肥胖成年女性中与代谢紊乱相关的肌肉力量和肌肉质量下降。

The decline in muscle strength and muscle quality in relation to metabolic derangements in adult women with obesity.

机构信息

Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University, Rome, Italy.

出版信息

Clin Nutr. 2019 Oct;38(5):2430-2435. doi: 10.1016/j.clnu.2019.01.028. Epub 2019 Feb 10.

DOI:10.1016/j.clnu.2019.01.028

PMID:30792144

Abstract

BACKGROUND & AIMS: The metabolic and functional characteristics related to sarcopenic obesity have not been thoroughly explored in the earlier stages of the aging process. The aim of the present study was to examine the phenotype of sarcopenic obesity, in terms of lean body mass, muscle strength and quality, in adult women with and without the Metabolic Syndrome (MetS), and its relationship with the features of myosteatosis.

METHODS

Study participants were enrolled at the Sapienza University, Rome, Italy. Body composition was assessed by DXA. The Handgrip strength test (HGST) was performed. HGST was normalized to arm lean mass to indicate muscle quality; intermuscular adipose tissue (IMAT) and intramyocellular lipid content (IMCL) were measured by magnetic resonance imaging and spectroscopy, as indicators of myosteatosis. Different indices of sarcopenia were calculated, based on appendicular lean mass (ALM, kg) divided by height squared, or weight. The NCEP-ATPIII criteria were used to diagnose the MetS. HOMA-IR was calculated. The physical activity level (PAL) was assessed through the IPAQ questionnaire.

RESULTS

54 women (age: 48 ± 14 years, BMI: 37.9 ± 5.4 kg/m) were included. 54% had the MetS (metabolically unhealthy, MUO). HGST/arm lean mass was lower in MUO women than women without the MetS (6.3 ± 1.8 vs. 7.8 ± 1.6, p = 0.03). No differences emerged in terms of absolute ALM (kg) or other indices of sarcopenia (ALM/h or ALM/weight) between metabolically healthy (MHO) vs. MUO women (p > 0.05). Muscle quality was negatively associated with HOMA-IR (p = 0.02), after adjustment for age, body fat, hs-CRP levels, and PAL. IMAT, but not IMCL, was significantly higher in obese women with the MetS compared to women without the MetS (p > 0.05). No association emerged between HGST/arm lean mass and IMAT or IMCL when HOMA-IR was included in the models.

CONCLUSION

Insulin resistance, and not sarcopenia or myosteatosis per se, was associated with muscle weakness, resulting in the phenotype of "dynapenic obesity" in middle-aged women with the metabolic syndrome.

摘要

背景与目的

与肌少症肥胖相关的代谢和功能特征在衰老过程的早期阶段尚未得到充分探索。本研究旨在探讨伴有或不伴有代谢综合征（MetS）的成年女性的肌少症肥胖表型，包括瘦体重、肌肉力量和质量，并探讨其与肌内脂肪增多症特征的关系。

方法

研究参与者在意大利罗马的萨皮恩扎大学招募。通过 DXA 评估身体成分。进行握力测试（HGST）。HGST 被标准化为手臂瘦体重，以表示肌肉质量；通过磁共振成像和光谱学测量肌间脂肪组织（IMAT）和肌内脂质含量（IMCL），作为肌内脂肪增多症的指标。根据四肢瘦体重（ALM，kg）除以身高平方或体重计算不同的肌少症指数。采用 NCEP-ATPIII 标准诊断 MetS。计算 HOMA-IR。通过 IPAQ 问卷评估体力活动水平（PAL）。

结果

纳入 54 名女性（年龄：48±14 岁，BMI：37.9±5.4kg/m）。54%患有 MetS（代谢不健康，MUO）。与无 MetS 的女性相比，MUO 女性的 HGST/手臂瘦质量较低（6.3±1.8 与 7.8±1.6，p=0.03）。代谢健康（MHO）与 MUO 女性之间，绝对 ALM（kg）或其他肌少症指数（ALM/h 或 ALM/体重）无差异（p>0.05）。肌肉质量与 HOMA-IR 呈负相关（p=0.02），调整年龄、体脂肪、hs-CRP 水平和 PAL 后仍有统计学意义。与无 MetS 的女性相比，患有 MetS 的肥胖女性的 IMAT 显著更高（p>0.05），但 IMCL 无差异。当将 HOMA-IR 纳入模型时，HGST/手臂瘦质量与 IMAT 或 IMCL 之间无关联。