Intramuscular Adipose Tissue and the Functional Components of Sarcopenia in Hospitalized Geriatric Patients

Abstract

Intramuscular adipose tissue (IMAT) could be an important missing value in the assessment of sarcopenia. This study tries to determine the relation between IMAT, muscle strength, functionality and mortality. In addition, the relation with nutritional status is screened. For six months, all patients admitted to the University Geriatric Center of Antwerp were evaluated for strength (hand grip), functionality (short physical performance battery-SPPB) and nutritional status. After one year, patients/relatives were contacted to obtain a current health status (mortality). A total of 303 patients were included at a mean age of 83.0 ± 6.4 years. The mean percentage of IMAT was 29.2% ± 13.0% (range 3.2%-86.2%). There was a negative correlation between IMAT and both grip strength and SPPB. SPPB was positively correlated with both grip strength and muscle mass. There was a positive correlation between IMAT and mortality. There was a negative correlation between grip strength, SPPB and mortality. IMAT did not have a clear relation with nutritional status. IMAT should be addressed in the work-up of sarcopenia, as it is correlated with muscle strength, functionality and mortality. In this cohort of hospitalized geriatric patients, there is a mean of about one-third of measured muscle volume that appears to be adipose tissue.

The mortality determinants of sarcopenia and comorbidities in hospitalized geriatric patients

“…The 'Low SPPB-scores' group have a fifty percent higher risk compared to the 'High SPPB-scores' group. These data of hospitalized geriatric patients confirm the results of other studies in different populations 4,10,13,15,[21][22][23] . Figure 1 gives an overview of the Kaplan Meier curves of all these significant class variables.…”

“…This questionnaire was taken on the first working day after the day of admission. The subjects were divided in three groups: 'Malnourished' (score 0-7), 'Risk of Malnutrition' (scores 8-11) and 'Normal nutritional status' (scores 12-14) 10 . The comorbidities were obtained later through research of medical records.…”

“…Unfortunately, these groups all use their own diagnostic criteria and cut off values. As a result, nowadays, there is still no universal operational definition of sarcopenia [8][9][10] . Sarcopenia is known to be associated with an increased risk for several adverse outcomes such as frailty, hospitalization, disability and mortality 4,13,14 .…”

Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis

“…Additionally, myosteatosis may have a greater impact on muscle function than muscle mass itself . In older hospitalized patients, myosteatosis is linked to longer hospital stay and increased mortality . Whether this translates into increased mortality in the NASH or patients with cirrhosis population remains to be determined.…”

Precision of MRI-based body composition measurements of postmenopausal women

“…Increased body fat, especially central fat deposits, are related to both high cardiovascular risks and increased risk to develop cancer [ 24 ]. Increased MFI has been shown to correlate with functional outcomes in sarcopenia [ 25 ] and is commonly observed in investigations of type 2 diabetes [ 26 ]. Obese postmenopausal women have an increased breast cancer risk, probably mainly due to increased oestrogen production by adipose tissue from adrenal androgens, but also due to chronic adipose tissue inflammation [ 27 ].…”