Passive muscle stiffness is correlated with the intramuscular adipose tissue in young individuals.

PURPOSE: We investigated the relationship between intramuscular adipose tissue (IntraMAT) and muscle stiffness (passive and mechanical) and lengthening in young individuals, hypothesizing that (1) passive muscle stiffness is negatively correlated with the IntraMAT content, and (2) the IntraMAT content is negatively correlated with mechanical changes in muscle stiffness and fascicle length during passive dorsiflexion. METHODS: Twenty men and women (20.3 ± 1.3 years) participated in this study. Axial T1-weighted magnetic resonance imaging was performed at the thickest point of the medial gastrocnemius (MG) to measure the IntraMAT cross-sectional area (CSA) and muscle tissue CSA (units; cm2). The shear wave velocity (SWV) and fascicle length at the three ankle joint angles, namely 15° with plantarflexion (PF15), 0° with neutral position (NP), and 15° with dorsiflexion (DF15), were measured as parameters of muscle stiffness (unit; m/s) and lengthening (unit; cm) using ultrasound shear wave elastography and B-mode imaging. We further calculated the changes in SWV and fascicle length from PF15 to NP and from NP to DF15 as mechanical muscle stiffness and lengthening, respectively. RESULTS: There was a relationship between IntraMAT CSA and absolute SWV at DF15 (r = - 0.47, P < 0.05). Further, a relationship was observed between IntraMAT CSA and change in SWV and fascicle length from NP to DF15 (r = - 0.47 and r = 0.59, P < 0.05); whereas no relationship was observed between changes in fascicle length and muscle SWV (r = - 0.23, P = 0.33). CONCLUSION: These results may indicate biomechanical and/or physiological associations between IntraMAT CSA and passive muscle stiffness.

The Influence of Daily Exercise on Muscle Echo Intensity and Stiffness in Young Women.

This study aimed to investigate the effect of daily exercise on skeletal muscle function, size, and quality in young women. Twenty-six young women participated in this study, categorized into daily exercise and non-exercise groups. The exercise group had performed exercise or training three times a week for more than six months. Knee extension and flexion, plantar flexion, and dorsiflexion peak torques were measured for muscle function. B-mode ultrasound images were taken from the thigh and calf, and muscle thickness and echo intensity were measured in the vastus lateralis and medial gastrocnemius. Shear modulus at different joint angles of the knee (0° [full extended], 40°, and 90°) and ankle (40 °plantarflexion, 0° [neutral], and 10° dorsiflexion) was measured from the vastus lateralis and medial gastrocnemius to determine muscle stiffness. Peak torque and echo intensity did not significantly differ between the exercise and non-exercise groups. Shear modulus in the medial gastrocnemius at 10° dorsiflexion was significantly lower in the exercise group compared with the non-exercise group (34.2±7.7 vs. 46.5±13.1 kPa, P<0.05). These results suggest that daily exercise and training could affect muscle stiffness, but do not lead to an increase in muscle function.

Unique Characteristics of Quadriceps Muscle Morphology and Function in Older Tennis Players.

We investigated the quadriceps muscle size and quantitative characteristics in older tennis players. Thirty-eight senior tennis players (70.8 ± 5.3 years) and 38 controls (71.6 ± 5.1 years) were included. To measure the muscle size and quality, we measured muscle thickness in the rectus femoris (RF), vastus lateralis, and vastus intermedius, and muscle echo intensity in the RF and vastus lateralis using B-mode transverse ultrasound, respectively. We measured knee extension peak torque for muscle function. Muscle thickness in the RF, vastus lateralis, and vastus intermedius were significantly larger in tennis players than in controls. Tennis players had a lower echo intensity in RF and a higher knee extension peak torque compared to controls. Stepwise multiple linear regression analysis implied that echo intensity and muscle thickness were predictors of knee extension peak torque. Higher muscle quality contributes to a higher knee extension peak torque in tennis players. Playing tennis may prevent age-related muscle atrophy and maintain muscle quality in older individuals.

Evaluation of rehabilitation exercise effects by using gradation-based skeletal muscle echo intensity in older individuals: a one-group before-and-after trial study.

BACKGROUND: Higher muscle echo intensity (EI) reflects higher content of fat and/or connective tissue within skeletal muscle, eventually inducing lower muscle strength, physical dysfunction, and metabolic impairment. Continuous exercise decreases muscle EI in older individuals; however, it is not well understood how several months' rehabilitation exercise affects gradation-based EI. The purpose of this study was to investigate the effects of 6 months of rehabilitation exercise on gradation-based higher and lower EI in older men and women. METHODS: Twenty-seven men and women (7 men, 20 women; age, 75.6 ± 6.4 years; height, 154.3 ± 8.5 cm; weight, 55.8 ± 9.7 kg) participated in this study. This study was a one-group before-and-after trial. They needed long-term care for activities of daily living. They performed rehabilitation exercises consisting of resistance exercises using a hydraulic resistance machine, stretching, and aerobic exercises using a recumbent bicycle once or twice a week for 6 months. B-mode ultrasonographic transverse image was taken from thigh muscles, e.g., rectus femoris, vastus lateralis, and biceps femoris. We calculated gradation-based cross-sectional area (CSA) from thigh muscles by dividing 256 greyscale level to 10 different components levels (e.g., 0-24, 25-49, 50-74, …, 200-224 and 225-249 a.u.). RESULTS: Lowest EI (e.g., 0-24 a.u.) CSA of thigh muscle was significantly increased after the exercise (0.3 ± 0.3 to 1.0 ± 0.8 cm2; P < 0.05). Middle to higher EI (e.g., 50-74, 75-99, 100-124, 125-149, 150-174, 175-199 and 200-224 a.u.) CSAs were significantly decreased from 23.0 to 68.7% after the exercise (P < 0.05). CONCLUSIONS: Several months' rehabilitation exercise affected both lower and higher EI in older men and women. This result suggests that rehabilitation exercise changes muscle composition by increasing contractile muscle tissue and decreasing fat and connective tissues.

Muscle quality characteristics of muscles in the thigh, upper arm and lower back in elderly men and women.

PURPOSE: The ratio of fat within skeletal muscle is an important parameter that is indicative of muscle quality, and can be assessed using ultrasonography to measure echo intensity (EI). Muscle EI indicates muscle strength and risk of physical dysfunction; however, this observation was determined following examinations of only selected muscle. The purpose of this study was to investigate the EI characteristics of muscles in several regions in elderly men and women, using physical function tests and serum cholesterol levels. METHODS: Twenty-two men and women (age 78 ± 8 years) participated in this study. The EIs were calculated from rectus femoris (RF), biceps femoris (BF) triceps brachii (TB) and multifidus (MF) using B-mode transverse ultrasound images. Seven functional tests (isometric knee-extension peak torque, functional reach, sit-to-stand, 5-m normal/maximal speed walking, handgrip strength and timed up-and-go) and blood lipid components including adipocytokines were measured in all participants. RESULTS: A statistically significant correlation between EI of the RF, TB and BF was observed (r = 0.46-0.50, P < 0.05), but not between EI of the MF and that of other muscles. EI of muscles of the limbs, which was averaged EI for RF, TB and BF, was negatively correlated with leptin levels (adjusted R2 = 0.27, P < 0.01), and EI of the MF was correlated with muscle mass and performance in the timed up-and-go test (adjusted R2 = 0.61, P < 0.01). CONCLUSION: These results suggest that EI might be influenced by specific parameters depending on the location of the muscle.

Effects of post-fracture non-weight-bearing immobilization on muscle atrophy, intramuscular and intermuscular adipose tissues in the thigh and calf.

OBJECTIVE: Disuse and/or a non-weight-bearing condition changes muscle composition, with decreased skeletal muscle tissue and increased fat within (intramuscular adipose tissue, IntraMAT) and between (intermuscular adipose tissue, InterMAT) given muscles. Excessive adipose tissue contributes to dysfunctional and metabolically impaired muscle. How these adipose tissues change during orthopedic treatment (e.g., cast immobilization, daily use of crutches) is not well documented. This study aimed to quantify changes in IntraMAT, InterMAT, and thigh and calf muscle tissue during orthopedic treatment. MATERIALS AND METHODS: We studied 8 patients with fifth metatarsal bone or fibular fractures. The ankle joint involved underwent plaster casting for approximately 4 weeks, with crutches used during that time. Axial T1-weighted MRI at the mid-thigh and a 30% proximal site at the calf were obtained to measure IntraMAT and InterMAT cross-sectional areas (CSAs) and skeletal muscle tissue CSA before treatment and 4 weeks afterward. RESULTS: Thigh and calf muscle tissue CSAs were significantly decreased from before to after treatment: thigh, 85.8 ± 7.6 to 77.1 ± 7.3 cm2; calf, 53.3 ± 5.5 to 48.9 ± 5.0 cm2 (p < 0.05). None of the IntraMAT or InterMAT changes was statistically significant. There was a relation between the percentage change of thigh IntraMAT CSA and muscle tissue CSA (rs = -0.86, p < 0.01). CONCLUSIONS: The 4 weeks of treatment primarily induced skeletal muscle atrophy with less of an effect on IntraMAT or InterMAT. There is a risk of increasing IntraMAT relatively by decreasing skeletal muscle tissue size during orthopedic treatment.

Three-dimensional comparison of intramuscular fat content between young and old adults.

BACKGROUND: Fat infiltration within skeletal muscle is known as intramuscular fat (IMF), which increases with aging. Studies have assessed IMF content, using the mid-thigh as a representative location. However, three-dimensional IMF distribution is not well understood. The aim of this study was to compare the IMF content in young and old adults by assessing its distribution along the length of the thigh. METHODS: Consecutive transaxial images of the right thighs in 15 young (age, 21.0 ± 0.4) and 15 old (age, 70.7 ± 3.8) were obtained by magnetic resonance imaging. We measured IMF cross-sectional area (CSA), skeletal muscle CSA and calculated volume- and CSA-based IMF content for the quadriceps femoris (QF), hamstring (HM) and adductor (AD). CSA-based calculations were performed at every 10% of femur length (Lf), with 0% Lf and 100% Lf indicating the proximal and distal ends of femur. RESULTS: IMF CSAs along the length of the thigh were similar in both age groups. In contrast, skeletal muscle CSAs in all three muscle groups were significantly lower in old adults than in young adults (variation: -15.2 to -1.6 cm2, P < 0.05). Thus, in volume-based measurements, the older adults had higher IMF contents than the younger adults (9.5% to 14.3% vs. 4.8% to 8.6%, respectively; P < 0.05). However, such age-dependent differences were not observed at the mid-thigh in the QF and AD. CONCLUSION: The results demonstrated an age-related increase in IMF content-confirmed in areas of the thigh-primarily based on finding lower amounts of skeletal muscle mass in CSAs in the older adults.

Reliability of size and echo intensity of abdominal skeletal muscles using extended field-of-view ultrasound imaging.

PURPOSE: This study aimed to examine the reliability of extended field-of-view (EFOV) ultrasound imaging to evaluate the cross-sectional area (CSA) and echo intensity of abdominal skeletal muscles. METHODS: Twenty-seven healthy young males (age 18.6 ± 1.0 years, body mass index 20.9 ± 2.8 kg/m2, waist circumference 75.0 ± 7.9 cm, body fat 16.6 ± 5.9%) visited the laboratory on 2 days. EFOV ultrasound images of the rectus abdominis, abdominal oblique, and erector spinae muscles were acquired at the height of the third lumbar vertebra with the subject lying on a bed. We then analyzed CSA and echo intensity using ImageJ software and calculated intra-class correlation coefficients (ICC) and the standard error of measurement (SEM). RESULTS: No significant differences (p = 0.149-0.679) were observed in CSA or echo intensity values for each skeletal muscle between days. ICC and SEM values in CSA for each skeletal muscle ranged between 0.944 and 0.958 and 4.9% and 7.3%, respectively. The corresponding values for echo intensity were 0.851-0.945 for ICC and 5.3-9.7% for SEM. CONCLUSIONS: The present results indicate that EFOV ultrasound imaging has high repeatability for measuring CSA and echo intensity of abdominal skeletal muscle groups in healthy college-aged males.

Skeletal muscle size is a major predictor of intramuscular fat content regardless of age.

PURPOSE: Skeletal muscles of older individuals have a larger amount of intramuscular adipose tissue (IntraMAT) than those of younger individuals. It is not understood how aging affects the IntraMAT content of individual muscles of the thigh. We assessed the relationship between IntraMAT content and skeletal muscle cross-sectional area (CSA), subcutaneous adipose tissue CSA, biochemical blood profiles, and physical activity. METHODS: Fifteen older (70.7 ± 3.8 years) and 15 younger (20.9 ± 0.3 years) men and women participated in this study. Magnetic resonance imaging of the right thigh was taken to measure IntraMAT content and skeletal muscle CSA for the quadriceps femoris (QF), hamstrings (HM), adductor (AD) muscle groups and subcutaneous adipose tissue CSA of the thigh. Fasting blood samples were collected to measure plasma lipids, adiponectin, and HbA1c levels. RESULTS: IntraMAT content in QF, HM, and AD for the Older group was significantly higher than in the Younger group. However, skeletal muscle CSA normalized by body weight (skeletal muscle CSA/bw) in the QF (P < 0.001) and total thigh (P < 0.01) were significantly lower in the Older group compared with the Younger group.There were no significant differences in HM and AD. Stepwise regression analysis with IntraMAT content as a dependent variable revealed that skeletal muscle CSA/bw of the thigh was the only predictive variable for IntraMAT content in Older and Younger groups. CONCLUSION: These results suggest that skeletal muscle size could be a major determinant of IntraMAT content regardless of age.

Association of skeletal muscle oxidative capacity with muscle function, sarcopenia-related exercise performance, and intramuscular adipose tissue in older adults.

Muscle function and exercise performance measures, such as muscle endurance capacity, maximal strength, chair stand score, gait speed, and Timed Up and Go score, are evaluated to diagnose sarcopenia and frailty in older individuals. Furthermore, intramuscular adipose tissue (IntraMAT) content increases with age. Skeletal muscle oxidative capacity determines muscle metabolism and maintains muscle performance. This study aimed to investigate the association of skeletal muscle oxidative capacity with muscle function, exercise performance, and IntraMAT content in older individuals. Thirteen older men and women participated in this study. Skeletal muscle oxidative capacity was assessed by the recovery speed of muscle oxygen saturation after exercise using near-infrared spectroscopy from the medial gastrocnemius. We assessed two muscle functions, peak torque and time to task failure, and four sarcopenia-related exercise performances: handgrip strength, gait speed, 30-s chair stand, and Timed Up and Go. The IntraMAT content was measured using axial magnetic resonance imaging. The results showed a relationship between skeletal muscle oxidative capacity and gait speed but not with muscle functions and other exercise performance measures. Skeletal muscle oxidative capacity was not related to IntraMAT content. Skeletal muscle oxidative capacity, which may be indicative of the capacity of muscle energy production in the mitochondria, is related to locomotive functions but not to other functional parameters or skeletal fat infiltration.

Relative contribution of neuromuscular activation, muscle size, and muscle quality to maximum strength output of the thigh muscles in young individuals.

This study aimed to investigate the relationship between maximal muscle strength and neuromuscular activation, muscle size, and quality of quadriceps (QF) and hamstring muscles (HM). The study included 24 young men and women. The neuromuscular activation parameter was recorded using a single-channel surface electromyography (EMG) with the root mean square (RMS) during maximal isometric knee extension and flexion from four muscles: rectus femoris and vastus lateralis for QF; biceps femoris and semitendinosus for HM. In addition, the peak torque was measured during the same session. B-mode ultrasonographic transverse images were obtained from the anterior, lateral, and posterior thighs. Furthermore, we calculated the muscle thickness (MT) and echo intensity (EI) of the four muscles as indicators of muscle size and quality. The averaged MT, EI, and absolute RMS of QF were calculated by averaging the values of the rectus femoris and vastus lateralis, and that of HM was calculated by averaging the values of the biceps femoris and semitendinosus. The knee extension peak torque was correlated with EI (r = -0.61, P < 0.01) and RMS (r = 0.53, P < 0.01) in the QF. In contrast, the knee flexion peak torque was correlated with RMS (r = 0.53, P < 0.05) but not with MT and EI in HM. In addition, EI and RMS in QF, and RMS in HM were selected as the major determinants of muscle strength in the stepwise regression analysis. These results suggest that muscle strength is moderately associated with different factors related to the thigh muscles in young individuals.

Muscle ultrasound and its application to point-of-care ultrasonography: a narrative review.

Technological advances of hand-held ultrasound devices and educational programmes for their use, such as point-of-care ultrasonography (POCUS) training, have contributed to the increasing application of these devices in clinical practice. With the greater impact of frailty and sarcopenia in aging societies, attention is being focused on the use of ultrasound for skeletal muscle assessment. In this narrative review, we discuss how ultrasound can be applied to skeletal muscle assessment, especially that of the quadriceps muscle, in clinical practice. Muscle thickness by ultrasound has been shown to have good reliability and validity for the evaluation of muscle size, and echo intensity has been used to evaluate muscle quality. Muscle ultrasound has not only been useful to diagnose sarcopenia in various settings, but has also been validated to predict health-related outcomes such as death and functional disability. Recommended methods for muscle ultrasound was published recently, and the results of future studies are expected to be comparable. Although several challenging issues with muscle ultrasound remain, if it could be incorporated into educational programmes such as POCUS training, more clinicians may be able to use ultrasound for skeletal muscle assessment in the future.KEY MESSAGESThe evolution of hand-held ultrasound devices enables physicians to perform ultrasound at the bedside as part of regular medical examinations.Muscle ultrasound is considered an effective tool for evaluating muscle size and quality, and has been studied in various settings.More clinicians may be able to evaluate skeletal muscle assessment with the development of educational programmes on muscle ultrasound in the future.

Serum Adiponectin and Leptin Is Not Related to Skeletal Muscle Morphology and Function in Young Women.

Adipokines secreted from adipose tissue, such as adiponectin and leptin, enhance skeletal muscle metabolism. Animal studies have shown that adipokine knockout leads to a reduction in muscle function. Muscle function is determined by muscle size and quality; therefore, it is speculated that lower adipokine levels affect skeletal muscle size and quality, eventually leading to lower muscle function. This study aimed to investigate the relationship between adipokines and skeletal muscle morphology and function in young individuals. A total of 21 young women participated in this study. Adiponectin and leptin levels were analyzed using fasting blood samples from all participants. B-mode ultrasound images of the thigh and calf were obtained, and the muscle thickness and echo intensity were measured in the vastus lateralis (VL) and medial gastrocnemius (MG). The shear modulus was measured from the VL and MG using shear wave elastography. Knee extension and plantar flexion peak torques were measured as muscle functions. Adiponectin and leptin were not related to echo intensity, shear modulus, and muscle thickness in the VL and MG (rs = -0.26-0.37, P > .05). Furthermore, no relationship was observed between adiponectin, leptin, knee extension, and dorsiflexion peak torque (rs = -0.28-0.41, P > .05). These negative results suggest that adiponectin and leptin levels in young women are not associated with muscle size and quality, nor are they related to muscle function.

Applicability of the seated step test for assessing thigh muscle sarcopenia in older individuals.

Assessment of lower limb muscle mass and related functions in older individuals is important because of their essential role in maintaining locomotion and activities of daily living. Therefore, a simple and reliable method for assessing these parameters should be established. The seated step test is easy and safe and can be used to assess lower limb agility; however, its relationship to skeletal muscle mass and function remains unknown. The present study aimed to investigate the relationships between the seated step test and lower limb muscle mass and function. For the analysis, we included 85 participants aged 73.1 ± 6.0 years. The participants performed an alternate up-down leg step test for 10 s while seated in a chair. Lower limb muscle mass was measured using bioimpedance analysis. Skeletal muscle mass index (SMI) was calculated using the following equation: lower limb muscle mass (kg) / height2 (m2). As the muscle functional parameters, we measured the isometric knee extension peak torque (KEPT), knee flexion peak torque (KFPT), and rate of torque development (RTD) for isometric knee extension in all participants. The seated step test score had a significant relationship with KEPT, KFPT, and SMI, but not with RTD. In the single regression analysis, the seated step test significantly predicted KEPT, KFPT, and SMI. These results suggest that up-down seated step test can be a reliable method to estimate lower limb muscle size and function in older individuals.

Effect of subcutaneous adipose tissue and muscle thicknesses on rectus femoris and vastus intermedius ultrasound echo intensities: a cadaver study.

PURPOSE: The purpose of this study was to examine the effect of subcutaneous adipose tissue (SCAT) thickness and rectus femoris (RF) muscle thickness on RF and vastus intermedius (VI) echo intensity using human cadavers. METHODS: The echo intensity of the RF and VI was measured in 11 legs of seven cadavers under three conditions: intact condition (Model 1), SCAT removed (Model 2), and SCAT and RF removed (Model 3). RESULTS: RF echo intensity in Model 1 (69.2 ± 20.3 a.u.) was significantly lower than that in Model 2 (83.4 ± 15.9 a.u.) (P = 0.003). VI echo intensity in Models 1 to 3 showed similar results to RF echo intensity (P = 0.003 to 0.001). Regarding the relationship between VI echo intensity and VI muscle thickness, the regression lines shifted upward in a parallel fashion in the order Model 1, Model 2, and Model 3. Multiple regression analysis revealed that the variation in RF echo intensity was explained by RF muscle thickness (P = 0.036) and SCAT thickness (P = 0.001), while the variation in VI echo intensity was explained by RF muscle thickness (P = 0.035). CONCLUSION: These results suggest that SCAT thickness and RF muscle thickness induce lower RF echo intensity, while RF muscle thickness induces lower VI echo intensity.

Contribution of skeletal muscle and serum lipids to muscle contraction induced by neuromuscular electrical stimulation in older individuals.

Intramyocellular lipids (IMCL) stored in droplets in muscle cells and free fatty acids (FFA) from fat cells in the blood are the main substrates of adenosine triphosphate during continuous muscle contractions of relatively lower intensity. Although it is known that the lipid oxidative capacity decreases with aging, the effect of IMCL and FFA on muscle contraction in older individuals remains unclear. The purpose of this study was to investigate the contribution of skeletal muscle lipids and blood lipids as energy sources for muscle contraction in older individuals. Eighteen older individuals (mean age: 70.4 ± 3.5 years) underwent muscle contraction intervention induced by intermittent neuromuscular electrical stimulation (NMES) to the vastus lateralis for 30 min. Fasting blood samples were obtained and proton magnetic resonance spectroscopy (1 H-MRS) was performed before and after NMES, and the parameters (including IMCL and extramyocellular lipid [EMCL]) from 1 H-MRS, along with FFA and adiponectin levels, were analyzed using the blood samples of all participants. Levels of IMCL and EMCL did not change (p > 0.05); however, FFA and adiponectin levels decreased from 1.1 ± 0.5 mEq/L to 0.8 ± 0.2 mEq/L and 12.0 ± 5.3 µg/ml to 11.4 ± 5.0 µg/ml, after NMES (p < 0.05), respectively. These findings indicate that serum lipids, but not skeletal muscle lipids, are the energy substrate utilized during involuntary muscle contraction in older individuals.

Impact of muscle echo intensity on post-exercise blood pressure response in older normotensive and hypertensive females: Pilot study.

Exaggerated post-exercise blood pressure (BP) is considered a risk factor for the development of cardiovascular disease in older females. Muscle echo intensity (EI) using ultrasound can be used to evaluate intramuscular fat, one of the risk factors for cardiovascular disease. This study aimed to determine whether intramuscular fat assessed by muscle echo intensity is associated with the post-exercise BP response in older females. Ten older normotensive (SBP <130 mmHg, 71 ± 4 years), eight systolic BP-controlled (78 ± 4 years), and 17 hypertensive (SBP ≥130 mmHg, 74 ± 6 years) females were studied. After obtaining ultrasound images to assess the EI, participants performed ramp-up exercise until 50% maximal voluntary contraction (MVC: ~30-s; 3% MVC/s gradually increased knee extension force from 0% to 50% MVC followed by sustaining the force at 50% MVC for 10-s) and then five MVCs (~50 s; 10-s rest between each contraction). BP was measured before and immediately after exercise. Mean arterial pressure (MAP) pre- and post-exercise were significantly lower in normotensive and SBP-controlled, than in -uncontrolled hypertensive females (PRE: 85 ± 5 and 87 ± 7 vs. 106 ± 9; POST: 92 ± 8 and 94 ± 9 vs. 103 ± 11 mmHg, respectively, p < 0.05). EI was negatively correlated with ∆diastolic BP (∆DBP) but not ∆SBP and ∆MAP in normotensive females only (∆SBP, r = -0.21, p = 0.56; ∆DBP, R = -0.73, p = 0.02; ∆MAP, R = -0.49, p = 0.15). Greater intramuscular fat as indicated by higher EI is associated with less BP elevation immediately after exercise in older normotensive females. Greater intramuscular fat may lead to lower intramuscular pressure, resulting in less post-exercise BP elevation.

Importance of skeletal muscle lipid levels for muscle function and physical function in older individuals.

The skeletal muscle contains lipids inside (intramyocellular lipids, IMCL) or outside (extramyocellular lipids, EMCL) its cells. The muscle lipid content increases with age; however, the characteristics of IMCL and EMCL in older individuals are not well known. We aimed to examine the characteristics of skeletal muscle lipids by investigating their relationship with muscle function and physical functions. Seven elderly men and 16 elderly women participated. The skeletal muscle lipid content, including IMCL and EMCL, was measured in the vastus lateralis by proton magnetic resonance spectroscopy. Isometric knee extension with maximal voluntary contraction (MVC) and time-to-task failure for knee extension with 50% MVC were measured as muscle functions. The participants performed six physical function tests: preferred gait speed, maximal gait speed, Timed Up and Go, chair sit-to-stand, handgrip strength, and stand from the floor. The time to knee extension task failure had a significant relationship with the IMCL (rs = -0.43, P < 0.05), but not with the EMCL content. Significant relationships were confirmed in the EMCL content with the sit-to-stand (rs = -0.48, P < 0.05) and stand-from-the-floor (rs = 0.53, P < 0.05) tests. These findings indicated that muscle lipids are associated with muscle and physical functional performances in older individuals. Novelty: No relationship was confirmed between IMCL and EMCL in older individuals. Muscle endurance performance had a relationship with IMCL, but not with EMCL. Relationships between EMCL and physical functional tests (e.g., sit-to-stand and stand from the floor) were confirmed.

Factors related to trunk intramuscular adipose tissue content - A comparison of younger and older men.

The present study investigated factors related to trunk intramuscular adipose tissue (IntraMAT) content in younger and older men. Twenty-three healthy younger (20 to 29 years) and 20 healthy older men (63 to 79 years) participated in this study. The trunk IntraMAT content was measured using magnetic resonance imaging at the height of the 3rd lumbar vertebra. In addition to blood properties and physical performance, dietary intake was assessed by a self-administered diet history questionnaire. The dietary intake status was quantified using the nutrient adequacy score for the intake of 10 selected nutrients by summing the number of items that met the criteria of dietary reference intakes for Japanese individuals. The results obtained revealed that the trunk IntraMAT content was significantly higher in the older group than in the younger group (p < 0.05). In the younger group, the trunk IntraMAT content significantly correlated with systolic and diastolic blood pressure and HbA1c (rs = 0.443 to 0.464, p < 0.05). In the older group, significant and negative correlations were observed between the trunk IntraMAT content and 5-m usual walking speed, handgrip strength, and nutrient adequacy scores (rs = -0.485 to -0.713, p < 0.05). These results indicate that factors associated with the trunk IntraMAT content differed in an age dependent manner. In the younger group, the trunk IntraMAT content correlated with the metabolic status such as blood pressure and HbA1c. In the older group, physical performance and the dietary intake status negatively correlated with the trunk IntraMAT content.

Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults.

OBJECTIVES: Muscle ultrasound is a non-invasive technique that enables identification of the quantity and quality of muscle tissue. It has been used not only for diagnosis of sarcopenia but also for prediction of outcomes in clinical practice. There is now increasing awareness that muscle changes detected during acute hospitalization indicate acute sarcopenia leading to worse outcomes. However, to our knowledge, few studies have investigated this in hospitalized older adults. The aim of this study was to determine whether muscle changes on muscle ultrasound can predict poor outcomes in acute hospitalized older adults. METHODS: This prospective, observational cohort study involved 145 acute hospitalized older adults. Bilateral anterior thigh thickness (BATT), echo intensity (EI), and corrected EI of the quadriceps were assessed on admission and 7 d later. The primary outcome was mortality, and the secondary outcomes were hospital-associated complications and decline in activities of daily living (ADLs) at 3 mo after discharge. RESULTS: Changes in BATT, EI, and corrected EI at 7 d after admission were found in 0.2%, 0.0%, and 0.2% of cases, respectively. The respective rates for mortality, hospital-associated complications, and ADL decline were 8.7%, 52.8%, and 43%, respectively. Multivariable logistic regression analysis showed that the BATT value at admission tended to be associated with mortality. Changes in BATT, EI, and collected EI were not associated with adverse outcomes. CONCLUSIONS: Acute muscle changes on muscle ultrasound were not associated with mortality, ADL decline, or hospital-associated complications in acute hospitalized older adults. More research in various settings is needed to clarify the value of muscle ultrasound in clinical practice.