Activity Levels, Myosteatosis and Insulin Resistance/Diabetes Mellitus

摘要 骨质疏松症是一种身体成分的测量方法，它测量脂肪渗透的存在和程度。 进入肌肉间隔，包括在肌肉纤维/束周围沉积，以及进入 肌肉组织本身。我们在这项异位脂肪测量方面的工作表明，肌肉瘤是强烈的和 与血糖调节措施显著相关，与内脏和肝脏肥胖无关。 考虑到血糖失调(即代谢综合征和/或糖尿病)之间的密切联系 和动脉僵硬，以及左心室的结构和功能，我们认为肌骨瘤病的研究 可能与心力衰竭的决定因素特别相关。与非西班牙裔白人相比， 西班牙裔/拉美裔美国人的肥胖率、心脏代谢危险因素和2型明显更高 糖尿病(T2 DM)，导致心力衰竭风险增加。评估不同项目的风险因素 在这个迅速增长的人口中，NIH委托西班牙裔社区健康 研究--拉丁裔研究(HCHS-SOL)。2007年，这项研究开始在四个不同的外地中心进行招聘 并招募了来自不同背景遗产群体的16,000多名西班牙裔/拉美裔美国人。小贩管理委员会- SOL现在已经完成了两次诊所访问，并计划于2019年12月开始注册访问3。在… 这次访问，研究将更新病史，获取空腹血样，用于测量 葡萄糖、胰岛素和血红蛋白A1C，并将接受2小时的糖耐量测试。此外，这项研究 将对返回的参与者进行以下评估：1)客观测量体力活动 和久坐行为；2)通过踝关节和脚趾臂部指数以及多普勒检测外周动脉疾病 波形和脉搏容量记录；3)颈动脉-股动脉脉搏波速度和4) 心脏结构和功能的磁共振成像。这种测量集合可以被利用 评估从体力活动/久坐行为到身体成分再到心脏代谢风险的途径 动脉僵硬对心脏结构和功能的影响。鉴于此，我们建议利用现有的HCHS-Sol 基础设施，并增加购买新的腹部和大腿中部计算机断层扫描，以 测量肌肉骨质疏松症和骨骼肌群，以及皮下、内脏和肝脏 肥胖症。本项目的目标是确定肌骨瘤病是否适用于上述。 来自不同背景遗产的西班牙裔/拉美裔美国人之间的途径，独立于其他人 身体成分的测量。

ABSTRACT Myosteatosis is a measure of body composition, which measures the presence and degree of fatty infiltration into the muscle compartment to include deposition around the muscle fibers/bundles, as well as into the muscle tissue itself. Our work on this measure of ectopic fat has shown myosteatosis to be strongly and significantly associated with measures of glucose regulation, independent of visceral and hepatic adiposity. Given the strong links between the glucose dysregulation (i.e. metabolic syndrome and/or diabetes mellitus) and arterial stiffness, as well as left ventricular structure and function, we believe the study of myosteatosis may be particularly relevant as a determinant of heart failure. Compared to non-Hispanic Whites, Hispanic/Latino Americans have significantly higher rates of obesity, cardiometabolic risk factors and type 2 diabetes mellitus (T2DM), resulting in an increased risk for heart failure. To assess the risk factors for different chronic diseases in this burgeoning population, the NIH commissioned the Hispanic Communities Health Study – Study of Latinos (HCHS-SOL). In 2007, this study began recruitment at four different field centers and enrolled over 16,000 Hispanic/Latino Americans from diverse background heritage groups. The HCHS- SOL has now completed two clinic visits and is scheduled to begin enrollment for visit 3 in December 2019. At this visit, the study will update the medical history, obtain fasting blood samples that will be used to measure glucose, insulin and hemoglobin A1C, and will acquire a 2-hour glucose tolerance test. Additionally, the study will conduct the following assessments on the returning participants: 1) objectively measured physical activity and sedentary behavior; 2) peripheral arterial disease by the ankle and toe brachial indices, as well as Doppler waveforms and pulse volume recordings; 3) arterial stiffness by carotid femoral pulse wave velocity and 4) cardiac structure and function by magnetic resonance imaging. This ensemble of measurements can be utilized to assess the pathway from physical activity/sedentary behavior to body composition to cardiometabolic risk to arterial stiffness to cardiac structure and function. Given this, we propose to leverage the existing HCHS-SOL infrastructure and add the acquisition of new computed tomography scans of the abdomen and mid-thigh to obtain measurements of myosteatosis and skeletal muscle mass, as well as subcutaneous, visceral and hepatic adiposity. The goal of this project is to determine the applicability of myosteatosis to the aforementioned pathway among Hispanic/Latino Americans from diverse background heritages, independent of other measures of body composition.