CNA205 Semester 2, 2014

Student Name: .

Section 2: Evaluation of a research article (1000 words)

The article used for the purpose of this study is Fat Infiltration in Muscle: New Evidence
for Familial Clustering and Associations with Diabetes by Several researches such as Iva
Miljkovic-Gacic, Xiaojing Wang, Candace M. Kammerer, Christopher L. Gordon,
Clareann H. Bunker, Lewis H. Kuller, Alan L. Patrick, Victor W. Wheeler4, Rhobert W.
Evans, and Joseph M. Zmuda from various institutional affiliations in the USA, Canada as
well as Trinidad & Tobago, such as

Department of Epidemiology, Graduate School of Public Health, University of

Pittsburgh, Pittsburgh, Pennsylvania, USA

Department of Human Genetics, Graduate School of Public Health, University of

Pittsburgh,

Pittsburgh, Pennsylvania, USA

Department of Radiology, McMaster University, Hamilton, Ontario, Canada

Tobago Health Studies Office, Tobago, Trinidad and Tobago

Citation for the Article:

Miljkovic-Gacic et al (2008) 'Fat Infiltration in Muscle: New Evidence for Familial
Clustering and Associations With Diabetes', Obesity (Silver Spring), vol. 16, no. 8, August,
pp. 18541860.

What is the study design used in the article?

The study design used in the article is mainly observation. A total of 471 people were
observed and various tests were carried out in order to discover the objective of the research,
which was to understand the role inheritance (such as hereditary causes), lifestyle (such as
smoking, lack of exercise etc.) and body weight composition (by means of Body Mass Index
or BMI) have in the development of various chronic illnesses such as Diabetes.
The observed sample was spread through eight multi-generation families of African origin, in
the island of Tobago (in the Caribbean). (Miljkovic-Gacic et al, 2008). Statistical Analysis
was performed on the collected data and the results were analysed accordingly.

What methods did the researcher/s use to collect and analyse their data, and why?
The researchers used a mixture of blood samples for measuring glucose or blood sugar levels
amongst the sample, as well as a peripheral quantitative computed tomography (pQCT) was
performed on the lower part of the leg, in the calf muscle, in all the members of the sample,
in order to determine the total presence of fat and muscle. Moreover, the members of the
sample were also questioned with regard to their lifestyle and general health, such as whether
they smoke, if and how often they consumed alcohol, if they had ever been pregnant (for
women) or used any contraceptive medication (for women) and at what age was their
menarche and menopause (for women). Additionally, the body weight of each participant was
also measured (to the nearest 0.1 Kg). The results of the blood sample, pQCT and questions
relating to lifestyle and reproduction were then statistically analyzed by the researchers using
a regression analysis after removing all variables with a Standard Deviation of 3.5. Using all
of the above-mentioned data, the researchers used a Mean trait value to further realize the
results of the survey so that they could eliminate random errors in the statistic.

What are the key findings of the study?

The researchers find that the lifestyle habits were healthier in women compared to their male
counterparts, as fewer women smoked and had a lower frequency of consuming alcohol.
However, the BMI was considerably higher in women than men. Moreover, skeletal muscle
density was lower in women, however, the composition of fat cells in the calf area was
significantly higher in women. However, the researchers conclude, based on their
observations that lifestyle habits did not have much of an impact with relation to the pQCT
outcomes in both men and women. The researchers also found that genetic factors and
hereditary factors played a huge role in determining the BMI and pQCT in the case of both
men and women. After the researchers made adjustments for age and gender, they found that
BMI was higher in Diabetic people in the observed sample than in non diabetic people.
How do these findings help to answer your clinical question, considering your
population and practice setting?
My clinical question was In the African American community, does controlling your
weight, have more of an effective outcome in reducing the risk of Type 2 Diabetes?
Although the research carried out by (Miljkovic-Gacic et al, 2008) does not answer the
question directly, it has some key implications regarding my research.
According to The Better Health Channel, Walking can improve your health and fitness by
helping you lose body fat, improve your fitness and avoid heart disease, type 2 diabetes,
osteoporosis and some cancers (Better Health Channel, 2012)
The researchers asked the respondents about their lifestyle habits, which included exercising
habits such as going for walks on a regular basis. Men averaged a higher walking per week
on the basis of minutes per week, and averaged significantly less when it came to being
diabetic. Hence, we can assume that as walking controls weight, controlling weight can have
an effective outcome in reducing the risk of Type 2 Diabetes. This may hold true, especially

since other lifestyle habits of the men observed were comparatively less healthy than the
females. This is because more men smoked and had a higher frequency of consuming
alcohol.
This research however, does not answer my clinical question convincingly. Large amount of
assumptions have had to be made on my behalf to infer a conclusion. Moreover, the risk of
diabetes, as documented in the research by (Miljkovic-Gacic et al, 2008), may be higher in
African-American females than males, it may be depend on other factors and variables such
as genes and use of contraceptive medicines, menarche and menopause or even pregnancy,
which only women are subject to.
There is a strong an immediate call for further research on the question posed by me. This
research, while it hints at answering the question, does not do so in any convincing manner.

References:
Better Health Channel (2012) Walking for good health, December, [Online], Available:
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Walking_for_good_health?
open [13 January 2015].
Miljkovic-Gacic et al (2008) 'Fat Infiltration in Muscle: New Evidence for Familial Clustering
and Associations With Diabetes', Obesity (Silver Spring), vol. 16, no. 8, August, pp. 1854
1860.

Appendix: