[The application of continuous glucose monitoring in the management of hepatic glycogen storage disease]

Objective: Continuous glucose monitoring (CGM) were performed in children with hepatic glycogen storage disease (GSD) to accurately understand the situation of glucose levels during their treatment, and to provide support for optimizing their nutritional management. Methods: In this retrospective research, 42 patients with hepatic GSD who under went 72 h CGM were collected from Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from October 2019 to January 2020. According to the genetic test results, they were divided into 5 groups: type Ⅰa, type Ⅰb, type Ⅲa, type Ⅵ and type Ⅸa. After long-term follow up and regular treatment, the clinical data (induding course, age, height, weight and biochemical parameters, etc.) on the day of CGM were summarized, and 72 h CGM were performed to assess the occurrence of hypoglycemia and hyperglycemia.χ² test, Fisher exact probability method, t test, analysis of variance or nonparametric test were used for comparison between groups. Results: Forty-two cases of hepatic GSD patients included 25 males and 17 females (20 cases of type Ⅰa, 3 cases of type Ⅰb, 10 cases of type Ⅲa, 3 cases of type Ⅵ and 6 cases of type Ⅸa).The age was 9.5 (6.7, 12.9) years, and the course of disease was 6.8 (5.1, 11.3) years. The average levels of glucose of the patients were all normal. However, the levels of standard deviation of blood glucose (SDBG) and mean amplitude of glycemic excursion (MAGE) were significantly different (F=2.747, 3.029,both P<0.05). Among them, the SDBG of type Ⅰa and Ⅲa were significantly higher than those of type Ⅸa ((1.10±0.36), (0.98±0.30) vs. (0.62±0.26) mmol/L, t=3.010, 2.440, both P<0.05), while the MAGE of type Ⅰ was higher than that of Ⅸa and Ⅲa ((2.3±0.9) mmol/L vs. (1.2±0.6) and (1.7±0.6) mmol/L, t=2.734, 2.302, both P<0.05, respectively). Conclusions: CGMS can accurately assess the fluctuations of blood glucose and effectively detect hidden hypoglycemia and hyperglycemia in hepatic GSD patients. For different types of hepatic GSD, individualized corn starch treatment doses should be given according to the different situation of blood glucose, so as to optimize the patient's treatment and improve their prognosis.

Long noncoding RNA SLC30A10 promotes colorectal tumor proliferation and migration via miR-21c/APC axis

OBJECTIVE

Colorectal cancer is a common malignancy and a common cause of tumor-related death. Long non-coding RNAs (lncRNAs) have become an important regulatory factor and tissue specific biomarker for a variety of cancers, including colorectal cancer. Recent evidence indicates that the novel lncRNA SLC30A10 plays an important role in tumor progression and metastasis. However, its role and molecular mechanisms in colorectal cancer are unclear.

PATIENTS AND METHODS

SLC30A10 expression was detected in 12 colorectal cancer and adjacent normal tissues by quantitative reverse transcription PCR. Insights into the underlying mechanisms of competitive endogenous RNAs (ceRNAs) were determined by transwell assay, CCK8 assay, and luciferase assay.

RESULTS

SLC30A10 was down-regulated in colorectal cancer tissues and cell lines, and its low expression was positively correlated with colorectal cancer progression and metastasis. Functionally, SLC30A10 depletion promotes cell proliferation and migration in colorectal cancer cells, while SLC30A10 overexpression has the opposite effect. Bioinformatics prediction and luciferase assay indicated that miR-21c is a direct target of SLC30A10, which plays the role of ceRNA in regulating colorectal cancer metastasis. In addition, miR-21c specifically targets APC gene.

CONCLUSIONS

Our findings suggest that reduced expression of SLC30A10 is associated with aggressive tumor phenotypes and poor patient outcomes in colorectal cancer. SLC30A10 inhibits colorectal cancer progression and metastasis by acting as a ceRNA for miR-21c to regulate APC expression, suggesting that SLC30A10 may serve as a potential prognostic biomarker and anti-metastatic therapeutic target for colorectal cancer.

Cohort Profile: West China Health and Aging Trend (WCHAT)

OBJECTIVES

The West China Health and Aging Trends study (WCHAT) is intended to focus on the research that will guide efforts to reduce disability, maximize health and independent functioning, and enhance quality of life at older ages in different ethnicities. And provide the basis for understanding trends and dynamics in late-life functioning, how these differ in various ethnic subgroups, and the economic or social consequences of aging and disability in western China.

PARTICIPANTS

The cohort enrolled 7536 participants and 7439 participants aged 50 years and older in the baseline in 2018 and every year would be followed up. Finding to date: The data in WCHAT were prospectively collected from Yunnan, Guizhou, Sichuan and Xinjiang by 7 medical institutions. A number of age-related outcome measures were collected though corresponding geriatric assessments. Blood testing, saliva, urine and feces testing are available for all cohort participants. Future plans: The data in WCHAT can be used for various types of epidemiological research, particularly for examining how the culture specific life styles and diet influences geriatrics related outcomes. We are initially planning cohort studies and established a sample biobank in relation to the risk and prognosis of frailty, sarcopenia and other geriatric syndromes. Strengths and limitations of this study: It is a first multi-ethnic cohort study in West China that aimed to investigate the influence of culture specific life styles, diet and living environment on the prevalence of geriatric syndromes like frailty, sarcopenia and so on. This is a prospective multi-center observational study, which will be conducted in various ethnic groups gathering places. This study collected information that related to fatigue, falls, and cognition were obtained through self-reports, which might have recall bias and grouping errors. This study has problems such as the interviewees' refusal to visit, death, going out, and large population mobility may lead to high loss of visit rates. This study collected information from a comparatively healthier elderly population in which external validity was limited.

The Relationship between Sarcopenia and Vitamin D Levels in Adults of Different Ethnicities: Findings from the West China Health and Aging Trend Study

OBJECTIVES

Sarcopenia is a condition associated with progressive loss of skeletal muscle mass and function resulting in substantial negative health outcomes and disability in older adults. It is thus important that sarcopenia-related risk factors be explored. The present study was based upon the Asian Working Group on Sarcopenia 2019 (AWGS2019) criteria to assess whether vitamin D levels are a risk factor associated with sarcopenia in various ethnic groups in western China.

DESIGN

Cross-sectional study.

SETTING

Communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

PARTICIPANTS

We included 4236 individuals that were 50 years of age or older from the West China Health and Aging Trend (WCHAT) study.

MEASUREMENTS

An InBody 770 instrument was used for bioimpedance-based analyses of muscle mass, while a digital grip strength dynamometer was used for handgrip strength-based measurements of muscle strength. Physical performance was assessed based upon gait speed over 4 m. Other secondary variables were additionally analyzed as potentially relevant risk factors.

RESULTS

Sarcopenia affected an estimated 22.45% of studied individuals who were 50 years of age or older, with respective prevalence rates in the < 60, 60-64, 65-79, and ≥80 age groups of 11.78%,19.44%, 32.65%, and 67.97%. Rates in males and females were 26.66% and 20.05%, respectively. In males, a significant difference in vitamin D levels was detected when comparing individuals with and without sarcopenia, although no such relationship was detected in females. Following adjustment for confounding variables, binary logistic regression analyses revealed that inadequate vitamin D was able to independently predict sarcopenia risk only in males (OR=1.875,95%CI: 1.109-3.169, P=0.019).

CONCLUSIONS

Among middle-aged and older adults of multiple ethnicities in western China, we found that inadequate vitamin D was an independent predictor of sarcopenia risk specifically in males.

Associations of Body Mass Index, Visceral Fat Area, Waist Circumference, and Waist-to-Hip Ratio with Cognitive Function in Western China: Results from WCHAT Study

OBJECTIVES

This study examined the relationship between cognitive performance and obesity parameters, such as body mass index (BMI), visceral fat area (VFA), waist circumference (WC), and waist-to-hip ratio (WHR) in western China.

STUDY DESIGN

A cross-sectional study.

METHODS

3914 participants, aged ≥50 years, were recruited in this study. Anthropometrics measurements, life-style factors, chronic disease comorbidities, and sleep qualities were recorded for each participant. Among the anthropometrics, BMI, WC, and WHR were assessed using standard procedures, while VFA was calculated using bioelectrical impedance analysis. Cognitive performance was estimated using the Short Portable Mental Status Questionnaire (SPMSQ). Finally, relationships between cognitive abilities and BMI, VFA, WC, and WHR were evaluated using univariate and multivariate regression analyses.

RESULTS

Cognitive decline (CD) occurred at a rate of 13.29% among the 3914 participants. A strong correlation was observed between cognitive abilities and BMI of male patients aged 50-59 yrs (OR 1.116,95% CI1.002-1.242), in the adjusted model. Alternately, WHR was shown to be significantly related to CD in females aged ≥70 years (OR 0.041, 95% CI0.002-0.671). WC was shown to have a strong association with CD in males (OR 1.023,95% CI1.003-1.024). Lastly, WHR was closely connected to CD in participants with BMI < 25 kg/m2 (OR 0.022,95% CI0.002-0.209).

CONCLUSIONS

Our findings suggest that a higher middle age BMI is associated with CD, whereas, in the elderly population, a higher WHR is related to improved cognitive performance. Further investigation is warranted to elucidate a relationship between VFA and CD.

The Role of Baseline Sarcopenia Index in Predicting Chemotherapy-Induced Undesirable Effects and Mortality in Older People with Stage III or IV Non-Small Cell Lung Cancer

OBJECTIVES

To assess the predictability value of Sarcopenia index( (SI, serum creatinine value/cystatin C value×100) in determining potential chemotherapy-induced undesirable reactions and eventual death of older patients diagnosed with stage III or IV of non-small cell lung cancer (NSCLC).

METHODS

General information was retrieved from health records and mortality data was obtained by phone interview. Serum Cr and CysC levels were measured before chemotherapy. The endpoints recorded were chemotherapy-induced undesirable reactions and mortality from any causes. Logit regression analysis was employed for the analysis of correlation between the SI and short-term adverse reactions to chemotherapy. Cox regression analysis was employed to analyze correlation between the SI and mortality.

RESULTS

In this study, 664 NSCLC patients were enrolled. Among them, 83.13% were diagnosed with adenocarcinoma lung cancer and 16.87% with squamous cell carcinoma lung cancer. As of March 1, 2019, 486 patients died, including 361(74.28%) males and 125 (25.72%) females. After the first course of chemotherapy, the proportion of short-term adverse reactions, including bone marrow suppression, digestive reactions, all infection, liver function impairment, and other adverse reactions (non-infectious fever or rashes) was 16%, 4.7%, 7.4, %, 6.6%, and 2.11%, respectively. After adjusting for confounding factors, there was no association between the SI and adverse reactions. We found that high SI was independently associated with a lower risk of mortality after adjusting for confounding factors in females (HR=0.593,95% CI: 0.382-0.92; p=0.02). There was no marked association existed between the SI and mortality in males.

CONCLUSION

Among patients with stage III or IV non-small cell lung cancer, the SI is associated with mortality in females, but not in males.

Comorbid Depressive Symptoms, Visual Impairment, and Sarcopenia among Middle-Aged and Older Women: Findings from the West China Health and Aging Trend study

Previous reports have described close relationships between sarcopenia and either visual impairment or depression, but there have been few analyses investigating the association between sarcopenia and the coexistence of both visual impairment and depression. Herein, we sought to explore the associations between sarcopenia and comorbid depressive symptoms and visual impairment among older females. A cross-sectional analysis of females between the ages of 50 and 95 (n = 2454) from the West China Health and Aging Trend (WCHAT) study was conducted. Patient muscle mass was assessed via a bioimpedance-based approach using an InBody 770 device, while muscle strength was estimated based on handgrip strength as quantified with a digital grip strength dynamometer. Depressive systems were evaluated with the 15-item Geriatric Depression Scale (GDS-15), and a questionnaire was employed to evaluate patient visual functionality. Associations between sarcopenia and comorbid depressive status and visual impairment were explored through logistic regression analyses. Comorbid depressive symptoms and visual impairment were observed in 6.2% of the women included in this study, while 18.9% suffered from sarcopenia. Following adjustment for covariates, relative to normal controls, study subjects with only depression (OR=1.45, 95%CI=1.04-2.02), only visual impairment (OR=1.69, 95%CI=1.27-2.26), or comorbid depression and visual impairment (OR=1.76, 95% CI=1.16-2.67) exhibited a higher risk of sarcopenia. These results suggest that comorbid depression and visual impairment are linked to the prevalence of sarcopenia in older Chinese women. As such, further efforts to screen older women for these two comorbid conditions may thus be necessary.

The Relationship between Pre-Admission Waiting Time and the Surgical Outcomes after Hip Fracture Operation in the Elderly

OBJECTIVES

To investigate the association between pre-admission waiting time and postoperative complications, length of stay (LOS), and costs during hospitalization.

METHOD

This was a single-center, observational study. The subjects of this study were elderly hip fracture patients who were admitted to the Department of Orthopedics, West China Hospital, Sichuan University, from December 2010 to June 14, 2017, and that underwent internal fixation or joint replacement surgery. The pre-admission waiting time was treated as a categorical variable according to median and first quartile values. Outcomes included postoperative complications (pneumonia and other complications [urinary tract infection, heart failure, non-A-grade healing]), LOS, and costs during hospitalization. LOS and costs during hospitalization were converted into binary outcomes based upon median values. Binary logistic regression analyses were used to analyze correlations between pre-admission waiting time and patient outcomes.

RESULTS

A total of 889 patients 60 years of age and older were enrolled in this study, of whom 65.47% were females and 34.53% were males. The proportion of patients with pre-admission waiting times less than 8 h, 8 - 24 h, and ≥ 24 h were 24.3%, 17.32%, and 58.38%, respectively. Postoperative pneumonia and other complications affected 12.04% and 6.30% of patients, respectively. Relative to patients with the pre-admission waiting times of less than 8 h, those with longer pre-admission waiting times exhibited a higher risk of postoperative pneumonia (8 - 24 h: OR = 2.72,95% CI: 1.29-5.74, p = 0.009; ≥ 24 h: OR = 2.76,95% CI: 1.48-5.14, p = 0.001). Patients with the pre-admission waiting time ≥ 24 h also exhibited a higher risk of the other complications (OR = 2.55, 95% CI: 1.53-4.26, p <0.001), a longer LOS (OR = 1.43, 95% CI:1.02-2.01, p = 0.036), and higher costs during hospitalization (OR = 1.51, 95% CI:1.05 - 2.17, p = 0.026) relative to patients with a waiting time less than 8 hours.

CONCLUSION

Pre-admission waiting time was associated with postoperative complications, LOS, and hospitalization costs among older Chinese patients undergoing surgery to treat hip fractures.

The Combined Effect of Hearing Impairment and Cognitive Impairment with Health-Related Outcomes in Chinese Older People

OBJECTIVES

To determine the risk of poor health-related outcomes in older adults with cooccurring hearing impairment and cognitive impairment, and to compare the risk of hearing impairment only, cognitive impairment only, and multiple morbidities.

DESIGN

Cross-sectional study.

SETTING

Community-dwelling older adults aged 60 years and older were included.

PARTICIPANTS

The data of missing hearing and cognitive status were excluded, and 3770 older people participated in the study.

MEASUREMENTS

The hearing function evaluation was conducted by questionnaire survey. Assessment of cognitive function was completed using the SPMSQ scale. The subjects were divided into hearing impairment and cognitive impairment group, hearing impairment only group, cognitive impairment only group and neither group. Multiple logistic regression was used to analyze the risks of hearing and cognitive impairment and health-related condition.

RESULTS

The prevalence of hearing impairment and cognitive impairment, hearing impairment only, cognitive impairment only, and neither were 9.4%, 8.3%, 29.9% and 52.4%, respectively. Compared with the control group, the individuals with hearing impairment and cognitive impairment were associated with depression (OR=3.48, 95% CI=2.66, 4.56), anxiety (OR=2.35, 95% CI=1.92, 3.33), frailty (OR=4.30, 95% CI=2.89, 6.40), and ADL impairment (OR=2.77, 95% CI=2.03, 3.77).

CONCLUSION

The studies shows that hearing impairment combined with cognitive impairment is significantly associated with anxiety, depression, frailty, and ADL impairment. Comprehensive management and intervention should be provided for older people to reduce the occurrence of adverse health consequences.

Analysis of the Prevalence of Sarcopenia and Its Risk Factors in the Elderly in the Chengdu Community

OBJECTIVE

To understand the prevalence of sarcopenia in the Chengdu community, analyze the risk factors of sarcopenia, and provide a theoretical basis for further development of strategies for sarcopenia prevention and treatment.

METHODS

A total of 938 individuals aged 60 years and above were recruited from the community of Chengdu. Skeletal muscle mass was measured by the bioelectrical impedance analysis (BIA), and sarcopenia was diagnosed according to the Asian Sarcopenia Working Group (AWGS) 2019 diagnostic criteria. A scale was generated to determine the age, living habits, and chronic diseases of enrolled subjects. The Mini Mental Examination Scale (MMSE) was used to assess their cognitive function, and the Geriatric Depression Scale (GDS-15) was used to identify depression.

RESULTS

Among the 938 residents enrolled in the study, 172 (18.34%) had sarcopenia, including 48 (5.12%) with severe sarcopenia. The prevalence of sarcopenia in males was 19.91% and 16.81% in females. According to the binary logistic regression, older age (OR = 1.104, 95%CI: 1.059-1.151) and impaired cognitive function (OR = 2.251, 95%CI: 1.145-4.424) were independent risk factors for sarcopenia in females. Among the males, older age (OR = 1.079, 95%CI: 1.037-1.124) was the independent risk factor for sarcopenia. A moderate increase in BMI reduced the prevalence of sarcopenia in both females and males. Multi-category logistic regression analysis documented that females of older age were more likely to develop severe sarcopenia (χ2 = 16.769, P < 0.01 vs. no sarcopenia), females with lower BMI were more likely to develop severe sarcopenia (χ2 = 13.654, P < 0.01 vs. no sarcopenia), females with heart disease were more likely to develop severe sarcopenia (χ2 = 5.786, P = 0.016 vs. no sarcopenia; χ2 = 5.791, P = 0.016 vs. non-severe sarcopenia), and females with impaired cognitive function were more likely to develop severe sarcopenia (χ2 = 13.381, P < 0.01 vs. no sarcopenia; χ2 = 7.529, P = 0.006 vs. non-severe sarcopenia). Males were more likely to develop severe sarcopenia with older age (χ2 = 18.435, P < 0.01 vs. no sarcopenia; χ2 = 9.8011, P=0.002 vs. non-severe sarcopenia), lower BMI (χ2 = 12.736, P < 0.01 vs. no sarcopenia), smoking (χ2 = 4.68, P = 0.031 vs. no sarcopenia; χ2 = 5.652, P = 0.017 vs. non-severe sarcopenia), and chronic obstructive pulmonary disease (COPD) (χ2 = 5.517, P = 0.019 vs. no sarcopenia).

CONCLUSION

In the Chengdu community, the prevalence of sarcopenia among individuals 60 years of age or older was higher in males than in females. In elderly females, older age and impaired cognitive function were independent risk factors for sarcopenia. Women with more advanced age, decreased BMI, heart disease, and impaired cognitive function were more likely to develop severe sarcopenia. In elderly males, increased age was an independent risk factor for sarcopenia, and older age, decreased BMI, smoking, and COPD increased the probability of developing severe sarcopenia.

Combined Effect of Osteoporosis and Poor Dynamic Balance on the Incidence of Sarcopenia in Elderly Chinese Community Suburban-Dwelling Individuals

OBJECTIVES

Given the increasing prevalence of osteoporosis and the important role dynamic balanced plays in the assessment of muscle function, we aimed to examine the joint and separate effects of osteoporosis and poor dynamic balance on the incidence of sarcopenia in Chinese elderly individuals.

DESIGN

This study was conducted on 658 (44.4% male) Chinese suburban-dwelling participants with a mean age of 68.42 ± 5.43 years who initially had no sarcopenia and were aged ≥60 years. A quantitative ultrasound scan of each participant's calcaneus with a T score less than -2.5 was used to identify the prevalence of osteoporosis. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria. We assessed dynamic balance using the Timed Up and Go Test (TUGT). Participants who scored in the top 20% on the TUGT were defined as having poor dynamic balance.

RESULTS

After a follow-up of three years, the incidence of sarcopenia in the general population was 8.1% (9.6% in males, 6.8% in females). The incidence of sarcopenia was progressively greater in people suffering from both osteoporosis and poor dynamic balance (OR=2.416, 95%CI=1.124-5.195) compared to those who only had osteoporosis (OR=0.797, 95%CI=0.378-1.682) or poor dynamic balance (OR=1.226, 95%CI=0.447-3.363) in models without adjustments. Even after adjusting for potential confounders, the result still held true (OR=2.431, 95%CI=1.053-5.614).

CONCLUSIONS

In our study, we found individuals who suffered from both osteoporosis and poor dynamic balance simultaneously had a significantly higher incidence of sarcopenia than those who suffered from either one or the other.

Sensory Impairment and All-Cause Mortality Among the Oldest-Old: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

OBJECTIVES

To investigate the association between sensory impairment and all-cause mortality among the oldest-old (aged 80 and older) in China.

DESIGN

Prospective cohort study.

SETTING

Community-based setting in 22 provinces of China.

PARTICIPANTS

A total of 8788 older adults aged 80 and over at baseline with complete hearing and vision function data were included as the study population.

MEASUREMENTS

Sensory impairment was categorized as no sensory impairment, hearing impairment (HI) only, vision impairment (VI) only and dual sensory impairment (DSI) according to hearing and vision function. Deaths were identified through interviews by close family members. Cox proportion hazards regression models were used to examine the association of sensory impairment with mortality, adjusting for socio-demographic data, life style factors and health status.

RESULTS

The mean age was 92.3 ± 7.6 years old, and 60.1% of participants were female. Among 8788 participants, 9.8% were recognized as DSI, 9.7% were HI only and 10.4% with VI only. Comparing with participants with no sensory impairment, those with VI only (HR=1.10, 95% CI=1.01-1.20) and DSI (HR=1.21, 95% CI=1.09-1.35) were significantly associated with higher risk of all-cause mortality in the fully adjusted model.

CONCLUSION

Our results demonstrated that VI only and DSI were significantly associated with higher risk of mortality among Chinese older adults aged 80 and over. The finding advocated that it is necessary to identify and manage sensory impairments for the advanced ages to reduce mortality risks.

Ethnic Groups Differences in the Prevalence of Sarcopenia Using the AWGS Criteria

OBJECTIVES

To estimate the prevalence of sarcopenia in different ethnic groups and the association with cultural life styles in west China.

DESIGN

A cross-sectional study.

SETTINGS

The communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

PARTICIPANTS

4500 participants aged 50 years or older in west China were enrolled in this study. Sarcopenia was defined according to the diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS).

MEASUREMENTS

We measured gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA) for all eligible participants. Life-style information were collected by reviewers. Relationships between sarcopenia and ethnic groups were analyzed using univariate and multivariate analyses.

RESULTS

We found 869 (19.31%) adults aged 50 years old or older were sarcopenia. The mean age is 62.4±8.3 years. The main ethnic groups enrolled in this study is Han, Tibetan, Qiang, Yi and Hui. The crude prevalence of sarcopenia is 22.3% in Han, 18.2% in Tibetan, 11.8% in Qiang, 34.7% in Yi and 26.7% in Hui. Compared to Han, after adjusting sex and age, Qiang has a lower prevalence of sarcopenia (odds ratio [OR]: 0.44, 95% CI 0.35-0.55), Yi has a higher prevalence of sarcopenia (OR: 1.78, 95% CI 1.29-2.43). While adding adjusting other potential cofounders, sarcopenia is still less prevalent in Qiang (OR: 0.44, 95% CI 0.34-0.57).

CONCLUSIONS

The crude prevalence of sarcopenia is 22.3% in Han, 18.2% in Tibetan, 11.8% in Qiang, 34.7% in Yi and 26.7% in Hui. Sarcopenia was less prevalent in Qiang compared with Han. Further studies to determine related factors of sarcopenia among different ethnic groups are recommended.

Prevalence and Risk Factors Governing the Loss of Muscle Function in Elderly Sarcopenia Patients: A longitudinal Study in China with 4 Years of Follow-Up

OBJECTIVES

Data regarding the occurrence of risk factors that promote the loss of muscle mass, strength and function in sarcopenia patients in elderly Chinese patients are sparse. Here, we investigated the alterations in muscle mass, function and strength in those with sarcopenia over a 4-year period. We further evaluated the risk factors leading to a loss of grip strength, gait speed and skeletal muscle mass index in sarcopenia patients.

DESIGN

A face-to-face cross-sectional survey.

SETTING AND PARTICIPANTS

The study population consisted of 560 Chinese aged over 59 years.

MEASUREMENTS

Study recordings took places over a four-year period from 2014. Muscle mass was assessed through bioelectrical impedance analysis (BIA) performed on an Inbody720, Biospace. Hand-grip strength and 6 m walking speed were used as measurements of muscle strength and function. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria (AWGS).

RESULTS

In total, 474 of the elderly residents completed the follow-up. The rates of decreased ASMI, grip strength, and gait speed in the sarcopenia patients increased over the 4-year period. Following multivariate analysis, age was identified as the main risk factor for all the observed decrease, gender was specifically related to the loss of ASMI, stroke was a risk factor for gait speed and sarcopenia. A high BMI was a risk factor for a low gait speed but was protective for a loss of skeletal muscle mass and sarcopenia.

CONCLUSIONS

Age leads to a decline in muscle strength and function. In elderly Chinese patients with sarcopenia, the rates of reduced grip strength, gait-speed and sarcopenia increased. A high BMI was protective against the decline in muscle mass and sarcopenia, but represented a risk factor for low gait speed. Stoke was identified to cause a loss of gait speed in sarcopenia patients.

Association Between Number of Teeth, Denture Use and Frailty: Findings from the West China Health and Aging Trend Study

OBJECTIVE

Frailty and poor oral health are both common age-related conditions. However, the association between oral health and frailty has not been explored thoroughly among older Chinese adults. We aimed to investigate the associations between number of teeth, denture use, and frailty among older adults in western China.

DESIGN

Cross-sectional study.

SETTING

Community-based.

PARTICIPANTS

Participants were 4037 community-dwelling individuals aged 60 and older from the West China Health and Aging Trend (WCHAT) study.

MEASUREMENTS

Frailty was assessed using the physical frailty phenotype (PFP) and categorized as non-frail, prefrail and frail. In addition, number of teeth and denture use were examined by calibrated dentists. Multinomial logistic regression models were performed to examine the association between number of teeth, denture use, and frailty.

RESULTS

The overall prevalence of frailty was 6.7% among 4037 participants aged 60 and older in western China. Participants with no more than 20 teeth were associated with higher odds of being prefrail or frail whether wearing dentures or not. Denture using could not help lower the odds of being prefrail or frail for older adults with fewer teeth.

CONCLUSIONS

This study suggested that frailty was associated with having fewer teeth (≤20 teeth) among older Chinese adults. Future research involving targeted interventions addressing number of teeth may help provide information to establish effective strategies for frailty prevention in older adults.

Sarcopenia, Obesity and Sarcopenia Obesity in Comparison: Prevalence, Metabolic Profile, and Key Differences: Results from WCHAT Study

OBJECTIVE

To identify the prevalence, lifestyle factors, chronic disease status, and assessing the metabolic profile, comparing key differences in a cohort of subjects with non-sarcopenia/non-obesity (H), sarcopenia/non-obesity (S), non-sarcopenia/obesity (O) and sarcopenia obesity (SO) in a multi-ethnic population in west China.

DESIGN

A cross-sectional study.

SETTING

The communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

PARTICIPANTS

We included 4,500 participants aged 50 years or older who did bioelectrical impedance in our analysis from West China Health and Aging Trend (WCHAT) study.

MEASUREMENTS

We measured gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA) for all participants. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia (AWGS). Obesity was defined as the highest sex-specific quintile of the percentage body fat. Different variables like anthropometry measures, life styles, chronic disease and blood test were collected. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences of metabolic profiles among different groups.

RESULTS

Of 4500 participants aged 50 years old or older, the proportions of H, O, S, SO were 63.0%, 17.7%, 16.7% and 2.6%, respectively. And the prevalence of S subjects in men was 18.3% and 15.7% in women, while the prevalence of SO was 3.7% in men and 2.0% in women. Data showed that the prevalence of S and SO has an aging increase pattern which was opposite with O. Both S and SO tends to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S seems to be worse than SO. Compared to H, S cohort showed a decrease in Vitamin D, triglyceride, albumin, fasting glucose, insulin, creatinine, ALT, nutrition scores and increase in HDL. SO cohort were observed for an increase in cholesterol, LDL, total protein and decrease in vitamin D. While O cohort showed an increase in triglyceride, cholesterol, LDL, total protein, glucose, insulin, WBC, uric acid, ALT and nutrition scores, but a decrease in HDL and vitamin D level.

CONCLUSIONS

Among individuals aged 50 years old or older in West China. S, O and SO participants demonstrate distinct differences in the life-styles, chronic disease profile, and metabolic profiles. The prevalence of S and SO has an aging increase pattern contrary to O. Both S and SO tend to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S looks like to be worse than SO. Besides, the S subjects seem to have more metabolic index changes than SO compared to H. While O subjects have some contrary metabolic index to S subjects.

Prevalence and Its Associated Factors of Physical Frailty and Cognitive Impairment: Findings from the West China Health and Aging Trend Study (WCHAT)

OBJECTIVES

Previous literature has reported that physical frailty (PF) closely associated with cognitive impairment (CI). In this study, we aim to describe and evaluate the prevalence and associated factors with different patterns of PF and cognitive impairment.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

Community-dwelling older adults aged ≥60 from the West China Health and Aging Trend (WCHAT) study were included in this study.

MEASUREMENTS

Participants were assessed the PF and cognitive impairment. PF was assessed using the physical phenotype as defined by Fried's criteria. Cognitive impairment was identified using the Short Portable Mental Status Questionnaire (SPMSQ). According different patterns of PF and cognitive impairment, participants were divided into 4 groups: not-PF and cognitive intact ( "neither" group), not-PF and cognitive impairment ("CI only" group), PF and cognitive intact ("PF only" group), and PF and cognitive impairment ("both" group). Multinomial logistic regression was used to explore the association between medical conditions and different patterns of PF and cognitive impairment after adjusting the demographic characteristics.

RESULTS

Among 4,103 participants (age 67.8 + 5.9 years, female 58.3%), 78.8%, 3.9%, 14.5% and 2.9% were "neither", "PF only", "CI only", and "both", respectively. The prevalence of "PF only", "CI only" and "both" were associated with age, lower education level and single status. In addition, there was substantial ethnicity heterogeneity in the prevalence of different patterns of PF and cognitive impairment. Comparing with "neither", PF and/or cognitive impairment had higher association with depression, ADLs impairment, and malnutrition. Of note, obesity was only significantly associated with "PF only", but not associated with "CI only" or "both".

CONCLUSIONS

We found the substantial demographic and medical conditions disparities in different patterns of PF and cognitive impairment. Further research should focus on the efficient and practical screen to predict the risk of "PF only", "CI only" and "both".

Using Technology to Improve Quality of Cancer Care in Resource-Limited Settings

PURPOSE

To highlight the importance of adapting affordable, holistic point-of-care technology (POCT) and data management software to improve quality of cancer care in resource-limited settings. Cancer is the second leading cause of death globally and was responsible for an estimated 9.6 million deaths in 2018, with low- and middle-income countries accounting for as much as 70% of these deaths.

METHODS

In 2004, the WHO outlined a set of criteria, called the ASSURED guidelines, to promote affordable, sensitive, specific, user-friendly, rapid, robust, equipment-free, and deliverable to end-user POCT. Although advances in POC cancer technology are relatively underexploited, early successes show that the field has significant potential to contribute to improving cancer detection, diagnosis, and treatment in low- and middle-income countries.

RESULTS

The current global disparity in cancer care can be addressed through mobilization of the research community to improve POCT, funding unique POCT concepts adapted for resource-limited settings, and training of scientists and engineers in designing robust data management software, such as the research electronic data capture for cancer research.

CONCLUSION

Improving cancer care holistically requires use of POCT with designs adapted to resource-limited settings and leveraging software with robust features for cancer research.