Intramuscular adipose tissue of the quadriceps is more strongly related to recovery of swallowing ability than is muscle mass in older inpatients: A prospective study

Akazawa, Naoki; Kishi, Masaki; Hino, Toshikazu; Tsuji, Ryota; Tamura, Kimiyuki; Hioka, Akemi; Moriyama, Hideki

doi:10.1016/j.nut.2021.111364

Cited by 10 publications

(32 citation statements)

References 44 publications

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“…Transverse ultrasound images were acquired using a B-mode ultrasound device (Nanomaxx; SonoSite Japan, Tokyo, Japan) with a linear-array probe (L25n/13–6 MHz; Nanomaxx; SonoSite Japan). Muscle mass and fraction of intramuscular adipose tissue of the rectus femoris and vastus intermedius were assessed on the basis of the muscle thickness and echo intensity [ 5 – 13 , 16 – 22 ], respectively. The validity of the muscle mass and fraction of intramuscular adipose tissue measurements using ultrasound was confirmed in recent studies using magnetic resonance imaging [ 23 – 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…Images of the rectus femoris and vastus intermedius were obtained at 30% of their distance from the anterior superior iliac spine to the proximal end of the patella [ 6 , 8 , 10 – 13 , 19 – 22 ]. The participants laid in the supine position with their lower limbs relaxed, while a water-soluble transmission gel was applied to the skin surface of their thighs.…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, the European Working Group of Sarcopenia in Older People2 (EWGSOP2) [ 4 ] suggested the importance of assessing not only muscle mass but also muscle quality, which includes the infiltration of fat into muscle, ratio of muscle strength to appendicular skeletal muscle mass, and bioimpedance analysis-derived phase angle, in the diagnosis of sarcopenia. Among the muscle quality parameters, intramuscular adipose tissue has been shown to be more closely related to muscle strength [ 5 , 6 ], stand-up, sit-down [ 5 , 7 ], and gait abilities [ 6 , 8 , 9 ], activities of daily living [ 10 , 11 ], swallowing function [ 12 , 13 ], onset of hip fracture [ 14 ], and mortality [ 15 ] than to muscle mass. Fraction of intramuscular adipose tissue is assessed with the echo intensity of the ultrasound image [ 5 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among the muscle quality parameters, intramuscular adipose tissue has been shown to be more closely related to muscle strength [ 5 , 6 ], stand-up, sit-down [ 5 , 7 ], and gait abilities [ 6 , 8 , 9 ], activities of daily living [ 10 , 11 ], swallowing function [ 12 , 13 ], onset of hip fracture [ 14 ], and mortality [ 15 ] than to muscle mass. Fraction of intramuscular adipose tissue is assessed with the echo intensity of the ultrasound image [ 5 – 13 ]. However, setting the reference value for echo intensity is difficult because measurement conditions (e.g., differences of ultrasound device, probe, and scanning conditions) influence echo intensity [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…A previous study [ 18 ] reported that quadriceps thickness assessed with ultrasound image is closely related to quadriceps echo intensity in community-dwelling older persons (male: r = − 0.734, p < 0.01; female: r = − 0.565, p < 0.01). However, this detailed relationship has not yet been assessed in older inpatients who experience various conditions, including nutritional deficiencies, inflammatory conditions, changes in the activities of daily living, and swallowing problems, which affect their muscle mass and intramuscular adipose tissue [ 8 , 10 – 13 , 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between muscle mass and fraction of intramuscular adipose tissue of the quadriceps in older inpatients

et al. 2022

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Background In 2021, the International Society of Physical and Rehabilitation Medicine (ISPRM) special interest group on sarcopenia included the quadriceps thickness assessed with ultrasound image as an indicator of muscle mass in the diagnosis criteria of sarcopenia. If quadriceps echo intensity of older inpatients is to be a strong predictor of quadriceps thickness, muscle quality of the quadriceps may be estimated by the muscle mass when diagnosing sarcopenia using the criteria of ISPRM. Objective This study aimed to examine the association between muscle mass and fraction of intramuscular adipose tissue of the quadriceps in older inpatients. Methods This cross-sectional study included 399 inpatients aged ≥ 65 years. Primary outcomes were muscle mass and fraction of intramuscular adipose tissue of the quadriceps. Images were acquired using a B-mode ultrasound. Muscle mass and fraction of intramuscular adipose tissue of the quadriceps were assessed based on the muscle thickness and echo intensity, respectively. A multiple regression analysis (forced entry method) was performed to confirm whether quadriceps echo intensity was related to quadriceps thickness even after adjusting for other factors. Results In the multiple regression analyses for both male and female models, quadriceps echo intensity (male: β = − 0.537, p < 0.001; female: β = − 0.438, p < 0.001), Geriatric Nutritional Risk Index (male: β = 0.236, p < 0.001; female: β = 0.213, p < 0.001), and subcutaneous fat thickness of the thigh (male: β = 0.197, p < 0.001; female: β = 0.248, p < 0.001) were independently and significantly associated with quadriceps thickness. Conclusions Our results show that there is a negative and significant association between muscle mass and fraction of intramuscular adipose tissue in older inpatients. Muscle quality of the quadriceps in older inpatients may be estimated to some extent by the muscle mass.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between muscle mass and fraction of intramuscular adipose tissue of the quadriceps in older inpatients

et al. 2022

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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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Associations of Trunk Muscle Mass and Muscle Quality Indicators with Self-Reported Dysphagia in Older Inpatients

et al. 2022

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Intramuscular adipose tissue of the quadriceps is more strongly related to recovery of swallowing ability than is muscle mass in older inpatients: A prospective study

Cited by 10 publications

References 44 publications

Relationship between muscle mass and fraction of intramuscular adipose tissue of the quadriceps in older inpatients

Relationship between muscle mass and fraction of intramuscular adipose tissue of the quadriceps in older inpatients

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

Associations of Trunk Muscle Mass and Muscle Quality Indicators with Self-Reported Dysphagia in Older Inpatients

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