Ricciardi Carlo, Ponsiglione Alfonso Maria, Recenti Marco, Amato Francesco, Gislason Magnus Kjartan, Chang Milan, Gargiulo Paolo
Department of Electrical Engineering and Information Technology, University of Naples "Federico II", Naples, Italy.
Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland.
Front Bioeng Biotechnol. 2023 Dec 12;11:1282024. doi: 10.3389/fbioe.2023.1282024. eCollection 2023.
The aging population poses significant challenges to healthcare systems globally, necessitating a comprehensive understanding of age-related changes affecting physical function. Age-related functional decline highlights the urgency of understanding how tissue composition changes impact mobility, independence, and quality of life in older adults. Previous research has emphasized the influence of muscle quality, but the role of tissue composition asymmetry across various tissue types remains understudied. This work develops asymmetry indicators based on muscle, connective and fat tissue extracted from cross-sectional CT scans, and shows their interplay with BMI and lower extremity function among community-dwelling older adults. We used data from 3157 older adults from 71 to 98 years of age (mean: 80.06). Tissue composition asymmetry was defined by the differences between the right and left sides using CT scans and the non-Linear Trimodal Regression Analysis (NTRA) parameters. Functional mobility was measured through a 6-meter gait (Normal-GAIT and Fast-GAIT) and the Timed Up and Go (TUG) performance test. Statistical analysis included paired t-tests, polynomial fitting curves, and regression analysis to uncover relationships between tissue asymmetry, age, and functional mobility. Findings revealed an increase in tissue composition asymmetry with age. Notably, muscle and connective tissue width asymmetry showed significant variation across age groups. BMI classifications and gait tasks also influenced tissue asymmetry. The Fast-GAIT task demonstrated a substantial separation in tissue asymmetry between normal and slow groups, whereas the Normal-GAIT and the TUG task did not exhibit such distinction. Muscle quality, as reflected by asymmetry indicators, appears crucial in understanding age-related changes in muscle function, while fat and connective tissue play roles in body composition and mobility. Our study emphasizes the importance of tissue asymmetry indicators in understanding how muscle function changes with age in older individuals, demonstrating their role as risk factor and their potential employment in clinical assessment. We also identified the influence of fat and connective tissue on body composition and functional mobility. Incorporating the NTRA technology into clinical evaluations could enable personalized interventions for older adults, promoting healthier aging and maintaining physical function.
老龄化人口给全球医疗保健系统带来了重大挑战，因此有必要全面了解影响身体功能的与年龄相关的变化。与年龄相关的功能衰退凸显了了解组织成分变化如何影响老年人的活动能力、独立性和生活质量的紧迫性。先前的研究强调了肌肉质量的影响，但不同组织类型之间的组织成分不对称的作用仍未得到充分研究。这项工作基于从横断面CT扫描中提取的肌肉、结缔组织和脂肪组织开发了不对称指标，并展示了它们与社区居住的老年人的BMI和下肢功能之间的相互作用。我们使用了来自3157名年龄在71岁至98岁（平均：80.06岁）的老年人的数据。组织成分不对称通过CT扫描以及非线性三峰回归分析（NTRA）参数来定义左右两侧之间的差异。功能性活动能力通过6米步态（正常步态和快速步态）以及计时起立行走（TUG）性能测试来测量。统计分析包括配对t检验、多项式拟合曲线和回归分析，以揭示组织不对称、年龄和功能性活动能力之间的关系。研究结果显示，组织成分不对称会随着年龄的增长而增加。值得注意的是，肌肉和结缔组织宽度不对称在不同年龄组之间表现出显著差异。BMI分类和步态任务也会影响组织不对称。快速步态任务显示正常组和慢速组在组织不对称方面存在显著差异，而正常步态和TUG任务则没有表现出这种差异。不对称指标所反映的肌肉质量在理解与年龄相关的肌肉功能变化方面似乎至关重要，而脂肪和结缔组织在身体成分和活动能力方面发挥着作用。我们的研究强调了组织不对称指标在理解老年人肌肉功能如何随年龄变化方面的重要性，证明了它们作为风险因素的作用以及在临床评估中的潜在应用。我们还确定了脂肪和结缔组织对身体成分和功能性活动能力的影响。将NTRA技术纳入临床评估可以为老年人提供个性化干预，促进更健康的衰老并维持身体功能。
