{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:05:45Z","timestamp":1785247545326,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate early changes in the rectus femoris muscle during sepsis-associated muscle wasting (SAMW) and their association with metabolic dysregulation through a dynamic analysis of ultrasound texture features and metabolomics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study, adults with sepsis underwent ultrasound of the right rectus femoris on intensive care unit (ICU) days 1, 4, and 7 to measure rectus femoris cross-sectional area (RF-CSA), muscle layer thickness (RF-MLT), and gray-level co-occurrence matrix texture features. Linear mixed-effects models were used to assess group, time, and group-by-time effects, and repeated-measures correlations were used to test longitudinal associations with metabolic\/inflammatory biomarkers. Untargeted metabolomics was performed in the SAMW subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 751 patients screened, 60 were included, and 16 (26.7%) developed SAMW. A significant group-by-time interaction was observed only for RF-CSA (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.031), which declined in SAMW (slope \u22120.121, SE 0.039;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0024). Patients with sepsis showed reduced systemic inflammation during the first week in the ICU; however, SAMW featured persistent muscle wasting, possibly driven by ongoing glucose\/lipid dysregulation and hypercatabolism. RF-MLT was negatively correlated with low-density lipoprotein (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and RF-CSA with total cholesterol (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Texture standard deviation correlated positively with glucose (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) and negatively with interleukin-6 (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.23,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Metabolomics identified 29 metabolites that progressively decreased from controls to SAMW on days 1 and 7, with enrichment of fatty acid pathways; docosahexaenoic acid and arachidonic acid emerged as key differential metabolites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although systemic inflammation gradually decreased during the first week of ICU stay in patients with sepsis, those who developed SAMW showed persistent loss of muscle mass associated with metabolic dysregulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>The study was registered at ClinicalTrials.gov (registration no.: ChiCTR2400092420).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1868564","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:04:03Z","timestamp":1784804643000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic muscle loss and metabolic dysregulation in sepsis-associated muscle wasting: an integrated ultrasound and metabolomics study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jinlan","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Critical Medicine, General Hospital of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyuan","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuepeng","family":"Bai","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery, General Hospital of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyu","family":"Mai","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Feng","sequence":"additional","affiliation":[{"name":"Ningxia Integrated Traditional Chinese and Western Medicine Hospital","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Critical Medicine, General Hospital of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"ofy 313","DOI":"10.1093\/ofid\/ofy313","article-title":"Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit","volume":"5","author":"Sakr","year":"2018","journal-title":"Open Forum Infect 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