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The thickness of the rectus abdominis muscle. The thickness of the rectus abdominis muscle were measured to the nearest 0.01mm from CT images with the picture archiving and communications system (PACS) viewer program (Marosis m-view 5.4). RAM, thickness of the thickest part of the rectus abdominis muscle thickness at the umbilicus level. https://doi.org/10.1371/journal.pone.0185040.g001
Source publication
Background and objective
Skeletal muscle has been suggested as an important factor in the pathophysiology of metabolic syndrome. During the aging process, muscle mass is lost in specific body parts. However, few studies have investigated the relationship between site-specific muscle loss assessed using computed tomography (CT) and metabolic syndrom...
Citations
... Regarding the research design, all studies were observational: 10 cross-sectional studies [10,[21][22][23][24][25][26][27][28][29], 3 cohort studies [9,30,31], and 1 case-control study [32]. In total, the 14 papers compared leukocyte concentrations between 21,005 MetS+ and 66,339 MetS− subjects. ...
... The ages of the participants ranged from 18 to 85 years. Most of the papers (57.14%) [9,22,24,[26][27][28]30,32] included participants of both sexes, but analysed the data globally; 3 studies (21.4%) included only men [21,23,25], and 3 others collected data from men and women separately [10,29,31]. In relation to provenance, half of the articles found were developed in the Chinese population [9,10,22,26,[28][29][30][31]. ...
... MetS was defined according to the National Cholesterol Education Program (NCEP-ATP III) third report criteria [33] in 7 research studies [22][23][24]27,29,31,32]; 3 studies [10,21,28] assessed MetS using the International Diabetes Federation (IDF) definition [34]; 2 studies [25,26] used harmonised criteria [35]; and 2 articles [9,30] as defined by the Chinese Diabetes Society [36]. ...
Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×109/L; CI95% 0.55–0.72; p < 0.00001; I2 = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.
... Of these, 17 met the inclusion criteria and were selected for systematic review and meta-analysis. Cohen's Kappa clinical concordance index between [25,26,[29][30][31][32][33][34][35][36][37][38][39][40] included participants of both sexes but analysed the data globally; 3 studies (17.65%) [24,27,28] collected data from men and women separately. Concerning origin, 5 articles were developed in China [27,31,37,38,40], 5 in Japan [26,32,34,35,37], three articles in Taiwan [25,30,39], 1 in Italy [24], 1 in Poland [33], Korea [28] and Iran [29]. ...
... Cohen's Kappa clinical concordance index between [25,26,[29][30][31][32][33][34][35][36][37][38][39][40] included participants of both sexes but analysed the data globally; 3 studies (17.65%) [24,27,28] collected data from men and women separately. Concerning origin, 5 articles were developed in China [27,31,37,38,40], 5 in Japan [26,32,34,35,37], three articles in Taiwan [25,30,39], 1 in Italy [24], 1 in Poland [33], Korea [28] and Iran [29]. Data were extracted from 17 reports from ALT [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40], 15 studies from AST [25,26,[28][29][30][31][32][33][34][35][36][37][38][39][40], and five from GGT [25,26,29,31,32]. ...
... Concerning origin, 5 articles were developed in China [27,31,37,38,40], 5 in Japan [26,32,34,35,37], three articles in Taiwan [25,30,39], 1 in Italy [24], 1 in Poland [33], Korea [28] and Iran [29]. Data were extracted from 17 reports from ALT [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40], 15 studies from AST [25,26,[28][29][30][31][32][33][34][35][36][37][38][39][40], and five from GGT [25,26,29,31,32]. ...
Background
Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by hypertension, central obesity, dyslipidaemia and dysregulation of blood glucose, associated with the risk of diabetes, cardiovascular disease and overall mortality. The presence of elevated liver enzymes may precede the development of MetS, with alterations of the liver being observed that are directly related to metabolic problems. The study aims to provide the best evidence on the association between liver enzymes (ALT, AST, GGT) and MetS by determining the effect size of these biomarkers.
Methods
A systematic review and meta-analysis of studies indexed in PubMed and Scopus databases were performed. Study quality was assessed using the STROBE tool. The Grade Pro tool was used to evaluate the evidence, and the quantitative synthesis was performed using RevMan (Cochrane Collaboration).
Results
Seventeen articles comparing liver enzyme concentrations between 76,686 with MetS (MetS+) and 201,855 without MetS (MetS-) subjects were included. The concentration of ALT, AST and GGT in the MetS + subjects was significantly higher than in the control group 7.13 IU/L (CI95% 5.73–8.54; p < 0.00001; I² = 96%), 2.68 IU/L (CI95% 1.82–3.54; p < 0.00001; I² = 96%) and 11.20 IU/L (CI95% 7.11–15.29; p < 0.00001; I² = 96%), respectively.
Conclusions
The evaluation of the relationship of liver enzymes in the pathophysiological process of MetS could lead to new insights into early diagnosis.
... In 2017, Choi et al used computed tomography to investigate the rectus abdominis muscle thickness in 798 males who attended health screening. 31 They found that participants with MetS had thinner rectus abdominis muscles than those without MetS. As central obesity is a predominant feature of MetS, 32 we speculated that trunk muscles would be affected more than extremity muscles, which led to an insignificant result in our observation. ...
Purpose
Limited imaging studies have investigated whether limb muscle quantity and quality change after metabolic syndrome (MetS) development. This pilot study examined MetS influence on limb muscle characteristics in older adults.
Methods
Participants were recruited from annual health examinations; their right biceps brachii, triceps brachii, rectus femoris, and gastrocnemius muscles were measured by ultrasound. Anthropometric parameters, blood biochemistry, and physical performance (handgrip strength and gait speed) were also examined.
Results
Overall, 129 participants were enrolled, including 26 with MetS. Although handgrip strength was lower in MetS patients, there were no significant between-group differences considering thickness and mean echogenicity of the four muscles. Handgrip strength was positively correlated with the thickness of biceps brachii, triceps brachii, and rectus femoris but was negatively associated with their echogenicity. On multivariate analysis, triceps muscle echogenicity was trivially associated (odds ratio, 0.93; 95% confidence interval, 0.86–0.99) with MetS, possibly due to multicollinearity with grip strength.
Conclusion
No significant difference was recognized in limb muscle thickness and echogenicity in the geriatric population with MetS compared with healthy controls by ultrasound imaging. However, the finding might be caused by the small sample size of our participants. Future large-scale studies should explore the influence of separated risk factors of MetS on limb muscle echotexture and examine whether manifestation differs in different age populations.
Aim: In this study, we evaluated the presence of sarcopenia multidimensionally in patients with knee osteoarthritis (OA) using clinical, ultrasonographic and biochemical parameters, and in this respect, it was aimed to investigate the relation between OA and sarcopenia and to identify the most practical, easily accessible and inexpensive method for investigating sarcopenia.Materials and methods: 102 patients with clinical and radiological diagnosis of knee osteoarthritis and 33 healthy control subjects were included in the study. The detailed musculoskeletal system examination of the patients included in the study was carried out by a single physician, and blood sample tests were recorded .Dual-X-ray absorptiometry (DEXA) is used to measure Body composition parameters and muscle mass measurements, isometric muscle strength evaluations, handgrip strength and gait speeds for diagnosis of sarcopenia. Short-form -36 (SF-36) The Nutritional Assessment-short form (MNA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the International Physical Assessment Questionnaire Short Form (IPAQ-SF) and the Center for Epidemiologic Studies Depression Scale (CES-D scale) were administered to every patient as outcome measures.Results: Body composition parameter results showed that sarcopenic patients had statistically lower values as fat mass, lean body mass and skeletal muscle index (p <0.001, p= 0.001, p <0.001, respectively) than those of non-sarcopenic and control group. It was determined that body composition values measured with DEXA, ultrasonographic measures, isokinetic muscle strength assessment, handgrip strength and gait speed had predictive values for sarcopenia. Conclusion: We found that patients with sarcopenic OA were older, weaker, undernourished, and restricted in their level of physical activity in the study in which we identified sarcopenia as approximately 12% in patients with osteoarthritis. Among the methods of determining sarcopenia, ultrasound becomes prominent with its practical, cheap and easily accessible features. We think that our results will increase the awareness of the presence of sarcopenia in OA patients.
Background:
Abdominal bulging at the donor site of free abdominal flaps for breast reconstruction is a common postoperative complication. In addition to the thickness of abdominal muscles, the authors identified the rectus abdominis diastasis as an important factor that compromises abdominal wall strength. This study aimed to assess the relationship between preoperative abdominal wall strength and postoperative abdominal bulging.
Methods:
A total of 224 patients were enrolled in this study. Patient demographics, the rectus and lateral abdominis muscle thicknesses, and the rate of rectus abdominis diastasis were compared (with versus without bulging). Muscle thickness and rectus abdominis diastasis were investigated by preoperative computed tomography.
Results:
The group with bulging consisted of 32 patients (14.3 percent), whereas the group without bulging consisted of 192 patients. The group with bulging had a significantly higher gestational history rate. The thickness of the rectus abdominis muscle in the group with bulging was significantly thinner (median, 8.6 mm versus 10.5 mm; p < 0.001) and the rate of rectus abdominis diastasis was significantly higher (78.1 percent versus 32.3 percent; p < 0.001). There were no significant differences with respect to the thickness of the lateral abdominal muscle and the other factors (i.e., age, body mass index, history of laparotomy. and operative details).
Conclusions:
Because the diagnosis of abdominal bulging was based on severity, the rate may be high compared to that reported from previous studies. Because the factor of gestational history correlated to thickness of the rectus abdominis muscle and rectus abdominis diastasis, this factor influenced the occurrence of abdominal bulging. Patients with a thin rectus abdominis muscle and rectus abdominis diastasis were at higher risk of abdominal bulging.
Clinical question/level of evidence:
Risk, III.
Rationale and Objectives
The rectus abdominis muscle exhibits early and significant muscle atrophy, which has largely been characterized using ultrasound measured muscle thickness. However, the validity of rectus abdominis muscle thickness as a metric of muscle size has not been established, limiting precise interpretation of age-related changes. In a heterogeneous cohort of women and men, our objectives were to: (1) evaluate the association between rectus abdominis muscle thickness and cross-sectional area (CSA), and (2) examine if the visceral adipose tissue (VAT) compartment confounds the validity of rectus abdominis muscle thickness.
Materials and Methods
Abdominal computed tomography scans of the third lumbar vertebrae from clinical and healthy populations were used to evaluate rectus abdominis thickness and CSA, and VAT CSA. Computed tomography scans were utilized due to the limited field of view of ultrasound imaging to capture the rectus abdominis CSA.
Results
A total of 348 individuals (31% women) were included in this analysis, with a mean ± standard deviation age and body mass index of 51.2 ± 15.4 years and 28.0 ± 5.1 kg/m², respectively. Significant correlations were observed between rectus abdominis thickness and CSA for women (r = 0.758; p < 0.001) and men (r = 0.688; p < 0.001). Independent of age, VAT CSA was negatively associated with rectus abdominis thickness in men (p = 0.011), but not women (p = 0.446).
Conclusion
These data support the use of rectus abdominis muscle thickness as a measurement of muscle size in both women and men; however, the VAT compartment may confound its validity to a minor extent in men.
Background:
Early identification of patients at high risk of prolonged mechanical ventilation is important in critical care. Sarcopenia, the loss of muscle mass and function, has been reported to be associated with extended mechanical ventilation and prolonged ICU stay. Although ultrasound is noninvasive and widely used in critical care, there is no standard method of using it to assess sarcopenia.
Objectives:
The study aims to investigate the relationship between outcomes of critically ill patients and the ratio of BMI to the thickness of rectus abdominis measured by a standardised ultrasound examination.
Design:
A retrospective cohort study.
Setting:
Surgical ICU of a tertiary referral hospital, from October 2017 to June 2018. The thickness of rectus abdominis was measured while performing extended focused assessment sonography for trauma. BMI was divided by the thickness of rectus abdominis over the upper abdomen to derive the BMI-RA thickness ratio.
Patients:
Sixteen male and 11 female patients admitted to ICU after major abdominal surgery.
Main outcome measures:
The primary outcome was in-hospital mortality, and the secondary outcomes were durations of mechanical ventilation, ICU stay and hospital stay. The disease severity, serum albumin level and BMI-RA thickness ratio were also analysed.
Results:
Ultrasound measurement was easy to perform without adverse effects. The BMI-RA thickness ratio was significantly higher in nonsurvivors and was associated with ICU stay, hospital stay and duration of mechanical ventilation. Multivariate logistic regression showed that the BMI-RA thickness ratio was a predictor of in-hospital mortality.
Conclusion:
The BMI-RA thickness ratio is related to the outcomes of patients transferred to ICU after major abdominal surgery. Measuring the thickness of rectus abdominis by ultrasound is well tolerated and easy to perform in surgical ICU. Larger prospective studies are required to confirm current findings.
