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PubMed2002

Muscle mass index in haemodialysis patients: a comparison of indices obtained by routine clinical examinations.

BACKGROUND: Measurement of muscle mass is useful for evaluating protein nutritional status. Various methods for estimating muscle mass in haemodialysis patients have recently been developed. METHODS: The validity of the estimate of creatinine production calculated with the creatinine kinetic model (CKM) was examined in 46 haemodialysis patients by comparing it with the actual creatinine production, this being determined from the sum of creatinine appearing in the dialysate and the estimated metabolic degradation. The correlation of various other muscle mass indices with creatinine production was also investigated in these patients. RESULTS: The estimate of creatinine production using CKM was significantly correlated with creatinine production calculated from the spent dialysate plus an estimate for the extra-renal creatinine degradation (r=0.90, P<0.001). A Bland-Altman analysis revealed that the mean prediction error for the estimate of creatinine production by CKM was +0.10 g/day and the limits of agreement were +0.34 to -0.14 g/day. The cross-sectional area of the thigh muscle measured by computed tomography (CT) was also significantly correlated with creatinine production (r=-0.86, P<0.01). In contrast, the correlations of 3-methylhistidine production measured in the spent dialysate, the mid-upper arm muscle circumference and the skeletal muscle mass estimated by an anthropometric prediction model with creatinine production were lower (r<0.82). CONCLUSION: Creatinine production calculated using CKM and CT measurement of thigh muscle area are valid methods for estimating muscle mass during routine clinical examinations of haemodialysis patients.

Aged↗

PubMed2000

Growth hormone and mild exercise in combination increases markedly muscle mass and tetanic tension in old rats.

OBJECTIVE: A decline of skeletal muscle mass and strength is seen with aging and immobilization. Growth hormone (GH) has been shown to increase muscle mass. In the present study the effects of a combination of mild exercise and GH on skeletal musculature tetanic tension, dry defatted weight (DDW), volume, water, fat and collagen concentrations were investigated in old rats. DESIGN: Recombinant human GH (2.7mg/kg per day) was injected subcutaneously for 73 days in 21-month-old female rats. Exercised rats ran on a treadmill, 8 m/min for 1 h/day. The in vivo maximal tetanic tension of the calf musculature (m. soleus, m. plantaris, m. gastrocnemius together) was analysed in anaesthetized rats by stimulating the ischiadic nerve. RESULTS: The maximal tetanic tension was increased by 23% in GH-injected compared to saline-injected rats. Mild exercise + GH in combination resulted in a further 18% increase in maximal tetanic tension. The mild exercise by itself did not influence the maximal tetanic tension significantly when compared with saline injected rats. The GH administration and/or mild exercise did not change skeletal muscle endurance, measured as tetanic tension during 30s of stimulation. Serum IGF-I concentration was increased twofold in GH-injected rats. CONCLUSION: The increased muscle mass induced by GH + mild exercise was associated with a corresponding increase in maximal tetanic tension. Combination of GH + mild exercise resulted in a substantial further increase of muscle mass and maximal tension compared with GH injections alone in these old rats.

Adipose Tissue↗

PubMed2001

The influence of aging and sex on skeletal muscle mass and strength.

This brief review examines the influence of aging on skeletal muscle mass and strength and specifically highlights sex-related differences. It is well established that aging is associated with a significant decline in muscle strength that becomes functionally important by the seventh decade of life. Age-related strength losses are mainly secondary to decline in skeletal muscle mass in men and women. While women may experience earlier strength losses than men, overall, age associated decreases in strength are similar when controlling for muscle mass. Although men may experience greater losses of total muscle mass, recent evidence, however, points toward greater declines in muscle quality in older women. The implications and potential mechanisms for these differences are discussed.

Adipose Tissue↗

PubMed1998

Body fat and skeletal muscle mass in relation to physical disability in very old men and women of the Framingham Heart Study.

BACKGROUND: Low muscle mass has been assumed to be associated with disability, but no studies confirming this association have been published. High body weight and high body mass index, both rough indicators of body fatness, have been shown to increase the risk for disability; however, the specific role of body fatness has not been studied. METHODS: The relations of skeletal muscle mass and percent body fat with self-reported physical disability were studied in 753 men and women aged 72 to 95 years. Cross-sectional data from biennial examination 22 (1992-1993) of the Framingham Heart Study were used. Body composition was assessed by dual-energy x-ray absorptiometry. Disability was scored as any versus none on a 9-item questionnaire. RESULTS: Total body and lower extremity muscle mass were not associated with disability in either men or women. However, a strong positive association between percent body fat and disability was observed. The odds ratio for disability in those in the highest tertile of body fatness was 2.69 (95% confidence interval 1.45-5.00) for women and 3.08 (1.22-7.81) for men compared to those in the lowest tertile. The increased risk could not be explained by age, education, physical activity, smoking, alcohol use, estrogen use (women only), muscle mass, and health status. Analyses restricting disability to mobility items gave similar results. CONCLUSIONS: In contrast to current assumptions, low skeletal muscle mass was not associated with self-reported physical disability. Persons with a high percent body fat had high levels of disability. Because it cannot be ruled out that persons with low skeletal muscle mass dropped out earlier in the study, prospective studies are needed to further assess the relationship between body composition and physical disability.

Absorptiometry, Photon↗

PubMed2006

Influence of sex and active muscle mass on renal vascular responses during static exercise.

During exercise, reflex renal vasoconstriction helps maintain blood pressure and redistributes blood flow to the contracting muscle. Sex and muscle mass have been shown to influence certain cardiovascular responses to exercise. Whether sex and/or muscle mass influence renal vasoconstrictor responses to exercise is unknown. We studied healthy men (n = 10) and women (n = 10) matched for age and body mass index during handgrip (HG, small muscle mass) and quadriceps contraction (QC, large muscle mass) as beat-to-beat changes in renal blood flow velocity (RBV; duplex ultrasound), mean arterial pressure (MAP; Finapres), and heart rate (ECG) were monitored. Renal vascular resistance (RVR) index was calculated as MAP / RBV. Responses to HG vs. QC were compared in 13 subjects. We found that 1) RVR responses to short (15-s) bouts and fatiguing HG were similar in men and women (change in RVR during 15-s HG at 70% of maximum voluntary contraction = 23 +/- 4 and 31 +/- 4% in men and women, respectively, P = not significant); 2) post-HG circulatory responses were similar in men and women; and 3) HG and QC were similar during short (15-s) bouts (change in RVR during HG at 50% of maximum voluntary contraction = 19 +/- 3 and 18 +/- 5% for arm and leg, respectively, P = not significant). Our findings suggest that muscle reflex-mediated renal vasoconstriction is similar in men and women during static exercise. Moreover, muscle mass does not contribute to the magnitude of the reflex renal vasoconstrictor response seen with muscle contraction.

Adaptation, Physiological↗

PubMed2006

The expressions of insulin-like growth factors, their receptors, and binding proteins are related to the mechanism regulating masseter muscle mass in the rat.

OBJECTIVE: The mechanism regulating skeletal muscle mass is unclear. The purpose of the present study was to investigate the extent to which insulin-like growth factors (IGFs), their receptors (IGFRs), and binding proteins (IGFBPs) are involved in the regulation of skeletal muscle mass. DESIGN: We measured the mRNA expression levels for IGFs, IGFRs, and IGFBPs in the rat masseter muscle hypertrophied by oral administration of clenbuterol for 3 weeks and determined the correlations between the weight of masseter muscle and the mRNA expression levels. RESULTS: The mRNA expression levels for IGF-I and II, IGFR1 and 2, and IGFBP4 and 6 showed clenbuterol-induced elevations and positive correlations with the weight of masseter muscle. That for IGFBP3 only exhibited a clenbuterol-induced decrease and a strong negative correlation with the weight of masseter muscle. The mRNA expression levels for IGFBP2 and 5 showed no significant changes between the control and clenbuterol groups, and no significant correlations. IGFBP1 mRNA was not detectable. CONCLUSION: These results suggest that IGF-I, II, IGFR1 and 2, and IGFBP3, 4 and 6 are related to the mechanism regulating masseter muscle mass in the rat.

Adrenergic beta-Agonists↗

PubMed1983

Cardiac muscle mass during vasodilation therapy of hypertension.

M-mode echocardiography has become a valuable tool in the evaluation of changes in left ventricular muscle mass during antihypertensive therapy. We evaluated the effects of treatment with the vasodilator trimazosin, alone and in combination with the diuretic polythiazide, on cardiac muscle mass in hypertensive subjects. Trimazosin alone was given to 11 subjects for 18 mo, and average supine blood pressure fell from 154/100 to 146/89 mm Hg. Heart rate and body weight did not change during therapy. Initially, a slight decrease (approximately 6%) was observed in left ventricular muscle mass, but left ventricular transverse dimension and left ventricular muscle mass returned to control levels during the last 6 mo of the 18-mo study. The combination of trimazosin and polythiazide was given to nine subjects and decreased blood pressure from 152/102 to 138/92 mm Hg. Heart rate increased and body weight decreased slightly. No changes in left ventricular muscle mass were observed during combination therapy. It is possible that increases in activity of the sympathetic nervous system during therapy with trimazosin alone, and the observed increase in renin activity during treatment with trimazosin and polythiazide, might have offset the effects of the reduction in blood pressure on left ventricular muscle mass.

Adult↗

PubMed1989

Effects of active muscle mass size on cardiopulmonary responses to exercise in congestive heart failure.

Previous studies from this laboratory demonstrated that in healthy young men, cardiac output is closely coupled to oxygen uptake during dynamic exercise, regardless of its mode or relative intensity, whereas other physiologic responses such as heart rate, blood pressure and ventilation are inversely related to the size of the active muscle mass when expressed as functions of oxygen uptake. The purpose of the current investigation was to determine whether congestive heart failure alters the pattern of physiologic responses to various modes of arm and leg exercise in proportion to the size of the active muscle mass. Cardiopulmonary responses to four modes of dynamic work (one arm curl, one arm cycle ergometry, one leg cycle ergometry and two leg cycle ergometry) were characterized in terms of absolute and relative intensities (oxygen uptake and mode-specific percent of peak oxygen uptake, respectively) in middle-aged men with congestive heart failure and control groups of healthy subjects and patients after myocardial infarction without heart failure. Peak oxygen uptake was reduced to the greatest extent in patients with heart failure for large muscle mass work (-13% for curl, -32% for one arm and one leg cycle ergometry and -37% for two leg cycle ergometry; p less than 0.05 versus the normal group for the three modes of ergometry). This finding was paralleled by a markedly blunted slope for the cardiac output-oxygen uptake relation for leg but not arm exercise that was only partially compensated for by a widened arteriovenous oxygen difference. Blood pressure expressed as a function of oxygen uptake remained inversely related to active muscle mass size in all groups of subjects despite attenuation of systolic pressure for heavy large muscle mass effort in the group with heart failure. Pulmonary ventilation at a given metabolic rate was not influenced by active muscle mass size. Thus, saturation of capacity for systemic oxygen transport occurs in conjunction with blunted cardiac output reserve in patients with heart failure during exercise involving a smaller muscle mass than in healthy subjects. The basic inverse relation between size of the active muscle mass and blood pressure at a given metabolic rate is not altered by aging or reduced cardiac reserve. The muscle mass effect on ventilation seen in young healthy subjects disappears with aging.

Blood Pressure↗

PubMed1999

Nutritional supplements to increase muscle mass.

Although nutritional supplements purported to increase muscle mass are widely available at health food stores, gyms, by mail order, and over the Internet, many of these supplements have little or no data to support their claims. This article reviews the theory and research behind popular nutritional supplements commonly marketed as muscle mass builders. Included are the minerals chromium, vanadyl sulfate, and boron, the steroid hormone dehydroepiandrosterone (DHEA), beta-methyl-hydroxy-beta-methylbutyrate (HMB), creatine, protein supplements, and amino acids. Research has shown that chromium vanadyl sulfate, and boron do not appear to be effective in increasing lean body mass. The few studies examining DHEA have not supported the claim of increased muscle gain. Preliminary work on HMB supports an anticatabolic effect, but only one human study is currently available. Many studies reported increased body mass and several have reported increased lean body mass following creatine ingestion. This weight gain is most likely water retention in muscle but could also be due to some new muscle protein. Although athletes have a greater protein requirement than sedentary individuals, this is easily obtained through the diet, negating the use of protein supplements. Studies on amino acids have not supported their claim to increase growth hormone or insulin secretion. Nutritional supplements can be marketed without FDA approval of safety or effectiveness. Athletes who choose to ingest these supplements should be concerned with unsubstantiated claims, questionable quality control, and safety of long-term use.

Adult↗

PubMed1997

Skeletal muscle mass and the reduction of VO2max in trained older subjects.

The role of skeletal muscle mass in the age-associated decline in maximal O2 uptake (VO2max) is poorly defined because of confounding changes in muscle oxidative capacity and in body fat and the difficulty of quantifying active muscle mass during exercise. We attempted to clarify these issues by examining the relationship between several indexes of muscle mass, as estimated by using dual-energy X-ray absorptiometry and treadmill VO2max in 32 chronically endurance-trained subjects from four groups (n = 8/group): young men (20-30 yr), older men (56-72 yr), young women (19-31 yr), and older women (51-72 yr). VO2max per kilogram body mass was 26 and 22% lower in the older men (45.9 vs. 62.0 ml.kg-1.min-1) and older women (40.0 vs. 51.5 ml.kg-1.min-1). These age differences were reduced to 14 and 13%, respectively, when VO2max was expressed per kilogram of appendicular muscle. When appropriately adjusted for age and gender differences in appendicular muscle mass by analysis of covariance, whole body VO2max was 0.50 +/- 0.09 l/min less (P < 0.001) in the older subjects. This effect was similar in both genders. These findings suggest that the reduced VO2max seen in highly trained older men and women relative to their younger counterparts is due, in part, to a reduced aerobic capacity per kilogram of active muscle independent of age-associated changes in body composition, i.e., replacement of muscle tissue by fat. Because skeletal muscle adaptations to endurance training can be well maintained in older subjects, the reduced aerobic capacity per kilogram of muscle likely results from age-associated reductions in maximal O2 delivery (cardiac output and/or muscle blood flow).

Absorptiometry, Photon↗

PubMed2001

Effects of whey protein and resistance exercise on body cell mass, muscle strength, and quality of life in women with HIV.

OBJECTIVE: To determine the effects of whey protein, resistance exercise, and combined protein and exercise treatment on body cell mass (BCM), muscle strength, and quality of life (QOL) in HIV-infected women with reduced BCM. DESIGN AND SETTING: Prospective, randomized, controlled trial at a university hospital in New York City. METHODS: A volunteer sample of 30 HIV-infected women were randomized to whey protein (PRO), progressive resistance exercise (PRE), or combined treatment (PRO-PRE) for 14 weeks after a 6-week control period. The main outcome measures were body weight, BCM, skeletal muscle, fat mass, muscle strength, and QOL. RESULTS: There were no significant changes in BCM, strength, or QOL during the control period. PRO patients gained 3.6 kg (P = 0.001), and 2.5 kg fat (P = 0.002) with no change in BCM (0.5 kg; P = 0.07) or skeletal muscle (0.6 kg; P = 0.12). The PRE group increased BCM (0.74 kg;P = 0.03) and skeletal muscle (1.2 kg; P < 0.001) and decreased fat (1.7 kg; P = 0.02). PRO-PRE increased BCM (0.61 kg; P = 0.01) without change in skeletal muscle (0.6 kg; P = 0.30). Strength increased for both exercise groups (range, 40.6-95.3%; P < 0.001). The QOL physical activity score improved for PRE (P = 0.02) and worsened for PRO (P = 0.01). CONCLUSIONS: Resistance exercise significantly increased BCM, muscle mass, muscle strength, and QOL in HIV-infected women with reduced BCM. Whey protein had little effect on BCM accrual. Combined protein and exercise did not increase BCM in excess of gains achieved by exercise alone.

Adult↗

PubMed1993

Nonparallel changes in global left ventricular chamber volume and muscle mass during the first year after transmural myocardial infarction in humans.

OBJECTIVES: This study was designed to serially assess time-dependent changes in both chamber volume and myocardial muscle mass after infarction in humans. BACKGROUND: Dilation of the left ventricular chamber has been previously described after transmural myocardial infarction. METHODS: Global left ventricular chamber volumes and muscle mass were quantified by using cine computed tomographic scanning in 18 patients at hospital discharge and 6 weeks, 6 months and 1 year after an initial transmural myocardial infarction (12 anterior and 6 inferior). No patient had heart failure during the initial hospital stay or on any subsequent follow-up visit. RESULTS: The patients with anterior myocardial infarction (estimated infarct extent 27 +/- 2% of left ventricle) demonstrated a progressive increase in left ventricular end-diastolic volume from 148 +/- 9 ml (mean +/- SEM) at hospital discharge to 180 +/- 9 ml at 1 year after infarction (p < 0.001). However, global left ventricular muscle mass decreased significantly during the 1st 6 weeks after infarction but returned by 1 year to nearly the value determined at hospital discharge (177 +/- 13 vs. 165 +/- 10 g, p = NS). The changes in global muscle mass did not parallel the steady and progressive increases in chamber end-diastolic volume. The end-diastolic chamber volume to muscle mass ratio, an index of global left ventricular wall tension, increased steadily after hospital discharge but remained level by 1 year after infarction. The time course of changes in global end-systolic chamber volume was roughly proportional to the concomitant changes in end-diastolic volume. During this same time period, left ventricular stroke volume remained constant or improved from that determined at baseline. Global left ventricular end-diastolic and end-systolic volumes remained relatively static during the 1st year in the patient subgroup with inferior wall myocardial infarction (estimated infarct extent 10 +/- 1% of left ventricle), but global muscle (myocardial) mass initially decreased and then increased in a pattern similar, although of smaller magnitude, to that observed in patients with anterior wall myocardial infarction. CONCLUSIONS: Overall, left ventricular end-diastolic and end-systolic chamber volumes increase progressively from hospital discharge to 1 year after an initial transmural myocardial infarction in patients with a moderately large anterior wall infarction but remain stable in patients with a small inferior wall infarction. Concurrently, total left ventricular muscle mass decreases significantly during the initial 6 weeks after infarction (presumed largely secondary to changes in the necrotic segments) but then returns to the hospital discharge baseline values by 1 year. These data are consistent with the late development of, at most, limited ventricular hypertrophy in the noninfarcted myocardium that occurs well after the early and progressive left ventricular chamber dilation observed in patients with a moderate to large myocardial infarction. These data, in particular as applied to patients with anterior infarction, suggest that ventricular wall tension is significantly elevated at least during the 1st year after an initial transmural myocardial infarction. These observations may explain the potential utility of agents aimed at reducing afterload or ventricular wall tension during the early convalescent phase after myocardial infarction.

Female↗

PubMed1974

The relationship of choline acetyltransferase activity at the neuromuscular junction to changes in muscle mass and function.

1. The role of muscle mass and function in the regulation of choline acetyltransferase activity at the neuromuscular junction has been investigated in the rat.2. Choline acetyltransferase (ChAc) is located in presynaptic nerve terminals and is a specific enzymatic marker of cholinergic innervation in muscle.3. ChAc activity increased co-ordinately with developmental growth of the soleus muscle. However, another form of muscle growth, work hypertrophy, did not produce an increase in ChAc.4. Growth arrest of muscle by hypophysectomy did not alter the normal development of ChAc activity, and cortisone-induced muscle atrophy did not reduce ChAc activity in the soleus or plantaris.5. Tenotomy-induced muscle atrophy provoked a significant fall in ChAc in the soleus and plantaris.6. The tonic soleus had significantly greater ChAc activity than the phasic plantaris.7. These observations suggest that muscle mass per se does not influence the development and regulation of ChAc in muscle but that the quality of muscle contraction may modulate enzyme activity.

Acetyltransferases↗

PubMed2002

Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women.

BACKGROUND: Sarcopenia refers to the loss of skeletal muscle mass with age. The objective of this study was to determine the prevalence of sarcopenia in a population of older, community-dwelling research volunteers. METHODS: Appendicular skeletal muscle mass was measured by dual x-ray absorptiometry in 195 women aged 64 to 93 years and 142 men aged 64 to 92 years. We defined sarcopenia as appendicular skeletal muscle mass/height(2) (square meters) less than 2 standard deviations below the mean for young, healthy reference populations. We used two different reference populations and compared prevalence in our population to that reported in previous studies. Body mass index (BMI) was calculated and physical activity and performance were measured with the Physical Activity Scale for the Elderly, the Short Physical Performance Battery, and the Physical Performance Test. We measured health-related quality of life by using the SF-36 general health survey. Serum estrone, estradiol, sex hormone-binding globulin, parathyroid hormone, and 25-hydroxy vitamin D were measured in all participants and bioavailable testosterone was measured only in men. Leg press strength and leg press power were determined in men. RESULTS: The prevalence of sarcopenia in our cohort was 22.6% in women and 26.8% in men. A subgroup analysis of women and men 80 years or older revealed prevalence rates of 31.0% and 52.9%, respectively. In women, skeletal muscle mass correlated significantly with BMI and levels of serum estrone, estradiol, and 25-hydroxy vitamin D; in men, it correlated significantly with BMI, single leg stance time, leg press strength, leg press power, SF-36 general health score, Physical Performance Test total score, and bioavailable testosterone levels. With the use of linear regression analysis, BMI was the only predictor of appendicular skeletal muscle mass in women, accounting for 47.9% of the variance (p <.05). In men, BMI accounted for 50.1%, mean strength accounted for 10.3%, mean power accounted for 4.1%, and bioavailable testosterone accounted for 2.6% of the variance in appendicular skeletal muscle mass (p <.05). CONCLUSIONS: Sarcopenia is common in adults over the age of 65 years and increases with age. BMI is a strong predictor of skeletal muscle mass in women and men. Strength, power, and bioavailable testosterone are further contributors in men. These data suggest that interventions to target nutrition, strength training, and testosterone replacement therapy should be further investigated for their role in preventing muscle loss with age.

Aged↗

PubMed2004

Effects of increased muscle mass on mouse sagittal suture morphology and mechanics.

The purpose of this study is to test predicted form-function relationships between cranial suture complexity and masticatory muscle mass and biomechanics in a mouse model. Specifically, to test the hypothesis that increased masticatory muscle mass increases sagittal suture complexity, we measured the fractal dimension (FD), temporalis mass, and temporalis bite force in myostatin-deficient (GDF8(-/-)) mice and wild-type CD-1 mice (all male, 6 months old). Myostatin is a negative regulator of muscle mass, and myostatin-deficient mice show a marked increase in muscle mass compared to normal mice. We predicted that increased sagittal suture complexity would decrease suture stiffness. The data presented here demonstrate that increased suture complexity (measured as FD) was observed in a hypermuscular mouse model (GDF8(-/-)) with significantly increased temporalis muscle mass and bite forces. Hypermuscular mice were also found to possess suture connective tissue that was less stiff (i.e., underwent more displacement before failure occurred) when loaded in tension. By decreasing stiffness, suture complexity apparently helps to dissipate mechanical loads within the cranium that are related to chewing. These results suggest that cranial suture connective tissue locally adapts to functional demands of the biomechanical suture environment. As such, cranial sutures provide a novel model for studies in connective tissue mechanotransduction.

Animals↗

PubMed1990

Age variations in the relation of body mass indices to estimates of body fat and muscle mass.

In some chronic disease studies, distinctions have been made regarding the importance of body mass index (BMI) as a risk factor in younger versus older men and women. In order to determine the significance of these differences in BMI-disease associations, we determined the extent of age-dependent variations in the relation of BMIs to body composition in large probability samples of U.S. men and women from the First and Second U.S. National Health and Nutrition Examination Surveys (NHANES I and II). BMIs are more highly correlated with estimates of body fat in younger than in older men and women, and with muscle mass in older than in younger adults. Caution should be exercised in interpreting the significance of BMI as a risk factor for chronic disease, particularly in comparison of age groups.

Adipose Tissue↗

PubMed2005

The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively--a randomised clinical trial.

AIM: Recent evidence suggests that the provision of energy-containing fluids is safe and may impact positively on markers of recovery. The aims of this study were to assess the tolerance of preoperative carbohydrate fluid administration and to determine its effect on postoperative metabolic and clinical responses. METHODS: Patients admitted to the Royal Infirmary of Edinburgh for major, elective abdominal surgery were recruited to this double-blind, randomised study and received either a placebo drink or carbohydrate (12.6g/100ml) drink (CHOD). Patients consumed 800 ml of their drink on the evening before surgery and 400 ml on the day of surgery 2-3 h before the induction of anaesthesia. Nutritional status was determined using body mass index (BMI) and upper arm anthropometry; all measurements were taken preoperatively, postoperatively and at discharge. Blood glucose and insulin concentrations were also measured preoperatively and on the first post operative day. Length of hospital stay (LOS) and postoperative complications were recorded. RESULTS: Seventy-two patients were recruited and 65 (34 male:31 female) completed this study. Thirty-four patients were randomised to receive the placebo drink (control group) and 31 patients to receive the carbohydrate drink (CHOD group). Groups were well-matched in terms of gender and age. There were no differences between the two groups at baseline for BMI (control: -25.1+/-1.7 kg/m2; CHOD -25.2+/-1.2 kg/m2), upper arm anthropometry or surgical procedure. At discharge loss of muscle mass (arm muscle circumference) was significantly greater in the control group when compared with the CHOD group (control: -1.1+/-0.15 cm; CHOD: -0.5+/-0.16 cm; P<0.05). Baseline insulin (control: 20.7+/-4.9 mU/l; CHOD: 24.6+/-6.2 mU/l) and glucose (control: 6.0+/-1.4 mmol/l; CHOD 5.7+/-1.4 mmol/l) were comparable in the two groups and did not differ postoperatively. No complications were recorded as a result of preoperative fluid consumption. Postoperative morbidity occurred in six patients from each group. Median LOS in the control group was 10 days (IQR=6), and 8 days (IQR=4) in the CHOD group. CONCLUSION: Preoperative consumption of carbohydrate-containing fluids is safe. Provision of a carbohydrate energy source prior to surgery may attenuate depletion of muscle mass after surgery. Further studies are required to determine if this preservation of muscle mass is reflected in improved function and reduced rehabilitation time.

Abdomen↗

PubMed2001

Relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome.

We investigated the relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome (PCOS). Subjects were 67 women with PCOS (mean age +/- standard deviation, 28.8 +/- 6.6 years). Baseline characteristics included age and height. Trunk-leg fat ratio and trunk-leg muscle ratio were assessed with dual-energy x-ray absorptiometry. Serum testosterone and dehydroepiandrosterone sulfate levels were measured with radioimmunoassays. Relationships among serum testosterone levels, body fat and muscle mass distribution were investigated using Pearson and partial correlation tests. Serum testosterone levels were positively correlated with trunk-leg fat ratio (r = 0.398, P < 0.01), but were inversely correlated with trunk-leg muscle ratio (r = -0.332, P < 0.05). Trunk-leg muscle ratio was inversely correlated with trunk-leg fat ratio (r = -0.360, P < 0.01). Serum testosterone levels were still correlated with trunk-leg fat ratio (r = 0.500, P < 0.001) and trunk-leg muscle ratio (r = -0.286, P < 0.05), after adjusting for age and height. Trunk-leg fat ratio was still correlated with trunk-leg muscle ratio, after adjusting for age, height, and serum testosterone levels. Based on these results, we concluded that higher serum testosterone levels may contribute to the upper body fat distribution and peripheral muscle mass distribution. In addition, peripheral muscle mass distribution may also contribute to the upper body fat distribution.

Absorptiometry, Photon↗