Cited by 154Nutrition and Health in AgingMuscle Physiology and DisordersStroke Rehabilitation and Recovery

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Atrophy and Intramuscular Fat in Specific Muscles of the Thigh: Associated Weakness and Hyperinsulinemia in Stroke Survivors

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Ryan, Alice S., Buscemi, Andrew, Forrester, Larry, Hafer-Macko, Charlene E., Ivey, Frederick M.·2011·Neurorehabilitation and neural repair

DOI 10.1177/1545968311408920PMC PMC3546168

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Abstract

PURPOSE: Sarcopenia and increased fat infiltration in muscle may play a role in the functional impairment and high risk for diabetes in stroke. Our purpose was to compare muscle volume and muscle attenuation across 6 muscles of the paretic and nonparetic thigh and examine the relationships between intramuscular fat and insulin resistance and between muscle volume and strength in stroke patients. METHODS: Stroke participants (70; 39 men, 31 women) aged 40 to 84 years, BMI = 16 to 45 kg/m(2) underwent multiple thigh CT scans, total body scan by DXA (dual-energy X-ray absorptiometry), peak oxygen intake (VO(2peak)) graded treadmill test, 6-minute walk, fasting blood draws, and isokinetic strength testing. RESULTS: Muscle volume is 24% lower and subcutaneous fat volume is 5% higher in the paretic versus nonparetic thigh. Muscle attenuation (index of amount of fat infiltration in muscle) is 17% higher in the nonparetic midthigh than the paretic. The semitendinosis/semimembranosis, biceps femoris, sartorius, vastus (medialis/lateralis), and rectus femoris have lower (between 9% and 19%) muscle areas on the paretic than the nonparetic thigh. Muscle attenuation is 15% to 25% higher on the nonparetic than the paretic side for 5 of 6 muscles. The nonparetic midthigh muscle attenuation is negatively associated with insulin. Eccentric peak torque of the nonparetic leg and paretic leg are associated with the corresponding muscle volume. CONCLUSIONS: The skeletal muscle atrophy, increased fat around and within muscle, and ensuing muscular weakness observed in chronic stroke patients relates to diabetes risk and may impair functional mobility and independence.

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Authors: Ryan, A. S., Buscemi, A., Forrester, L., Hafer-Macko, C. E., & Ivey, F. M.
Affiliations: University of Maryland, Baltimore (US)
Baltimore VA Medical Center, University of Maryland School of Medicine, Baltimore, MD, USA
ORCID: Ryan, Alice S.
Venue: Neurorehabilitation and neural repair
Publisher: SAGE Publications
Published: 2011-07-06
Volume: 25
Issue: 9
Pages: 865-872
ISSN: 0888-4390 (ISSN-L)
1545-9683
1552-6844
DOI: 10.1177/1545968311408920
PMC: PMC3546168
OpenAlex: W2023729390
Cited by: 154
References: 20
Citations by year: 2026: 7 · 2025: 16 · 2024: 13 · 2023: 6 · 2022: 17 · 2021: 10 · 2020: 24 · 2019: 9 · 2018: 11 · 2017: 8 · 2016: 15 · 2015: 11 · 2014: 3 · 2013: 3 · 2012: 1
FWCI: 1.53
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Neurorehabilitation and neural repair (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (K01AG019242, R29-AG14487, R29AG014487, R01AG19310, R01AG019310, KO1-AG019242, P60AG012583, P60 AG12583, P30AG028747, R01AG030075)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords: stroke, sarcopenia, muscle atrophy, intramuscular fat, fatty infiltration, thigh muscle, paretic limb, muscle volume, muscle attenuation, insulin resistance, muscle strength, isokinetic strength, diabetes risk, functional mobility
MeSH terms: Adipose Tissue, Adult, Aged, Aged, 80 and over, Female, Humans, Hyperinsulinism, Male, Middle Aged, Muscular Atrophy, Paresis, Radiography, Survivors, Muscle Weakness, Stroke

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Atrophy and Intramuscular Fat in Specific Muscles of the Thigh: Associated Weakness and Hyperinsulinemia in Stroke Survivors

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