scholarly journals Insulin resistance in transgender individuals correlates with android fat mass

2021 ◽  
Vol 12 ◽  
pp. 204201882098568
Author(s):  
Ingrid Bretherton ◽  
Cassandra Spanos ◽  
Shalem Y. Leemaqz ◽  
Gehan Premaratne ◽  
Mathis Grossmann ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Fat Distribution ◽  
Trans Men ◽  
Increased Risk ◽  
Android Fat ◽  
In Trans ◽  
Trans Women

Background: Transgender individuals receiving gender-affirming hormone therapy (GAHT) are at increased risk of adverse cardiovascular outcomes. This may be related to effects on body composition and insulin resistance. Aims: To examine relationships between body fat distribution and insulin resistance in transgender individuals on established GAHT. Methods: Comparisons of body composition (dual energy X-ray absorptiometry) and insulin resistance [Homeostasis Model of Insulin Resistance (HOMA2-IR)] were made between transgender individuals (43 trans men and 41 trans women) on established GAHT (>12 months) and age-matched cisgender controls (30 males and 48 females). Multiple linear regressions were used to examine the relationship between HOMA2-IR and fat mass with gender, adjusting for age and total duration of GAHT and Pearson correlation coefficients are reported. Results: Compared with control cisgender women, trans men had mean difference of +7.8 kg (4.0, 11.5), p < 0.001 in lean mass and higher android:gynoid fat ratio [0.2 (0.1, 0.3), p < 0.001], but no difference in overall fat mass or insulin resistance. Compared with control cisgender men, trans women had median difference in lean mass of −6.9 kg (–10.6, –3.1), p < 0.001, fat mass of +9.8 kg (3.9, 14.5), p = 0.001, lower android:gynoid fat ratio −0.1 (–0.2,–0.0), p < 0.05), and higher insulin resistance 1.6 (1.3–1.9), p < 0.001). Higher HOMA2-IR correlated with higher android ( r2 = 0.712, p < 0.001) and gynoid ( r2 = 0.572, p < 0.001) fat mass in both trans men and trans women. Conclusion: Android fat more strongly correlates with insulin resistance than gynoid fat in transgender individuals. Higher fat mass and insulin resistance in trans women may predispose to increased cardiovascular risk. Despite adverse fat distribution, insulin resistance was not higher in trans men.

scholarly journals Body composition in childhood: effects of normal growth and disease

2003 ◽  
Vol 62 (2) ◽  
pp. 521-528 ◽  
Author(s):  
J. C. K. Wells
Keyword(s):  
Body Composition ◽  
Childhood Obesity ◽  
Fat Mass ◽  
Lean Mass ◽  
Normal Weight ◽  
Fat Free Mass ◽  
General Interest ◽  
Childhood And Adolescence ◽  
Adult Disease ◽  
Increased Risk

Body composition in children is of increasing interest within the contexts of childhood obesity, clinical management of patients and nutritional programming as a pathway to adult disease. Energy imbalance appears to be common in many disease states; however, body composition is not routinely measured in patients. Traditionally, clinical interest has focused on growth or nutritional status, whereas more recent studies have quantified fat mass and lean mass. The human body changes in proportions and chemical composition during childhood and adolescence. Most of the weight gain comprises lean mass rather than fat. In general, interest has focused on percentage fat, and less attention has been paid to the way in which lean mass varies within and between individuals. In the general population secular trends in BMI have been widely reported, indicating increasing levels of childhood obesity, which have been linked to reduced physical activity. However, lower activity levels may potentially lead not only to increased fatness, but also to reduced lean mass. This issue merits further investigation. Diseases have multiple effects on body composition and may influence fat-free mass and/or fat mass. In some diseases both components change in the same direction, whereas in other diseases, the changes are contradictory and may be concealed by relatively normal weight. Improved techniques are required for clinical evaluations. Both higher fatness and reduced lean mass may represent pathways to an increased risk of adult disease.

scholarly journals Serum estradiol is associated with lean mass in elderly Swedish men

2010 ◽  
Vol 162 (4) ◽  
pp. 737-745 ◽  
Author(s):  
Liesbeth Vandenput ◽  
Dan Mellström ◽  
Magnus K Karlsson ◽  
Eric Orwoll ◽  
Fernand Labrie ◽  
...  
Keyword(s):  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Association Studies ◽  
Serum Testosterone ◽  
Fat Distribution ◽  
Free Testosterone ◽  
Elderly Men ◽  
Central Fat ◽  
Free Serum

ObjectiveAssociation studies in men have shown that androgens are inversely related to fat measures, while the relation between sex steroids and lean mass remains unclear. We, therefore, investigated the associations between serum sex steroid levels and body composition in elderly men with a main focus on lean mass measures.Design and methodsA cross-sectional survey of a population-based cohort of 3014 elderly men, aged 69–80 years (Osteoporotic Fractures in Men study, Sweden). Serum levels of testosterone and estradiol (E2) were measured by mass spectrometry, sex hormone-binding globulin (SHBG) levels were measured by IRMA, and measures of body composition were obtained by dual-energy X-ray absorptiometry.ResultsTotal as well as free serum testosterone associated independently inversely (P<0.001), while total as well as free serum E2associated independently directly (P<0.001) with total body fat mass and trunk fat mass. Serum SHBG associated independently inversely with central fat distribution. Serum E2and free E2but not serum testosterone or free testosterone levels associated positively with lean mass (P<0.01). Elderly men within the lowest quartile of free E2had 0.5 kg less lean mass in the legs than subjects within the highest quartile, while the subjects in the different quartiles of free testosterone did not differ in lean mass.ConclusionsSerum E2, but not serum testosterone, is directly associated with lean mass in this large study of elderly Swedish men. In addition, serum SHBG is associated with central fat distribution and we confirmed that serum testosterone is inversely associated with fat mass.

scholarly journals Incident diabetes risk is not increased in transgender individuals using hormone therapy

2021 ◽  
Author(s):  
Daan van Velzen ◽  
Chantal Wiepjes ◽  
Nienke Nota ◽  
Daniel van Raalte ◽  
Renée de Mutsert ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
General Population ◽  
Hormone Therapy ◽  
Trans Men ◽  
Data Registry ◽  
Central Registry ◽  
In Trans ◽  
Trans Women

Abstract Background In trans women receiving hormone therapy, body fat and insulin resistance increases, with opposite effects in trans men. These metabolic alterations may alter the risk of developing type 2 diabetes in trans women and trans men. We aimed to compare the incidence of type 2 diabetes of adult trans women and trans men during hormone therapy with rates from their birth sex in the general population. Methods Retrospective data from the Amsterdam Cohort of Gender Dysphoria with transgender individuals on hormone therapy between 1972 and 2018 were linked to a nationwide health data registry. Because no central registry of diabetes is available, the occurrence of diabetes was inferred from the first dispense of a glucose-lowering agent. Standardized incidence ratios (SIR) were computed for trans women and trans men in comparison with the same birth sex from the general population. Results Compared to their birth sex in the general population, no difference in the incidence of type 2 diabetes mellitus was observed in trans women (N=2585, 90 cases, SIR 0.94 95%CI 0.76–1.14) or trans men (N=1514, 32 cases, SIR 1.40 95%CI 0.96–1.92). Conclusion Despite studies reporting an increase in insulin resistance in feminizing hormone therapy and a decrease in insulin resistance in masculinizing hormone therapy, the incidence of diabetes in transgender individuals after initiation of hormone therapy was not different compared to the general population.

scholarly journals SAT0441 BODY COMPOSITION AND FAT DISTRIBUTION IN PATIENTS WITH PSORIASIS OR PSORIATIC ARTHRITIS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1177.1-1177
Author(s):  
E. Toussirot ◽  
F. Aubin ◽  
M. Desmarets ◽  
D. Wendling ◽  
B. Auge ◽  
...  
Keyword(s):  
Body Composition ◽  
Psoriatic Arthritis ◽  
Waist Circumference ◽  
Fat Mass ◽  
Visceral Fat ◽  
Fat Distribution ◽  
Control Group ◽  
Metabolic Complications ◽  
Total Adiponectin ◽  
Android Fat

Background:Obesity is a leading comorbidity in both psoriasis (Pso) and psoriatic arthritis (PsA) and is associated with common metabolic complications and increased cardiovascular (CV) risk. Obesity is also a risk factor for the onset of these diseases. Body composition and fat distribution have been rarely evaluated in Pso and PsA.Objectives:In this study, we aimed to characterize the fat mass distribution in patients with Pso or PsA compared to a control group, with a special emphasis on the android/visceral region.Methods:case-control study (NCT02849795). Patients with Pso (plaque psoriasis) or PsA (CASPAR criteria) were evaluated. Each patient was paired to a control subject, recruited in the same outpatient population, and matched for sex, age and body mass index (BMI) category. Clinical assessment included BMI, anthropometric measurements (waist circumference, waist /hip ratio), disease activity (PASI for Pso, CPDAI for PsA) and the SCORE CV risk score. Laboratory parameters of inflammation (ESR, CRP, IL-6), lipid parameters (total cholesterol, LDL and HDL cholesterol, triglycerides), metabolic parameters (glycemia, insulin, HOMA), serum adipokines (total and high molecular weight [HMW] adiponectin, leptin, resistin and retinol binding protein 4 [RBP4]) were measured. Body composition (lean mass, fat mass) and fat distribution (android/gynoid regions and visceral fat) were evaluated (DEXA, Lunar GE, CoreScan). Our primary criteria was the fat mass in the android/visceral region. Comparisons between patients and controls were performed with paired t tests, between all groups with ANCOVA (adjusted for age, sex, and BMI category) and Tukey post-hoc tests. Pearson correlations between CV risk and fat mass were calculated within groups.Results:52 patients with Pso and 52 patients with PsA and their respective paired-control were evaluated. Total fat mass was increased in Pso but not in PsA. Android fat and visceral fat were found higher in Pso (p<0.05) while the fat mass measurements did not differ between the patients with PsA and their controls. Waist circumference was higher in patients with Pso compared to their controls. Leptin, leptin/fat mass ratio, and total adiponectin were elevated in PsA while only the HMW/total adiponectin ratio was decreased in Pso. Insulin levels and HOMA were increased in both Pso and PsA groups. Finally, RBP4 was higher in both Pso and PsA patients compared to their respective controls. In patients with Pso, android and visceral fat were correlated with SCORE (r=0.3, p=0.02 and r= 0.6, p < 0.0001 respectively). In ANCOVA analysis, visceral fat was higher in Pso patients (p=0.0029), with a trend toward higher android fat (p=0.055), compared to PsA patients.Conclusion:visceral fat is increased in patients with Pso but not in PsA. In parallel, both groups showed an elevation of circulating RBP4. Patients with Pso and PsA were also characterized by metabolic disturbances as showed by the increase in HOMA, and specific adipokine changes. In the Pso group, visceral fat is associated with CV risk evaluated by SCORE. Weight control and reduction of fat mass, especially visceral fat mass, may thus be an important concern in patients with Pso and appears less relevant in PsA.Disclosure of Interests:None declared

scholarly journals Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy

2021 ◽  
Author(s):  
Maartje Klaver ◽  
Daan van Velzen ◽  
Christel de Blok ◽  
Nienke Nota ◽  
Chantal Wiepjes ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Hormone Therapy ◽  
Body Fat ◽  
Visceral Fat ◽  
Cardiometabolic Risk ◽  
Trans Men ◽  
Total Body Fat ◽  
In Trans ◽  
Trans Women ◽  
Total Body

Abstract Introduction Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. Methods In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. Results In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (−2 grams; 95% CI −15, 11), albeit with a large range from −318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI −10, 16; range −372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. Conclusions Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.

scholarly journals Osteocalcin as a Predictor of Body Composition in Healthy Adults

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1627-1627
Author(s):  
Rosemary DeLuccia ◽  
May Cheung ◽  
Asma Altasan ◽  
Sumer Al-Ani ◽  
Rushali Parekh ◽  
...  
Keyword(s):  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Visceral Adiposity ◽  
Fat Percentage ◽  
Mass Percentage ◽  
Android Fat ◽  
Gynoid Fat ◽  
Serum Ionized Calcium ◽  
Total Fat

Abstract Objectives The objectives of this study were to determine if body composition and nutrient status are dependent on serumosteocalcin concentrations in healthy adults. Methods Adults 20 to 70 years of age completed fasting blood sampling to measure serum ionized calcium concentrations, serum ionized magnesium concentrations, and serum total osteocalcin concentrations. Dual Energy X-Ray Absorptiometry was also completed to measure body composition variables including body mass index (BMI), total fat mass, total fat freemass, total lean mass, android fat, gynoid fat, trunk fat, and visceral adipose tissue. Results A sample of 60 women and 78 men with a median age of 33.0 (21.0) years were categorized into two groups accordingto the median osteocalcin concentration measured: low osteocalcin (12.11 ± 2.72 ng/mL), and high osteocalcin (26.80 ± 9.72 ng/mL). Means, standard deviations, medians and interquartile ranges were calculated and independent t-tests, and Mann Whitney U tests were conducted to determine differences between groups in body composition variables. Total fat mass, total fat percentage, android fat, trunk fat, and trunk fat percentage were all significantly higher, and totalfat free mass, fat free mass percentage, total lean mass, lean mass percentage, serum ionized calcium concentrations, and serum ionized magnesium concentrations were all significantly lower (P &lt; 0.05) in the low osteocalcin groupcompared to the high osteocalcin group. There were no differences (P &gt;0.05) between groups in weight, gynoid fat, visceral adiposity tissue, or visceral adiposity tissue percentage. Conclusions The results of this study provide preliminary evidence that serum osteocalcin concentrations can predict bodycomposition. Interventional studies should consider methods to alter osteocalcin concentrations through vitamin ormineral supplementation as a means to improve body composition in adults. Funding Sources American Heart Association; Drexel University.

scholarly journals Association between 25-Hydroxyvitamin D Status and Components of Body Composition and Glucose Metabolism in Older Men and Women

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1826 ◽  
Author(s):  
Svea-Vivica Mathieu ◽  
Karina Fischer ◽  
Bess Dawson-Hughes ◽  
Gregor Freystaetter ◽  
Felix Beuschlein ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Glucose Metabolism ◽  
Fat Mass ◽  
Lean Mass ◽  
Cell Function ◽  
Smoking Status ◽  
Community Dwelling ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Obesity and sarcopenia are major causes of morbidity and mortality among seniors. Vitamin D deficiency is very common especially among seniors and has been associated with both muscle health and obesity. This study investigated if 25-hydroxyvitamin D (25(OH)D) status is associated with body composition and insulin resistance using baseline data of a completed RCT among relatively healthy community-dwelling seniors (271 seniors age 60+ years undergoing elective surgery for unilateral total knee replacement due to osteoarthritis). Cross-sectional analysis compared appendicular lean mass index (ALMI: lean mass kg/height m2) and fat mass index (FMI: fat mass kg/height m2) assessed by DXA and insulin resistance between quartiles of serum 25(OH)D concentration using multivariable linear regression adjusted for age, sex, smoking status, physical activity, and body mass index (BMI). Participants in the lowest serum 25(OH)D quartile (4.7–17.5 ng/mL) had a higher fat mass (9.3 kg/m2) compared with participants in the third (8.40 kg/m2; Q3 = 26.1–34.8 ng/mL) and highest (8.37 kg/m2; Q4 = 34.9–62.5 ng/mL) quartile (poverall = 0.03). Higher serum 25(OH)D quartile status was associated with higher insulin sensitivity (poverall = 0.03) and better beta cell function (p = 0.004). Prevalence of insulin resistance tended to be higher in the second compared with the highest serum 25(OH)D quartile (14.6% vs. 4.8%, p = 0.06). Our findings suggest that lower serum 25(OH)D status may be associated with greater fat mass and impaired glucose metabolism, independent of BMI and other risk factors for diabetes.

scholarly journals Relationships between insulin resistance and frailty with body composition and testosterone in men undergoing androgen deprivation therapy for prostate cancer

2016 ◽  
Vol 175 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Ada S Cheung ◽  
Rudolf Hoermann ◽  
Philippe Dupuis ◽  
Daryl Lim Joon ◽  
Jeffrey D Zajac ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Insulin Resistance ◽  
Body Composition ◽  
Androgen Deprivation Therapy ◽  
Fat Mass ◽  
Lean Mass ◽  
Androgen Deprivation ◽  
Total Testosterone ◽  
The Mean ◽  
Control Prospective Study

Objective While androgen deprivation therapy (ADT) has been associated with insulin resistance and frailty, controlled prospective studies are lacking. We aimed to examine the relationships between insulin resistance and frailty with body composition and testosterone. Design Case–control prospective study. Methods Sixty three men with non-metastatic prostate cancer newly commencing ADT (n=34) and age-matched prostate cancer controls (n=29) were recruited. The main outcomes were insulin resistance (HOMA2-IR), Fried’s frailty score, body composition by dual x-ray absorptiometry and short physical performance battery (SPPB) measured at 0, 6 and 12months. A generalised linear model determined the mean adjusted difference (95% CI) between groups. Results Compared with controls over 12months, men receiving ADT had reductions in mean total testosterone level (14.1–0.4nmol/L, P<0.001), mean adjusted gain in fat mass of 3530g (2012, 5047), P<0.02 and loss of lean mass of 1491g (181, 2801), P<0.02. Visceral fat was unchanged. HOMA2-IR in the ADT group increased 0.59 (0.24, 0.94), P=0.02, which was most related to the increase in fat mass (P=0.003), less to lean mass (P=0.09) or total testosterone (P=0.088). Frailty increased with ADT (P<0.0001), which was related to decreased testosterone (P=0.028), and less to fat mass (P=0.056) or lean mass (P=0.79). SPPB was unchanged. Conclusions ADT is associated with increased insulin resistance and frailty within 12months of commencement, independently of confounding effects of cancer or radiotherapy. Insulin resistance appears to be mediated by subcutaneous or peripheral sites of fat deposition. Prevention of fat gain is an important strategy to prevent adverse ADT-associated cardiometabolic risks.

scholarly journals Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study

2006 ◽  
Vol 154 (1) ◽  
pp. 131-139 ◽  
Author(s):  
Lenora M Camarate S M Leão ◽  
Mônica Peres C Duarte ◽  
Dalva Margareth B Silva ◽  
Paulo Roberto V Bahia ◽  
Cláudia Medina Coeli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Postmenopausal Women ◽  
Fat Mass ◽  
Visceral Fat ◽  
Increased Risk

Background: There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease. Objective: We aimed to assess the effects of androgen replacement on cardiovascular risk factors. Design: Thirty-seven postmenopausal women aged 42–62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo. Methods: Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography. Results: A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance. Conclusion: This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.

Abstract 17105: Is There a Difference in Lean and Fat Mass in HF Patients Based on NYHA Classifications (I-II versus III-IV)?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Christine Haedtke ◽  
Debra K Moser ◽  
Susan J Pressler ◽  
Terry Lennie
Keyword(s):  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Nyha Class ◽  
Class I ◽  
Unexpected Finding ◽  
Class Iii ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Nyha Classification

Introduction: As NYHA Class increases from I (ordinary physical activity does not cause undue fatigue), to Class IV (Symptoms are present while at rest) physical limitations become severe. It has previously been shown that HF patients have increased fat within the muscle thus decreasing exercise performance and tolerance. It is unclear if all NYHA classes are similarly affected. Hypothesis: HF patients with NYHA class III-IV will have more fat and less lean mass than those with NYHA class I-II. Methods: Secondary data analysis using cross sectional data from N=253. The parent study was a multicenter study about nutrition and body composition among patients with HF (preserved or reduced, and NYHA classification I-IV) who had been on a stable medication regimen, able to participate in dual-energy X-ray absorptiometry scan and/or BodPod body composition measures, able to read and speak English, and had no cognitive impairment. Women and men were analyzed separately due to known differences in fat and lean mass. Results: Table 1: Sample characteristic’s Testing the hypothesis using 2-way ANOVA and comparing the percentage of body weight that is lean and fat mass in NYHA class I-II vs III-IV found the interaction of gender and NYHA was not significant in either % lean or %fat (p=0.221, 0.190 respectively). NYHA class by itself was not significant (p=0.067) in %lean but was significant in %fat (p=0.046). Gender was significant in both %lean and %fat with men having 9.6% less fat (1.139 SE) and 9.8% more lean mass (1.066 SE) (p≤0.001). NYHA class III-IV had 2.3% (1.139 SE) more fat than those in NYHA class I-II. The R squared was 0.265 and adjusted R squared was 0.256. Conclusions: Part of our hypothesis was correct in that NYHA class III-IV had more fat mass than those in class I-II, but no difference was found in lean. This is an unexpected finding as healthy people gain fat mass while losing lean mass as they age. Additional studies are needed to further examine this result.

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