Intramuscular adipose tissue determined by T1-weighted MRI at 3 T primarily reflects extramyocellular lipids

Akima, Hiroshi; Hioki, Maya; Yoshiko, Akito; Koike, Teruhiko; Sakakibara, Hisataka; Takahashi, Hideyuki; Oshida, Yoshiharu

doi:10.1016/j.mri.2015.12.038

Cited by 127 publications

(143 citation statements)

References 45 publications

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“…The reliability and validity of the MT and RF EI at the anterior mid-thigh have been repeatedly confirmed in previous studies [19,20,[24][25][26][27]29]. The MT reflects the quadriceps muscle volume (r = 0.46, p < 0.05) [26] and cross-sectional area (r = 0.91, p < 0.001) [24].…”

Section: Mt and Ei As Measured By Ussupporting

confidence: 58%

“…The RF muscle EI was measured as an index of muscle quality [19,20,28]. The mean gray scale value, which was obtained from 256 levels of gray (0 = black, 255 = white) within a region of interest in the RF, was used for analysis.…”

Section: Mt and Ei As Measured By Usmentioning

confidence: 99%

“…The quality of the quadriceps femoris in post-stroke patients has been assessed using medical imaging modalities such as magnetic resonance imaging [5], computed tomography [6], and ultrasonography (US) [17]. A higher ratio of intramuscular fat to muscle tissue generally represents lower muscle quality [18][19][20], and one study showed that this ratio in the paretic limb was 4.9% higher than that in the nonparetic limb with statistical significance [6]. Lower muscle quality is associated with lower physical performance, higher insulin resistance, [6,18,21], and muscle atrophy [22,23].…”

mentioning

confidence: 99%

“…US is an ideal technique for the measurement of muscle quality and quantity, which are frequently assessed according to the muscle thickness (MT) and echo intensity (EI) [9,17,20,21,[24][25][26][27]. The advantages of US are that it is noninvasive as well as less expensive and more portable than other medical imaging modalities such as magnetic resonance imaging, computed tomography, and dual-energy X-ray absorptiometry.…”

mentioning

confidence: 99%

“…MT is positively associated with the muscle size and is thus used as an index of muscle quantity [24,25]. Higher muscle EI as shown by US indicates lower muscle quality; that is, a higher ratio of intramuscular fat to muscle tissue [19,20,28].…”

mentioning

confidence: 99%

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Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Maeda

Imada²,

Ishida

et al. 2019

Eur Neurol

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Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage (β = –0.26, p < 0.01), body weight (β = 0.68, p < 0.01), and serum albumin (β = 0.34, p < 0.01), with an adjusted R² of 0.81. The MT in the non-paretic limb was explained by the muscle EI (β = –0.55, p < 0.01) and age (β = –0.40, p < 0.01), with an adjusted R² of 0.69. The muscle EI was explained by the MT in the paretic limb (β = –0.34, p < 0.01) and non-paretic limb (β = –0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.

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Section: Mt and Ei As Measured By Ussupporting

confidence: 58%

Section: Mt and Ei As Measured By Usmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Maeda

Imada²,

Ishida

et al. 2019

Eur Neurol

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Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Akazawa

Kishi

Hino

et al. 2021

J cachexia sarcopenia muscle

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Background The relationship between intramuscular adipose tissue at admission and recovery of activities of daily living (ADL) remains unclear. This study aimed to examine the relationship between intramuscular adipose tissue in the quadriceps at admission and recovery of ADL in older inpatients. Methods This prospective study included 404 inpatients aged ≥65 years (54.7% female). Recovery of ADL during hospital stay was assessed using the Barthel Index (BI) score at discharge, BI score change, and BI efficiency. Higher BI at discharge, BI score change, and BI efficiency indicate more improvement in ADL. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Multiple regression analysis was performed to identify factors independently associated with BI score at discharge, BI score change, and BI efficiency. The independent variables were BI score at admission, echo intensity and muscle thickness of the quadriceps, age, sex, number of medications, C‐reactive protein concentration, updated Charlson Comorbidity Index score, Food Intake Level Scale, Geriatric Nutritional Risk Index score, days from onset disease, length of hospital stay, number of units of rehabilitation therapy, and subcutaneous fat thickness of the thigh. Results The medians (inter‐quartile range) of the BI score at discharge, BI score change, and BI efficiency were 60.0 (35.0–80.0), 10.0 (0.0–25.0), and 0.11 (0.00–0.37), respectively. The median (inter‐quartile range) of the length of hospital stay (days) and days from onset disease were 58.0 (39.0–92.0) and 79.0 (49.0–112.0), respectively. Quadriceps echo intensity was independently and significantly associated with the BI score at discharge (β = −0.13, P < 0.01), BI score change (β = −0.23, P < 0.01), and BI efficiency (β = −0.21, P < 0.01). Quadriceps thickness was not independently and significantly associated with the BI score at discharge (β = −0.02, P = 0.68), BI score change (β = −0.02, P = 0.79), and BI efficiency (β = 0.03, P = 0.67). Conclusions Our study indicates that greater intramuscular adipose tissue in the quadriceps at admission is more strongly related to worse recovery of ADL than less muscle mass in older inpatients. Greater intramuscular adipose tissue in the quadriceps in older inpatients is considered to be a predictor of worse recovery of ADL, and intervening for greater intramuscular adipose tissue may be important for improving ADL in older inpatients.

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Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Akazawa

Kishi²,

Hino³

et al. 2021

J cachexia sarcopenia muscle

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Background The longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living (ADL) in older inpatients remains unclear. This study aimed to examine whether decrease of intramuscular adipose tissue of the quadriceps in older inpatients is related to the recovery of ADL than increase of muscle mass. Methods This longitudinal study included 202 inpatients aged ≥65 years [median age: 83.0 (77.0–88.0), 56.4% female]. Recovery of ADL during hospital stay was assessed using the change in Barthel index (BI) score (i.e. BI score at discharge minus BI score at admission) and BI score at discharge. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Higher echo intensity indicates greater intramuscular adipose tissue. Multiple regression analysis was performed to identify the factors independently associated with the change in BI score and BI score at discharge. Changes in quadriceps echo intensity and thickness and subcutaneous fat thickness of the thigh, quadriceps echo intensity and thickness, and subcutaneous fat thickness of the thigh at admission, age, sex, days from onset disease, BI score at admission, and disease were set as independent variables. Results The means of the change in quadriceps echo intensity and thickness were −2.3 ± 15.7 and 0.1 ± 0.4 cm, respectively. The median of the change in BI score was 15.0 (0.0–30.0). The quadriceps echo intensity at discharge was significantly lower than at admission (P = 0.043). The quadriceps thickness (P = 0.004) and BI score at discharge (P < 0.001) were significantly higher than those at admission. Change in quadriceps echo intensity was independently and significantly associated with the change in BI score (β = −0.25, P = 0.006) and BI score at discharge (β = −0.18, P = 0.006). In contrast, change in quadriceps thickness was not independently and significantly associated with the change in BI score (β = 0.09, P = 0.244) and BI score at discharge (β = 0.06, P = 0.244). Conclusions Our study indicates that a decrease of intramuscular adipose tissue of the quadriceps is related to the recovery of ADL than an increase of muscle mass in older inpatients. Intramuscular adipose tissue of the quadriceps in older inpatients is considered to be a predictor for the recovery of ADL, and intervening for intramuscular adipose tissue may be important for improving ADL in older inpatients.

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Intramuscular adipose tissue determined by T1-weighted MRI at 3 T primarily reflects extramyocellular lipids

Cited by 127 publications

References 45 publications

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

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