Aims and objectives: This study aimed to determine the influences of gender, BMI and observed body shape on subcutaneous fat and muscle thicknesses, and theoretical injection outcome, at the ventrogluteal and dorsogluteal intramuscular injection sites.Background: Debate continues as to whether the dorsogluteal or ventrogluteal

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Intramuscular injections given at the dorsogluteal and ventrogluteal sites are intended for the gluteus maximus and gluteus medius muscles, respectively. However, little research has confirmed the reliability of these sites for the presence and thickness of the target and other muscles, and subcutaneous fat. This study characterised and compared these at the V-method and G-method ventrogluteal sites and dorsogluteal site (n=60). Gluteus maximus, medius and minimus were identified at each site, plus tensor fascia latae at ventrogluteal sites. Gluteus maximus and subcutaneous fat were significantly thicker and gluteus minimus significantly thinner at the dorsogluteal site than both ventrogluteal sites. Gluteus medius was the thickest muscle at each injection site, and thicker at the G-method than the V-method ventrogluteal site. Therefore, the dorsogluteal site reliably targets gluteus maximus, and the G-method ventrogluteal site was more reliable than the V-method ventrogluteal site to target gluteus medius in terms of presence and thickness.

The ventrogluteal site is increasingly recommended for long-acting antipsychotic intramuscular injections; however, it remains infrequently utilized due to nurses' lack of confidence in site identification. The more recent G (geometric) method of ventrogluteal site identification is less subjective and likely more reliable than the V method for successful intramuscular injection outcomes. Knowledge of muscle and subcutaneous fat thicknesses, and the influence of sex and anthropometry on theoretical injection outcome, is necessary to support evidence-based use of the ventrogluteal site. In the presents study, we compared the V and G methods for injection site subcutaneous fat, muscle, and total tissue thicknesses, and theoretical injection outcome (bone injury, intramuscular or subcutaneous), and determined anthropometric predictors of injection outcome. Subcutaneous fat and muscle thicknesses were measured via ultrasound, bilaterally at V and G method sites (28 males, 32 females). Muscle and total tissue were significantly thicker, and successful intramuscular injection significantly more likely, using the G versus V method (75% versus 57%). Females had significantly thicker subcutaneous fat than males at both sites. Even using the G method, 92% of males but only 59% of females, would have a successful intramuscular injection, with remaining females at risk of bone injury (16%) or subcutaneous injection (25%). The G method site is more reliable for successful intramuscular injection, with less risk of bone injury than the V method site. Appropriate needle-length selection is essential for females with a body mass index (BMI) <23 kg m and weight <60 kg (to avoid bone injury), and BMI >30 kg m and hip >90 cm (to avoid subcutaneous injection).

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The pro‐inflammatory cytokines IL‐1α, IL‐6 and TNF‐α are associated with major depressive disorder, psychological distress, cardiovascular health and obesity. However, there is limited research that has examined multiple associations between these variables, particularly among individuals with major depressive disorder who are treatment free, in comparison with a control cohort, and including analyses of sex differences. In this study, data were analysed from 60 individuals with major depressive disorder and 60 controls, including plasma IL‐1α, IL‐6 and TNF‐α, adiposity measures (body mass index, waist circumference), cardiovascular health indices (blood pressure, heart rate) and psychological symptoms (depressive severity, anxiety, hostility, stress). The cytokines were compared by group and sex and correlated with measures of adiposity, cardiovascular health indices and psychological health. Plasma IL‐1α and IL‐6 were higher in major depressive disorder group versus control, but with a sex interaction for IL‐6, with this group difference only among females. TNF‐α did not differ between groups. IL‐1α and IL‐6 correlated with depressive severity, anxiety, hostility and stress, whereas TNF‐α correlated only with anxiety and hostility. Psychopathology was associated with IL‐1α in males only and with IL‐6 and TNF‐α in females only. None of the cytokines correlated with body mass index, waist circumference, blood pressure or heart rate. The result of group by sex interaction for IL‐6 and sex‐specific associations between pro‐inflammatory cytokines and psychometrics could be aetiologically important in depression interventions and treatments for females versus males, warranting further investigation.

No abstract

The pro-inflammatory cytokines IL-1α, IL-6 and TNF-α are associated with major depressive disorder, psychological distress, cardiovascular health, and obesity. However, there is limited research that has examined multiple associations between these variables, among individuals with major depressive disorder in comparison to a control cohort, including sex differences. In this study, data was analysed from 60 individuals with major depressive disorder and 60 controls, including plasma IL-1α, IL-6 and TNF-α, adiposity measures (body mass index; waist circumference), cardiovascular health indices (blood pressure; heart rate) and psychological symptoms (depressive severity; anxiety; hostility; stress). The cytokines were compared by group and sex, and correlated with measures of adiposity, cardiovascular health indices and psychological health. Plasma IL-1α and IL-6 were higher in major depressive disorder group versus control, but with a sex interaction for IL-6, with this group difference only among females. TNF-α did not differ between groups. IL-1α and IL-6 correlated with depressive severity, anxiety, hostility, and stress, while TNF-α correlated only with anxiety and hostility. Psychopathology was associated with IL-1α in males only, and with IL-6 and TNF-α in females only. None of the cytokines correlated with body mass index, waist circumference, blood pressure or heart rate. The result of group by sex interaction for IL-6, and sex specific associations between pro-inflammatory cytokines and psychometrics could be aetiologically important in depression interventions and treatments for females versus males, warranting further investigation.