FFM) and lean tissue mass (LTM) were developed and cross-validated from BIA using dual-energy X-ray absorptiometry (DXA) as the reference measurement of body composition. METHODS: The study population consisted of 49 girls and 52 boys aged 9-11 years from Malm?, Sweden. Bioelectrical impedance was measured between hand and foot at 50 kHz. Predictive equations were developed by multiple linear regression and cross-validated against DXA measurements of body composition. RESULTS: FFM was predicted from BIA and anthropometric variables with an adjusted R(2)= 0.95 and root mean square error (RMSE) = 0.84 kg, and LTM was predicted with an adjusted R(2)= 0.95 and RMSE = 0.87 kg. Cross-validation revealed a mean RMSE = 0.95 kg FFM and a mean RMSE = 0.96 kg LTM. Prediction of body composition from equations developed in previous literature was mixed when applied to the present cohort of children. CONCLUSIONS: FFM and LTM are predicted with sufficient accuracy at the population level. We recommend that the predictive equations developed in the present study are used in prepubescent European children aged 9-11 years only in order to minimize confounding of results because of possible differences in population samples.     

Association of dietary protein intake with skeletal muscle mass in older adults: A systematic review

Protein supplementation has been shown to be effective in attenuating the loss of lean body mass and muscle mass in older adults; however, its benefits as dietary protein remain unclear. This systematic review of observational studies aimed to investigate the association of dietary protein intake with skeletal muscle mass (SM). Observational studies that investigated the association of dietary protein intake with SM in older adults were retrieved from MEDLINE, Web of Science and Cochrane-CENTRAL databases. Of the 26 analyses in the 17 studies, 18 showed a significant positive association. In cohort studies, 55.6% (five of nine analyses) showed a significant positive association. Of these, four analyses were adjusted for well-known confounding factors, used energy-adjusted protein intake, and used the amount of change of SM between baseline and follow-up as the outcome, with two of them showing a significant positive association. Although 69.2% (18 of 26 analyses) of the 17 studies showed a significant positive association between dietary protein intake and SM in older adults, most studies were cross-sectional and had at least one important methodological limitation. Therefore, we could not draw any conclusions. Thus, well-designed cohort studies are needed in future to identify the association between dietary protein intake and SM in older adults. Geriatr Gerontol Int 2021; 21: 1077–1083 .     

Mortality risk in older men associated with changes in weight, lean mass, and fat mass

OBJECTIVES: To evaluate risk of all‐cause mortality associated with changes in body weight, total lean mass, and total fat mass in older men. DESIGN: Longitudinal cohort study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Four thousand three hundred thirty‐one ambulatory men aged 65 to 93 at baseline. MEASUREMENTS: Repeated measurements of body weight and total lean and fat mass were taken using dual‐energy X‐ray absorptiometry 4.6 ± 0.4 years apart. Percentage changes in these measures were categorized as gain (+5%), loss (–5%), or stable (?5% to +5%). Deaths were verified centrally according to death certificate reviews, and proportional hazard models were used to estimate the risk of mortality. RESULTS: After accounting for baseline lifestyle factors and medical conditions, a higher risk of mortality was found for men with weight loss (hazard rat (HR)=1.84, 95% confidence interval (CI)=1.50–2.26), total lean mass loss (HR=1.78, 95% CI=1.45–2.19), and total fat mass loss (HR=1.72, 95% CI=1.34–2.20) than for men who were stable for each body composition measure. Men with total fat mass gain had a slightly greater mortality risk (HR=1.29, 95% CI=0.99–1.67) than those who remained stable. These associations did not differ according to baseline age, obesity, or self‐reported health status (P for interactions >.10), although self‐reported weight loss intent altered mortality risks with total fat mass (P for interaction=.04) and total lean mass (P for interaction=.09) change. CONCLUSION: Older men who lost weight, total lean mass, or total fat mass had a higher risk of mortality than men who remained stable.     

Antihypertensive medications and differences in muscle mass in older persons: the Health, Aging and Body Composition Study

OBJECTIVES: To evaluate whether older persons using angiotensin-converting enzyme (ACE) inhibitors have a larger lower extremity muscle mass (LEMM) than users of other antihypertensive drugs. DESIGN: Cross-sectional analysis of data from the Health, Aging and Body Composition (Health ABC) Study. SETTING: University of Tennessee, Memphis, and University of Pittsburgh clinics. PARTICIPANTS: A community-based sample of 2,431 well functioning participants of the Health ABC, aged 70 to 79, who were free of heart failure, were selected according to use of antihypertensive medications: ACE inhibitors (n=197), beta-blockers (n=169), thiazides (n=216), calcium-channel blockers (n=340), or none (n=1,509). MEASUREMENTS: LEMM, assessed using dual-energy x-ray absorptiometry, compared by index drug in analysis of variance models unadjusted and adjusted for demographics, study site, height, body fat, physical activity, blood pressure, coronary artery disease, diabetes mellitus, and chronic pulmonary disease. RESULTS: LEMM significantly differed across the study groups, being larger in users of ACE inhibitors than in users of other drugs (unadjusted and adjusted models). LEMM was comparable in users of ACE inhibitors and no drug users. A trend toward larger LEMM was also observed in sex- and ethnicity-stratified analyses and in the subgroup of noncoronary hypertensive participants. CONCLUSION: In older persons, use of ACE inhibitors is associated cross-sectionally with larger LEMM. This finding suggests a possible explanation of the benefits of ACE inhibitors in wasting syndromes. If confirmed in longitudinal studies, this pharmacological action might have important implications for the prevention of physical disability in older patients with hypertension.     

Assessment of appendicular skeletal muscle mass by bioimpedance in older community-dwelling Korean adults

It is crucial to investigate age-related body composition changes in geriatric medicine. Bioelectrical impedance analysis (BIA) is easy to perform, non-invasive, relatively inexpensive, and portable. However, the accuracy of measurement by BIA is questionable. To develop and cross-validate the predictive equation for estimated appendicular skeletal muscle mass (ASM) using BIA in older community-dwelling Korean adults, we include two cohorts: study participants aged 65–80 years in the Ansung cohort for the Korean Health and Genome Study (men, n = 285; women, n = 435) used as equation-generating group, and Korean Longitudinal Study of Health Aging (KLoSHA) as cross-validation group (men, n = 202; women, n = 208). Dual energy X-ray absorptiometry (DXA) and BIA were performed in both cohorts. Using multiple linear regression analysis, we drew a predictive equation for DXA-measured ASM by BIA resistance. From DXA and BIA measurements in the Ansung cohort, we generated the estimated equation ASM (kg) = [(Ht²/R × 0.104) + (age × −0.050) + (gender × 2.954) + (weight × 0.055)] + 5.663 where Ht is height in centimeters; R is BIA resistance in 250 Ω; for gender, men = 1 and women = 0; and age is in years. We validated this equation in the KLoSHA. The r² of the estimated ASM was 0.890. This BIA equation provides valid estimates of ASM in older Korean adults.     

Association between insulin resistance and lean mass loss and fat mass gain in older men without diabetes mellitus

OBJECTIVES: To examine the associations between insulin resistance and changes in body composition in older men without diabetes mellitus. DESIGN: Longitudinal cohort study of older men participating in the Osteoporotic Fractures in Men (MrOS) study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Three thousand one hundred thirty‐two ambulatory men aged 65 and older at baseline. MEASUREMENTS: Baseline insulin resistance was calculated for men without diabetes mellitus using the homeostasis model assessment of insulin resistance (HOMA‐IR). Total lean, appendicular lean, total fat, and truncal fat mass were measured using dual energy X‐ray absorptiometry scans at baseline and 4.6 ± 0.3 years later in 3,132 men with HOMA‐IR measurements. RESULTS: There was greater loss of weight, total lean mass, and appendicular lean mass and less gain in total fat mass and truncal fat mass with increasing quartiles of HOMA‐IR (P<.001 for trend). Insulin‐resistant men in the highest quartile had higher odds of 5% or more loss of weight (odds ratio (OR)=1.88, 95% confidence interval (CI)=1.46–2.43), total lean mass (OR=2.09, 95% CI=1.60–2.73) and appendicular lean mass (OR=1.57, 95% CI=1.27–1.95) and lower odds of 5% or more gain in total fat mass (OR=0.56, 95% CI=0.45–0.68) and truncal fat mass (OR=0.52, 95% CI=0.42–0.64) than those in the lowest quartile. These findings remained significant after accounting for age, site, baseline weight, physical activity, and change in physical activity. These associations were also independent of other metabolic syndrome features and medications. CONCLUSION: Greater lean mass loss and lower fat mass gain occurred in insulin‐resistant men without diabetes mellitus than in insulin‐sensitive men. Insulin resistance may accelerate age‐related sarcopenia.     

Skeletal muscle mass and body fat in relation to successful ageing of older adults: The multi-national MEDIS study

BackgroundThe determinants that promote successful ageing still remain unknown. The aim of the present work was to evaluate the role of skeletal muscle mass and body fat percentage (BF%), in the level of successful ageing.Methodsduring 2005–2011, 2663 older (aged 65–100 years) from 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the study. Appendicular skeletal muscle mass (ASM), skeletal muscle mass index (SMI) and BF% were calculated using population formulas. Dietary habits, energy intake, expenditure and energy balance were derived throughout standard procedures. A successful ageing index ranging from 0 to 10 was used.ResultsThe mean ASM mass was 24 ± 6.0 kg, the SMI was 0.84 ± 0.21 and the BF% was 44%. Females had lower SMI and higher BF% in comparison with males, respectively [(SMI: 0.66 ± 0.09 vs. 1.03 ± 0.11; BF%: 51% vs. 34%, (p < 0.001)]. High successful agers had better rates in ASM (p = 0.01), SMI (p < 0.001) and BF% (p < 0.001), compared with the medium and low successful ones. Changes in SMI [b-coefficient (95% CI):2.14 (1.57 to 2.71)] were positively associated with successful ageing, while changes in BF% [b-coefficient (95% CI): −0.04 (−0.05 to −0.03)] were inversely associated with successful ageing. Results from sensitivity analysis showed that the effects of variations on body composition were consistent, less pronounced in the positive energy balance group and more pronounced among the oldest old.ConclusionsBody composition changes seem to be associated with lower quality of life in the older adults, as measured through successful ageing.     

Relationship Between Total Body Adiposity Assessed by Dual-Energy X-ray Absorptiometry,Birth Weight and Metabolic Syndrome in Young Thai Adults

Objective: The aim of this study was to compare body fat distribution using dual-energy X-ray absorptiometry (DXA) in young adult subjects with metabolic syndrome (MS) with those without MS and also to determine whether a significant association existed between total body fat mass (FM) and MS along with the effect of birth weight.Methods: This cross-sectional study was conducted on 393 young adult subjects (175 male, 218 female). Body mass index (BMI), waist circumference, blood pressure, triglyceride, high-density lipoprotein cholesterol and glucose levels were determined. Total body FM, lean mass (LM) and percentage of body fat (%BF) were assessed by DXA. Adult Treatment Panel III criteria were used for the diagnosis of MS.Results: The prevalence of MS was 5.6% among this group of young adult subjects aged 18.5-21.8 years. Subjects with MS (n=22) had significantly higher values for weight, height, BMI, waist circumference, %BF, total body FM, total body LM, and regional FM and LM. There was no statistically significant difference in bone mineral density between the two groups. There was also no association between birth weight and MS. Multiple logistic regression analysis showed that every 5 kg of total body FM (OR 1.68; 95%CI 1.06-2.66) adjusted for gender, birth weight status, and total body LM were significantly associated with MS.Conclusion: Total body FM measured by DXA was related to MS in Thai young adults. Thus, body composition analysis might have a role in the identification of subjects with MS status.Conflict of interest:None declared.