Quantity over quality: having larger muscles could compensate for poor muscle quality in Chronic Kidney Disease patients

Posted by ap507 at Aug 06, 2018 09:43 AM |
University of Leicester research shows that having larger muscles can ‘outweigh’ lack of muscle quality when performing physical tasks

Issued by University of Leicester on 6 August 2018

An infographic about the research is available here: https://www.dropbox.com/sh/9ehqp6vvdx56cgn/AADKRyqAqmF1T-ZEhW_zLZPSa?dl=0

Peer-reviewed?

Type of study?

Subject of study?

Peer-reviewed

Observational

Humans

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The size of muscles in patients suffering from Chronic Kidney Disease (CKD) could be more important to maintaining good physical performance than muscle quality, new research has shown.

In a paper published in the journal Nephrology Dialysis Transplantation, researchers from the University of Leicester have found that patients with large muscles had better physical function, walking ability, and strength – and that having large muscle size could in some instances ‘outweigh’ having poor muscle quality. In this regard, quality was determined by the amount of fat or fibrosis (excess connective tissue) within the muscle tissue.

The research suggests that it doesn’t necessarily matter how much fat or fibrosis is contained within a muscle – as, if the muscle is big enough, it could compensate for the lack of quality in regard to physical performance.

When fat or fibrosis gets into the muscle, this gives it the marbling effect similar to that seen on steak or other forms of meat.

This infiltration of fat can stop the muscle working properly, as it can stop the muscle fibres from contracting as well as they could without the fat being present. Fat infiltration in the muscle can also affect muscle metabolism and cause inflammation to the cells.

The study, led by Dr Tom Wilkinson and Professor Alice Smith from the University of Leicester’s Department of Infection, Immunity and Inflammation, and Leicester’s Hospitals, recruited 61 non-dialysis CKD patients and observed how muscle quality can be reduced when fat or fibrosis gets into the muscle.

The team used 2D ultrasound scans of the rectus femoris muscle of the quadriceps in the leg – an important muscle for everyday tasks such as walking and climbing stairs.

Physical function and strength was assessed using various tests such as walking tests, leg strength tests, walking speed, and chair stand tests.

They found that patients with greater overall body fat (e.g., overweight and obese patients) had more fat in the muscle, resulting in lower muscle quality, but that the negative effects were reduced when the muscles themselves were larger.

Dr Wilkinson said: “In cases of kidney disease, poor muscle quality was correlated with poor physical performance. However, muscle size remains the largest predictor of physical function, even when muscle quality was taken into account.

“Therefore, in addition to the loss of muscle size, our study shows that muscle quality should be considered an important factor that may contribute to deficits in mobility and function in CKD. Interventions such as exercise, especially weight lifting type exercise as previously shown by our research, could improve both of these factors.”

The study was partly funded by the NIHR Leicester Biomedical Research Centre.

The paper, ‘Quality over quantity? Association of skeletal muscle myosteatosis and myofibrosis on physical function in chronic kidney disease’, published in the journal Nephrology Dialysis Transplantation, is available here: https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfy139/5042971   / https://doi.org/10.1093/ndt/gfy139

ENDS

Notes to editors:

For more information contact Dr Tom Wilkinson on t.j.wilkinson@leicester.ac.uk or Professor Alice Smith on alice.smith@leicester.ac.uk

The NIHR Leicester Biomedical Research Centre:

The National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC) is a partnership between University Hospitals of Leicester NHS Trust, the University of Leicester and Loughborough University. It is funded by the National Institute for Health Research (NIHR).

The NIHR Leicester BRC undertakes translational clinical research in priority areas of high disease burden and clinical need. These include cardiovascular disease, respiratory disease, and lifestyle, obesity and physical activity. There is also a cross-cutting theme for precision medicine. The BRC harnesses the power of experimental science to explore and develop ways to help prevent and treat chronic disease. It brings together 70 highly skilled researchers, 30 of which are at the forefront of clinical services delivery. By having scientists working closely with clinicians, the BRC can deliver research that is relevant to patients and the professionals who treat them. www.leicesterbrc.nihr.ac.uk

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research,

Established by the Department of Health and Social Care, the NIHR:

  • Funds high quality research to improve health
  • Trains and supports health researchers
  • Provides world-class research facilities
  • Works with the life sciences industry and charities to benefit all
  • Involves patients and the public at every step

For further information, visit the NIHR website (www.nihr.ac.uk)

 

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