“Working to enhance the evidence base needed to predict and prevent disease”

Introduction and
Diseases

Global healthcare systems are facing unprecedented challenges associated with a rapid rise in obesity and metabolic-related disease, as well as an aging population. Research shows that detailed understanding of the volume, distribution, and quality of fat and muscles in our bodies can be vital to properly diagnosing and treating illness.

AMRA is confronting these global health challenges with AMRA® Profiler Research, a cloud-based analysis service and a new, holistic concept in body composition measurement, the Body Composition Profile (BCP).

Today, AMRA® Profiler Research is an invaluable service for those involved in drug development and academic research of metabolic and musculoskeletal disease.

A quarter of the world’s adults have Metabolic Syndrome – a cluster of factors that increase the risk of several chronic diseases, such as heart disease, cancer, stroke, liver disease and diabetes [6]

Non-communicable diseases that more commonly affect adults and older people impose the greatest burden on global health [3]

Approximately 415 million adults globally have diabetes; by 2040 this will rise to 642 million [8]—cause two-thirds of annual deaths

Approximately 13% of the world’s adult population is obese and an additional 39% is overweight [2]

Diseases

Obesity-related Disease

Compared with people without the syndrome, people with Metabolic Syndrome are three times as likely to have, and twice as likely to die from a heart attack or stroke. They are also five times more likely to develop Type 2 diabetes. [6]

Metabolic Syndrome is a cluster of risk factors that often occur together and, when they do, lead to the diseases discussed on this page. Risk factors include abdominal obesity, high fasting blood sugar (glucose), high blood pressure and abnormal cholesterol. [12]

The risk of developing Metabolic Syndrome is closely linked to obesity and a lack of physical activity. [12] High volumes of abdominal fat are correlated with heart disease, high blood pressure, stroke, high cholesterol, and Type 2 diabetes, so it is vital that we understand and can precisely measure the different types of fat in our bodies. [14]

Diabetes

Diabetes accounts for 5 million deaths per year – meaning someone dies from diabetes every 6 seconds. [8]

Diabetes is characterized by high blood sugar (glucose), an important source of energy for muscles, tissues, and the brain, which at uncontrolled levels leads to carrying a high amount of visceral fat is associated with insulin resistance, which leads to glucose intolerance and Type 2 diabetes. [32]

Cardiovascular Disease

Cardiovascular disease (CVD) is the number one cause of death globally. [9]

CVD affects the heart and blood vessels and is related to the development of plaque in arterial walls (atherosclerosis). Plaque narrows arteries and leads to blood clots that stop blood flow, causing a heart attack or stroke. [9]

Studies have shown that visceral fat is directly associated with the development of Cardiovascular Disease, whereas BMI, abdominal subcutaneous fat, and liver fat are not significantly associated. [16]

Fatty Liver

Cirrhosis due to fatty liver inflammation is now a leading cause of liver transplantation in the US and is anticipated to become the leading cause within the next two decades. [20]

Non-alcoholic Fatty Liver Disease (NAFLD) covers a wide spectrum of non-alcohol related, fatty liver disorders that include Non-alcoholic Steatohepatitis (NASH).[20]

NAFLD is associated with obesity, Type 2 diabetes, dyslipidemia, and Metabolic Syndrome. [20]

NASH is considered to be the liver expression of Metabolic Syndrome, increasing the risk of cirrhosis, liver failure, hepatocellular carcinoma (HCC), and morbidity and mortality from CVD.

Sarcopenia

Approximately 5–10 % of people over 65 are estimated to suffer from sarcopenia. [29]

Sarcopenia is the age-related loss of skeletal muscle and strength, a disease that plays a significant role in quality of life, as it leads to falls, disabilities, and death. [26;27] Sarcopenic obesity is the combination of increased Visceral Adipose Tissue and decreased muscle mass, increasing metabolic and cardiovascular risk, and making BMI a poor health indicator in the elderly. [26]

Cachexia

Cachexia is serious and often part of the final course many diseases. Every year cachexia is responsible for the death of 10–15% of patients with Chronic Obstructive Pulmonary Disease (COPD) and up to 80% in patients with cancer. [30]

Cachexia is a metabolic condition with underlying illness, typically cancer or COPD. [26; 27] Cachexia is characterized by rapid muscle loss with or without fat loss, anorexia, inflammation, and anemia. Cachexia is resistant to nutritional support and reduces cancer treatment tolerance, thus leading to poor prognosis and decreased survival. [28]

Cancer

A growing body of evidence indicates that obesity increases the risk of several types of cancer, including colorectal cancer, postmenopausal breast cancer, endometrial cancer, renal cell carcinoma, esophageal adenocarcinoma, pancreatic cancer, and liver cancer. [21]

There are a number of likely mechanisms that may explain the relationship between obesity and cancer risk, including pathways involved in insulin resistance, inflammation, and sex hormones. [21]

Studies have shown associations between visceral fat, Metabolic Syndrome and increased risk of breast cancer, colorectal cancer and esophageal adenocarcinoma. Visceral fat and Metabolic Syndrome have also been associated with increased tumor progression and reduced survival. [17]

Musculoskeletal Disorders

33% of obese adults have a limiting long-term illness or disability in England. [34]

Obesity is associated with a range of disabling musculoskeletal conditions in adults. [33] Physical inactivity and muscle atrophy, as well as secondary conditions (such as depression, chronic pain, mobility problems and arthritis) have all been found to contribute to the development of obesity among people with physical disabilities. [34]

References
  1. Marie Ng, PhD et al. "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013",The Lancet, Volume 384, No. 9945, p766–781, 30 August 2014
  2. Obesity and overweight, Fact sheet N°311, WHO
  3. The world’s population is rapidly ageing, WHO
  4. Ian J. Neeland, MD et al. "Body Fat Distribution and Incident Cardiovascular Disease in Obese Adults", J Am Coll Cardiol. 2015;65(19):2150-2151
  5. Stacy A. Porter, MA et al. "Abdominal Subcutaneous Adipose Tissue: A Protective Fat Depot?" American Diabetes Association, Diabetes Care June 2009 vol. 32 no. 6 1068-1075
  6. Worldwide Definition of the Metabolic Syndrome, International Diabetes Federation (IDF)
  7. Diseases and Conditions - Diabetes, Mayo Clinic
  8. Seventh Edition 2015 provides the latest facts & figures, The IDF Diabetes Atlas
  9. Cardiovascular diseases (CVDs), WHO
  10. Healthy Aging Facts, National Council On Aging
  11. Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis, World Gastroenterology Organisation
  12. What Is Metabolic Syndrome? National Heart Lung and Blood Institute
  13. Marjolein Visser et al. "Muscle Mass, Muscle Strength, and Muscle Fat Infiltration as Predictors of Incident Mobility Limitations in Well-Functioning Older Persons", The Journals of Gerontology, Medical Sciences 04/2005; 60(3):324-33.
  14. Jean-Pierre Després et al. “Abdominal obesity and metabolic syndrome”, Nature 444, 881-887 (14 December 2006)
  15. Bergman R.N. et al., "Why Visceral Fat is Bad: Mechanisms of the Metabolic Syndrome", OBESITY Vol. 14 Supplement February 2006
  16. Ian J. Neeland, MD et al., “Body Fat Distribution and Incident Cardiovascular Disease in Obese Adults”, J Am Coll Cardiol. 2015;65(19):2150-2151
  17. Suzanne L. Doyle et al. “Visceral obesity, metabolic syndrome, insulin resistance, and cancer." Proceedings of the Nutrition Society, Volume 71, Issue 01, February 2012
  18. Kearns, Karen et al. “Chronic Disease Burden Associated with Overweight and Obesity in Ireland: The Effects of a Small BMI Reduction at Population Level.” BMC Public Health, 2014;14:143.
  19. Global health and aging Washington DC: National Institute on Aging, National Institutes of Health. NIH Publication no. 11–7737. 2011.
  20. Zezos, Petros, and Eberhard L Renner. “Liver Transplantation and Non-Alcoholic Fatty Liver Disease.” World Journal of Gastroenterology, 2014;15532–15538.
  21. Pischon T, Nimptsch K. Obesity and Risk of Cancer: An Introductory Overview. Recent Results Cancer Res. 2016;208:1–15.
  22. Mathers CD, Loncar D Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Med, 2006;3(11): e442.
  23. Balisteri W. New Studies Highlight Increasing Global Prevalence of NAFLD/NASH and Its Considerable Toll. Medscape. Jan 18, 2017.
  24. Lok C. Cachexia: The last illness. Nature. 2015 Dec 10;528(7581):182-3
  25. Morley, John E., Stefan D. Anker, and Stephan von Haehling. “Prevalence, Incidence, and Clinical Impact of Sarcopenia: Facts, Numbers, and Epidemiology—update 2014.” Journal of Cachexia, Sarcopenia and Muscle 5.4 (2014): 253–259
  26. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010;39(4):412–423.
  27. Muscaritoli M, Anker SD, Argiles J, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia–anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr 2010;29:154–159.
  28. Gullett NP, Mazurak VC, Hebbar G, et al. Nutritional interventions for cancer-induced cachexia. Curr Probl Cancer 2011;35(2):58–90.
  29. Morley JE, Anker SD and von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology—update 2014. J Cachexia Sarcopenia Muscle 2014;5(4):253–259.
  30. von Haehling S and Anker SD. Prevalence, incidence and clinical impact of cachexia: facts and numbers—update 2014. J Cachexia Sarcopenia Muscle 2014;5(4):261–263.
  31. Blond E, Disse E, Cuerq C, et al. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral? Diabetologia. 2017 Mar 28. doi: 10.1007/s00125-017-4264-9. [Epub ahead of print].
  32. Guilherme A, Virbasius JV, Puri V, et al. Adipocyte dysfunctions linking obesity to insulin resistance and type 2 diabetes. Nat Rev Mol Cell Biol. 2008;9(5):367–377.
Services

AMRA® Profiler Research

AMRA® Profiler Research enables regional and complete segmentation and quantification of muscle and fat tissue volumes in the body.

Services

Cloud-Based Analysis

AMRA’s service helps expand and refine the understanding of relationships between fat, muscle and disease development, thus supporting research findings that can be applied to therapeutic product investigation and, in the future, to patient management.
  

Body Composition Profile

What is BCP?

Body composition profiling is a comprehensive, holistic concept developed by AMRA to further our understanding of individual metabolic status. A Body Composition Profile (BCP) is based upon a combination of selected biomarkers that, when used in combination, can describe an individual’s or a group’s fat and muscle distribution.

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