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Clinical Trial
. 2008 Nov;88(11):1336-44.
doi: 10.2522/ptj.20080079. Epub 2008 Sep 18.

Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function

Tiffany N Hilton  1 , Lori J Tuttle, Kathryn L Bohnert, Michael J Mueller, David R Sinacore
Affiliations
Clinical Trial

Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function

Tiffany N Hilton et al. Phys Ther. 2008 Nov.

Abstract

Background and purpose: The primary purpose of this study was to report differences in calf intermuscular adipose tissue (IMAT), muscle strength (peak torque), power, and physical function in individuals with obesity, diabetes mellitus (DM), and peripheral neuropathy (PN) compared with those without these impairments. A secondary purpose was to assess the relationship between IMAT and muscle strength, power, and physical function.

Subjects and methods: Six participants with obesity, DM, and PN (2 women, 4 men; mean age=58 years, SD=10; mean body mass index=36.3, SD=5; mean modified Physical Performance Test [PPT] score=22, SD=3) and 6 age- and sex-matched control subjects without these impairments were assessed and compared in muscle strength, muscle power, physical functioning, and muscle and fat volume, including IMAT in the calf muscles. Muscle, adipose tissue, and IMAT volumes of each calf were quantified by noninvasive magnetic resonance imaging. Muscle strength and power of the plantar-flexor and dorsiflexor muscles were quantified using isokinetic dynamometry. The modified PPT was used to assess physical function.

Results: Leg muscle and fat volumes were similar between groups, although IMAT volumes were 2.2-fold higher in the subjects with obesity, DM, and PN (X=120 cm(3), SD=47) than in the control subjects (X=54 cm(3), SD=41). Muscle strength, muscle power, ratio of leg muscle power to leg muscle volume, and modified PPT scores were lower in subjects with obesity, DM, and PN compared with the control subjects.

Discussion and conclusion: The data indicate that excess fat infiltration in leg skeletal muscles is associated with low calf muscle strength, low calf muscle power, and impaired physical function in individuals who are obese with DM and PN.

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Figures

Figure 1.
Figure 1.
Magnetic resonance image of the distal lower extremity acquired at 1.5T in: (A) a 57-year-old male participant with diabetes mellitus, peripheral neuropathy, and a body mass index (BMI) of 27.3; (2) a 58-year-old female participant with diabetes mellitus, peripheral neuropathy, and a BMI of 45.4, and (C) a 50-year-old male participant without diabetes mellitus or peripheral neuropathy and a BMI of 24.5. Note the excessive intermuscular adipose tissue volume in images A and B.
Figure 2.
Figure 2.
Relationship between average dorsiflexion and plantar-flexion muscle power at 60°/s and average bilateral distal lower-extremity intermuscular adipose tissue (IMAT) volume (cm3) (r=−.60).
Figure 3.
Figure 3.
Relationship between Physical Performance Test (PPT) score and average bilateral distal lower-extremity intermuscular adipose tissue (IMAT) volume (cm3) (r= −.92).
See this image and copyright information in PMC

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