Premorbid Obesity, but Not Nutrition, Prevents Critical Illness-induced Muscle Wasting and Weakness

Overview

Journal J Cachexia Sarcopenia Muscle

Date 2016 Nov 30

PMID 27897405

Citations 37

Authors

Chloe Goossens

Mirna Bastos Marques

Sarah Derde

Sarah Vander Perre

Thomas Dufour

Steven E Thiessen

Fabian Guiza

Thomas Janssens

Greet Hermans

Ilse Vanhorebeek

Katrien De Bock

Greet Van den Berghe

Lies Langouche

Affiliations

Soon will be listed here.

Abstract

Background: The 'obesity paradox' of critical illness refers to better survival with a higher body mass index. We hypothesized that fat mobilized from excess adipose tissue during critical illness provides energy more efficiently than exogenous macronutrients and could prevent lean tissue wasting.

Methods: In lean and premorbidly obese mice, the effect of 5 days of sepsis-induced critical illness on body weight and composition, muscle wasting, and weakness was assessed, each with fasting and parenteral feeding. Also, in lean and overweight/obese prolonged critically ill patients, markers of muscle wasting and weakness were compared.

Results: In mice, sepsis reduced body weight similarly in the lean and obese, but in the obese with more fat loss and less loss of muscle mass, better preservation of myofibre size and muscle force, and less loss of ectopic lipids, irrespective of administered feeding. These differences between lean and obese septic mice coincided with signs of more effective hepatic fatty acid and glycerol metabolism, and ketogenesis in the obese. Also in humans, better preservation of myofibre size and muscle strength was observed in overweight/obese compared with lean prolonged critically ill patients.

Conclusions: During critical illness premorbid obesity, but not nutrition, optimized utilization of stored lipids and attenuated muscle wasting and weakness.

Citing Articles

L-shaped association of body mass index with prognosis in individuals with sepsis: a multicenter cohort study.

Cui K, Teng X, Liu W, Zhao X, Xu S, Bai L Diabetol Metab Syndr. 2025; 17(1):43.

PMID: 39901292 PMC: 11789304. DOI: 10.1186/s13098-025-01607-w.

Glucocorticoid treatment increases cholesterol availability during critical illness: effect on adrenal and muscle function.

De Bruyn L, Teblick A, Van Oudenhove T, Vander Perre S, Derese I, Pauwels L Crit Care. 2024; 28(1):295.

PMID: 39238038 PMC: 11378467. DOI: 10.1186/s13054-024-05079-8.

Which factors are associated with acquired weakness in the ICU? An overview of systematic reviews and meta-analyses.

Fuentes-Aspe R, Gutierrez-Arias R, Gonzalez-Seguel F, Marzuca-Nassr G, Torres-Castro R, Najum-Flores J J Intensive Care. 2024; 12(1):33.

PMID: 39232808 PMC: 11375885. DOI: 10.1186/s40560-024-00744-0.

Nutritional therapy for the prevention of post-intensive care syndrome.

Oshima T, Hatakeyama J J Intensive Care. 2024; 12(1):29.

PMID: 39075627 PMC: 11285132. DOI: 10.1186/s40560-024-00734-2.

The obesity paradox and 90 day mortality in chronic critically ill patients: a cohort study using a large clinical database.

Xu D, Lu Y, Wang Y, Li F Eur J Med Res. 2024; 29(1):392.

PMID: 39075583 PMC: 11285416. DOI: 10.1186/s40001-024-01962-w.

References

Jolley S, Bunnell A, Hough C . ICU-Acquired Weakness. Chest. 2016; 150(5):1129-1140. PMC: 5103015. DOI: 10.1016/j.chest.2016.03.045. View

Kress J, Hall J . ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014; 370(17):1626-35. DOI: 10.1056/NEJMra1209390. View

Langouche L, Vanhorebeek I, Vlasselaers D, Vander Perre S, Wouters P, Skogstrand K . Intensive insulin therapy protects the endothelium of critically ill patients. J Clin Invest. 2005; 115(8):2277-86. PMC: 1180545. DOI: 10.1172/JCI25385. View

Gouni I, Oka K, Etienne J, Chan L . Endotoxin-induced hypertriglyceridemia is mediated by suppression of lipoprotein lipase at a post-transcriptional level. J Lipid Res. 1993; 34(1):139-46. View

Surwit R, Feinglos M, Rodin J, Sutherland A, Petro A, Opara E . Differential effects of fat and sucrose on the development of obesity and diabetes in C57BL/6J and A/J mice. Metabolism. 1995; 44(5):645-51. DOI: 10.1016/0026-0495(95)90123-x. View

von Haehling S, Morley J, Coats A, Anker S . Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2015. J Cachexia Sarcopenia Muscle. 2015; 6(4):315-6. PMC: 4670739. DOI: 10.1002/jcsm.12089. View

Derde S, Vanhorebeek I, Guiza F, Derese I, Gunst J, Fahrenkrog B . Early parenteral nutrition evokes a phenotype of autophagy deficiency in liver and skeletal muscle of critically ill rabbits. Endocrinology. 2012; 153(5):2267-76. DOI: 10.1210/en.2011-2068. View

Vanhorebeek I, Langouche L, Van den Berghe G . Endocrine aspects of acute and prolonged critical illness. Nat Clin Pract Endocrinol Metab. 2006; 2(1):20-31. DOI: 10.1038/ncpendmet0071. View

Puthucheary Z, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P . Acute skeletal muscle wasting in critical illness. JAMA. 2013; 310(15):1591-600. DOI: 10.1001/jama.2013.278481. View

10.

Karsenty C, Ulmer M, Chanussot F, Ratanasavanh R, DEBRY G . Paradoxical effect of ethanol on liver lipogenesis in the genetically-obese Zucker rat. Br J Nutr. 1985; 54(1):15-20. DOI: 10.1079/bjn19850087. View

11.

Puthucheary Z, Phadke R, Rawal J, McPhail M, Sidhu P, Rowlerson A . Qualitative Ultrasound in Acute Critical Illness Muscle Wasting. Crit Care Med. 2015; 43(8):1603-11. DOI: 10.1097/CCM.0000000000001016. View

12.

Derde S, Hermans G, Derese I, Guiza F, Hedstrom Y, Wouters P . Muscle atrophy and preferential loss of myosin in prolonged critically ill patients. Crit Care Med. 2011; 40(1):79-89. DOI: 10.1097/CCM.0b013e31822d7c18. View

13.

Komatsu M, Waguri S, Koike M, Sou Y, Ueno T, Hara T . Homeostatic levels of p62 control cytoplasmic inclusion body formation in autophagy-deficient mice. Cell. 2007; 131(6):1149-63. DOI: 10.1016/j.cell.2007.10.035. View

14.

Bjorntorp P, Bergman H, VARNAUSKAS E . Plasma free fatty acid turnover rate in obesity. Acta Med Scand. 1969; 185(4):351-6. DOI: 10.1111/j.0954-6820.1969.tb07347.x. View

15.

Hill N, Saeed S, Phadke R, Ellis M, Chambers D, Wilson D . Detailed characterization of a long-term rodent model of critical illness and recovery. Crit Care Med. 2015; 43(3):e84-96. DOI: 10.1097/CCM.0000000000000854. View

16.

Jagoe R, Lecker S, Gomes M, Goldberg A . Patterns of gene expression in atrophying skeletal muscles: response to food deprivation. FASEB J. 2002; 16(13):1697-712. DOI: 10.1096/fj.02-0312com. View

17.

Marques M, Perre S, Aertgeerts A, Derde S, Guiza F, Casaer M . Critical illness induces nutrient-independent adipogenesis and accumulation of alternatively activated tissue macrophages. Crit Care. 2013; 17(5):R193. PMC: 4056380. DOI: 10.1186/cc12887. View

18.

Hogue Jr C, Stearns J, Colantuoni E, Robinson K, Stierer T, Mitter N . The impact of obesity on outcomes after critical illness: a meta-analysis. Intensive Care Med. 2009; 35(7):1152-70. DOI: 10.1007/s00134-009-1424-5. View

19.

Lavie C, De Schutter A, Alpert M, Mehra M, Milani R, Ventura H . Obesity paradox, cachexia, frailty, and heart failure. Heart Fail Clin. 2014; 10(2):319-26. DOI: 10.1016/j.hfc.2013.12.002. View

20.

Goossens C, Marques M, Derde S, Vander Perre S, Dufour T, Thiessen S . Premorbid obesity, but not nutrition, prevents critical illness-induced muscle wasting and weakness. J Cachexia Sarcopenia Muscle. 2016; 8(1):89-101. PMC: 5326828. DOI: 10.1002/jcsm.12131. View