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One-Year Lifestyle Intervention, Muscle Lipids, and Cardiometabolic Risk


Medicine & Science in Sports & Exercise: October 2019 - Volume 51 - Issue 10 - p 2156–2165
doi: 10.1249/MSS.0000000000002030

Purpose Low-attenuation muscle (LAM) area at mid-thigh, a computed tomography (CT)–derived index of intramuscular lipids, is associated with insulin resistance, obesity, and type 2 diabetes. The present study aimed at testing the hypothesis that changes in LAM area in trunk muscles from a single abdominal scan could provide relevant information to evaluate the effects of a lifestyle intervention without the use of a mid-thigh CT scan.

Methods Cardiometabolic risk variables, including waist circumference, lipoprotein–lipid profile, glucose tolerance, and cardiorespiratory fitness, were assessed in a sample of 102 dyslipidemic viscerally obese men at baseline and after a 1-yr lifestyle intervention. Abdominal (L4–L5) and mid-thigh CT scans were performed and abdominal muscles classified as psoas and core muscles. Scans were segmented to calculate muscle areas, LAM areas, and mean attenuation values.

Results All muscle groups showed a decrease in LAM areas (P < 0.0001) in response to the lifestyle intervention. Changes in LAM areas were significantly associated with changes in triglycerides, high-density lipoprotein (HDL) cholesterol, cholesterol/HDL cholesterol ratio and log triglycerides/HDL cholesterol ratio (mid-thigh, 0.20 ≤ |r| ≤ 0.29; psoas, 0.28 ≤ |r| ≤ 0.38; core, 0.29 ≤ |r| ≤ 0.34, P < 0.05). Changes in core LAM area were significantly associated with changes in 2-h glucose levels, glucose area measured during the oral glucose tolerance test and homeostasis model assessment of insulin resistance (0.21 ≤ r ≤ 0.34, P < 0.05). Stepwise regression analyses showed that changes in LAM psoas area were associated with changes in HDL cholesterol and the cholesterol/HDL cholesterol ratio independently from changes in visceral adiposity.

Conclusions Changes in trunk LAM areas are useful indices of changes in mid-thigh LAM area observed with a 1-yr lifestyle intervention. Thus, an additional mid-thigh scan is not necessary to evaluate muscle lipid content by CT when an abdominal CT scan is available.

1Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec–Université Laval, Québec, QC, CANADA

2Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, CANADA

3Endocrinology and Nephrology Unit, CHU de Québec, Université Laval Research Center, Québec, QC, CANADA

4Faculty of Pharmacy, Université Laval, Québec, QC, CANADA

Address for correspondence: Jean-Pierre Després, Ph.D., Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec–Université Laval 2725, chemin Sainte-Foy, A-2087 Québec QC G1V 4G5, Canada; E-mail:

Submitted for publication January 2019.

Accepted for publication April 2019.

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Online date: May 4, 2019

© 2019 American College of Sports Medicine