Validation of an Artificial Intelligence-Based Ultrasound Imaging System for Quantifying Muscle Architecture Parameters of the Rectus Femoris in Disease-Related Malnutrition (DRM).

(1) Background: The aim was to validate an AI-based system compared to the classic method of reading ultrasound images of the rectus femur (RF) muscle in a real cohort of patients with disease-related malnutrition. (2) Methods: One hundred adult patients with DRM aged 18 to 85 years were enrolled. The risk of DRM was assessed by the Global Leadership Initiative on Malnutrition (GLIM). The variation, reproducibility, and reliability of measurements for the RF subcutaneous fat thickness (SFT), muscle thickness (MT), and cross-sectional area (CSA), were measured conventionally with the incorporated tools of a portable ultrasound imaging device (method A) and compared with the automated quantification of the ultrasound imaging system (method B). (3) Results: Measurements obtained using method A (i.e., conventionally) and method B (i.e., raw images analyzed by AI), showed similar values with no significant differences in absolute values and coefficients of variation, 58.39-57.68% for SFT, 30.50-28.36% for MT, and 36.50-36.91% for CSA, respectively. The Intraclass Correlation Coefficient (ICC) for reliability and consistency analysis between methods A and B showed correlations of 0.912 and 95% CI [0.872-0.940] for SFT, 0.960 and 95% CI [0.941-0.973] for MT, and 0.995 and 95% CI [0.993-0.997] for CSA; the Bland-Altman Analysis shows that the spread of points is quite uniform around the bias lines with no evidence of strong bias for any variable. (4) Conclusions: The study demonstrated the consistency and reliability of this new automatic system based on machine learning and AI for the quantification of ultrasound imaging of the muscle architecture parameters of the rectus femoris muscle compared with the conventional method of measurement.

Impact of the rs822393 Variant on Adiponectin Levels and Metabolic Parameters after Weight Loss Secondary to a High-Fat Hypocaloric Diet with Mediterranean Pattern.

INTRODUCTION: The effects of the rs822393 variant of ADIPOQ gene on metabolic parameters such as insulin resistance and adiponectin levels following weight loss through dietary intervention are still uncertain. The aim of this study was to evaluate the role of rs822393 of ADIPOQ gene on adiponectin levels and metabolic parameters after weight loss with a high-fat hypocaloric diet with Mediterranean pattern during 12 weeks. METHODS: A population of 283 patients with obesity was allocated to a dietary intervention trial with a high-fat hypocaloric diet during 12 weeks. Adiposity and biochemical parameters were determined. rs822393 was assessed with a dominant model analysis (CC vs. CT + TT). RESULTS: These patients had three different genotypes: CC (59.0%), CT (33.6%), and TT (7.4%). The allelic frequencies for C and T were 0.89 and 0.20, respectively. Basal and post-intervention HDL cholesterol, adiponectin levels, and adiponectin/leptin ratio were lower in T-allele than non-T-allele carriers. After dietary intervention, BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin, HOMA-IR, leptin, total cholesterol, and LDL cholesterol levels improved significantly in both genotype groups. Moreover, HDL cholesterol (CC vs. CT + TT) (delta: 8.9 ± 1.1 mg/dL vs. 1.7 ± 0.8 mg/dL; p = 0.02), serum adiponectin in non-T-allele carriers (43.1 ± 5.9 ng/dL vs. 2.8 ± 3 0.0 ng/dL; p = 0.01), and adiponectin/leptin ratio (1.37 ± 0.1 units vs. 0.17 ± 0.08 units; p = 0.02) improved only in non-T-allele carriers after weight loss. CONCLUSION: Individuals with obesity and without the T allele of rs822393 experienced improvements in adiponectin levels, adiponectin/leptin ratio, and HDL cholesterol levels after following a high-fat hypocaloric diet with a Mediterranean pattern.

Role of rs2282679 in 25-hydroxyvitamin D levels and insulin resistance after a sleeve gastrectomy.

BACKGROUND & AIMS: Some studies have reported links between 25-hydroxyvitamin D levels and the presence of obesity and some genetic variants. The aim of our design was to evaluate the effects of rs2282679 genetic variant of CG gene on 25-hydroxyvitamin D levels, weight loss and metabolic parameters after a robotic sleeve gastrectomy in premenopausal females with obesity. METHODS: 76 participants were enrolled. 25-hydroxyvitamin D levels, biochemical evaluation and anthropometric parameters were registered before surgery and after 3, 6 and 12 months follow up. Genotype of rs2282679 CG gene was evaluated. RESULTS: The improvements in anthropometric parameters, blood pressure and lipid profile were similar in both genotypes (TT vs TG + GG). Basal insulin levels and HOMA-IR were greater in G allele carriers than non-carriers (Delta: 6.7 ± 1.2 mUI/L; p = 0.01) and (Delta: 1.3 ± 0.1 units; p = 0.02). 25-hydroxyvitamin D levels were lower in G allele carriers than non-carriers (Delta: 8.1 ± 1.1 ng/dl; p = 0.03). The levels of insulin and HOMA-IR remained greater in G allele carriers than non-carriers throughout all the visits. The levels of 25-hydroxyvitamin D remained lower in G allele carriers than non-G allele. The average level of 25-hydroxyvitamin D at 12 months in non-G allele carriers were above 30 ng/dl (36.0 ± 3.1 ng/dl) and the level in G allele carriers were below (24.9 ± 4.9 ng/dl). CONCLUSIONS: rs 2282679 (GC) was related with low 25 hydroxyvitamin D levels and insulin resistance. In addition, the presence of G allele produced a decrease in the improvement of 25-hydroxyvitamin D levels and insulin resistance after weight loss during 12 months.

Relationship between adiponectin and muscle mass in patients with metabolic syndrome and obesity.

BACKGROUND: Adiponectin is one of the most important adipokines in human beings. Obesity and sarcopenia are associated with a low-level chronic inflammatory status, and adiponectin plays an anti-inflammatory role. AIMS: The objective of the current work was to study the association between muscle mass, determined via bioelectrical impedance (BIA), and circulating adiponectin levels among obese patients with metabolic syndrome who are older than 60 years of age. METHODS: We performed a cross-sectional study incorporating 651 patients with obesity and metabolic syndrome. Anthropometric data, BIA data (total fat mass (FM), fat-free mass (FFM), fat-free mass index (FFMi), skeletal muscle mass (SMM) and skeletal muscle mass index (SMMi)), arterial pressure, HOMA-IR (homeostasis model assessment of insulin resistance), and biochemical parameters were recorded. RESULTS: The patients were separated into two groups based on their median SMMi (skeletal muscle mass index) levels. The low-SMMi group presented adiponectin levels that were higher than those in the high-SMMi group (delta value: 4.8 + 0.7 ng/dl: p = 0.02). Serum adiponectin values were negatively correlated with fat mass (FM), fat-free mass (FFM), fat-free mass index (FFMi), SMM, and SMMi. Adiponectin presented a negative correlation with HOMA-IR and a positive correlation with HDL-cholesterol. In the final multivariate model using SMMi as a dependent variable, adiponectin levels explained 18 % of the variability (Beta -0.49, CI95% -0.89 to -0.16) after adjusting for age and gender. CONCLUSIONS: Serum adiponectin levels are negatively associated with low skeletal muscle mass among obese subjects with metabolic syndrome who are older than 60 years of age.

Role of irisin and myostatin on sarcopenia in malnourished patients diagnosed with GLIM criteria.

OBJECTIVES: Sarcopenia is characterized by the loss of muscle mass. Skeletal muscle can produce and secrete different molecules called myokines. Irisin and myostatin are antagonistic myokines, and to our knowledge, no studies of both myokines have been conducted in patients with disease-related malnutrition (DRM). This study aimed to investigate the role of circulating irisin and myostatin in sarcopenia in patients with DRM. METHODS: The study included 108 outpatients with DRM according to the Global Leadership Initiative on Malnutrition criteria. Participants had a mean age of 67.4 ± 3.4 y. Anthropometric data, muscle mass by ultrasound at the rectus femoris quadriceps (RFQ) level, impedancemetry (skeletal muscle mass [SMM], appendicular SMM [aSMM], and aSMM index [aSMMI]), dynamometry, biochemical parameters, dietary intake, circulating irisin and myostatin levels were determined in all patients. Confirmed sarcopenia was diagnosed as criteria of probable sarcopenia (low muscle strength) plus abnormal aSMMI. RESULTS: Of the 108 patients, 44 presented sarcopenia (41%); 64 did not present with the disorder (59%). The following parameters were worse in patients with sarcopenia: Patients without sarcopenia were stronger than those with the disorder (7.9 ±1.3 kg; P = 0.01). Circulating irisin levels were higher in patients without sarcopenia than those with sarcopenia (651.3 ± 221.3 pg/mL; P =0.01). Myostatin levels were similar in both groups. Finally, logistic regression analysis reported a low risk for sarcopenia (odds ratio, 0.39; 95% confidence interval, 0.19-0.92; P = 0.03) in high irisin median levels as a dichotomic parameter after adjusting for body mass index, sex, energy intake, and age. CONCLUSION: The present study reported that low levels of serum irisin were closely associated with sarcopenia in patients with DRM.