Search Results (101)

Iberian pigs reared in a semi-extensive outdoor system, known as cebo de campo, have their commercial feed supplemented with natural pasture. However, the availability and quality of pastures vary seasonally under the Mediterranean conditions of the southwestern Iberian Peninsula. This study evaluates the effect of the seasonal fattening period on fatty acid content and nutritional quality indices (atherogenic index, thrombogenic index, hypocholesterolemic/hypercholesterolemic ratio, and healthy fatty index) in subcutaneous adipose tissue and intramuscular fat from 258 purebred Iberian pigs raised under the cebo de campo system during three periods: winter–spring (December–April, n = 63), spring–summer (May–August, n = 99), and summer–autumn (August–November, n = 96). Winter–spring pigs exhibited significantly higher monounsaturated and polyunsaturated fatty acids and lower saturated fatty acids compared to spring–summer and summer–autumn groups in subcutaneous adipose tissue. Nutritional quality indices were more favorable in winter–spring pigs, indicating superior cardiovascular health benefits. Principal component analysis revealed clear seasonal group separation, with the first two components explaining 88.51% of the variance in subcutaneous fat. Significantly higher neophytadiene concentrations, a biomarker of pasture intake, in winter–spring pigs confirmed greater pasture consumption. These findings demonstrate that seasonal factors significantly influence the nutritional quality of meat produced in cebo de campo Iberian pig systems. This influence is much clearer in subcutaneous adipose tissue than intramuscular fat, as winter–spring fattening is associated with a more favorable lipid profile. Full article

Background: Age- and cancer-related sarcopenia and malnutrition are common in older patients with colorectal cancer (CRC) and may negatively influence treatment tolerance and prognosis. However, the comparative prognostic value of post-chemotherapy changes in CT-based body composition parameters at the third lumbar vertebra (L3) and the twelfth thoracic vertebra (T12) levels, and their associations with nutritional indices, remain unclear. This study aimed to examine and compare the prognostic relevance of post-chemotherapy body composition changes at L3 and T12 and to assess their relationship with nutritional indices in older patients with metastatic CRC (mCRC). Methods: This retrospective study included 87 older patients with mCRC. Baseline and ~3-month follow-up CT scans were analyzed at L3 and T12 using 3D Slicer to quantify skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), visceral-to-subcutaneous fat ratio (VSR), and intramuscular adipose tissue index (IMATI). Changes (Δ) in CT-derived body composition after chemotherapy were calculated as percentage change using ((follow-up − baseline)/baseline) × 100. Prognostic Nutritional Index (PNI) and Geriatric Nutritional Index (GNRI), which are established nutritional assessment tools, were calculated from baseline laboratory/anthropometric data. Agreement between T12 and L3 was assessed, and associations with grade ≥ 3 toxicity, progression-free survival (PFS), and overall survival (OS) were evaluated using multivariable models and ROC analyses. Results: Mean age was 69.0 ± 4.5 years (59 male/28 female), and 26.4% developed grade ≥ 3 adverse events. Over 3 months, mean SMI declined significantly at both L3 (46.7 ± 8.8 → 42.8 ± 9.8 cm²/m²) and T12 (34.6 ± 8.2 → 31.6 ± 8.1 cm²/m²) (p < 0.001 for both), accompanied by decreases in VATI and VSR; T12-IMATI increased significantly. Baseline PNI showed a weak positive correlation with L3-SMI (r = 0.302, p = 0.033), whereas GNRI showed moderate correlations with SMI at L3 (r = 0.502, p < 0.001) and T12 (r = 0.317, p = 0.025) and was associated with longitudinal changes in muscle metrics. T12-SMI consistently yielded lower values than L3-SMI, and agreement varied by compartment (best for SATI; weakest for VSR). Lower GNRI and greater L3-SMI loss were independently associated with grade ≥ 3 toxicity; ΔL3-SMI showed the highest discrimination (AUC = 0.79, 95% CI = 0.69–0.87, p < 0.001; cut-off >5.1% loss). All patients progressed (median PFS 7.6 months); mortality was 82.8% (median follow-up: 25 months). In multivariable analysis, PFS, CRP, GNRI, and ΔL3-SMI remained independently associated with OS. ΔL3-SMI provided the strongest mortality discrimination (AUC = 0.85, 95% CI = 0.74–0.94, p < 0.001; cut-off >10.4% loss), while ΔIMATI was also informative (AUC = 0.71, 95% CI = 0.59–0.82, p = 0.023). Conclusions: In older patients with mCRC, early post-chemotherapy skeletal muscle loss—particularly at the L3 level—showed the strongest prognostic association with severe toxicity and mortality. GNRI provided complementary prognostic information as a marker of baseline immunonutritional reserve. Although T12-derived measurements were correlated with L3-derived values, systematic bias suggests that they should not be interpreted interchangeably for longitudinal risk stratification. Full article

Background: Sarcopenia is associated with adverse surgical outcomes. Recent literature suggested that pre-surgery prehabilitation, nutrition and β-Hydroxy β-methylbutyric acid (HMB) supplementation improve myological and functional outcomes. However, long-term outcomes remain uncertain. Thus, we aimed to analyse findings from the long-term follow-up of surgical patients undergoing oral supplementation and prehabilitation. Methods: A prospective single-centre pilot cohort study was conducted to evaluate the effects of multimodal prehabilitation using high-protein oral nutritional supplementation (HP-ONS) with HMB. Sarcopenic patients between 40 and 90 years old and undergoing gastrointestinal surgery were included from June 2022 to January 2024. Patients were followed up from two to four weeks pre-operatively to six months post-operatively. Paired Wilcoxon signed-rank tests were conducted to evaluate outcomes between time points. Results: 36 patients were included with a median age of 71.5 years (IQR: 55–90), and 50% were male. 12 (33.3%) patients were sarcopenic, while 24 (66.7%) were severely sarcopenic. No significant difference in IMAT% was observed at post-operative six months. Number of chair rise repetitions (Median:15 vs. 11, p < 0.001) and six-min walk test (Median: 387 m vs. 349 m, p = 0.020), mid-arm muscle circumference (Median: 23.7 cm vs. 22.5 cm, p = 0.013), mid-arm muscle area (Median: 44.8 cm² vs. 39.3 cm², p = 0.005), weight (Median: 51.6 kg vs. 50.8 kg, p = 0.023) and BMI (Median: 23.2 kg/m² vs. 21.8 kg/m², p = 0.025) increased significantly at six-months post-operatively from surgery. Conclusions: Our findings suggest that improvements in anthropometric and functional outcomes from prehabilitation may persist beyond the acute recovery period. If supported by future works, multimodal prehabilitation has the potential to optimise postoperative recovery amongst sarcopenic older adult surgical patients. Full article

Background/Objectives: Chronic heat stress impairs lipid mobilization from adipocytes, which reduces substrate availability for muscle metabolism. Systemic inflammation is a key facilitative response to heat stress, and we sought to determine if mitigating inflammation in heat-stressed wether lambs would improve lipid flux. Methods: Two cohorts of commercial feedlot lambs were heat stressed for 30 days. In study 1, heat-stressed lambs received dexamethasone injections every 3 days, fish oil capsules twice daily, or no intervention. In study 2, heat-stressed lambs received daily boluses of ω-3 polyunsaturated fatty acid Ca²⁺ salts (ω-3 PUFA) or no intervention. Results: In both studies, heat stress reduced ex vivo epinephrine-stimulated free fatty acid and glycerol mobilization from visceral adipose tissue. These deficits were partially resolved by fish oil and fully resolved by ω-3 PUFA. In study 1, fish oil recovered heat stress-induced deficits in circulating triglycerides and HDL-cholesterol but not in circulating free fatty acids. Fish oil and dexamethasone resolved the increase in muscle PPARα, indicating less lipid utilization for metabolism. In study 2, ω-3 PUFA resolved heat stress-induced deficits in muscle CD36 and PPARγ, indicating improved lipid uptake capacity. However, interventions did not resolve reduced intramuscular lipid content in either study. Conclusions: We conclude that inflammation was a primary facilitator of impaired lipid mobilization in heat-stressed lambs but was not the sole driver of lipid dysregulation. Nevertheless, targeting inflammation was a beneficial strategy for improving lipid flux during chronic heat stress. Full article

Body composition, specifically the quantification of skeletal muscle and adipose tissue using preoperative computed tomography (CT) imaging, is a clinically significant predictor of postoperative complications after lung cancer surgery. The main features of CT-derived body composition analysis are: skeletal muscle index, muscle density, adipose tissue quantification and automated or semi-automated segmentation. Low skeletal muscle mass (sarcopenia) independently increases the risk of perioperative complications, including respiratory complications, and is associated with longer hospital length of stay and worse long-term survival. Sarcopenic obesity—characterized by low muscle mass in the context of high adiposity—further elevates complication risk and prolongs recovery. CT-derived measures such as muscle cross-sectional area, muscle density, and adipose tissue distribution (visceral, subcutaneous, and intramuscular) provide more precise risk stratification than BMI alone. Skeletal muscle area and density are inversely correlated with postoperative complications and recurrence risk; patients with lower muscle mass and density experience more adverse outcomes. In men, age and reduced skeletal muscle area are particularly strong predictors of complications after pneumonectomy. Obesity, when not accompanied by sarcopenia or myosteatosis, may confer a survival advantage—the so-called “obesity paradox”—but this protective effect is lost in patients with low muscle mass or poor muscle quality. Systemic inflammation and nutritional status further modulate the impact of body composition on surgical risk. This review highlights the critical role of CT-derived body composition analysis in predicting postoperative outcomes following lung cancer surgery. Full article

Research has demonstrated that incorporating nitrate into animal feed can effectively decrease methane production in ruminants, though its impact on carcass characteristics and meat attributes in Hu sheep requires further investigation. This experiment examined how a dietary inclusion of 3% calcium nitrate (CN) influenced slaughter parameters, meat properties, gut microbial populations, and host gene regulation in Hu sheep. The study involved sixty healthy male Hu sheep aged 120 days with comparable body weights (31.11 ± 3.39 kg), randomly allocated into two groups: a control group receiving standard feed (CON) and a CN-supplemented group. The trial lasted 60 days, including a 15-day adaptation period and a 45-day formal trial period. They were housed individually and fed twice daily (at 8:00 and 18:00). The findings revealed that CN supplementation notably reduced the water loss rate in the longissimus dorsi muscle (LD), elevated meat color brightness, and enhanced the proportion of polyunsaturated fatty acids (PUFA), particularly n-6 PUFA, along with the n-3/n-6 PUFA ratio. Conversely, it reduced the levels of saturated fatty acids such as myristic acid (C14:0) and oleic acid (C18:1n9t). Additionally, the treatment boosted ruminal Ammoniacal nitrogen content and total short-chain fatty acid production, thereby contributing to energy metabolism in the animals. Microbiological examination demonstrated that CN supplementation led to a decrease in Fibrobacterota and Methanobrevibacter populations within the ruminal environment, while promoting the growth of Proteobacteria in the duodenal region. The gene expression profiling of digestive tract tissues showed an increased activity in nitrogen processing genes (including CA4) and oxidative phosphorylation pathways (such as ATP6), indicating an improved metabolic efficiency and acid–base homeostasis in the host animals. These findings demonstrate that CN-enriched diets enhance the carcass characteristics of Hu sheep by modifying intramuscular lipid profiles through gastrointestinal microbial community restructuring and metabolic pathway adjustments. Such modifications affect energy utilization and acid–base equilibrium, ultimately impacting muscle characteristics and adipose tissue distribution, presenting viable approaches for eco-friendly livestock farming practices. Full article

Background/Objectives: Although cross-sectional muscle quality has shown prognostic relevance, the impact of temporal changes in muscle composition in septic shock has not been fully explored. This study aimed to investigate whether deterioration in muscle quality on serial computed tomography (CT) scans is associated with mortality in patients with septic shock. Methods: We conducted a retrospective single-center study using a prospectively collected registry of adult patients with septic shock between May 2016 and May 2022. Patients who underwent CT on the day of emergency department (ED) presentation and had a CT performed more than 180 days earlier were included. Muscle quality maps were generated and segmented based on CT attenuation values into normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA), and intramuscular adipose tissue area. Differences between the ED and prior CT scans were also calculated. The primary outcome was the 28-day mortality. Results: Among the 768 enrolled patients, the 28-day mortality was 18.0%. Both survivors and non-survivors showed a significantly greater increase in LAMA (20.8 vs. 9.8 cm²) and a greater decrease in NAMA (−26.0 vs. −18.8 cm²). Multivariate analysis identified increased LAMA as an independent risk factor for 28-day mortality (adjusted OR 1.03; 95% CI: 1.01–1.04; p < 0.01). Conclusions: An increase in LAMA on serial CT scans was associated with higher short-term mortality in patients with septic shock, suggesting that temporal degradation of skeletal muscle quality may serve as a potential prognostic marker. Full article

Intramuscular fat (IMF) significantly impacts meat quality. Exosomes have attracted increasing attention for their regulatory roles in muscle-adipose tissue crosstalk; however, their precise mechanisms remain largely unclear. Based on this, this study aimed to establish a muscle-adipose co-culture system to better simulate the in vivo physiological environment. Using exosomal miRNAs as molecular links, we investigated how bovine muscle satellite cells influence lipid accumulation and adipogenesis in preadipocytes. We established a co-culture system of bovine muscle satellite cells and preadipocytes and found that co-culture significantly inhibited lipid droplet accumulation and adipogenesis in preadipocytes. Therefore, we hypothesized that exosomes derived from bovine muscle satellite cells regulate the adipogenic differentiation of bovine preadipocytes through intercellular communication and that specific exosomal miRNAs play pivotal roles in this regulatory process. We successfully isolated and identified muscle-derived (Mu-EXO), adipose-derived (Ad-EXO), and co-culture exosomes (Co-EXO). High-throughput sequencing revealed the differential expression profiles of miRNAs. Notably, the bovine-specific miRNA bta-miR-2904, annotated in miRBase v22 with limited cross-species conservation, was significantly enriched in Mu-EXO and Co-EXO compared with Ad-EXO. Further functional experiments demonstrated that overexpression of bta-miR-2904 markedly inhibited lipid droplet accumulation, triglyceride content, and the expression of adipogenesis-related genes in preadipocytes; inhibition had opposite effects. Our results demonstrate that bovine muscle-derived exosomal miR-2904 inhibits lipid accumulation and adipogenesis in preadipocytes. These results establish a theoretical basis for understanding skeletal muscle-adipose crosstalk and offer a novel molecular target for regulating intramuscular fat deposition in beef cattle. Full article

Background/Objectives: This study evaluated the validity of DEXA-derived muscle quantification by assessing its agreement with AI-assisted CT measurements of muscle volume and intramuscular adipose tissue. It also examined whether inter-limb asymmetry improves DEXA–CT agreement beyond absolute DEXA values. The influence of lower-limb rotation on DEXA measurements was assessed, and the study aimed to clarify how DEXA should be obtained and interpreted to more accurately reflect true muscle status. Methods: Fifty-two patients who completed CT and DEXA within 14 days were included. CT was used to obtain pure muscle volume and intramuscular adipose tissue (IMAT) using a standardized AI segmentation protocol, and corresponding DEXA thigh segmentation provided lean mass and fat percentage. Position-specific correlation analysis, regression, and Bland–Altman agreement testing were performed for 104 limbs. The same analyses were applied to inter-limb differences to isolate within-person asymmetry and reduce between-person variance. Results: DEXA lean mass correlated with CT pure muscle volume (r = 0.776, p < 0.001), and inter-limb asymmetry further improved alignment with CT (r = 0.857, p < 0.001). However, DEXA fat mass asymmetry demonstrated no association with CT IMAT asymmetry (r = −0.004, p = 0.979). When results were stratified by the recorded rotational groups, the highest correlation was observed in the neutral position (r = 0.900, p < 0.001). Bland–Altman analyses showed wide limits of agreement for all absolute measurements, whereas inter-limb asymmetry demonstrated markedly narrower limits of agreement, indicating superior numerical consistency. Conclusions: Absolute DEXA estimates showed limited agreement with CT and varied with limb position. Inter-limb asymmetry improved lean mass assessment, whereas fat mass and percentage did not correspond to CT-based IMAT. DEXA may therefore be used as a complementary tool for evaluating regional muscle quantity, but not for assessing muscle quality. Full article

Background/Aim: Extracellular-to-total body water ratio (ECW/TBW) and phase angle (PhA, PA) reflect hydration and cellular health, but their relationship with bone, muscle, and fat, as primary components of body composition, is not fully elucidated. This study aimed to evaluate sex-specific differences in body composition and assess the diagnostic potential of ECW/TBW and PhA for identifying low bone/muscle mass, as well as increased fat mass, in generally healthy adults. Methods: This post hoc analysis utilized data from a multicenter, cross-sectional, Italian study (2010–2014) that included 20–90 years adults (n = 9717). Body composition was measured by bioelectrical impedance (BIA-ACC, BioTekna^®), assessing bone, muscle mass, fat mass, ECW, TBW, and PhA. Low bone/muscle mass, as well as adiposity, were defined using standard cutoffs. Associations were examined using nonparametric tests and multiple regression analyses. Results: The mean age of men and women was similar (mean ~48 years). Men had significantly higher body mass index (BMI), intramuscular adipose tissue (IMAT%), T-score (bone), S-score (muscle), and PhA, while women had significantly higher fat mass (FM%) and ECW/TBW. ECW/TBW showed excellent discrimination for low muscle mass (AUC 0.845–0.922) and low bone mass (AUC 0.696–0.885), outperforming PhA. Neither ECW/TBW nor PhA reliably predicted increased fat mass. Regression models indicated ECW/TBW was strongly associated with age, sex, BMI, fat mass, and bone/muscle scores (R² = 0.943), whereas PhA’s association was moderate (R² = 0.368). Conclusions: ECW/TBW and PhA reflected sex-specific differences for body composition and effectively identified low muscle and bone mass (with better predictability of the former). Both showed a limited predictive ability for fat mass. Overall, both parameters provide complementary insights into sarcopenia and osteopenia and could be used for easy and non-invasive screening for these conditions. Full article

Background and Objectives: This study aimed to evaluate the prognostic impact of baseline body composition measurements and changes in muscle and adipose tissue during treatment on overall survival (OS) in metastatic non-small cell lung cancer (NSCLC) patients treated with nivolumab. Materials and Methods: Eighty-eight metastatic NSCLC patients who were initiated on nivolumab between January 2022 and December 2024 were retrospectively analyzed. Body composition parameters were derived from baseline and 3-month ¹⁸F-FDG PET/CT scans at the L3 level, including psoas muscle index (PMI), skeletal muscle index (SMI), intramuscular adipose content (IMAC), and subcutaneous fat density (SFD). Treatment-related changes in body composition were evaluated, and survival analyses were performed using Kaplan–Meier estimates and Cox regression models. Results: Overall, 34.1% (n = 30) of patients were classified as sarcopenic. Median OS was significantly longer in non-sarcopenic patients (19 months vs. 5 months, p < 0.001). In univariate analysis, older age, higher comorbidity burden, liver metastasis, baseline sarcopenia, and adverse treatment-related changes in muscle and nutritional parameters were found to be associated with OS. In multivariate analysis, only unfavorable changes in skeletal muscle (ΔSMI; HR 3.39, p = 0.003) and subcutaneous fat radiodensity (ΔSFD; HR 2.45, p = 0.02) remained independent adverse prognostic factors. Baseline body composition parameters did not maintain their independence in multivariate models. Conclusions: Our study demonstrates that muscle loss or insufficient gain and unfavorable changes in subcutaneous fat radiodensity during nivolumab treatment more strongly predict overall survival compared to baseline measurements. These findings highlight the clinical importance of monitoring dynamic body composition throughout treatment, rather than static assessments, in NSCLC patients receiving immunotherapy. Full article

Background: Lipedema is a progressive disorder of subcutaneous connective tissue, predominantly affecting women, and characterized by an increase in subcutaneous adipose tissue, particularly in the lower body. This study aims to explore the gut microbiota (GM) profile in lipedema patients to characterize the associated GM and compare it with the control group. Methods: A prospective randomized case–control pilot study was conducted from September 2023 to May 2024, involving 55 Caucasian women, aged 20–60. The participants were divided into two groups: 35 with lipedema (LIPPY) and 20 controls (CTRL). Body composition was assessed using Dual X-ray Absorbimetry (DXA), and GM analysis was performed through 16S rRNA gene sequencing. Results: LIPPY subjects showed increased Intramuscular Adipose Tissue (IMAT) and reduced Lean Mass (LM)/Fat Mass (FM) ratios. While alpha and beta diversity metrics did not differ significantly between groups, differential abundance analysis identified a significant reduction in Eggerthellaceae (Log Fold Change (LFC) = −0.19, p = 0.04) and enrichment of Propionibacteriaceae (LFC = +0.18, p = 0.009) and Acidaminococcaceae (LFC = +0.32, p = 0.013) in the LIPPY group. Genus-level analysis showed a significant reduction in Blautia and Ruminiclostridium (LFC = −0.32 and −0.02; p = 0.02 and 0.04) and enrichment of Anaerostipes, Propionibacterium, and Phascolarctobacterium (LFC = +0.07, +0.17, and +0.34; p = 0.02, 0.005, 0.005, respectively). In correlation analyses, within LIPPY, Eggerthellaceae correlated negatively with Body Mass Index (BMI) (ρ = −0.61, p < 0.05) and positively with Appenicular (Appen) LM/Weight and AppenLM/BMI (ρ = +0.43 and +0.41, p < 0.05), while Anaerostipes correlated positively with these lean mass indices (ρ = +0.40, p < 0.05). In CTRL, only Anaerostipes showed a significant negative correlation with BMI (ρ = −0.64, p < 0.05). Conclusions: This study provides the first evidence of a distinct GM profile in LIPPY, with notable links to adverse body composition markers such as IMAT. Trial Registration: Trial registered on 24 June 2013 with ClinicalTrial.gov (NCT01890070). Full article

Background: An accurate prognostic assessment is essential to optimize treatment strategies in head and neck cancer (HNC). This study aimed to develop and internally evaluate an AI-assisted survival risk score derived from automatically quantified cervical muscle parameters on routine radiotherapy-planning CT scans. Methods: Pretreatment CT images were processed in a single-center cohort of 65 HNC patients, using AI-assisted automated segmentation to obtain the cervical skeletal muscle index (SMI), intramuscular adipose tissue area (IMAT), and mean muscle attenuation (HU). A multivariable Cox regression model was used to generate the continuous FUNC-RISK score, and model performance was assessed using time-dependent ROC curves at 36 and 60 months. Results: Patient-, tumor-, and treatment-related characteristics were not predictive of survival. SMI (p = 0.006) and IMAT (p = 0.047) were significantly associated with overall survival in a univariable analysis, while HU showed a borderline association (p = 0.087). All three parameters were included in the multivariable model, yielding the following equation: FUNC-RISK = (−0.364 × SMI) + (−0.087 × IMAT) + (0.011 × HU). The model demonstrated moderate discrimination (AUC = 0.734 at 36 months; 95% CI 0.604–0.863; p = 0.002, and AUC = 0.689 at 60 months; 95% CI 0.558–0.819; p = 0.009). Based on the median score (−3.18), patients were stratified into low- and high-risk groups. Five-year overall survival was 71.9% ± 7.9% for the low-risk group versus 39.4% ± 8.5% for the high-risk group (p = 0.006). Conclusions: FUNC-RISK provides preliminary evidence of clinically meaningful prognostic stratification based on AI-derived cervical muscle quantity and quality metrics obtained from routine radiotherapy-planning CT scans. These exploratory results support the potential role of automated body-composition analysis in personalized risk assessment for HNC, although external multicenter validation is required before clinical implementation. Full article

Background: Long pulse width stimulation (LPWS; 120–150 ms) has the potential to stimulate denervated muscles in persons with spinal cord injury (SCI). We examined whether testosterone treatment (TT) + LPWS would increase skeletal muscle size, leg lean mass and improve overall metabolic health in SCI persons with denervation. We hypothesized that one year of combined TT + LPWS would downregulate gene expression of muscle atrophy and upregulate gene expression of muscle hypertrophy and increase mitochondrial health in SCI persons with lower motor neuron (LMN) injury. Methods: Ten SCI participants with chronic LMN injury were randomized into either 12 months, twice weekly, of TT + LPWS (n = 5) or a TT+ standard neuromuscular electrical stimulation (NMES; n = 5). Measurements were conducted at baseline (week 0), 6 months following training (post-intervention 1), and one week following 12 months of training (post-intervention 2). Measurements included body composition assessment using magnetic resonance imaging (MRI) and dual x-ray absorptiometry (DXA). Metabolic profile assessment encompassed measurements of resting metabolic rate, carbohydrate and lipid profiles. Finally, muscle biopsy was captured to measure RNA signaling pathways and mitochondrial oxidative phosphorylation. Results: Compliance and adherence were greater in the TT + NMES compared to the TT + LPWS group. There was a 25% increase in the RF muscle CSA following P1 measurement in the TT + LPWS group. There was a recognizable non-significant decrease in intramuscular fat in both groups. There was a trend (p = 0.07) of decrease in trunk fat mass following TT + LPWS, with an interaction (p = 0.037) in android lean mass between groups. There was a trend (p = 0.08) in mean differences in DXA-visceral adipose tissue (VAT) between groups at P1 measurements. For genes targeting muscle atrophy, TT + LPWS showed a trending decline in MURF1 and FOXO3 genes returning to similar levels as TT + NMES before 12 months. Conclusions: These pilot data demonstrated the safety of applying LPWS in persons with SCI. Six months of TT + LPWS demonstrated increases in rectus femoris muscle CSA. The effects on muscle size were modest between groups. Signaling pathway analysis suggested downregulation of genes involved in muscle atrophy pathways. Future clinical trials may consider a home-based approach with more frequent applications of LPWS. Full article

Background: This study aimed to investigate longitudinal changes in muscle mass, quality, and composition (sarcopenia and myosteatosis) in adult people with cystic fibrosis (pwCF) using artificial intelligence (AI)-assisted body composition analysis (BCA) with chest computed tomography (CT) at the T12 level and to examine the influence of CFTR modulator therapy with elexacaftor/tezacaftor/ivacaftor (ETI). Methods: A retrospective observational study was conducted on 102 adult pwCF (42 females (41%), mean age 33.9 ± 11.1 years) who underwent routine chest CT scans with a minimum of six months between scans. PwCF were categorized into ETI and no ETI groups. AI-assisted BCA was performed on chest CT images at the T12 level to measure skeletal muscle area (SMA), inter- and intramuscular adipose tissue (IMAT), and low-attenuation muscle area (LAMA). IMAT/SMA ratio and height- and weight-related skeletal muscle indices (SMI) were calculated. Results: The ETI group showed a significant increase in SMA over time (p < 0.001), whereas the IMAT, LAMA, and IMAT/SMA ratio increased in both groups (all p < 0.05). SMI showed alterations only in the ETI group, with an increase in SMA/m² (p < 0.001) and a decrease in SMA/kg (p = 0.003) and SMA/BMI (p = 0.006). Sex-specific analysis showed that SMA and myosteatosis increased regardless of sex (all p < 0.05). Weight-adjusted SMI decreased only in females receiving ETI therapy (p < 0.05). Conclusions: Adult pwCF, particularly those undergoing ETI therapy, experience significant changes in body composition, including increased muscle mass and myosteatosis. Trends in the development of sarcopenic obesity have been observed, particularly in female pwCF. These findings emphasize the importance of comprehensive body composition assessments and targeted interventions in pwCF treated with ETI to optimize muscle mass and quality while managing adipose tissue accumulation. Full article