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Catikkas NM, Safer VB, Bas S, Gunay DS, Durak A, Utku IK, Safer U. Comparison of muscle and fat parameters measured by ultrasonography and dual-energy x-ray absorptiometry between older palliative care patients with and without type 2 diabetes mellitus. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:608-618. [PMID: 38600828 DOI: 10.1002/jcu.23688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/09/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS There are limited data on the comparison of body compositions between diabetic and non-diabetic patients. We aimed to compare the muscle mass and fat parameters measured by ultrasonography (USG) and dual-energy x-ray absorptiometry (DXA) between older palliative care patients with and without type 2 diabetes mellitus (DM). METHODS We conducted a prospective, cross-sectional study. We recorded the demographics, comorbidities, blood pressures, microvascular complications, pressure injuries, ambulation and nutritional status, and laboratory parameters. We measured the handgrip strength with a hand dynamometer and anthropometric parameters. We analyzed the subcutaneous fat thickness, muscle thickness (MT), and cross-sectional area (CSA) of the rectus femoris (RF) and biceps brachii muscles by USG and the total and regional muscle mass and fat parameters by DXA. We performed a regression analysis to examine the independently associated factors of DM. RESULTS We included 55 patients (mean age: 79.0 ± 8.0 years, 56.4%: female). 43.6% had type 2 DM. The patients with DM had significantly higher glucose and HbA1c levels and lower RFMT and RFCSA values than the patients without DM (p < 0.01, for all). The RFMT was independently associated with DM after adjusting age, sex, and body mass index (Odds ratio = 0.735, 95% confidence interval = 0.565-0.956, p = 0.022). CONCLUSION Our study demonstrated that the RFMT might be associated with type 2 DM. This was the first study comparing the body compositions measured by USG and DXA between older diabetic and non-diabetic palliative patients with a wide range of laboratory evaluations. Longitudinal, multi-center studies are warranted to understand the underlying mechanisms.
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Catikkas NM, Safer U. Some critical issues for the assessment of sarcopenia. J Surg Oncol 2024; 129:663-664. [PMID: 37986688 DOI: 10.1002/jso.27515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023]
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Catikkas NM, Safer U. Letter Regarding: Association of Sarcopenia With Mortality in Patients With Chronic Limb-Threatening Ischemia Undergoing Endovascular Revascularization. J Surg Res 2024; 294:279-280. [PMID: 37867017 DOI: 10.1016/j.jss.2023.09.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 10/24/2023]
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Safer VB, Catikkas NM, Bas S, Sevindik Gunay D, Durak A, Utku IK, Safer U. Ultrasonographically Measured Rectus Femoris Cross-sectional Area might Predict Osteosarcopenia. Curr Med Imaging 2024; 20:e15734056275133. [PMID: 38676518 DOI: 10.2174/0115734056275133231211115630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 04/29/2024]
Abstract
AIM We have aimed to investigate the role of ultrasonographic muscle parameters (UMP) in predicting osteosarcopenia in bedridden patients in a palliative care center. BACKGROUND The role of ultrasound has not been evaluated in predicting osteosarcopenia. OBJECTIVE Reduced muscle thickness (MT) and cross-sectional area (CSA) have often been observed in individuals with sarcopenia, reflecting muscle loss and atrophy. Meanwhile, the potential role of muscle ultrasound has not been evaluated in predicting osteosarcopenia. METHODS We have conducted a prospective, observational study between January 2021 and 2022. We have recorded the demographics, comorbidities, and nutritional status by using the mini nutritional assessment-short form. We measured handgrip strength with a hand dynamometer and the muscle mass with dual X-ray absorptiometry. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People 2 criteria. Osteoporosis was diagnosed according to the World Health Organization criteria. We have categorized the body phenotypes into four groups: "non-sarcopenic non-osteoporotic," "sarcopenic alone," "osteoporotic alone," and "sarcopenic osteoporotic." We have measured the subcutaneous fat thickness (SFT), MT, and CSA of the rectus femoris (RF) and biceps brachii (BB) via ultrasonography. A multivariate regression analysis was performed and area under curve (AUC) values were used to evaluate the accuracy of UMPs. RESULTS We included 31 patients (mean age: 74.6±12.1 years, 54.8%: male). The prevalences of sarcopenia, osteoporosis, and sarcopenic osteoporosis were 71%, 48.4%, and 41.9%, respectively. Only the "sarcopenic osteoporotic" phenotype was negatively correlated with all UMPs. In the regression analysis, only the "sarcopenic osteoporotic" phenotype was independently associated with RFCSA (ß=-0.456, p= 0.024). The AUC for all patients was >0.700. CONCLUSION RFCSA measurement might be useful in the screening for osteosarcopenia. This has been the first study investigating the relationship between UMPs and body phenotypes. Multi-center and large-scale studies are, however, needed.
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Catikkas NM, Safer U. The bioelectrical impedance analysis and sarcopenia: Devices & standardization protocols. Clin Nutr 2023; 42:2484-2485. [PMID: 38411020 DOI: 10.1016/j.clnu.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/20/2023] [Indexed: 02/28/2024]
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Catikkas NM, Safer U. Bioelectrical impedance analysis: Caution should be needed to avoid misinterpretation. Clin Nutr 2023; 42:2289-2290. [PMID: 37775415 DOI: 10.1016/j.clnu.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
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Safer U, Naharci MI, Tasci I, Safer VB. Peripheral Vascular Disease is Associated with Impaired Activities of Daily Living in the Elderly with Dementia: A Prospective Study. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:452-460. [PMID: 35490332 DOI: 10.2174/1871527321666220427105957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/15/2021] [Accepted: 11/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although distinct disorders, peripheral vascular disease (PVD) and dementia are both associated with a progressive decline in activities of daily living in elderly patients. OBJECTIVE This study aimed to compare the functional performance scores between elderly patients with and without dementia and with or without PVD. METHODS Patients with Alzheimer's disease, vascular dementia, and mixed type dementia and controls were prospectively enrolled. Functional performance scores for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were evaluated using the Barthel scale and Lawton scale, respectively. PVD was diagnosed using the ankle brachial index (ABI). RESULTS Controls without PVD were age- and sex-matched with 57 patients with both dementia and PVD and with 69 patients without dementia. The patients with PVD in both groups had lower mean BALD scores. Adjusting for age, clinical dementia rating, and depression, PVD was associated with a higher likelihood of being in the quartiles of lower BADL scores in those with dementia (p=0.020). Adjusting for age, sex, Mini-Mental State Examination (MMSE) score, depression, and comorbidity and drug counts among the patients without dementia, a significant association was observed with PVD and a higher likelihood of being in the quartiles of lower BADL scores (p=0.044). PVD was related to a higher likelihood of being in the quartiles of lower IADL scores in the non-dementia subjects (p=0.001) after adjusting for age, depression, MMSE, education, and comorbidity count. CONCLUSION PVD presence determined the poorer status of BADL in demented individuals but not of the level of IADL. It is still unclear whether modifying PVD health risks and undergoing ABI screening may help demented people become more independent.
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Durak A, Safer U. Comment on "Sarcopenia as a Predictor of Survival in Patients with Pancreatic Adenocarcinoma After Pancreatectomy". Ann Surg Oncol 2022; 29:3515-3516. [PMID: 35294654 DOI: 10.1245/s10434-022-11366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
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Sevindik Günay D, Safer U, Binay Safer V. Comment on "Effects of adequate dietary protein with whey protein, leucine, and vitamin D supplementation on sarcopenia in older adults: An open-label, parallel-group study". Clin Nutr 2021; 41:583-584. [PMID: 34998614 DOI: 10.1016/j.clnu.2021.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/13/2021] [Indexed: 11/03/2022]
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Binay Safer V, Tasci İ, Safer U. Comment on "Sarcopenia: An important prognostic factor for males treated for a locally advanced esophageal carcinoma". Dig Liver Dis 2020; 52:1374-1375. [PMID: 32891546 DOI: 10.1016/j.dld.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/04/2020] [Indexed: 12/11/2022]
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Binay Safer V, Tasci I, Safer U. Letter to the Editor Regarding "Effect of Sarcopenia on Mortality After Percutaneous Vertebral Augmentation Treatment for Osteoporotic Vertebral Compression Fractures in Elderly Patients: A Retrospective Cohort Study". World Neurosurg 2020; 139:710. [PMID: 32689695 DOI: 10.1016/j.wneu.2020.04.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 01/14/2023]
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Binay Safer V, Safer U. Comment on "The effect of sarcopenia on perioperative complications in abdominally based free-flap breast reconstruction". J Surg Oncol 2020; 122:1827-1828. [PMID: 32959384 DOI: 10.1002/jso.26201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 11/07/2022]
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Binay Safer V, Tasci I, Safer U. Comment on article by Abe et al. Geriatr Gerontol Int 2020; 20:797-798. [PMID: 32743921 DOI: 10.1111/ggi.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/28/2022]
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Safer U, Tasci I, Safer VB. Letter to the Editor Regarding "Temporal Muscle as an Indicator of Sarcopenia Is Independently Associated with Hunt and Kosnik Grade on Admission and the Modified Rankin Scale Score at 6 Months of Patients with Subarachnoid Hemorrhage Treated by Endovascular Coiling". World Neurosurg 2020; 139:659. [PMID: 32689667 DOI: 10.1016/j.wneu.2020.03.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 11/29/2022]
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Binay Safer V, Tasci I, Safer U. Comment on "Usefulness of Platelet-To-Lymphocyte Ratio as a Marker of Sarcopenia for Critical Limb Threatening Ischemia". Ann Vasc Surg 2020; 68:e583-e584. [PMID: 32603843 DOI: 10.1016/j.avsg.2020.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/29/2022]
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Binay Safer V, Tasci I, Safer U. Crohn's disease, visceral obesity and sarcopenia. Clin Nutr 2020; 39:2315-2316. [PMID: 32536584 DOI: 10.1016/j.clnu.2020.05.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
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Safer U, Tasci I, Binay Safer V. Cirrhosis, hepatocellular carcinoma, and sarcopenia. Clin Nutr 2020; 39:2636-2637. [PMID: 32540182 DOI: 10.1016/j.clnu.2020.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/21/2020] [Indexed: 11/19/2022]
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Binay Safer V, Tasci I, Safer U. Amount of laryngeal upward movement and pharyngeal area as indicators of decreased swallowing muscle function in sarcopenia. J Oral Rehabil 2020; 47:1577-1578. [PMID: 32478868 DOI: 10.1111/joor.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/24/2020] [Indexed: 12/01/2022]
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Başgöz B, İnce S, Safer U, Naharcı Mİ, Taşçı İ. Low bone density and osteoporosis among older adults with Alzheimer's disease, vascular dementia, and mixed dementia: A Cross-sectional Study With Prospective Enrollment. Turk J Phys Med Rehabil 2020; 66:193-200. [PMID: 32760897 PMCID: PMC7401688 DOI: 10.5606/tftrd.2020.3803] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/27/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES This study aims to examine bone mineral density (BMD) and osteoporosis in older adults with dementia compared to those with a normal cognitive status and to evaluate the type, severity, and duration of dementia. PATIENTS AND METHODS Between May 2013 and May 2017, a total of 363 participants aged ≥65 years (136 males, 227 females; mean age 78.4±5.4 years; range 66 to 99 years) with and without Alzheimer's disease (AD), vascular dementia (VaD), or mixed dementia (AD-VaD) were included in this single-center, prospective, cross-sectional study. The dementia group included 93 patients with dementia and the control group included 270 age- and sex-matched healthy individuals. We used dual-energy X-ray absorptiometry (DXA) to measure BMD of the lumbar spine, total hip, and femoral neck. RESULTS Controlled for age and sex, demented and non-demented participants had a similar BMD (g/cm2) at lumbar spine [F (1, 358):0.83, p=363], but lower BMD values of total hip [F (1, 359):10.26, p=0.001] and femoral neck [F (1, 359):15.21, p<0.001] in the patients with dementia. Adjusted percentage of osteoporosis and low bone mass based on total hip and femoral neck T-scores were also significantly higher in the patient group. The mean BMD values, frequency of osteoporosis, and low bone mass did not significantly differ according to the subtype of dementia, sex, and disease duration or severity. CONCLUSION Our study results show that demented elders have a lower BMD and higher frequency of osteoporosis at the hip, but not at the lumbar spine, irrespective of sex and type of dementia. Based on these results, we can speculate that not only AD, but also VaD and AD-VaD may be associated with bone loss at the hip.
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Tasci I, Basgoz BB, Cintosun U, Safer U, Naharci MI. Age at First Osteoporosis Screening Among Older Women and Men: Is Bone Mineral Density Measurement Ordered Timely? Endocr Metab Immune Disord Drug Targets 2020; 19:534-540. [PMID: 30585552 DOI: 10.2174/1871530319666181226125756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/09/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND US National Osteoporosis Foundation has specified age cut-offs for osteoporosis screening in older women and men. OBJECTIVE In this study, we investigated whether Turkish seniors undergo their first ever osteoporosis screening early, on time or late. METHODS We determined the age of older women and men at their first-time Bone Mass Densitometry (BMD) testing using the medical records of a geriatric outpatient unit. The timing of the BMD test was considered ''late'' when performed after the age of 65 and 70 in women and men, respectively. An "early" screening was defined as having a BMD measurement before these age cut-offs. RESULTS We included 481 individuals in the study (mean age: 74.5±6.5 years, women: 62%). On admission, around 18% of the sample could give no definite information and another 35% had never been assessed for osteoporosis. Among those with a past screening, 64.8% reported comorbid osteoporosis and 33% reported no osteoporosis. Mean age of the first-time BMD measurement was 67.4±7.7 years. The first-time BMD measurement was on time in 9.7%, early in 37.4% and late in 52.9% of the subjects. Half of the individuals with a self-reported osteoporosis diagnosis were non-osteoporotic on a new BMD ordered following the geriatric assessment. Multimorbidity (≥3), parental hip fracture, and smoking were the independent predictors of being early screened. CONCLUSION We found two-thirds of women and men unscreened for osteoporosis despite being indicated by age. Early and late screening were both prevalent. Self-reported osteoporosis diagnosis was mostly inconsistent with BMD testing in our sample.
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Binay Safer V, Safer U. Comment on "Clinical characteristics of aneurysmal subarachnoid hemorrhage (SAH) in the elderly over 75: Would temporal muscle be a potential prognostic factor as an indicator of sarcopenia?". Clin Neurol Neurosurg 2019; 188:105600. [PMID: 31756615 DOI: 10.1016/j.clineuro.2019.105600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
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Safer VB, Safer U. Comment on "Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach". J Surg Oncol 2019; 120:1508. [PMID: 31646645 DOI: 10.1002/jso.25745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/07/2019] [Indexed: 01/21/2023]
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Safer U, Safer VB. The Association of Sarcopenia and Bone Mineral Densitometry in a Small Population of Turkish Elderly (P21-048-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz041.p21-048-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Mortality rate of hip fracture is 18%-33% in following year. Epidemiological studies showed that sarcopenia is associated with mortality, morbidity and functional loss. Little is known about sarcopenia diagnostic criteria (ESPEN 2009) and bone mineral densitometry (BMD) scores in Turkish Elderly Population.
Methods
In this single centered observational study, elderly patients without cognitive impairment underwent assessment. Demographic features, mini nutrition assessment- sort form (MNA-sf) score, BMD, hand grip strength, 5 meter walking speed, skeletal muscle mass(SMM) and skeletal muscle mass index (SMM/Height 2) were recorded. We assessed sarcopenia criteria and BMD score relation.
Results
Forty-seven patients were fulfills inclusion criteria and underwent assessment. Mean age was 75.7661.03 and 63.8% were female. Three of all were sarcopenic according to ESPEN 2009 guidelines. 83% were normal and 17% were at malnutrition risk according to MNA-sf score. Hand grip straight (r¼0.286, p¼0.05) and SMM (r¼0.38, p¼0.011) were significantly positive correlates with femur total T score but there were no correlations between SMM index and 5 meters walking speed.
Conclusions
This preliminary study showed relations between skeletal muscle mass, hand grip strength and femur total BMD score in a small Turkish Elderly Patients Population. Sarcopenia and osteoporosis relation in Turkish Population should be assessed in multicentre large population-based study.
Funding Sources
Conflict of Interest: No conflict of interest, Fund: None.
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Tasci I, Safer U, Naharci MI. Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Diabetes Ther 2019; 10:1005-1018. [PMID: 30924077 PMCID: PMC6531590 DOI: 10.1007/s13300-019-0602-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Undernutrition is prevalent in older age. Current management of type 2 diabetes mellitus (T2DM) requires modified diet patterns; however, older adults with diabetes may also be at the risk of undernutrition due to age, disease, and medication-related factors. Our objectives in this study were to examine the proportion and associations of undernutrition among community-dwelling older adults with T2DM. METHODS This prospective, cross-sectional study involved older outpatient adults (≥ 65 years) with and without T2DM. We assessed the nutritional status using the Mini Nutritional Assessment-Short Form. Undernutrition referred to being either at risk of malnutrition or malnourished. Variables independently associated with undernutrition were evaluated by logistic regression analysis. RESULTS Five hundred forty-six older adults [n = 215 with T2DM and n = 331 control; mean (SD) age, 74.9 (6.3) years; 388 (71.1%) female] were included in the study. The frequency of undernutrition was 31.1%, which was higher in patients with T2DM than in those without (36.7% vs. 27.5%, p < 0.05). However, the difference was no longer significant after adjustment for covariates (gender, lower education, lower body mass index, cardiovascular disease, multimorbidity, cognitive performance, functional performance, depressive symptoms, and polypharmacy). In the T2DM group, the ratio of multiple antihyperglycemic drug use (≥ 2) was higher in those with undernutrition compared with normal nutritional status (78.5% vs. 59.6%, p = 0.005). On multivariable analysis, decreased functional performance, depressive symptoms, and use of multiple antihyperglycemic drugs were associated with undernutrition in patients with T2DM. CONCLUSIONS Undernutrition was more common among older adults with T2DM compared with the control group. Undernutrition was further dependent on chronic conditions and diabetes management.
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Binay Safer V, Yılmaz F, Safer U. Sarcopenia and heart valve surgery. J Thorac Cardiovasc Surg 2019; 157:e199. [PMID: 30901807 DOI: 10.1016/j.jtcvs.2018.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 10/27/2022]
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