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. 2024 Jul;12(13):e16127.
doi: 10.14814/phy2.16127.

Intermuscular adipose tissue accumulation is associated with higher tissue sodium in healthy individuals

Lale A Ertuglu  1 , Melis Sahinoz  1 , Aseel Alsouqi  2 , Serpil Muge Deger  3 , Andrew Guide  4 , Mindy Pike  5 , Cassianne Robinson-Cohen  6 , Elvis Akwo  6 , Michael Pridmore  7 , Rachelle Crescenzi  7   8 , Meena S Madhur  9   10 , Annet Kirabo  9 , David G Harrison  9 , Friedrich C Luft  11 , Jens Titze  12 , T Alp Ikizler  6 , Jorge L Gamboa  9
Affiliations

Intermuscular adipose tissue accumulation is associated with higher tissue sodium in healthy individuals

Lale A Ertuglu et al. Physiol Rep. 2024 Jul.

Abstract

Background and aims: High tissue sodium accumulation and intermuscular adipose tissue (IMAT) are associated with aging, type 2 diabetes, and chronic kidney disease. In this study, we aim to investigate whether high lower-extremity tissue sodium accumulation relates to IMAT quantity and whether systemic inflammatory mediators and adipocytokines contribute to such association.

Methods: Tissue sodium content and IMAT accumulation (percentage of IMAT area to muscle area) were measured in 83 healthy individuals using sodium imaging (23Na-MRI) and proton (1H-MRI) imaging of the calf. Insulin sensitivity was assessed by glucose disposal rate (GDR) measured with the hyperinsulinemic-euglycemic clamp.

Results: Median (interquartile range) muscle and skin sodium contents were 16.6 (14.9, 19.0) and 12.6 (10.9, 16.7) mmol/L, respectively. Median IMAT was 3.69 (2.80, 5.37) %. In models adjusted for age, sex, BMI, GDR, adiponectin, and high-sensitivity C-reactive protein, increasing tissue sodium content was significantly associated with higher IMAT quantity (p = 0.018 and 0.032 for muscle and skin tissue sodium, respectively). In subgroup analysis stratified by sex, skin sodium was significantly associated with IMAT only among men. In interaction analysis, the association between skin sodium and IMAT was greater with increasing levels of high-sensitivity C-reactive protein and interleukin-6 (p for interaction = 0.022 and 0.006, respectively).

Conclusions: Leg muscle and skin sodium are associated with IMAT quantity among healthy individuals. The relationship between skin sodium and IMAT may be mediated by systemic inflammation.

Keywords: inflammation; intermuscular adipose tissue; tissue sodium accumulation.

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Conflict of interest statement

TAI reports personal fees from Fresenius Kabi, Abbott Renal Care, and Nestle. JLG serves as a consultant for Pharvaris Gmbh.

Figures

FIGURE 1
FIGURE 1
The regression plots of muscle (a) and skin (b) sodium with IMAT. Plots presented with linear regression line along with 95% confidence intervals. IMAT positively correlated with muscle and skin sodium (r = 0.34, p = 0.0018 and r = 0.40, p = 0.0002, respectively).
FIGURE 2
FIGURE 2
Interaction between skin sodium and plasma hsCRP for the association with IMAT. At higher hsCRP levels, there was a greater increase in IMAT per unit change in skin sodium. p for interaction 0.022. There was no significant interaction between muscle sodium and plasma hsCRP for the association with IMAT.
See this image and copyright information in PMC

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