Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Association of Breastfeeding Duration with Body Composition in Children Aged 3–5 Years

Objective This study aimed to assess the relationship between the body composition of children aged 3–5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0–17 years of age in China(CNHSC),a nationwide cross-sectional study.Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews.The body composition of preschool children was measured using bioelectrical impedance analysis.A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total,2,008 participants were included in the study.Of these,89.2%were ever breastfed and the median duration of breastfeeding was 12 months(IQR 7–15 months).Among children aged 3 years,the height-for-age Z-score(HAZ)for the ever breastfed group was lower than that for never breastfed group(0.12 vs.0.42,P=0.043).In addition,the weight-for-age Z-score(WAZ)of the ever breastfed group was lower than that of the never breastfed group(0.31 vs.0.65,P=0.026),and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed.Compared to the formula-fed children,the fat-free mass of breastfed infants was higher for children aged 3 years(12.84 kg vs.12.52 kg,P=0.015)and lower for those aged 4 years(14.31 kg vs.14.64 kg,P=0.048),but no difference was detected for children aged 5 years(16.40 kg vs.16.42 kg,P=0.910)after adjusting for potential confounders.No significant difference was detected in the weight-for-height Z-score(WHZ),body mass index(BMI)-for-age Z-score(BAZ),fat-free mass index,and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3–5 years.Conclusion No obvious associations were detected between breastfeeding duration,BMI,and fat mass indicators.Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

Exploring overweight and obesity beyond body mass index:A body composition analysis in people with and without patellofemoral pain

Background:We compared body mass index(BMI),body fat,and skeletal muscle mass between(1) a mixed-sex nonathletic cohort of people with patellofemoral pain(PFP) and pain-free people,and(2) a nonathletic cohort of people with PFP and pain-free people subgrouped by sex(i.e.,men and women with PFP vs.pain-free men and women).Methods:This cross-sectional study included 114 people with PFP(71 women,43 men) and 54 pain-free controls(32 women,22 men).All participants attended a single testing session to assess body composition measures,which included BMI,percentage of body fat(%BFBioimpedance),and skeletal muscle mass(both assessed by bioelectrical impedance analysis),and percentage of body fat(%BFskinfoid)(assessed by skinfold caliper analysis).A one-way univariate analysis of covariance(age and physical activity levels as covariates) was used to compare body composition measures between groups(i.e.,PFP vs.pain-free group;women with PFP vs.pain-free women;men with PFP vs.pain-free men).Results:Women with PFP presented significantly higher BMI,%BFBiompedance,and %BFSkinfold,and lower skeletal muscle mass compared to pain-free women(p≤0.04;effect size:-0.47 to 0.85).Men with PFP and men and women combined had no differences in BMI,%BFBioimpedance,%BFSkinfold,and skeletal muscle mass compared to their respective pain-free groups(p> 0.05).Conclusion:Our findings indicate that BMI and body composition measures should be considered as part of the evaluation and management of people with PFP,especially in women,who have demonstrated higher BMI and body fat and lower skeletal muscle mass compared to pain-free controls.Future studies should not assess body composition measures in a mixed-sex population without distinguishing men participants from women participants.

The Association of Maternal Body Composition and Dietary Intake with the Risk of Gestational Diabetes Mellitus during the Second Trimester in a Cohort of Chinese Pregnant Women

Objective To investigate the association of maternal body composition and dietary intake with the risk of gestational diabetes mellitus （GDM）. Methods A total 154 GDM subjects and 981 controls were enrolled in a prospective cohort study in 11 hospitals from May 20, 2012 to December 31, 2013. Bioelectrical impedance analysis and dietary surveys were used to determine body composition and to evaluate the intake of nutrients in subjects at 21-24 weeks＇ gestation （WG）. Logistic regression analysis was applied to explore the relationships of maternal body composition and dietary intake with the risk of GDIVl morbidity. Results Age, pre-pregnant body weight （BW）, and body mass index （BMI） were associated with increased risk of GDM. Fat mass （FM）, fat mass percentage （FMP）, extracellular water （ECW）, BMI, BW, energy, protein, fat, and carbohydrates at 21-24 WG were associated with an increased risk of GDM. In contrast, fat free mass （FFM）, muscular mass （MM）, and intracellular water （ICW） were associated with a decreased risk of GDM. Conclusion Maternal body composition and dietary intake during the second trimester of pregnancy were associated with the risk of GDM morbidity.

Leisure-time physical activity,anthropometrics,and body composition as predictors of quality of life domains after spinal cord injury:an exploratory cross-sectional study

The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropometric variables,and body composition variables.This exploratory cross-sectional study consisted of baseline data collected as part of a randomized clinical trial at a VA Medical Center and SCI center.A convenience sample of 36 community-dwelling persons with SCI participated in the current study.Outcome measures included the World Health Organization Quality of Life Short Form(WHOQOL-BREF),Leisure-Time Physical Activity Questionnaire for People with Spinal Cord Injury(LTPAQ-SCI),anthropomorphic measures(waist,hip,and abdominal circumference),and dual-energy x-ray absorptiometry(DXA)to quantify regional and total body composition.Multiple regression models suggested that engagement in LTPA accounted for 35.7%of the variance in physical health QOL,33.5%in psychological QOL,14.2%in social relationships QOL,and 38.2%in environmental QOL.Anthropometric measures accounted for 11.3%,3.1%,12.0%,and 6.7%of the variance in these QOL indices,respectively,and DXA indices accounted for 18.7%,17.5%,27.4%,and 21.9%.Within these models,the number of minutes of heavy LTPA per day uniquely predicted physical health QOL,the number of mild LTPA days per week uniquely predicted psychological QOL,and the amount of mild LTPA per day uniquely predicted environmental QOL.Bivariate analyses also suggested that android and trunk fat,as well as supine waist and abdominal circumferences,were positively associated with social relationships QOL.Encouraging individuals with SCI to engage in LTPA may robustly enhance multiple aspects of QOL while reducing the risk for cardiovascular and metabolic morbidities associated with SCI.Moreover,this may lead to a further understanding of how QOL may impact longitudinal intervention trials.The study protocol and procedures were reviewed and approved by the McGuire VA Research Institutional Review Board(IRB#02152,approval date August 9,2015;IRB#02375,approval date May 2,2018).

Effect of Stocking Density on Water Quality and(Growth, Body Composition and Plasma Cortisol Content) Performance of Pen-Reared Rainbow Trout(Oncorhynchus mykiss)

The goal of the study was to examine the effect of stocking density on the water quality of culture area, as well as the growth, body composition and cortisol content of rainbow trout(Oncorhynchus mykiss). Pen-reared trout were stocked in densities of 40, 60, 80 fish individuals m^(-3)(4.6, 6.6, 8.6 kg m^(-3), SD1, SD2 and SD3 groups, respectively) for 300 days. Compared to the water from SD1 and SD2, that from SD3 exhibited significantly higher NH_4^+-N content and COD(chemical-oxygen-demand), and a significant reduction of dissolved oxygen in day 180(40.6 kg m^(-3)). Stocking density was significantly associated with body weight, standard length, VSI(viscerosomatic index), CF(condition factor) and FC(food coefficient) in group SD3, particularly in day 240 and day 300(45 or 49.3 kg m^(-3)). Increased crude fat and decreased crude protein were displayed in high density group when the density reached to 36 kg m^(-3). As a cumulative effect of density-related stress, VSI, CF, FC, moisture, and crude protein content varied over time in each density group(SD1, SD2, and SD3). In summary, trout exhibited a better growth performance in low density(26.3 kg m^(-3)) than those reared in high densities(36 and 45 kg m^(-3)). The results indicate that rainbow trout(114.44 g ± 6.21 g, 19.69 cm ± 0.31 cm) initially stocked in 6.6 or 8.6 kg m^(-3) should be lightened to less than 36 kg m^(-3) after an intensive rearing for 240 days.

The levels of osteopontin in human milk of Chinese mothers and its associations with maternal body composition

Objective:This study explored the content and change trend of osteopontin(OPN)in breast milk and analyzed the relationship between OPN in breast milk and maternal body composition.Methods:Breast-feeding mothers were recruited in Xinhua Hospital to collect breast milk and provide pertinent information.The content of OPN in breast milk was determined by enzyme-linked immunosorbent assay(ELISA).Determination of protein content in human milk was performed via the BCA method.The maternal body composition was determined by the bioelectrical impedance method.Serum glucocorticoid receptorα,adiponectin,insulin,and leptin were determined by ELISA.SPSS 25 was used for statistical analysis.Results:In the longitudinal cohort,106 mothers provided 318 milk samples at different lactation periods.The results indicate that the OPN showed dynamic changes.OPN levels were(343.2±163.5)mg/L during 1-14 days postpartum,(228.4±121.5)mg/L during 2-4 months postpartum,and(204.8±100.6)mg/L during 5-7 months postpartum.The content of OPN was very high in the first 1-14 days postpartum and then decreased.Compared with early postpartum milk,the OPN content of mature milk showed a significant relationship with maternal weight-related parameters.Additional body composition analysis was performed in 88 women at the mature milk phase.The results show that the OPN in milk is related to the mother’s body composition,especially the content of skeletal muscle mass,but not to relevant humoral factors.Conclusions:The levels of OPN in human milk of Chinese mothers showed dynamic changes with the extension of lactation time.The OPN in human milk was related to the mother’s body composition but not related to related humoral factors.

The Effects of Lactobacillus rhamnosus GG on Mechanical Properties of Long Bones and Body Composition in Immunodeficient Mice

This study aimed to assess whether a daily supplementation with Lactobacillus rhamnosus GG (LGG) can alter the body composition as well as bone turnover and the mechanical properties of the bones in systemic immunodeficiency. For this, we use an in vivo model of severe combined immunodeficient (scid) mice supplemented daily with LGG over 8 weeks period. After 8 weeks of the treatment, the animals were assessed by DEXA and then the blood was collected from the hepatic portal vein for bone turnover biomarkers;post-mortem, the caecum was removed for isolation and enumeration of the gut bacteria, while femurs/tibiae were excised for the assessment of their mechanical properties. LGG treatment affected the composition of the gut microbiota at the order level, and it decreased (P = 0.002) total adipose tissue content. Moreover, LGG treatment decreased the stiffness (N/mm) of both femurs (P = 0.008) and tibiae (P = 0.011). To conclude, this study shows that dietary supplementation with LGG in immunodeficient animals can alter mechanical properties of the long bones and concomitantly it can modify host’s total adiposity level.

Hydration status,body composition,and anxiety status in aeronautical military personnel from Spain:a crosss-ectional study

Background: An adequate hydration status is critical to ensure efficiency during mental and physical activities.Our goal was to assess the hydration status of a Spanish group of aeronautical military men and to determine the association of hydration status with body composition and anxiety.Methods: A total of 188 men were evaluated through a validated hydration questionnaire, anthropometric and biochemical parameters, and an anxiety questionnaire. Based on these methods, the criteria of hydration were established.Results: Of the total sample, 81% met the hydration criteria(urine color = well hydrated, water balance ≥0 ml, and total water intake/weight ≥35 ml/kg), and 19% did not meet the hydration criteria(urine color = not sufficiently hydrated or dehydrated, water balance <0 ml, and total water intake/weight <35 ml/kg). Subjects not meeting the hydration criteria had lower urine pH, negative water balance, and lower water intake. The latter also had higher anxiety status(score=4 vs. 3, P=0.026), weight [(84.7±10.5) kg vs.(80.5±10.2) kg], body mass index [(26.3±3.1) kg/m;vs.(25.2±2.8) kg/m;], body fat [(22.3±5.6)% vs.(18.3±6.5)%], urine specific gravity, and urine color. Using a logistic binary regression model, hydration status was related significantly with the percentage of body fat(P=0.004), but no relation was found with age, comorbidities, or medications. Furthermore, total water intake/weight was positively correlated with percentage of body water(r=0.357, P=0.000) and negatively with body fat(kg)(r=–0.427, P=0.000), percentage of body fat(r=–0.405, P=0.000), and waist/hip ratio(r=–0.223, P=0.002). Based on a linear regression model, total water intake/weight was related significantly with percentage of body fat(P=0.001) and percentage of body water content(P=0.035). No relation was found, however, with waist/hip ratio, age, comorbidities, or medications.Conclusions: These findings all suggest a relationship between hydration status and body composition but also set the bases for future studies that relate hydration status and anxiety status. These results can be used to improve the hydration status and body composition of military personnel.

Challenges in the noninvasive detection of body composition using near-infrared spectroscopy

Noninvasive detection of body composition plays a significant role in the improvement of life quality and reduction in complications of the patients,and the near-infrared(NIR)spectroscopy,with the advantages of painlessness and convenience,is considered as the most promising tool for the online noninvasive monitoring of body composition.However,quite different from other fields of online detection using NIR spectroscopy,such as food safety and environment monitoring,noninvasive detection of body composit ion demands higher precision of the instruments as well as more rigor-ousness of measurement conditions.Therefore,new challenges emerge when NIR spectroscopy is applied to the noninvasive detection of body composition,which,in this paper,are first concluded from the aspects of measurement methods,measurement conditions,instrument precision,multi-component influence,individual difference and novel weak signal extraction method based on our previous research in the cutting edge field of NIR noninvasive blood glucose detection.Moreover,novel ideas and approaches of our group to solve these problems are introduced,which may provide evidence for the future development of noninvasive blood glucose detection,and further contibute to the noninvasive detection of other body compositions using NIR spectroscopy.

Statistical Medical Pattern Recognition for Body Composition Data Using Bioelectrical Impedance Analyzer

Identifying patterns,recognition systems,prediction methods,and detection methods is a major challenge in solving different medical issues.Few categories of devices for personal and professional assessment of body composition are available.Bioelectrical impedance analyzer is a simple,safe,affordable,mobile,non-invasive,and less expensive alternative device for body composition assessment.Identifying the body composition pattern of different groups with varying age and gender is a major challenge in defining an optimal level because of the body shape,body mass,energy requirements,physical fitness,health status,and metabolic profile.Thus,this research aims to identify the statistical medical pattern recognition of body composition data by using a bioelectrical impedance analyzer.In previous studies,a pattern was identified for four indicators that concern body composition(e.g.,body mass index(BMI),body fat,muscle mass,and total body water).The novelty of our study is the fact that we identified a recognition pattern by using medical statistical methods for a body composition that contains seven indicators(e.g.,body fat,visceral fat,BMI,muscle mass,skeletal muscle mass,sarcopenic index,and total body water).The youth that exhibited the body composition pattern identified in our study could be considered healthy.Every deviation of one or more parameters outside the margins of the pattern for body composition could be associated with health issues,and more medical investigations would be needed for a diagnosis.BIA is considered a valid and reliable device to assess body composition along with medical statistical methods to identify a pattern for body composition according to the age,gender,and other relevant parameters.

Effects of Testosterone Supplementation on Body Composition in HIV Patients:A Meta-analysis of Double-blinded Randomized Controlled Trials

This study was designed to evaluate the effects of testosterone supplementation（TS） on body composition in patients with HIV and the side effects of TS.A comprehensive literature search strategy was used to retrieve relevant randomized controlled trials（RCTs） examining the effects of TS on body composition.A total of 14 eligible studies were included,enrolling 388 and 349 randomized patients in TS and control groups,respectively.The quality of studies included was assessed,and data on total body weight（BW）,lean body mass（LBM）,fat mass（FM）,serum total testosterone（TT）,free testosterone（FT） levels,and adverse events were extracted and analyzed using Review Manager software 5.3.Meta-analysis results showed that TS was associated with a small but significant modification in total BW,serum TT,and FT levels in HIV-infected patients and in patients given various drug administrations.TS also significantly increased LBM in male patients,but no significant difference in LBM was observed between female counterparts treated with TS or not.Conversely,TS relative to placebo did not lead to a significant reduction in FM.No significant difference was observed between the two groups in terms of adverse effects.Our findings suggested that TS may be recommended to improve body composition in patients with HIV-related weight loss.However,owing to the high heterogeneity across included trials,further evaluations using large-scale,multi-center,blinded RCTs are needed.

Effects of Dietary Carbohydrate-lipid Ratio on Growth, Body Composition and Digestive Enzyme Activities of Juvenile Peanut Worm,Sipunculus nudus

[Objective] This study was conducted to investigate the effects of dietary carbohydrate-lipid( C / L) ratios on growth performance,body composition and digestive enzyme activities of juvenile peanut worm. [Methods]Juvenile peanut worm with average body weight of( 16. 77 ± 0. 40) mg were fed with five isonitrogenous and isoenergetic diets formulated to contain different carbohydrate / lipid( C / L) ratios( 0. 68,1. 02,1. 62,2. 61 or 4. 35) for 8 weeks. [Results] The dietary C / L ratios had no significant effects on survival of juvenile peanut worm( P 】 0. 05). With the increasing of dietary C / L ratios,weight growth rate( WGR)and specific growth rate( SGR) increased when dietary C / L ratios were between 0. 68 and 2. 61,and then decreased significantly with dietary C / L ratio further increased. When the dietary C / L ratio was 2. 61( carbohydrate level was 20. 64%,lipid level was 7. 92%) both WGR and SGR produced the maximum value,they were 451. 78 ± 16. 85% and 3. 41 ± 0. 06 % / d,respectively. The dietary C / L ratios had significant effects on body moisture,body protein content and body lipid content( P 【 0. 05),but no significant effects on body ash content of juvenile peanut worm( P 】 0. 05). Different C / L ratios had significant effects on amylase activity and lipases activity of juvenile peanut worm( P 【 0. 05),but no significant effects on protease activity( P 】 0. 05). [Conclusion]The regression model analysis showed that the most suitable dietary C / L ratio which can make juvenile peanut worm acquire the best weight growth rate is 2. 42.

Effects of COVID-19 Lockdown on Body Composition and Fitness Performance among Football Players in Negro African Environment

Context and Objective: The nutritional and sports dimension of the lockdown implemented during the COVID-19 pandemic is unexplored in the African environment. The purpose of this study was to assess the effects of COVID-19 lockdown on body composition and fitness performance in Congolese football players. Methods: This was an observational study carried out in Brazzaville between February 9 and October 30, 2020. It included 16 male players among Congolese senior national team and 11 male football players of first division Brazzaville clubs. Two types of measurements were carried out: anthropometric measures (height, body mass, total fat percent, lean body mass);physical capacities [30 m sprint, repeated sprint, aerobic endurance (Yo-Yo Intermittent Recovery test), vertical jump (Squat Jump test, Countermovement test)]. The measurements were realized at 4 times: before lockdown (month of february, T0), 1st week of june (T1), 1st week of september (T2), 1st week of october (T3). Data were compared using Student t test, Sokal S test, Anova, Newman-Keuls test (multiple contrasts) and correlation analysis. Results: A significant increase in body mass (p Conclusion: The present data suggest that COVID-19 lockdown promotes weight gain and decreased physical ability in football players.

Changes Induced by Physical Activity, Weight Loss and Calorie Restriction in Body Composition, Lipoproteins and Functional Capacity in Obese Congolese Women

Background. The effects of physical exercises combined with a low-calorie diet on weight loss, body composition, lipoproteins profile, and physical fitness had been well described. However, Central Africa’s studies investigating these kinds of diets and exercise regimens are lacking. Objective. To investigate the effects of adding 14-weeks exercises to a hypocaloric diet on changes in body composition, lipoproteins concentrations, and physical capacities in obese Congolese women. Population and Methods. In total, 34 obese women aged 30 - 39 years (mean age: 33.7 ± 2.4 years) assigned to 14-weeks training program and low energy ketogenic diet. Body composition was assessed using classic methods and impedancemetry. Fasting plasma glucose (FPG) and fasting serum insulin were assessing using enzymatic colorimetric and radioim-munoradiometric methods. HOMA-IR and lipoproteins concentrations were assessed using standardized laboratory methods. VO2peak was measured on a treadmill during a progressive exercise test. Speed, cadence and stride length were measured along the 10-m level walkway. Muscular endurance was measured using the tests of sit-up and inflections-extensions of elbows. All the variables of the study were assessed at the beginning, in the 7-weeks, and in the 14-weeks of training methods. Results. Declines in body weight (16%), percent fat (12.1%), fat weight (26.4%), abdominal fat (34.2%), and waist circumference (10.4%) were found. A significant decrease in FPG (13%), fasting serum insulin (60.9%), HOMA-IR (64.7%), total cholesterol (12.2%), LDL-cholesterol (20.3%), triglycerides (92.8%), and VLDL-triglycerides (17.5%) was shown. In contrast, significant increase in HDL-cholesterol (27.13%) was found. The peak oxygen consumption VO2peak relative to body weight improved more in the 14-weeks training program (13.4%). Obese women exhibited higher values in the 14-weeks training program for speed gait (16.5%), cadence (9.1%), and stride length (15.7%) during normal walk and rapid walk. Weight loss combined with a low-calorie diet and 14-weeks training program improved significantly muscular endurance capacities. Conclusion. Exercise added to hypocaloric diet leads to decreases in body composition, to improve in insulin sensitivity, to enhancement of VO2peak and functional fitness. This may be helpful for the treatment of the metabolic complications of abdominal obesity.

Characteristics of Body Composition and Relationship between Muscle Mass and Muscle Strength among Elderly Women in Different Age Groups

Age-related changes in the body composition of older adults differ among age groups. The purpose of the present study was to clarify the characteristics of body compositions in young (age, 65 - 74 years;yE group) and old (age, ≥75 years;oE group) elderly women, and compare the relationship between muscle mass and strength in elderly women with that in young women for preventing motor function loss in older adults. A total of 30 elderly and 45 young women aged ≥ 65 and 19 - 22 years, respectively, participated in this study. The participants underwent body composition measurement via bioelectrical impedance analysis and examinations of handgrip and leg muscle strength. The age-related body composition changes varied among age groups. Compared with young women, fat-free mass (FFM) in the yE group did not decrease significantly;however, fat mass (FM) and waist-hip ratio (WHR) were significantly greater. Compared with the yE group, decreases in FFM, FM, and WHR in the oE group were significant;furthermore, the decrease in FM measurements was attributed to the loss of FM in the trunk and limbs (upper and lower). The measurement results suggested that the greater FM decrease in the oE group was characterized by decreases in both visceral and subcutaneous fat. In the yE group, the muscle mass was comparable to that in young women;however, there was a remarkable reduction in the lower-limb muscle mass (9% - 10%). In the oE group, muscle mass was reduced in all body parts, including upper and lower limbs and trunk. In young women, significant positive correlations between muscle mass and muscle strength in the upper and lower limbs were observed. No such correlations in the lower limbs were found in elderly women, indicating that muscle mass is not proportionally reflected in muscle strength. In conclusion, for improving and maintaining the health of elderly women, especially those above the age of 75 years, it is important to maintain muscle mass, including muscle strength, and prevent the loss of muscle quality.

Effects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: A systematic review

BACKGROUND Transgender individuals receiving masculinising or feminising gender-affirming hormone therapy with testosterone or estradiol respectively,are at increased risk of adverse cardiovascular outcomes,including myocardial infarction and stroke.This may be related to the effects of testosterone or estradiol therapy on body composition,fat distribution,and insulin resistance but the effect of genderaffirming hormone therapy on these cardiovascular risk factors has not been extensively examined.AIM To evaluate the impact of gender-affirming hormone therapy on body composition and insulin resistance in transgender individuals,to guide clinicians in minimising cardiovascular risk.METHODS We performed a review of the literature based on PRISMA guidelines.MEDLINE,Embase and PsycINFO databases were searched for studies examining body composition,insulin resistance or body fat distribution in transgender individuals aged over 18 years on established gender-affirming hormone therapy.Studies were selected for full-text analysis if they investigated transgender individuals on any type of gender-affirming hormone therapy and reported effects on lean mass,fat mass or insulin resistance.RESULTS The search strategy identified 221 studies.After exclusion of studies that did not meet inclusion criteria,26 were included(2 cross-sectional,21 prospectiveuncontrolled and 3 prospective-controlled).Evidence in transgender men suggests that testosterone therapy increases lean mass,decreases fat mass and has no impact on insulin resistance.Evidence in transgender women suggests that feminising hormone therapy(estradiol,with or without anti-androgen agents)decreases lean mass,increases fat mass,and may worsen insulin resistance.Changes to body composition were consistent across almost all studies:Transgender men on testosterone gained lean mass and lost fat mass,and transgender women on oestrogen experienced the reverse.No study directly contradicted these trends,though several small studies of short duration reported no changes.Results for insulin resistance are less consistent and uncertain.There is a paucity of prospective controlled research,and existing prospective evidence is limited by small sample sizes,short follow up periods,and young cohorts of participants.CONCLUSION Further research is required to further characterise the impact of genderaffirming hormone therapy on body composition and insulin resistance in the medium-long term.Until further evidence is available,clinicians should aim to minimise risk by monitoring cardiovascular risk markers regularly in their patients and encouraging healthy lifestyle modifications.

Stable isotopes and body composition in children: History, fundamentals, and clinical applications

The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studies on the subject, indexed in the database PubMed, LILACS, BVS and SciELO. The body composition was characterized by the amount of bone tissue, muscle and adipose tissue, also including the organs as well as levels of body water. Your knowledge becomes increasingly important in light of the changes that occur in the nutritional status of various types of diseases in frameworks, such as diabetes mellitus, protein energy malnutrition, in cases of obesity and metabolic syndrome. The ability to accurately assess body fat mass especially in children is associated with the importance of effective strategies for prevention and treatment of childhood obesity. Historically, in addition to clinical applications, measurements of total body water were used to determine body composition in nutritional studies. To the knowledge of the body composition, the body water can be measured and used by the ingestion of a dose of labeled water. The measured isotope enrichment is a function of the amount of body water. The method of deuterium is particularly interesting for the assessment of body composition in children, due to its characteristics of collection and analysis.

Predictive Value of Body Composition Analysis for the Prognosis of Patients with Advanced Gastrointestinal Tumors

Objective There is strong evidence that the body composition can affect the progression-free survival(PFS)and overall survival(OS)in patients with a variety of cancers.The main objective of this study was to investigate the effect of body composition on the prognosis of patients with advanced gastrointestinal and colorectal cancers who received first-line palliative chemotherapy.Methods Patients who were newly-diagnosed with advanced gastrointestinal or colorectal cancer and received standard first-line palliative chemotherapy from January 2017 to December 2018 were included in this retrospective study.An analysis of computed tomography images was performed to determine the skeletal muscle index(SMI),which reflects the skeletal muscle mass and skeletal muscle density(SMD)related to muscle strength.A Kaplan-Meier survival analysis and log-rank test were used to compare the survival relationships among groups stratified by the SMI,and a Cox proportional hazard model was used for a multivariate analysis.Results A total of 108 patients met the inclusion criteria,including 41 cases of gastric cancer,46 cases of left colorectal cancer,and 21 cases of right colon cancer.In patients with gastric cancer,the OS of women was significantly shorter than that of men.The OS of patients with a low SMI,low SMD,and low phase angle(PA)was significantly shorter than that of patients with high values(P≤0.05).In the multivariate analysis,the SMD was significantly associated with the patients'long-term survival[Hazard Ratio(HR)=0.904,95%CI:0.840~0.974,P=0.008].For patients with a low SMI and PA,the PFS was significantly shorter than that of patients with high values(P≤0.05).In patients with left colon cancer,the PA and SMD were both independent risk factors for a poorer long-term prognosis(HR=0.375,95%CI:=0.167~0.840,P=0.017;HR=0.887,95%CI:0.824~0.954,P=0.001).Among right colon cancer patients,the PFS and OS of those with a low SMD were significantly lower than those for patients with high values(P≤0.05).Conclusion The PA is an independent risk factor for the OS of left colon cancer patients;the SMD is an independent risk factor for the survival of patients with gastric cancer,left colon cancer,and right colon cancer.

Prevalence of hypertension and its associations with body composition across Chinese and American children and adolescents

Background The age of onset of hypertension(HTN)is decreasing,and obesity is a significant risk factor.The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied.This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN.Methods Seven thousand,five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8–18 years from the 2013–2015 China Child and Adolescent Cardiovascular Health study and the 2011–2018 National Health and Nutrition Examination Surveys were analyzed.Blood pressure and body composition(fat and muscle)were measured by trained staff.The crude prevalence and age-standardized prevalence rate(ASPR)of primary HTN and its subtypes[isolated systolic hypertension(ISH)and isolated diastolic hypertension(IDH)]were calculated based on 2017 American Academy of Pediatrics guidelines.Multivariable-adjusted linear regression coefficients and odds ratios(ORs)were calculated to assess the associations of body composition indicators with HTN,ISH and IDH.Results The ASPR of HTN was 18.5%in China(CN)and 4.6%in the United States(US),whereas the obesity prevalence was 7.4%and 18.6%,and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN.Increased fat mass,muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries.The percent of muscle body mass had a protective effect on HTN and ISH in both countries[HTN(CN:OR=0.83,95%CI=0.78–0.88;US:OR=0.72,95%CI=0.64–0.81);ISH(CN:OR=0.87,95%CI=0.80–0.94;US:OR=0.71,95%CI=0.62–0.81)],and the protective effect was more common among children and adolescents with high levels of physical activity.Conclusions The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US,and the contribution of obesity to HTN was higher in the US than in CN.Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations.Optimizing body composition positively influences blood pressure in children and adolescents,particularly those with high-level physical activity.