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Sutin AR, Luchetti M, Stephan Y, Mansor N, Kekäläinen T, Terracciano A. Purpose in life and grip strength: An individual-participant meta-analysis of 115,972 participants from 24 countries across four continents. GeroScience 2024:10.1007/s11357-024-01335-5. [PMID: 39354238 DOI: 10.1007/s11357-024-01335-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/28/2024] [Indexed: 10/03/2024] Open
Abstract
This research examines the replicability and generalizability of the association between purpose in life and grip strength. An individual-participant meta-analysis of 27 samples (total N=115,972) from 24 countries that spanned four continents (Asia, Europe, North and South America) with self-reported purpose in life and dynamometer-assessed grip strength. Purpose in life was associated with stronger grip strength in every sample and aggregated in a random-effects meta-analysis (meta-analytic estimate=.06, p<.001). The association was similar across samples from different world regions and not moderated by methodological factors (e.g., scale content). The association was apparent across age, sex, race, and education and slightly stronger among males and participants with relatively less education. Every standard deviation in purpose was associated with a 23% lower likelihood of weak grip strength (meta-analytic OR=.81, 95% CI=.79-.84, p<.001) based on a standard threshold. Purpose in life is associated with grip strength, a marker of overall musculoskeletal health. The association replicates across diverse locations around the world and generalizes across sociodemographic groups.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL, 32306, USA.
| | - Martina Luchetti
- Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL, 32306, USA
| | | | | | | | - Antonio Terracciano
- Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL, 32306, USA
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Persits I, Mirzai S, Sarnaik KS, Volk MC, Yun J, Harb S, Puri R, Kapadia S, Krishnaswamy A, Chen PH, Reed G, Tang WHW. Sarcopenia and frailty in patients undergoing transcatheter aortic valve replacement. Am Heart J 2024; 276:49-59. [PMID: 39032584 DOI: 10.1016/j.ahj.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Skeletal muscle mass (SMM) plays a crucial role in risk assessment in transcatheter aortic valve replacement (TAVR) candidates, yet it remains underutilized. Traditional methods focus on weakness or performance but omit SMM. This study compared traditional and novel markers of sarcopenia and frailty in terms of their ability to predict adverse outcomes post-TAVR. METHODS Three risk models were evaluated for the composite outcome of perioperative complications, 1-year rehospitalization, or 1-year mortality: (1) sarcopenia by combining low muscle mass (LMM) and weakness/performance assessed by hand grip strength or gait speed; (2) frailty by an Adapted Green score; and (3) frailty by the Green-SMI score incorporating LMM by multilevel opportunistic pre-TAVR thoracic CT segmentation. RESULTS In this study we included 184 eligible patients from January to December of 2018, (96.7%) of which were balloon expandable valves. The three risk models identified 22.8% patients as sarcopenic, 63.6% as frail by the Adapted Green score, and 53.8% as frail by the Green-SMI score. There were higher rates of the composite outcome in patients with sarcopenia (54.8%) and frailty (41.9% with the Adapted Green and 50.5% with the Green-SMI score) compared to their nonsarcopenic (30.3%) and nonfrail counterparts (25.4% with the Adapted Green and 18.8% with the Green-SMI score). Sarcopenia and frailty by Green-SMI, but not by the Adapted Green, were associated with higher risks of the composite outcome on multivariable adjustment (HR 2.2 [95% CI: 1.25-4.02], P = .007 and HR 3.4 [95% CI: 1.75-6.65], P < .001, respectively). CONCLUSIONS The integration of preoperative CT-based SMM to a frailty score significantly improves the prediction of adverse outcomes in patients undergoing TAVR.
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Affiliation(s)
- Ian Persits
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
| | - Saeid Mirzai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH; Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Kunaal S Sarnaik
- Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - James Yun
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Serge Harb
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Rishi Puri
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Samir Kapadia
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Amar Krishnaswamy
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Po-Hao Chen
- Department of Diagnostic Radiology, Section of Musculoskeletal Imaging, Cleveland Clinic, Diagnostics Institute, Cleveland, OH
| | - Grant Reed
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - W H Wilson Tang
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH.
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Locatelli JC, Costa JG, Haynes A, Naylor LH, Fegan PG, Yeap BB, Green DJ. Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition? Diabetes Care 2024; 47:1718-1730. [PMID: 38687506 DOI: 10.2337/dci23-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
This narrative review highlights the degree to which new antiobesity medications based on gut-derived nutrient-stimulated hormones (incretins) cause loss of lean mass, and the importance of resistance exercise to preserve muscle. Glucagon-like peptide 1 receptor agonists (GLP-1RA) induce substantial weight loss in randomized trials, effects that may be enhanced in combination with glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Liraglutide and semaglutide (GLP-1RA), tirzepatide (GLP-1 and GIP receptor dual agonist), and retatrutide (GLP-1, GIP, and glucagon receptor triple agonist) are peptides with incretin agonist activity that induce ∼15-24% weight loss in adults with overweight and obesity, alongside beneficial impacts on blood pressure, cholesterol, blood glucose, and insulin. However, these agents also cause rapid and significant loss of lean mass (∼10% or ∼6 kg), comparable to a decade or more of aging. Maintaining muscle mass and function as humans age is crucial to avoiding sarcopenia and frailty, which are strongly linked to morbidity and mortality. Studies indicate that supervised resistance exercise training interventions with a duration >10 weeks can elicit large increases in lean mass (∼3 kg) and strength (∼25%) in men and women. After a low-calorie diet, combining aerobic exercise with liraglutide improved weight loss maintenance compared with either alone. Retaining lean mass during incretin therapy could blunt body weight (and fat) regain on cessation of weight loss pharmacotherapy. We propose that tailored resistance exercise training be recommended as an adjunct to incretin therapy to optimize changes in body composition by preserving lean mass while achieving fat loss.
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Affiliation(s)
- João Carlos Locatelli
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Juliene Gonçalves Costa
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Andrew Haynes
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - P Gerry Fegan
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
- Medical School, Curtin University, Perth, Australia
| | - Bu B Yeap
- Medical School, Curtin University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
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Costa Pereira JPD, Rüegg RAB, Costa EC, Fayh APT. Muscle quality and major adverse cardiovascular events in post-acute myocardial infarction: A prospective cohort study. Nutr Metab Cardiovasc Dis 2024; 34:2266-2272. [PMID: 38866608 DOI: 10.1016/j.numecd.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/23/2024] [Accepted: 04/24/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND & AIMS Functional muscle quality, as assessed through the muscle quality index (MQI), represents a contemporary method to measure the capacity to generate force. Despite its potential, the prognostic significance of MQI remains uncertain in various clinical conditions, particularly among patients following acute myocardial infarction (AMI). In light of this, our study sought to evaluate the prognostic relevance of MQI concerning major adverse cardiovascular events (MACE) in patients following AMI. METHODS AND RESULTS This is a secondary analysis of a prospective cohort study that included subjects aged ≥20 years from a Cardiovascular Unit Hospital. Functional muscle quality was estimated using MQI, defined as the ratio of handgrip strength (HGS) to muscle mass (MM) derived from bioelectrical impedance analysis. The outcomes included prolonged length of hospital stay, new adverse cardiovascular events (AMI, stroke and hospital readmission for unstable angina), and cardiovascular mortality. A composite score comprising all adverse events over the 1-year follow-up was calculated and defined as MACE. This study included 163 patients, with a median age of 61 years (IQ: 54-69 years), and the majority consisted of males (76.1%). Individual components of the functional muscle quality (HGS and MM) were not associated with any of the adverse outcomes. Only MQI was associated mortality over the 1-year follow-up. For each increase in MQI, the hazard of mortality decreases: adjusted HR: 0.08 (95% CI 0.01-0.84). CONCLUSION Functional muscle quality assessed by the MQI may be a valuable clinical predictor of 1-year cardiovascular mortality in patients hospitalized post-AMI.
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Affiliation(s)
- Jarson Pedro da Costa Pereira
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, PE, Brazil
| | - Rodrigo Albert Baracho Rüegg
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, Brazil.
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Matsuo H, Yoshimura Y, Maeno Y, Tanaka S. Possible sarcopenia and its association with hospital-associated dysphagia and decline in physical function: Findings from a heart failure patients prospective cohort study. Clin Nutr ESPEN 2024; 63:364-370. [PMID: 38971404 DOI: 10.1016/j.clnesp.2024.06.060] [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: 05/27/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND & AIMS There is limited evidence regarding the association of sarcopenia with dysphagia and physical function in patients with heart failure. This study examined the association between possible sarcopenia and both swallowing and physical function in individuals with acute heart failure (AHF). METHODS This prospective cohort study included hospitalized patients with AHF. Possible sarcopenia was assessed on admission using calf circumference and grip strength according to an international diagnostic criteria. The primary outcome was dysphagia at discharge using the Food Intake Level Scale (FILS), and the secondary outcome was physical function at discharge using the Barthel Index (BI). Multiple regression analysis and logistic regression, adjusted for potential confounders, were used to examine the association between possible sarcopenia at admission and FILS and BI at discharge. RESULTS A total of 320 patients (mean age 81.5 years; 170 women) were included in the analysis; 199 (59.4%) were diagnosed with possible sarcopenia. Multivariate analysis showed that possible sarcopenia at admission was significantly associated with FILS at discharge (β = -0.1204; p = 0.039). Possible sarcopenia at admission was not significantly associated with BI at discharge (OR = 2.066; 95% CI, 0.910-4.692, p = 0.083). CONCLUSIONS Possible sarcopenia was associated with decline in swallowing function during hospitalization in patients with AHF. These findings highlight the need for early detection and treatment of possible sarcopenia in this setting.
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Affiliation(s)
- Haruyo Matsuo
- Department of Nursing, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto, 869-1106, Japan.
| | - Yuichi Maeno
- Department of Rehabilitation, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
| | - Sayoko Tanaka
- Department of Nutritional Management, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
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Dos Santos AP, Cordeiro JFC, Abdalla PP, Bohn L, Sebastião E, da Silva LSL, Tasinafo-Júnior MF, Venturini ACR, Andaki ACR, Mendes EL, Marcos-Pardo PJ, Mota J, Machado DRL. Low handgrip strength is associated with falls after the age of 50: findings from the Brazilian longitudinal study of aging (ELSI-Brazil). Arch Public Health 2024; 82:172. [PMID: 39354567 PMCID: PMC11446049 DOI: 10.1186/s13690-024-01340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/03/2024] [Indexed: 10/03/2024] Open
Abstract
AIM This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. METHODS This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. RESULTS A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables. CONCLUSIONS Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s.
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Affiliation(s)
- André Pereira Dos Santos
- Faculty of Sport of the University of Porto, Street Dr. Plácido da Costa 91, Porto, 4200-450, Portugal.
- College of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Human Exposome and Infectious Diseases Network (HEID), Ribeirão Preto, Brazil.
| | | | - Pedro Pugliesi Abdalla
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lucimere Bohn
- Center for Research in Sport, Physical Education, Exercise, and Health (CIDEFES), Lusófona University - University Center of Porto, Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, United States
| | - Leonardo Santos Lopes da Silva
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Márcio Fernando Tasinafo-Júnior
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Cláudia Rossini Venturini
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Alynne Christian Ribeiro Andaki
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Edmar Lacerda Mendes
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Pablo Jorge Marcos-Pardo
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- Centro de Investigación para el Bienestar y la Inclusión Social (CIBIS Research Center), SPORT Research Group (CTS-1024), Almería, Spain
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- College of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- School of Education and Communication (ESEC), University of Algarve, Penha Campus, Faro, Portugal
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Nishida C, Iemitsu M, Kurihara T, Kishigami K, Miyachi M, Sanada K. Differences in sarcopenia indices in elderly Japanese women and their relationships with obesity classified according to waist circumference, BMI, and body fat percentage. J Physiol Anthropol 2024; 43:22. [PMID: 39354553 PMCID: PMC11446072 DOI: 10.1186/s40101-024-00370-7] [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: 03/04/2024] [Accepted: 09/02/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Sarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)). METHODS Subjects were 170 community-dwelling healthy elderly women aged 65-79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively. RESULTS When obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups. CONCLUSION Our findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals.
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Affiliation(s)
- Chihiro Nishida
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Toshiyuki Kurihara
- Faculty of Science, Yamaguchi University, 3003 Yoshida, Yamaguchi, 753-8512, Japan
| | - Keiko Kishigami
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji Higashi, Kusatsu, Shiga, 525-8577, Japan.
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Ye C, Liu D, Kong L, Wang Y, Dou C, Xu M, Zheng J, Zheng R, Li M, Zhao Z, Lu J, Chen Y, Wang W, Bi Y, Xu Y, Wang T, Ning G. Effect of Relative Protein Intake on Hypertension and Mediating Role of Physical Fitness and Circulating Fatty Acids: A Mendelian Randomization Study. Mayo Clin Proc 2024; 99:1589-1605. [PMID: 39001774 DOI: 10.1016/j.mayocp.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/25/2024] [Accepted: 02/20/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE To investigate the causal effect of protein intake on hypertension and the related mediating pathways. PATIENTS AND METHODS Using genome-wide association study summary statistics of European ancestry, we applied univariable and multivariable Mendelian randomization to estimate the bidirectional associations of relative protein intake and related metabolomic signatures with hypertension (FinnGen: Ncase=42,857/Ncontrol=162,837; UK Biobank: Ncase=77,723/Ncontrol=330,366) and blood pressure (International Consortium of Blood Pressure: N=757,601) and two-step Mendelian randomization to assess the mediating roles of 40 cardiometabolic factors therein. Mendelian randomization estimates of hypertension from FinnGen and UK Biobank were meta-analyzed without heterogeneity. We performed the study from May 15, 2023, to September 15, 2023. RESULTS Each 1-SD higher relative protein intake was causally associated with 69% (odds ratio, 0.31; 95% CI, 0.11 to 0.89) lower hypertension risk independent of the effects of other macronutrients, and was the only macronutrient associated with 2.21 (95% CI, 0.52 to 3.91) mm Hg lower pulse pressure, in a unidirectional manner. Higher plant protein-related metabolomic signature (glycine) was associated with lower hypertension risk and pulse pressure, whereas higher animal protein-related metabolomic signatures (leucine, isoleucine, valine, and isovalerylcarnitine [only systolic blood pressure]) were associated with higher hypertension risk, pulse pressure, and systolic blood pressure. The effect of relative protein intake on hypertension was causally mediated by frailty index (mediation proportion, 40.28%), monounsaturated fatty acids (13.81%), saturated fatty acids (11.39%), grip strength (5.34%), standing height (3.99%), and sitting height (3.61%). CONCLUSION Higher relative protein intake causally reduces the risk of hypertension, partly mediated by physical fitness and circulating fatty acids.
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Affiliation(s)
- Chaojie Ye
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijie Kong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiying Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun Dou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhang Y, Tian Z, Cheng X, Fang B, Liu Q, Li J, Wang Y, Wang H, Guo X, Chen G, Li H, Sun L, Hu B, Zhang D, Liang C, Sheng J, Tao F, Wang J, Yang L. The Association Between the Non-essential Metal Mixture and Handgrip Strength in Chinese Community-Dwelling Older Adults. Biol Trace Elem Res 2024:10.1007/s12011-024-04389-w. [PMID: 39322923 DOI: 10.1007/s12011-024-04389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 09/17/2024] [Indexed: 09/27/2024]
Abstract
There is limited research on the effects of non-essential metal (NEM) mixture on handgrip strength in the elderly. This study aimed to assess the associations of single NEMs and their mixture with handgrip strength in Chinese community-dwelling older adults. A total of 3807 elderly people aged 60 years or above were included in this study. Measurement of urinary aluminum (Al), arsenic (As), barium (Ba), cadmium (Cd), and gallium (Ga) concentrations was conducted by inductively coupled plasma mass spectrometry (ICP-MS). Handgrip strength was measured using a hand dynamometer. Four statistical models, including general linear regression and generalized additive models (GAMs), as well as Bayesian kernel machine regression (BKMR) and quantile-based computation regression (QGC) models, were used to assess the individual and joint effects of urine NEMs with handgrip strength, respectively. After adjusting for covariates, Ga (ß = - 0.27; 95% CI, - 0.54 ~ - 0.01) and As ( β = - 0.34; 95% CI, - 0.61 ~ - 0.07) were negatively associated with handgrip strength. The GAMs and BKMR further suggested that the negative associations of Ga and As with handgrip strength were linear and inverted U-shaped, respectively. The BKMR and QGC models showed that the NEM mixture was negatively related to handgrip strength, with Ga and As contributing the most within the mixture. Moreover, we also observed an interaction between As and Ga on handgrip strength. Longitudinal studies are needed to verify these findings.
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Affiliation(s)
- Yan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Ziwei Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Xuqiu Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Bohao Fang
- Department of Clinical Medicine, School of the Second Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Qiang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Junzhe Li
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Yuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Hongli Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China
| | - Guimei Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Huaibiao Li
- Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China
| | - Liang Sun
- Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China
| | - Bing Hu
- Fuyang Center for Diseases Prevention and Control, Fuyang, 236069, Anhui, China
| | - Dongmei Zhang
- School of Health Services Management, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Chunmei Liang
- Department of Hygiene Inspection and Quarantine, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jie Sheng
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, Anhui, China
| | - Jun Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Linsheng Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Center for Big Data, Population Health of IHM, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China.
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10
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Liao J, Wang J, Jia S, Cai Z, Liu H. Correlation of muscle strength, working memory, and activities of daily living in older adults. Front Aging Neurosci 2024; 16:1453527. [PMID: 39372646 PMCID: PMC11449751 DOI: 10.3389/fnagi.2024.1453527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 09/10/2024] [Indexed: 10/08/2024] Open
Abstract
Objective This study aims to investigate the relationship between muscle strength, working memory, and activities of daily living (ADL) in older adults. Additionally, it seeks to clarify the pathways and effects of working memory in mediating the relationship between muscle strength and ADL. Methods Using a cross-sectional study design, we recruited 245 older adults individuals from nursing homes. We collected data on grip strength, the 30-s sit-to-stand test, the N-back task, and ADL. The data were analyzed using independent sample t-tests, χ2 tests, correlation analysis, and structural equation modeling. Results Grip strength significantly influenced ADL (effect size = -0.175, 95% CI: -0.226 to -0.124). Grip strength also had a significant direct effect on ADL (effect size = -0.114, 95% CI: -0.161 to -0.067). The 1-back task correct rate significantly mediated the relationship between grip strength and ADL (effect size = 0.054, 95% CI: -0.084 to -0.029). The 30-s sit-to-stand test significantly impacted ADL (effect size = -0.280, 95% CI: -0.358 to -0.203). It also had a significant direct effect on ADL (effect size = -0.095, 95% CI: -0.183 to -0.007). The 1-back task correct rate significantly mediated the relationship between the 30-s sit-to-stand test and ADL (effect size = -0.166, 95% CI: -0.236 to -0.106). Conclusion There exists a strong correlation between muscle strength, working memory, and ADL. Increased muscle strength leads to better ADL performance and improved working memory tasks. Low cognitive load working memory tasks can mediate the relationship between muscle strength and ADL. Regular physical exercise can enhance muscle strength, slow down the decline of working memory, thereby maintaining or improving ADL in older adults.
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Affiliation(s)
- Jinlin Liao
- College of Physical Education and Health, Longyan University, Longyan, China
| | - Jing Wang
- School of Sports and Health of Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Shuqi Jia
- Shanghai University of Sport, Shanghai, China
| | - Zhidong Cai
- Sports Department of Suzhou University of Science and Technology, Suzhou, China
| | - Hairong Liu
- Physical Education Department of Shanghai International Studies University, Shanghai, China
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11
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Sayer AA, Cooper R, Arai H, Cawthon PM, Ntsama Essomba MJ, Fielding RA, Grounds MD, Witham MD, Cruz-Jentoft AJ. Sarcopenia. Nat Rev Dis Primers 2024; 10:68. [PMID: 39300120 DOI: 10.1038/s41572-024-00550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 09/22/2024]
Abstract
Sarcopenia is the accelerated loss of skeletal muscle mass and function commonly, but not exclusively, associated with advancing age. It is observed across many species including humans in whom it can lead to decline in physical function and mobility as well as to increased risk of adverse outcomes including falls, fractures and premature mortality. Although prevalence estimates vary because sarcopenia has been defined in different ways, even using a conservative approach, the prevalence is between 5% and 10% in the general population. A life course framework has been proposed for understanding not only the occurrence of sarcopenia in later life but also influences operating at earlier life stages with potentially important implications for preventive strategies. Harnessing progress in understanding the hallmarks of ageing has been key to understanding sarcopenia pathophysiology. Considerable convergence in approaches to diagnosis of sarcopenia has occurred over the last 10 years, with a growing emphasis on the central importance of muscle strength. Resistance exercise is currently the mainstay of treatment; however, it is not suitable for all. Hence, adjunctive and alternative treatments to improve quality of life are needed. An internationally agreed approach to definition and diagnosis will enable a step change in the field and is likely to be available in the near future through the Global Leadership Initiative in Sarcopenia.
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Affiliation(s)
- Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Rachel Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Peggy M Cawthon
- California Pacific Medical Center, Research Institute, San Francisco, CA, USA
- University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Marie-Josiane Ntsama Essomba
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Miranda D Grounds
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Miles D Witham
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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12
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Martins LC, Oliveira E Silva MP, Dos Santos ACO, da Silveira VM, de Araújo PSR. Prevalence and associated factors related to sarcopenia in people living with HIV/AIDS. BMC Infect Dis 2024; 24:933. [PMID: 39251940 PMCID: PMC11385512 DOI: 10.1186/s12879-024-09845-5] [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: 12/26/2023] [Accepted: 08/30/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The use of antiretrovirals has increased the survival of People Living with HIV/AIDS (PLWHA), resulting in an aging population and a rise in the incidence of sarcopenia. The lack of uniformity among the prevalences found in studies may be associated with the use of different diagnostic criteria, highlighting the need for local studies to determine the prevalence of sarcopenia. METHODS Cross-sectional study to estimate the prevalence and associated factors of sarcopenia using the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). This study included PLWHA of both sexes, aged 40 years or older, who were treated at the infectious disease outpatient clinic of a tertiary hospital from 2019 to 2021. Muscle mass was quantified through electrical bioimpedance, using resistance and reactance to calculate appendicular lean mass (ALM) in kg/m². Muscle strength, measured in kg, was assessed using a manual dynamometer, and muscle function was evaluated using the gait speed test (m/s). Numerical variables were analyzed using measures of central tendency and dispersion. The chi-square test was used to assess associations in categorical variables. Odds ratios (OR) and 95% Confidence Intervals (CI) were calculated to evaluate the strength of associations. RESULTS Among the 218 PLWHA, the prevalence of sarcopenia was 8.7% (95% CI: 5.6 to 13.3). The mean age of the study population was 51.8 ± 8.3 years; 53.7% were male, 72.9% were brown/Black, 97.7% reported not using illicit drugs, and 24.8% were classified as obese. Multivariate analysis showed that the time since HIV diagnosis (P = 0.022) and the use of illicit drugs were associated with the diagnosis of sarcopenia. CONCLUSION The prevalence of sarcopenia using the EWGSOP2 criteria was low. People with a longer duration of HIV infection and those using illicit drugs were more likely to develop sarcopenia.
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Affiliation(s)
- Luciana Cardoso Martins
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Avenida Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, CEP: 50740-465, Brasil.
| | - Marcelo Palmares Oliveira E Silva
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Avenida Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, CEP: 50740-465, Brasil
| | - Ana Célia Oliveira Dos Santos
- Institute of Biological Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE, CEP: 50100-130, Brasil
| | - Vera Magalhães da Silveira
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Avenida Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, CEP: 50740-465, Brasil
| | - Paulo Sérgio Ramos de Araújo
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Avenida Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, CEP: 50740-465, Brasil
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation, s/n - Cidade Universitária, Recife, PE, 50740-465, Brasil
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13
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Islam MR, Nyström CD, Kippler M, Kajantie E, Löf M, Rahman SM, Ekström EC. Accelerometer-Measured Physical Activity, Fitness and Indicators of Cardiometabolic Risk among Rural Adolescents: A Cross-Sectional Study at 15-Year Follow-up of the MINIMat Cohort. J Epidemiol Glob Health 2024; 14:987-1003. [PMID: 38771489 PMCID: PMC11442897 DOI: 10.1007/s44197-024-00245-1] [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: 09/29/2023] [Accepted: 05/12/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among rural adolescents in low- and middle-income countries. Thus, we examined the associations of PA and fitness with selected cardiometabolic indicators along with potential gender-based differences in a birth cohort of rural adolescents from southeast Bangladesh. METHODS We utilized data from the 15-year follow-up of Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort (n = 2253). Wrist-worn ActiGraph wGT3x-BT accelerometers were used to estimate sedentary time (ST) and PA. Fitness was assessed using: handgrip strength, standing long jump, and Chester Step Test. Anthropometric parameters, systolic blood pressure (SBP), and fasting lipid, insulin and glucose levels were measured. We calculated insulin resistance using the Homeostasis Model Assessment equation (HOMA-IR). Linear regression and isotemporal substitution models were fitted. RESULTS The adolescents spent 64 min/day (inter-quartile range: 50-81) in moderate-to-vigorous physical activity (MVPA). A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% confidence interval (CI): 2.9-6.8%) lower waist circumference (WC), 3.2 mmHg (95% CI: 1.5-4.8) lower SBP, 10.4% (95% CI: 2.9-17.3%) lower TG, and 24.4% (95% CI: 11.3-34.9%) lower HOMA-IR. MVPA showed similar associations of notably smaller magnitude. Except for WC, the associations were more pronounced among the boys. Substituting ST with VPA of equal duration was associated with lower WC, SBP, triglyceride and HOMA-IR. Grip strength was favorably associated with all indicators, displaying considerably large effect sizes. CONCLUSION Our findings indicated beneficial roles of PA- particularly VPA- and muscular fitness in shaping cardiometabolic profile in mid-adolescence. VPA and grip strength may represent potential targets for preventive strategies tailored to adolescents in resource-limited settings.
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Affiliation(s)
| | | | - Maria Kippler
- Institute of Environmental Medicine, Unit of Metals and Health, Karolinska Institutet, Stockholm, Sweden
| | - Eero Kajantie
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital & University of Oulu, Oulu, Finland
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Syed Moshfiqur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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14
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Mey R, Calatayud J, Casaña J, Torres-Castro R, Cuenca-Martínez F, Suso-Martí L, Andersen LL, López-Bueno R. Handgrip strength and respiratory disease mortality: Longitudinal analyses from SHARE. Pulmonology 2024; 30:445-451. [PMID: 36274049 DOI: 10.1016/j.pulmoe.2022.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND While the association between handgrip strength and all-cause mortality is more deeply explored, no previous studies have been specifically focused on handgrip strength and respiratory disease mortality. The purpose of the study was to investigate the association between handgrip strength and respiratory disease mortality in a large representative sample. METHODS Individuals aged 50 or over from 27 European countries and Israel participated in this longitudinal study. Data on handgrip strength and all-cause and respiratory disease mortality were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6 and 7. We estimated the sub hazard ratios (SHRs) for respiratory disease mortality using a Fine-Gray sub-distribution method with both time-varying exposure and covariates and mortality due to other causes as competing risk. Furthermore, we assessed dose-response associations of handgrip strength (modelled as a continuous exposure) with respiratory disease mortality using restricted cubic splines and estimated hazard ratios (HRs). RESULTS We included 60,883 men and 74,904 women with a mean age of 63.6 (SD 9.7) years at study entry. During a median (interquartile range) of 7.4 years of follow-up 565 (0.4%) participants died due to respiratory diseases. The increase of 1 single kg of handgrip strength showed a 6% incidence reduction on respiratory disease mortality (SHR, 0.94; 95%CI, 0.92-0.96) after adjusting for potential confounders. Furthermore, each kg increase of handgrip strength reduced respiratory disease mortality risk in a dose-response fashion and a significant threshold for values of 41 kg (HR, 0.49; 95%CI, 0.26-0.92) and higher was identified. CONCLUSIONS Higher handgrip strength is associated with lower mortality due to respiratory disease. Intervention studies are needed to determine whether strength training in respiratory disease patients can prevent premature mortality.
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Affiliation(s)
- R Mey
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; VUMC School of Medical Sciences, Amsterdam UMC, the Netherlands
| | - J Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - J Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - R Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - F Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - L Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - L L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - R López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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15
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Farrell SW, Leonard D, Li Q, Barlow CE, Shuval K, Berry JD, Pavlovic A, DeFina LF. Association between baseline levels of muscular strength and risk of stroke in later life: The Cooper Center Longitudinal Study. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:642-649. [PMID: 37839524 PMCID: PMC11282351 DOI: 10.1016/j.jshs.2023.10.003] [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: 06/17/2023] [Revised: 08/22/2023] [Accepted: 09/16/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Muscular strength is an important component of physical fitness. We evaluated the relationship between baseline muscular strength and risk of stroke among adults who were aged ≥65 years during follow-up. METHODS We included 7627 healthy adults (mean age = 43.9 years, 86.0% male) underwent a baseline physical examination between 1980 and 1989. Muscular strength was determined by 1-repetition maximum measures for bench press and leg press and categorized into age- and sex-specific tertiles for each measure. Cardiorespiratory fitness (CRF) was assessed via a maximal treadmill exercise test. Those enrolled in fee-for-service Medicare from 1999 to 2019 were included in the analyses. Associations between baseline strength and stroke outcomes were estimated using a modified Cox proportional hazards model. In a secondary analysis, we examined stroke risk by categories of CRF where Quintile 1 = low, Quintiles 2-3 = moderate, and Quintiles 4-5 = high CRF based on age and sex. RESULTS After 70,072 person-years of Medicare follow-up, there were 1211 earliest indications of incident stroke. In multivariable analyses, the hazard ratio (95% confidence interval (95%CI)) for stroke across bench press categories were 1.0 (referent), 0.96 (0.83-1.11), and 0.89 (0.77-1.04), respectively (p trend = 0.14). The trend across categories of leg press was also non-significant (p trend = 0.79). Adjusted hazard ratio (95%CI) for stroke across ordered CRF categories were 1.0 (referent), 0.90 (0.71-1.13), and 0.72 (0.57-0.92) (p trend < 0.01). CONCLUSION While meeting public health guidelines for muscular strengthening activities is likely to improve muscular strength as well as many health outcomes in older adults, performing such activities may not be helpful in preventing stroke. Conversely, meeting guidelines for aerobic activity is likely to improve CRF and lower stroke risk.
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Affiliation(s)
| | - David Leonard
- Research Division, The Cooper Institute, Dallas, TX 75230, USA
| | - Qing Li
- Research Division, The Cooper Institute, Dallas, TX 75230, USA
| | | | - Kerem Shuval
- Research Division, The Cooper Institute, Dallas, TX 75230, USA
| | - Jarett D Berry
- Department of Internal Medicine, University of Texas at Tyler School of Medicine, Tyler, TX 75799, USA
| | | | - Laura F DeFina
- Research Division, The Cooper Institute, Dallas, TX 75230, USA
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16
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Qi KJ, Li Q, Lu GL, Zhang MJ, Zhang MZ, Yan JM, He QQ. The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study. Arch Gerontol Geriatr 2024; 124:105481. [PMID: 38733920 DOI: 10.1016/j.archger.2024.105481] [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: 04/08/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the combined effect of handgrip strength (HGS) and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly people. METHODS The data was used from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults who participated in surveys between 2011 and 2018 were included in the study. They were divided into 4 different types of obesity phenotypes based on obesity and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically abnormal non-overweight/obesity (MANO), and metabolically abnormal overweight/obesity (MAO). The HGS level was divided into low and high groups according to the median values. Cox proportional risk regression model was used to analyze the joint effect of HGS and obesity phenotype on the risk of stroke among participants. RESULTS A total of 7904 participants aged 58.89±9.08 years were included in this study. After adjusting for potential confounders, high HGS&MHO (HR=1.86, 95 % CI=1.12-3.09), high HGS&MANO (HR=2.01, 95 %CI=1.42-2.86), high HGS&MAO (HR=2.01, 95 % CI=1.37-2.93), low HGS&MHNO (HR=1.57, 95 % CI=1.00-2.46), low HGS&MHO (HR=2.09, 95 % CI=1.29-3.38), low HGS&MANO (HR=2.02, 95 % CI=1.35-3.03), and low HGS&MAO (HR=2.48, 95 % CI=1.72-3.58) group had significantly higher risks of stroke than the high HGS&MHNO group. CONCLUSION The coexistence of metabolically unhealthy and low HGS can synergistically increase the risk of stroke in Chinese middle-aged and elderly people.
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Affiliation(s)
- Kai-Jie Qi
- School of public health, Wuhan University, Wuhan, China
| | - Qiang Li
- School of health and nursing, Wuchang University of Technology, Wuhan, China
| | - Gao-Lei Lu
- School of public health, Wuhan University, Wuhan, China
| | - Min-Jie Zhang
- School of public health, Wuhan University, Wuhan, China
| | - Min-Zhe Zhang
- School of public health, Wuhan University, Wuhan, China
| | - Jia-Min Yan
- Department of Laboratory Medicine, Wuhan Children's Hospital, Wuhan, China.
| | - Qi-Qiang He
- School of public health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.
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Hulme A, Sangelaji B, Walker C, Fallon T, Denham J, Martin P, Woodruffe S, Bell K, Aniftos M, Kirkpatrick J, Cotter N, Osborn D, Argus G. Efficacy of a student-led interprofessional health clinic in regional Australia for preventing and managing chronic disease. J Interprof Care 2024; 38:893-906. [PMID: 39045867 DOI: 10.1080/13561820.2024.2380436] [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: 11/03/2023] [Revised: 07/03/2024] [Accepted: 07/06/2024] [Indexed: 07/25/2024]
Abstract
Increasing chronic disease rates in regional Australian communities necessitates innovative models of healthcare. We evaluated the efficacy of an interprofessional chronic disease program, delivered within a regional student-led nursing and allied health clinic in Southern Queensland, Australia. Changes to anthropometric, aerobic fitness and strength, and quality of life outcomes were examined at four time points spanning 16 months: intake, program transition (4 months), 6 and 12 months (post-transition). Our primary aim was to investigate whether the health improvements achieved during the program were sustained at 12 months in a subset of participants who provided complete data. Significant improvements were found in 6 of 11 measures, including the 6-minute walk test, grip strength, and self-reported quality of life across physical and psychosocial dimensions, with these improvements maintained to final review. No significant changes were found in body mass index (BMI), waist circumference, fat mass, or muscle mass. This is the first health clinic in regional Australia to deliver a student-led model of interprofessional and collaborative service to tackle the increasing burden of chronic disease in the community. The cost-effectiveness of this service and other potential clinical and social benefits remain to be investigated.
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Affiliation(s)
- Adam Hulme
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Bahram Sangelaji
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Clara Walker
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Tony Fallon
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Joshua Denham
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Health and Medical Sciences Ipswich Campus, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Priya Martin
- Rural Clinical School (RCS), Faculty of Medicine, The University of Queensland, Toowoomba, Queensland, Australia
| | - Steve Woodruffe
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Kate Bell
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Michelle Aniftos
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Jayne Kirkpatrick
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Nicola Cotter
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Dayle Osborn
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
| | - Geoff Argus
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Science, The University of Queensland, Toowoomba, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba, Queensland, Australia
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Yoo K, Park YS, Kim HJ, Kim JH. Association of smoking cessation with dynapenia among older lifetime smokers in Korea. Tob Induc Dis 2024; 22:TID-22-150. [PMID: 39220716 PMCID: PMC11365039 DOI: 10.18332/tid/191822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION Muscle strength is known to play an important role in the health of older adults. The health burden of cigarette smoking among older adults remains significant. We investigated the association between smoking cessation and dynapenia among older lifetime smokers in Korea. METHODS This study is a secondary dataset analysis of cross-sectional data from theKorea National Health and Nutrition Examination Survey (KNHANES) 2016- 2019. We included 1450 participants aged 65-79 years, excluding those who had never smoked. Dynapenia was defined as grip strength <28 kg for men and <18 kg for women based on the Asian Working Group for Sarcopenia 2019 criteria. Multivariable logistic regression analysis evaluated the association between smoking cessation and dynapenia. RESULTS Compared with current smokers, the adjusted odds ratio (AOR) of dynapenia in former smokers was 0.66 (95% CI: 0.44-0.99). The AORs for smoking cessation periods of ≤10 years, 10-20 years, 20-30 years, and >30 years were 0.67 (95% CI: 0.39-1.16), 0.61 (95% CI: 0.36-1.03), 0.65 (95% CI: 0.37-1.14), and 0.52 (95% CI: 0.25-1.06), respectively. The AOR for dynapenia significantly decreased with the years since smoking cessation (p for trend=0.043). CONCLUSIONS Our findings suggest that smoking cessation can reduce the likelihood of dynapenia among older lifetime smokers, with a decreasing likelihood trend associated with longer cessation periods.
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Affiliation(s)
- Keunjoong Yoo
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hye Jin Kim
- Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jeong Hyeon Kim
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Cheung WW, Zhou P, Zheng R, Gertler A, Oliveira EA, Mak RH. Leptin signalling altered in infantile nephropathic cystinosis-related bone disorder. J Cachexia Sarcopenia Muscle 2024. [PMID: 39210624 DOI: 10.1002/jcsm.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 07/01/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The CTNS gene mutation causes infantile nephropathic cystinosis (INC). Patients with INC develop Fanconi syndrome and chronic kidney disease (CKD) with significant bone deformations. C57BL/6 Ctns-/- mice are an animal model for studying INC. Hyperleptinaemia results from the kidney's inability to eliminate the hormone leptin in CKD. Ctns-/- mice have elevated serum leptin concentrations. Leptin regulates bone metabolism through its receptor that signals further via the hypothalamic melanocortin 4 receptor (MC4R). Leptin signalling may affect bone health in Ctns-/- mice. METHODS We first defined the time course of bone abnormalities in Ctns-/- mice between 1 and 12 months of age. We used both genetic and pharmacological approaches to investigate leptin signalling in Ctns-/- mice. We generated Ctns-/-Mc4r-/- double knockout mice. Bone phenotype of Ctns-/-Mc4r-/- mice, Ctns-/- mice and wild type (WT) mice at 1, 4, and 9 months of age were compared. We then treated 12-month-old Ctns-/- mice and WT mice with a pegylated leptin receptor antagonist (PLA) (7 mg/kg/day, IP), a MC4R antagonist agouti-related peptide (AgRP) (2 nmol, intracranial infusion on days 0, 3, 6, 9, 12, 15, 18, 21, 24, and 27), or vehicle (normal saline), respectively, for 28 days. Whole-body (BMC/BMD, bone area) and femoral bone phenotype (BMC/BMD, bone area, length and failure load) of mice were measured by DXA and femoral shaft biochemical test. We also measured lean mass content by EchoMRI and muscle function (grip strength and rotarod activity) in mice. Femur protein content of JAK2 and STAT3 was measured by ELISA kits, respectively. RESULTS Bone defects are present in Ctns-/- mice throughout its first year of life. The deletion of the Mc4r gene attenuated bone disorder in Ctns-/- mice. Femoral BMD, bone area, length, and strength (failure load) were significantly increased in 9-month-old Ctns-/-Mc4r-/- mice than in age-matched Ctns-/- mice. PLA and AgRP treatment significantly increased femoral bone density (BMC/BMD) and mechanical strength in 12-month-old Ctns-/- mice. We adopted the pair-feeding approach for this study to show that the protective effects of PLA or AgRP on bone phenotype are independent of their potent orexigenic effect. Furthermore, an increase in lean mass and in vivo muscle function (grip strength and rotarod activity) are associated with improvements in bone phenotype (femoral BMC/BMD and mechanical strength) in Ctns-/- mice, suggesting a muscle-bone interplay. Decreased femur protein content of JAK2 and STAT3 was evident in Ctns-/- mice. PLA or AgRP treatment attenuated femur STAT3 content in Ctns-/- mice. CONCLUSIONS Our findings suggest a significant role for dysregulated leptin signalling in INC-related bone disorder, either directly or potentially involving a muscle-bone interplay. Leptin signalling blockade may represent a novel approach to treating bone disease as well as muscle wasting in INC.
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Affiliation(s)
- Wai W Cheung
- Division of Pediatric Nephrology, Rady Children's Hospital, University of California, San Diego, La Jolla, CA, USA
| | - Ping Zhou
- Department of Pediatric Nephrology and Rheumatology, Sichuan Provincial Maternity and Child Health Care Hospital, Sichuan Clinical Research Center for Pediatric Nephrology and The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, China
| | - Ronghao Zheng
- Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Arieh Gertler
- School of Biological and Population Health Sciences, Institute of Biochemistry, Food Science and Nutrition, Hebrew University of Jerusalem, Rehovot, Israel
| | - Eduardo A Oliveira
- Department of Pediatrics, Division of Pediatric Nephrology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Robert H Mak
- Division of Pediatric Nephrology, Rady Children's Hospital, University of California, San Diego, La Jolla, CA, USA
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Rostamzadeh S, Allafasghari A, Allafasghari A, Abouhossein A. Handgrip strength as a prognostic factor for COVID-19 mortality among older adult patients admitted to the intensive care unit (ICU): a comparison Alpha (B.1.1.7) and Delta (B.1.617.2) variants. Sci Rep 2024; 14:19927. [PMID: 39198687 PMCID: PMC11358457 DOI: 10.1038/s41598-024-71034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 08/23/2024] [Indexed: 09/01/2024] Open
Abstract
Handgrip strength (HGS) is a non-invasive and reliable biomarker of overall health, physical function, mobility, and mortality. This study aimed to investigate the possible relationship between HGS and mortality in older adult patients hospitalized with COVID-19 in the intensive care unit (ICU) by Alpha (B.1.1.7) and Delta (B.1.617.2) variants. This retrospective cohort study was conducted on 472 COVID-19 patients (222 female and 250 male) aged 60-85 years admitted to the ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient's medical records. Using a JAMAR® hydraulic dynamometer, the average grip strength value (kg) after three measurements on the dominant side was recorded for subsequent analysis. Low grip strength (LGS) was defined as an arbitrary cut-off of two standard deviations below the gender-specific peak mean value of normative HGS in Iranian healthy population, i.e. < 26 kg in males and < 14 kg in females. The findings showed lower mean grip strength and high frequency of LGS in the non-survivors patients versus survivors group and in the Delta (B.1.617.2) variant vs. Alpha (B.1.1.7) variant, respectively (both p < 0.01). The binary logistic regression analysis showed that chronic obstructive pulmonary disease (COPD) (adjusted odds ratio [OR] 5.125, 95% CI 1.425-25.330), LGS (OR 4.805, 95% CI 1.624-10.776), SaO2 (OR - 3.501, 95% CI 2.452-1.268), C-reactive protein (CRP) level (OR 2.625, 95% CI 1.256-7.356), and age (OR 1.118, 95% CI 1.045-1.092) were found to be independent predictors for mortality of patients with Alpha (B.1.1.7) variant (all p < 0.05). However, only four independent predictors including COPD (OR 6.728, 95% CI 1.683-28.635), LGS (OR 5.405, 95% CI 1.461-11.768), SaO2 (OR - 4.120, 95% CI 2.924-1.428), and CRP level (OR 1.893, 95% CI 1.127-8.692) can be predicted the mortality of patients with Delta (B.1.617.2) variant (p < 0.05). Along with the well-known and common risk factors (i.e. COPD, CRP, and SaO2), handgrip strength can be a quick and low-cost prognostic tool in predicting chances of mortality in older adults who are afflicted with COVID-19 variants.
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Affiliation(s)
- Sajjad Rostamzadeh
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atabak Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amin Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Abouhossein
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Reljic D, Zieseniss N, Herrmann HJ, Neurath MF, Zopf Y. Protein Supplementation Increases Adaptations to Low-Volume, Intra-Session Concurrent Training in Untrained Healthy Adults: A Double-Blind, Placebo-Controlled, Randomized Trial. Nutrients 2024; 16:2713. [PMID: 39203849 PMCID: PMC11357491 DOI: 10.3390/nu16162713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/06/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024] Open
Abstract
Combined endurance and resistance training, also known as "concurrent training", is a common practice in exercise routines. While concurrent training offers the benefit of targeting both cardiovascular and muscular fitness, it imposes greater physiological demands on the body compared to performing each modality in isolation. Increased protein consumption has been suggested to support adaptations to concurrent training. However, the impact of protein supplementation on responses to low-volume concurrent training is still unclear. Forty-four untrained, healthy individuals (27 ± 6 years) performed two sessions/week of low-volume high-intensity interval training on cycle ergometers followed by five machine-based resistance training exercises for 8 weeks. Volunteers randomly received (double-blinded) 40 g of whey-based protein (PRO group) or an isocaloric placebo (maltodextrin, PLA group) after each session. Maximal oxygen consumption (VO2max) and overall fitness scores (computed from volunteers' VO2max and one-repetition maximum scores, 1-RM) significantly increased in both groups. The PRO group showed significantly improved 1-RM in all major muscle groups, while the PLA group only improved 1-RM in chest and upper back muscles. Improvements in 1-RM in leg muscles were significantly greater in the PRO group versus the PLA group. In conclusion, our results indicate that adaptations to low-volume concurrent training, particularly leg muscle strength, can be improved with targeted post-exercise protein supplementation in untrained healthy individuals.
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Affiliation(s)
- Dejan Reljic
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (N.Z.); (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Nilas Zieseniss
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (N.Z.); (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Hans Joachim Herrmann
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (N.Z.); (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Markus Friedrich Neurath
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (N.Z.); (H.J.H.); (M.F.N.); (Y.Z.)
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Yurdagül Zopf
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (N.Z.); (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
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Choi Y, Lee DC, Han Y, Sung H, Yoon J, Kim YS. Combined association of aerobic and muscle strengthening activity with mortality in individuals with hypertension. Hypertens Res 2024:10.1038/s41440-024-01788-3. [PMID: 39138362 DOI: 10.1038/s41440-024-01788-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/05/2024] [Accepted: 06/17/2024] [Indexed: 08/15/2024]
Abstract
Evidence on the association between meeting both aerobic physical activity (PA) and muscle-strengthening activity (MSA) guidelines with mortality in individuals with hypertension is scarce. We included 34,990 adults from the 2007 to 2013 Korea National Health and Nutrition Examination Survey, linking mortality follow-up data until 2019. Adherence to PA guidelines was assessed based on the current PA guidelines using a self-reported questionnaire and categorized as follows: meeting MSA only, aerobic PA only, both MSA and aerobic PA, or neither. Associations of hypertension and adherence to PA guidelines with all-cause and cardiovascular disease (CVD) mortality were examined using Cox proportional hazard models. Over 9.2 years, 1948 participants died from any cause and 419 from CVD. Meeting both PA guidelines was associated with the lowest risk of all-cause and CVD mortalities in the total sample regardless of hypertension status. In individuals with hypertension, meeting aerobic PA guidelines only had a 24% lower risk of both all-cause and CVD mortality, and meeting both PA guidelines further reduced risks by 40% and 43%, respectively; however, meeting MSA guidelines only was not associated with either all-cause or CVD mortality. In individuals without hypertension, only meeting both MSA and aerobic PA guidelines, but not meeting either MSA or aerobic PA guidelines, showed reduced risk of CVD mortality. In Korean population, non-hypertensive individuals who met both guidelines had a lower risk of CVD mortality. However, hypertensive individuals showed a reduced risk of both all-cause and CVD mortality when meeting aerobic PA or both guidelines, but not MSA alone.
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Affiliation(s)
- Younghwan Choi
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Duck-Chul Lee
- School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yunmin Han
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Hoyong Sung
- Department of Physical Education, Korea Military Academy, Seoul, South Korea
| | - Jiyeon Yoon
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Yeon Soo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea.
- Institute of Sport Science, Seoul National University, Seoul, South Korea.
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Zhu J, Wang J, Fan C, Wu D, Feng Q. Handgrip Strength and Low Muscle Strength Rate in Chinese Adults - China, 2020. China CDC Wkly 2024; 6:821-824. [PMID: 39157045 PMCID: PMC11325096 DOI: 10.46234/ccdcw2024.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/01/2024] [Indexed: 08/20/2024] Open
Abstract
What is already known on this topic? Handgrip strength (HS) serves as a diagnostic marker for low muscle strength rate (LMSR) and reflects the level of skeletal muscle. Over the past two decades, global data indicate a downward trend in HS across various countries. What is added by this report? According to the latest national data, the mean HS among Chinese adults aged 20 years and older was recorded at 40.4 kg for males and 25.1 kg for females in 2020. A decline in HS was observed with increasing age, particularly among women. Additionally, lower HS values were reported in rural areas, whereas LMSR was more prevalent in these regions. What are the implications for public health practice? The analysis of HS and LMSR among Chinese adults is essential for the development and implementation of targeted interventions aimed at improving HS prevalence rates. This analysis is highly significant for public health, contributing to increased public awareness of LMSR and the promotion of preventative measures.
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Affiliation(s)
- Jiarong Zhu
- Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China
| | - Jingjing Wang
- Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China
| | - Chaoqun Fan
- Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China
| | - Dongming Wu
- Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China
| | - Qiang Feng
- Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China
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24
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Michel E, Zory R, Guerin O, Prate F, Sacco G, Chorin F. Assessing muscle quality as a key predictor to differentiate fallers from non-fallers in older adults. Eur Geriatr Med 2024:10.1007/s41999-024-01020-y. [PMID: 39096327 DOI: 10.1007/s41999-024-01020-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/01/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Falling is an important public health issue because of its prevalence and severe consequences. Evaluating muscle performance is important when assessing fall risk. The study aimed to identify factors [namely muscle capacity (strength, quality, and power) and spatio-temporal gait attributes] that best discriminate between fallers and non-fallers in older adults. The hypothesis is that muscle quality, defined as the ratio of muscle strength to muscle mass, is the best predictor of fall risk. METHODS 184 patients were included, 81% (n = 150) were women and the mean age was 73.6 ± 6.83 years. We compared body composition, mean grip strength, spatio-temporal parameters, and muscle capacity of fallers and non-fallers. Muscle quality was calculated as the ratio of maximum strength to fat-free mass. Mean handgrip and power were also controlled by fat-free mass. We performed univariate analysis, logistic regression, and ROC curves. RESULTS The falling patients had lower muscle quality, muscle mass-controlled power, and mean weighted handgrip than the non-faller. Results showing that lower muscle quality increases fall risk (effect size = 0.891). Logistic regression confirmed muscle quality as a significant predictor (p < .001, OR = 0.82, CI [0.74; 0.89]). ROC curves demonstrated muscle quality as the most predictive factor of falling (AUC = 0.794). CONCLUSION This retrospective study showed that muscle quality is the best predictor of fall risk, above spatial and temporal gait parameters. Our results underscore muscle quality as a clinically meaningful assessment and may be a useful complement to other assessments for fall prevention in the aging population.
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Affiliation(s)
- Emeline Michel
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France.
- Université Côte d'Azur, LAMHESS, Nice, France.
| | - Raphael Zory
- Université Côte d'Azur, LAMHESS, Nice, France
- Institut Universitaire de France (IUF), Paris, France
| | - Olivier Guerin
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, INSERM, CNRS, Nice, France
| | - Frederic Prate
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
| | - Guillaume Sacco
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, UPR 7276 CoBTek, Nice, France
| | - Fréderic Chorin
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, LAMHESS, Nice, France
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Bhattarai U, Bashyal B, Shrestha A, Koirala B, Sharma SK. Frailty and chronic diseases: A bi-directional relationship. Aging Med (Milton) 2024; 7:510-515. [PMID: 39234207 PMCID: PMC11369349 DOI: 10.1002/agm2.12349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/31/2024] [Indexed: 09/06/2024] Open
Abstract
Frailty is a multidimensional syndrome associated with a decline in reserve capacity across multiple organ systems involving physical, psychological, and social aspects. Weakness is the earliest indicator of the frailty process. Multi-morbidity is the state of presence of two or more chronic diseases. Frailty and chronic diseases are interlinked as frail individuals are more prone to develop chronic diseases and multi-morbid individuals may present with frailty. They share common risk factors, pathogenesis, progression, and outcomes. Significant risk factors include obesity, smoking, aging, sedentary, and stressful lifestyle. Pathophysiological mechanisms involve high levels of circulating inflammatory cytokines as seen in individuals with frailty and chronic diseases such as hypertension, cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, and anemia. Hence, frailty and chronic diseases go hand in hand and it is of utmost importance to identify them and intervene during early stages. Screening frailty and treating multi-morbidity incorporate both pharmacological and majorly non- pharmacological measures, such as physical activities, nutrition, pro-active care, minimizing polypharmacy and addressing reversible medical conditions. The purpose of this mini-review is to highlight the interrelation of frailty and chronic diseases through the discussion of their predictors and outcomes and how timely interventions are essential to prevent the progression of one to the other.
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Affiliation(s)
- Urza Bhattarai
- Department of Internal MedicineB.P. Koirala Institute of Health SciencesDharanNepal
| | | | - Anu Shrestha
- B.P. Koirala Institute of Health SciencesDharanNepal
| | - Binu Koirala
- John Hopkins School of NursingBaltimoreMarylandUSA
| | - Sanjib Kumar Sharma
- Department of Internal MedicineB.P. Koirala Institute of Health SciencesDharanNepal
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Zheng H, Sun W, Zhou Z, Tian F, Xiao W, Zheng L. Cut-off points for knee extension strength: identifying muscle weakness in older adults. Eur Geriatr Med 2024; 15:913-925. [PMID: 38926333 DOI: 10.1007/s41999-024-01009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE Generalized muscle weakness is the primary characteristic of sarcopenia. Handgrip strength (HGS) is widely employed to detect muscle weakness. However, knee extension strength (KES) declines much earlier and more pronounced than HGS, and there is a stronger correlation between KES and functional performance. Therefore, KES may be a more appropriate proxy for identifying muscle weakness compared to HGS. The purpose of this review was to clarify the KES measurement towards a standardized approach and summarize the cut-off points for KES. METHODS A literature search was conducted in Web of Science, PubMed, Elsevier, Scopus and Medline databased up to July 10th, 2023. RESULTS A total of 12 articles were ultimately included in this review, which proposed various cut-off points for KES. Notably, these studies exhibited high heterogeneities, including diverse living settings for participants, KES measurement, methods for KES normalization, methodologies for determining cut-off points and study designs. CONCLUSIONS No consensus on cut-off points for KES was reached due to the heterogeneities in KES measurement and normalized methods among studies. To enhance the comparability among studies and facilitate the sarcopenia screening framework, a standardized approach for KES measurement and KES normalization are needed. Regarding KES measurement, the hand-held dynamometer-based isometric KES is easy to access and ideally suited for both clinical and community settings, while isokinetic KES, representing the gold standard, is preferred for research settings. Additionally, it is suggested to normalize isometric KES to body weight (BW), while normalizing isokinetic KES to allometrically scaled BW.
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Affiliation(s)
- Huifen Zheng
- School of Exercise and Health, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China
| | - Wei Sun
- College of Sport and Health, Shandong Sport University, Jinan, China
| | - Zifei Zhou
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Jing'an District , Shanghai, 20072, China
| | - Fei Tian
- Changzhi Medical College, Changzhi, China
| | - Weihua Xiao
- School of Exercise and Health, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China.
| | - Longpo Zheng
- School of Exercise and Health, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China.
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Jing'an District , Shanghai, 20072, China.
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Lu Z, Hu Y, He H, Chen X, Ou Q, Liu Y, Xu T, Tu J, Li A, Lin B, Liu Q, Xi T, Wang W, Huang H, Xu D, Chen Z, Wang Z, Shan G. Associations of muscle mass, strength, and quality with diabetes and the mediating role of inflammation in two National surveys from China and the United states. Diabetes Res Clin Pract 2024; 214:111783. [PMID: 39002932 DOI: 10.1016/j.diabres.2024.111783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
AIMS The evidence for joint and independent associations of low muscle mass and low muscle strength with diabetes is limited and mixed. The study aimed to determine the associations of muscle parameters (muscle mass, strength, quality, and sarcopenia) and sarcopenia obesity with diabetes, and the previously unstudied mediating effect of inflammation. MATERIALS AND METHODS A total of 13,420 adults from the 2023 China National Health Survey (CNHS) and 5,380 adults from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were included in this study. Muscle mass was determined using bioelectrical impedance analysis (BIA) in the CNHS, and whole-body dual X-ray absorptiometry (DXA) in the NHANES. Muscle strength was assessed using digital hand dynamometer. Multivariate logistic regression models were used to evaluate the associations of muscle parameters and sarcopenia obesity with diabetes. Inflammatory status was assessed using blood cell counts and two systemic inflammation indices (platelet-to-lymphocyte ratio (PLR) and system inflammation response index (SIRI)). Mediation analysis was conducted to examine inflammation's role in these associations. RESULTS Low muscle mass and strength were independently related to diabetes. Low muscle quality was associated with elevated diabetes risk. Sarcopenia has a stronger association with diabetes compared to low muscle strength alone or mass alone (CNHS, odds ratio (OR) = 1.93, 95 % confidence interval (CI):1.64-2.27; NHANES, OR = 3.80, 95 %CI:2.58-5.58). Participants with sarcopenia obesity exhibit a higher risk of diabetes than those with obesity or sarcopenia alone (CNHS, OR = 2.21, 95 %CI:1.72-2.84; NHANES, OR = 6.06, 95 %CI:3.64-10.08). Associations between muscle parameters and diabetes were partially mediated by inflammation (mediation proportion: 1.99 %-36.64 %, P < 0.05). CONCLUSION Low muscle mass and muscle strength are independently or jointly associated with diabetes, and inflammation might be a potential mechanism underlying this association. Furthermore, the synergistic effects of sarcopenia and obesity could significantly increase diabetes risk.
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Affiliation(s)
- Zhiming Lu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Qiong Ou
- Sleep Center, Department of Respiratory and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health of Jilin University, Changchun, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Ang Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Qihang Liu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Tianshu Xi
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Weihao Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Haibo Huang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Da Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Zhili Chen
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Zichao Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China; State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Filges B, Bahls M, Radke D, Groß S, Ewert R, Stubbe B, Markus MR, Felix SB, Völzke H, Dörr M, Köhler A, Ittermann T. Body surface scan anthropometrics are associated with grip strength in the general population. Nutr Metab Cardiovasc Dis 2024; 34:1864-1873. [PMID: 38664126 DOI: 10.1016/j.numecd.2024.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND AND AIM Body shape and anthropometrics are well-known risk factors for cardiovascular diseases (CVD) and mortality. Hand-grip strength (HGS) is also a meaningful marker of health and a promising predictor of CVD and mortality. There is a lack of studies that have systematically investigated associations between body shape and anthropometrics with HGS. In a population-based study, we investigated if anthropometric markers derived from 3D body scanning are related to HGS. METHODS AND RESULTS We used the data of 1,599 individuals aged 36 to 93 years, who participated in the Study of Health in Pomerania. A total of 87 anthropometric markers, determined by a 3D body scanner, were included in the analysis. Anthropometric measurements were standardized and used as exposure variables. HGS was measured with a hand dynamometer and used as outcome. Sex-stratified linear regression models adjusted for age and height were used to relate standardized anthropometrics and HGS. Anthropometric markers were ranked according to -log-p-values. In men, left and right forearm circumference, left arm length to neck (C7), left forearm length, and forearm-fingertip length were most strongly related to HGS. In women, right forearm circumference, forearm-fingertip length, shoulder breadth, left forearm circumference, and right wrist circumference showed the most significant associations with HGS. The final prediction models contained 13 anthropometric markers in males (R2=0.54) and eight anthropometric markers in females (R2=0.37). CONCLUSIONS The identified parameters may help estimate HGS in the clinical setting. However, studies in clinical settings are essential to validating our findings.
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Affiliation(s)
- Berit Filges
- Institute for Community Medicine, Department SHIP Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
| | - Martin Bahls
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Dörte Radke
- Institute for Community Medicine, Department SHIP Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Groß
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany
| | - Marcello Rp Markus
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, Department SHIP Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Armin Köhler
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, Department SHIP Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Germany.
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de Luis Román D, Gómez JC, García-Almeida JM, Vallo FG, Rolo GG, Gómez JJL, Tarazona-Santabalbina FJ, Sanz-Paris A. Diabetic Sarcopenia. A proposed muscle screening protocol in people with diabetes : Expert document. Rev Endocr Metab Disord 2024; 25:651-661. [PMID: 38315411 PMCID: PMC11294263 DOI: 10.1007/s11154-023-09871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To propose the grounds for "diabetic sarcopenia" as a new comorbidity of diabetes, and to establish a muscle screening algorithm proposal to facilitate its diagnosis and staging in clinical practice. METHOD A qualitative expert opinion study was carried out using the nominal technique. A literature search was performed with the terms "screening" or "diagnostic criteria" and "muscle loss" or "sarcopenia" and "diabetes" that was sent to a multidisciplinary group of 7 experts who, in a face-to-face meeting, discussed various aspects of the screening algorithm. RESULTS The hallmark of diabetic sarcopenia (DS) is muscle mass atrophy characteristic of people with diabetes mellitus (DM) in contrast to the histological and physiological normality of muscle mass. The target population to be screened was defined as patients with DM with a SARC-F questionnaire > 4, glycosylated haemoglobin (HbA1C) ≥ 8.0%, more than 5 years since onset of DM, taking sulfonylureas, glinides and sodium/glucose cotransporter inhibitors (SGLT2), as well as presence of chronic complications of diabetes or clinical suspicion of sarcopenia. Diagnosis was based on the presence of criteria of low muscle strength (probable sarcopenia) and low muscle mass (confirmed sarcopenia) using methods available in any clinical consultation room, such as dynamometry, the chair stand test, and Body Mass Index (BMI)-adjusted calf circumference. DS was classified into 4 stages: Stage I corresponds to sarcopenic patients with no other diabetes complication, and Stage II corresponds to patients with some type of involvement. Within Stage II are three sublevels (a, b and c). Stage IIa refers to individuals with sarcopenic diabetes and some diabetes-specific impairment, IIb to sarcopenia with functional impairment, and IIc to sarcopenia with diabetes complications and changes in function measured using standard tests Conclusion: Diabetic sarcopenia has a significant impact on function and quality of life in people with type 2 diabetes mellitus (T2DM), and it is important to give it the same attention as all other traditionally described complications of T2DM. This document aims to establish the foundation for protocolising the screening and diagnosis of diabetic sarcopenia in a manner that is simple and accessible for all levels of healthcare.
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Affiliation(s)
- Daniel de Luis Román
- Center Investigación of Endocrinology and Nutrition, University of Valladolid, Valladolid, Spain.
| | | | - José Manuel García-Almeida
- Clinical Management Unit of Endocrinology and Nutrition, Virgen de la Victoria Clinical Hospital, Málaga, Spain
| | | | | | - Juan José López Gómez
- Endocrinology and Nutrition Department, University Clinical Hospital of Valladolid, Valladolid, Spain
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Kadir NANA, Abdul-Razak S, Daher AM, Nasir NM. Handgrip strength, and erectile dysfunction among men with metabolic syndrome attending an institutional primary care clinic in Malaysia: A cross-sectional study. J Family Med Prim Care 2024; 13:2900-2911. [PMID: 39228540 PMCID: PMC11368348 DOI: 10.4103/jfmpc.jfmpc_1761_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 09/05/2024] Open
Abstract
Background Erectile dysfunction (ED) is an independent predictor for cardiovascular diseases (CVD). The prevalence increases with age, but little is known about the relationship between handgrip strength (HGS) and ED, especially among men with a high risk of CVD. This study aimed to determine the prevalence of ED among men aged ≥40 years with metabolic syndrome (MetS) and its association with HGS. Materials and Methods A cross-sectional study at an institutional primary care clinic in Malaysia was conducted between June 2021 and October 2021. HGS and erectile function were assessed using a hand dynamometer and International Index of Erectile Function (IIEF-5) questionnaire, respectively. Multiple logistic regression analyses were performed to determine the association between sociodemographics, clinical characteristics, and HGS with ED. Results A total of 334 participants were recruited. The prevalence of ED was 79% (95% confidence interval [CI]: 0.75-0.84). ED was associated with elderly aged ≥60 years (odds ratio [OR] 3.27, 95%CI: 1.60-6.69), low HGS (OR 15.34, 95%CI: 5.64-41.81) and high total cholesterol (OR 0.36, 95%CI: 0.16-0.78). Conclusion In conclusion, age above 60 years and those with low HGS are at higher risk of ED. Thus, robust screening of ED among men with MetS and improving muscle strength and physical fitness may be warranted.
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Affiliation(s)
- Nik A. Nik Abdul Kadir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| | - Suraya Abdul-Razak
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
- Cardiovascular and Lungs Research Institute (CaVaLRI), Hospital Al-Sultan Abdullah UiTM, Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Aqil M. Daher
- Department of Community Medicine, School of Medicine, International Medical University, Bukit Jalil, KL, Malaysia
- College of Health and Medical Techniques, Almaaqal University, Basrah, Iraq
| | - Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
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Zanotelli A, Rossi AP, Del Monte L, Vantini G, Stabile G, Urbani S, Giani A, Zoico E, Babbanini A, Fantin F, Zamboni M, Mazzali G. The Role of Combined Muscle Ultrasound and Bioimpedentiometry Parameters for Sarcopenia Diagnosis in a Population of Hospitalized Older Adults. Nutrients 2024; 16:2429. [PMID: 39125310 PMCID: PMC11313821 DOI: 10.3390/nu16152429] [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: 06/23/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND For the study of quantitative and qualitative muscle parameters, ultrasound and bioelectric impedance analysis are reliable, non-invasive, and reproducible. The aim of this study was to test the combined role of those techniques for the diagnosis of sarcopenia in a population of hospitalized older males and females. METHODS A total of 70 subjects were recruited, including 10 healthy adults and 60 hospitalized elderly patients with a good level of independence and cooperation, with and without sarcopenia. The rectus femoris cross-sectional area (CSA), thickness, echogenicity, and compressibility were measured with ultrasound echography. The phase angles (PhAs) and skeletal muscle mass were calculated by bioimpedence analysis. The muscle quality index (MQI) was calculated as the product of CSA and PhA. RESULTS Muscle compressibility was greater and PhA was lower in sarcopenic when compared with non-sarcopenic subjects. The threshold values for sarcopenia diagnosis in both sexes of CSA, of PhA, and of the MQI were identified. The obtained CSA values showed an AUC of 0.852 for women and 0.867 for men, PhA of 0.792 in women and 0.898 in men, while MQI was 0.900 for women and 0.969 for men. CONCLUSIONS The newly calculated cut-off values of CSA, PhA, and MQI predicted the presence of sarcopenia with good sensitivity and specificity values. The use of the MQI proved to be more promising than the separate use of CSA and PhA in both male and female subjects.
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Affiliation(s)
- Alfredo Zanotelli
- Section of Geriatric Medicine, Ospedale Santa Maria del Carmine, 38068 Rovereto, Italy;
| | - Andrea P. Rossi
- Division of Geriatrics, Department of Medicine, Ospedale Cà Foncello, 31100 Treviso, Italy
| | - Letizia Del Monte
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Gianluca Vantini
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Giovanni Stabile
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Silvia Urbani
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Anna Giani
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Elena Zoico
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Alessio Babbanini
- Division of Geriatrics, Department of Medicine, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy;
| | - Francesco Fantin
- Division of Geriatrics, University of Trento, 38100 Trento, Italy;
| | - Mauro Zamboni
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
| | - Gloria Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, 37100 Verona, Italy; (L.D.M.); (G.V.); (G.S.); (S.U.); (A.G.); (E.Z.); (M.Z.); (G.M.)
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Roman-Liu D, Kamińska J, Tokarski TM. Population-specific equations of age-related maximum handgrip force: a comprehensive review. PeerJ 2024; 12:e17703. [PMID: 39056055 PMCID: PMC11271657 DOI: 10.7717/peerj.17703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
Background The measurement of handgrip force responses is important in many aspects, for example: to complement neurological assessments, to investigate the contribution of muscle mass in predicting functional outcomes, in setting realistic treatment goals, evaluating rehabilitation strategies. Normative data about handgrip force can assist the therapist in interpreting a patient's results compared with healthy individuals of the same age and gender and can serve as key decision criteria. In this context, establishing normative values of handgrip strength is crucial. Hence, the aim of the this study is to develop a tool that could be used both in rehabilitation and in the prevention of work-related musculoskeletal disorders. This tool takes the form of population-specific predictive equations, which express maximum handgrip force as a function of age. Methodology In order to collect data from studies measuring maximum handgrip force, three databases were searched. The search yielded 5,058 articles. Upon the removal of duplicates, the screening of abstracts and the full-text review of potentially relevant articles, 143 publications which focussed on experimental studies on various age groups were considered as fulfilling the eligibility criteria. A comprehensive literature review produced 1,276 mean values of maximum handgrip force. Results A meta-analysis resulted in gender- and world region-specific (general population, USA, Europe and Asia) equations expressing maximum force as a function of age. The equations showed quantitative differences and trends in maximum handgrip force among age, gender and national groups. They also showed that values of maximum handgrip force are about 40% higher for males than for females and that age-induced decrease in force differs between males and females, with a proved 35% difference between the ages of 35 and 75. The difference was lowest for the 60-64 year olds and highest for the 18-25 year-olds. The equations also showed that differences due to region are smaller than those due to age or gender. Conclusions The equations that were developed for this study can be beneficial in setting population-specific thresholds for rehabilitation programmes and workstation exposure. They can also contribute to the modification of commonly used methods for assessing musculoskeletal load and work-related risk of developing musculoskeletal disorders by scaling their limit values.
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Affiliation(s)
- Danuta Roman-Liu
- Ergonomics, Central Institute for Labour Protection–National Research Institute, Warsaw, Poland
| | - Joanna Kamińska
- Ergonomics, Central Institute for Labour Protection–National Research Institute, Warsaw, Poland
| | - Tomasz Macjej Tokarski
- Ergonomics, Central Institute for Labour Protection–National Research Institute, Warsaw, Poland
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Zhang Y, Morita M, Hirano T, Doi K, Han X, Matsunaga K, Jiang Z. A Novel Method for Identifying Frailty and Quantifying Muscle Strength Using the Six-Minute Walking Test. SENSORS (BASEL, SWITZERLAND) 2024; 24:4489. [PMID: 39065887 PMCID: PMC11281094 DOI: 10.3390/s24144489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
The six-minute walking test (6MWT) is an essential test for evaluating exercise tolerance in many respiratory and cardiovascular diseases. Frailty and sarcopenia can cause rapid aging of the cardiovascular system in elderly people. Early detection and evaluation of frailty and sarcopenia are crucial for determining the treatment method. We aimed to develop a wearable measuring system for the 6MWT and propose a method for identifying frailty and quantifying walking muscle strength (WMS). In this study, 60 elderly participants were asked to wear accelerometers behind their left and right ankles during the 6MWT. The gait data were collected by a computer or smartphone. We proposed a method for analyzing walking performance using the stride length (SL) and step cadence (SC) instead of gait speed directly. Four regions (Range I-IV) were divided by cutoff values of SC = 2.0 [step/s] and SL = 0.6 [m/step] for a quick view of the frail state. There were 62.5% of frail individuals distributed in Range III and 72.4% of non-frail individuals in Range I. A concept of a WMS score was proposed for estimating WMS quantitatively. We found that 62.5% of frail individuals were scored as WMS1 and 41.4% of the non-frail elderly as WMS4. The average walking distances corresponding to WMS1-4 were 207 m, 370 m, 432 m, and 462 m, respectively. The WMS score may be a useful tool for quantitatively estimating sarcopenia or frailty due to reduced cardiopulmonary function.
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Affiliation(s)
- Yunjin Zhang
- Faculty of Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube 755-8611, Japan
| | - Minoru Morita
- Faculty of Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube 755-8611, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Keiko Doi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1, Minamikogushi, Ube 755-8505, Japan
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Xin Han
- Faculty of Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube 755-8611, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1, Minamikogushi, Ube 755-8505, Japan
| | - Zhongwei Jiang
- Faculty of Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 2-16-1 Tokiwadai, Ube 755-8611, Japan
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Bornhöft L, Bernhardsson S, Nordeman L, Grimby-Ekman A, Dottori M, Larsson MEH. Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 - a pragmatic randomised controlled trial. Scand J Prim Health Care 2024:1-10. [PMID: 38963325 DOI: 10.1080/02813432.2024.2373298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/22/2024] [Indexed: 07/05/2024] Open
Abstract
METHODS Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires. RESULTS Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels. CONCLUSIONS Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function.ClinicalTrials registration: NCT03693521.
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Affiliation(s)
- Lena Bornhöft
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research, Education, Development and Innovation, Region Västra Götaland, Sweden
- Primary Care Rehabilitation, Närhälsan Torslanda Rehabilitation Clinic, Region Västra Götaland, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research, Education, Development and Innovation, Region Västra Götaland, Sweden
- General practice - Family medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Nordeman
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research, Education, Development and Innovation, Region Västra Götaland, Sweden
| | - Anna Grimby-Ekman
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Maria Dottori
- Primary Health Care Research, Education, Development and Innovation, Region Västra Götaland, Sweden
| | - Maria E H Larsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research, Education, Development and Innovation, Region Västra Götaland, Sweden
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He YY, Jin ML, Fang XY, Wang XJ. Associations of muscle mass and strength with new-onset diabetes among middle-aged and older adults: evidence from the China health and retirement longitudinal study (CHARLS). Acta Diabetol 2024; 61:869-878. [PMID: 38507082 DOI: 10.1007/s00592-024-02265-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The associations of muscle mass and strength with new-onset Type 2 diabetes mellitus (T2DM) remain controversial. We aimed to longitudinally evaluate muscle mass and strength in predicting T2DM among Chinese middle-aged and older adults. METHODS We enrolled 6033 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS), a cohort survey, between 2011 and 2012. The appendicular skeletal muscle mass (normalized by weight, ASM/BW%), relative hand grip strength (normalized by weight, HGS/BW), and five-repetition chair stand test (5CST). were all categorized into tertiles (lowest, middle, and highest groups) at baseline, respectively. Individuals were followed up until the occurrence of diabetes or the end of CHARLS 2018, whichever happened first. Cox proportional hazards models to calculate hazard ratios with 95% confidence intervals (CI) and mediation analysis were used. RESULTS During follow-up, 815 (13.5%) participants developed T2DM. After adjusting for covariates, lower ASW/BW% was not associated with a higher risk of diabetes. Compared with individuals in the highest tertile of HGS/BW, those in the lowest tertile had 1.296 (95%CI 1.073-1.567) higher risk of diabetes. Compared with individuals in the lowest tertile of 5CST, those in the highest tertile had 1.329 times (95%CI 1.106-1.596) higher risk of diabetes. By subgroup, both the lowest HGS/BW and highest 5CST were risk factors for diabetes among obesity. The mediation analysis revealed that the effect of HGS/BW on the risk of diabetes is mainly mediated by insulin resistance. CONCLUSIONS Lower muscle strength is associated with an increased risk of diabetes, especially in obese populations.
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Affiliation(s)
- Yun-Yun He
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Mei-Ling Jin
- Department of Nephrology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiang-Yang Fang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiao-Juan Wang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China.
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Ghorbanzadeh A, Abud A, Liedl D, Rooke T, Wennberg P, Wysokinski W, McBane R, Houghton DE. Reduced calf muscle pump function is not explained by handgrip strength measurements. J Vasc Surg Venous Lymphat Disord 2024; 12:101869. [PMID: 38460817 DOI: 10.1016/j.jvsv.2024.101869] [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: 11/17/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE Reduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between handgrip strength (HGS) and CPF. METHODS Patients referred to the Gonda Vascular Laboratory for noninvasive venous studies were identified and consented. Patients underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cutoff for reduced CPF (rCPF) was defined as an ejection fraction of <45%. Maximum HGS bilaterally was obtained (three trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated. RESULTS 115 patients (mean age, 59.2 ± 17.4 years; 67 females, mean body mass index, 30.83 ± 6.46) were consented and assessed for HGS and CPF. rCPF was observed in 53 right legs (46%) and 67 left legs (58%). CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) patients. HGS was reduced bilaterally in 74 (64.3%), unilaterally in 23 (20%), and normal in 18 (15.7%) patients. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side. CONCLUSIONS There is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF, indicating different pathophysiological mechanisms for each process.
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Affiliation(s)
- Atefeh Ghorbanzadeh
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Abdi Abud
- University of Missouri-Columbia School of Medicine, Columbia, MO
| | - David Liedl
- Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Thom Rooke
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Paul Wennberg
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Waldemar Wysokinski
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Robert McBane
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Damon E Houghton
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN.
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Komici K, Bencivenga L, Arganese C, Rengo G, Guerra G. The relationship between muscle strength and epicardial fat in healthy adults. Exp Gerontol 2024; 192:112447. [PMID: 38692441 DOI: 10.1016/j.exger.2024.112447] [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: 03/06/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Muscular strength and muscle mass are considered key factors for healthy ageing. Modification of body composition and redistribution of adipose tissue has been described in advanced age. Muscle strength has an important predictive role for health outcomes. However, little is known regarding the relationship between muscle strength and epicardial fat. METHODS AND MATERIALS In a cohort of healthy adults following physical capacity evaluations, anthropometric measurements, handgrip strength (HGS), echocardiography and bioimpedance analysis (BIA) were performed. Kruskal-Wallis test, Spearman's correlation and regression analysis adjusted for confounders were applied. RESULTS A total population of 226 adults, age range 18-83 years, were included. Epicardial fat thickness resulted significantly associated with age p < 0.001, HGS (p < 0.001). Regression analysis adjusted for confounders revealed an independent relationship between handgrip strength and epicardial fat thickness: regression coefficient: -1.34; R2 = 0.27 and p = 0.044. CONCLUSIONS The relationship between epicardial fat and muscle strength is inverse and independent. Implementation of HGS measurement may be useful for the identification of subjects with excessive epicardial fat and cardiovascular risk. Measurement of epicardial fat could be helpful in the early detection of physical decline associated to ageing.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Caterina Arganese
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy; Istituti Clinci Scientifici Maugeri IRCCS-Scientific Intitute of Telese Terme, Telese Terme (BN), Italy
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
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Cui M, Wang J, Deng M, Meng H, Fan Y, Ku C, Wang R, Wu B, Dai M, Ping Z. Longitudinal relationship between grip strength and cognitive function in a European population older than 50 years: A cross-lagged panel model. Arch Gerontol Geriatr 2024; 122:105396. [PMID: 38484671 DOI: 10.1016/j.archger.2024.105396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/28/2024] [Accepted: 03/02/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the dynamic longitudinal relationship between grip strength and cognitive function. METHODS 6175 participants aged ≥50 years were included in the study using three waves of follow-up data from the Survey of Health, Ageing, and Retirement in Europe in 2015 (T1), 2017 (T2) and 2019 (T3). Cognitive function was assessed using numeracy, verbal fluency, immediate recall, delayed recall and total. The cross-lagged panel model was used for analysis. RESULTS There was a correlation between grip strength and cognitive function. Standardized path coefficient from numeracy T1 to grip strength T2 was 0.017 (p = 0.003), and from numeracy T2 to grip strength T3 was 0.014 (p = 0.012). Standardized path coefficient from grip strength T1 to numeracy T2 was 0.096 (p < 0.001), and from grip strength T2 to numeracy T3 was 0.113 (p < 0.001). Other indicators of cognitive function had similar relationships with grip strength. CONCLUSIONS The study found a statistically significant longitudinal and bidirectional relationship between grip strength and cognitive function in a sample of people aged ≥50 years from several European countries.
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Affiliation(s)
- Man Cui
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Juan Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Miao Deng
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Hailan Meng
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Yanshuai Fan
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Chaoyue Ku
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Ruizhe Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Binbin Wu
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Man Dai
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China.
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McGrath R, McGrath BM, Jurivich D, Knutson P, Mastrud M, Singh B, Tomkinson GR. Collective Weakness Is Associated With Time to Mortality in Americans. J Strength Cond Res 2024; 38:e398-e404. [PMID: 38595265 PMCID: PMC11189751 DOI: 10.1519/jsc.0000000000004780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
ABSTRACT McGrath, R, McGrath, BM, Jurivich, D, Knutson, P, Mastrud, M, Singh, B, and Tomkinson, GR. Collective weakness is associated with time to mortality in Americans. J Strength Cond Res 38(7): e398-e404, 2024-Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg·kg -1 (body mass normalized), or <1.05 kg·kg -1 ·m -2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg·kg -1 , or <0.79 kg·kg -1 ·m -2 . Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all-cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (CI: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging.
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Affiliation(s)
- Ryan McGrath
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
- Fargo VA Healthcare System, Fargo, ND, USA
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | | | - Donald Jurivich
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Peter Knutson
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Michaela Mastrud
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA
| | - Ben Singh
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Grant R. Tomkinson
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Bai X, Xiao W, Soh KG, Zhang Y. A 12-week Taijiquan practice improves balance control and functional fitness in fall-prone postmenopausal women. Front Public Health 2024; 12:1415477. [PMID: 38989125 PMCID: PMC11233800 DOI: 10.3389/fpubh.2024.1415477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/06/2024] [Indexed: 07/12/2024] Open
Abstract
Purpose Falls are the leading cause of accidental death among older persons, with postmenopausal women facing a greater hazard of falling due to osteoporosis. This study aimed to examine the effects of Taijiquan practice on balance control and functional fitness in at-risk females. Methods Chinese women who self-reported a tendency to fall and had a baseline one-leg stand test time (4.1 s in the Taijiquan group) below the national average for their age group (60-64 years: 10.9 s, 65-69 years: 9.9 s) were assigned to either a control group (n = 26, mean age = 63.9 years) or a Taijiquan group (n = 24, mean age = 63.9 years). The Taijiquan group participated in a 12-week supervised intervention, while the control group maintained their daily activities. The average duration of each exercise session was 52 min. Static balance and functional fitness were assessed at the beginning and end of the intervention. Results After 12 weeks, the Taijiquan group significantly outperformed the control group in terms of balance, flexibility, and muscular fitness (all p < 0.05). Participants in the Taijiquan group improved their one-leg stand by 61.0% (+2.5 s, Hedge's g = 0.85), arm curl by 8.3% (+1.7 repetitions, g = 0.53), handgrip strength by 8.3% (+1.9 kg, g = 0.65), and sit-and-reach by 163.2% (+6.2 cm, g = 1.17). Conclusion The improvement in balance, coupled with other functional fitness benefits, suggests that Taijiquan could serve as a useful exercise for older women with an elevated risk of falling.
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Affiliation(s)
- Xiaorong Bai
- School of Physical Education, Huzhou University, Huzhou, China
| | - Wensheng Xiao
- School of Physical Education, Huzhou University, Huzhou, China
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yang Zhang
- Independent Researcher, Windermere, FL, United States
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Silva-Santos T, Guerra RS, Valdiviesso R, Amaral TF. Hand Grip Force-Time Curve Indicators Evaluated by Dynamometer: A Systematic Review. Nutrients 2024; 16:1951. [PMID: 38931305 PMCID: PMC11206825 DOI: 10.3390/nu16121951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance. METHODS A systematic review was performed including studies whose participants' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve. RESULTS a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time. CONCLUSIONS Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.
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Affiliation(s)
- Tânia Silva-Santos
- LAETA-INEGI/FEUP, Associated Laboratory of Energy, Transports and Aerospace, Institute of Science and Innovation in Mechanical and Industrial Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (T.S.-S.); (R.S.G.)
| | - Rita S. Guerra
- LAETA-INEGI/FEUP, Associated Laboratory of Energy, Transports and Aerospace, Institute of Science and Innovation in Mechanical and Industrial Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (T.S.-S.); (R.S.G.)
- FP-I3ID, FP-BHS, Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal
| | - Rui Valdiviesso
- FCNAUP, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal;
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Teresa F. Amaral
- LAETA-INEGI/FEUP, Associated Laboratory of Energy, Transports and Aerospace, Institute of Science and Innovation in Mechanical and Industrial Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (T.S.-S.); (R.S.G.)
- FCNAUP, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal;
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Kerr HL, Krumm K, Anderson B, Christiani A, Strait L, Li T, Irwin B, Jiang S, Rybachok A, Chen A, Dacek E, Caeiro L, Merrihew GE, MacDonald JW, Bammler TK, MacCoss MJ, Garcia JM. Mouse sarcopenia model reveals sex- and age-specific differences in phenotypic and molecular characteristics. J Clin Invest 2024; 134:e172890. [PMID: 39145448 PMCID: PMC11324300 DOI: 10.1172/jci172890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 06/04/2024] [Indexed: 08/16/2024] Open
Abstract
Our study was to characterize sarcopenia in C57BL/6J mice using a clinically relevant definition to investigate the underlying molecular mechanisms. Aged male (23-32 months old) and female (27-28 months old) C57BL/6J mice were classified as non-, probable-, or sarcopenic based on assessments of grip strength, muscle mass, and treadmill running time, using 2 SDs below the mean of their young counterparts as cutoff points. A 9%-22% prevalence of sarcopenia was identified in 23-26 month-old male mice, with more severe age-related declines in muscle function than mass. Females aged 27-28 months showed fewer sarcopenic but more probable cases compared with the males. As sarcopenia progressed, a decrease in muscle contractility and a trend toward lower type IIB fiber size were observed in males. Mitochondrial biogenesis, oxidative capacity, and AMPK-autophagy signaling decreased as sarcopenia progressed in males, with pathways linked to mitochondrial metabolism positively correlated with muscle mass. No age- or sarcopenia-related changes were observed in mitochondrial biogenesis, OXPHOS complexes, AMPK signaling, mitophagy, or atrogenes in females. Our results highlight the different trajectories of age-related declines in muscle mass and function, providing insights into sex-dependent molecular changes associated with sarcopenia progression, which may inform the future development of novel therapeutic interventions.
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Affiliation(s)
- Haiming L. Kerr
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Kora Krumm
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Anthony Christiani
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lena Strait
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Theresa Li
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brynn Irwin
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Siyi Jiang
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Artur Rybachok
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Amanda Chen
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Elizabeth Dacek
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lucas Caeiro
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | | | - James W. MacDonald
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Theo K. Bammler
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | | | - Jose M. Garcia
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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Bicbavova GR, Livzan MA, Drapkina OM, Lisyutenko NS, Romanyuk AE. Sarcopenia and Dinapenia in Patients with Ulcerative Colitis (Cross-Sectional Observational Study). ANNALS OF THE RUSSIAN ACADEMY OF MEDICAL SCIENCES 2024; 79:112-122. [DOI: 10.15690/vramn17389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Background. Sarcopenia is a generalised, progressive decline in skeletal muscle mass, strength and performance leading to reduced quality of life, increased risk of falls, hospitalisation and mortality. Primary sarcopenia results from age-related changes in muscle tissue. In certain cases, sarcopenia develops secondary as a consequence of diseases including ulcerative colitis (UC), which is associated with a systemic inflammatory process, malabsorption syndrome, restriction of patients’ physical activity and nutrient deficiencies. The term “dynapenia” or “probable sarcopenia” has been proposed to describe the decrease in muscle strength. Studies have demonstrated that muscle strength is a more relevant marker for predicting adverse outcomes because its measurement is more practical, whereas muscle mass is technically difficult to measure.
Aims — to increase the effectiveness of the diagnosis of dinapenia, to assess the prevalence and risk factors of its formation in patients with UC.
Methods. A single-centre, observational cross-sectional study included 80 UC patients. To identify factors associated with the development of dinapenia, patients with dinapenia were compared with patients without dinapenia. The investigated parameters in patients: sex, age, body mass index, peculiarities of the course of the disease, ongoing treatment, concomitant pathology, peculiarities of nutrition, nutritional deficiency, malabsorption syndrome, bad habits, psychological stress and sleep duration, physical activity, laboratory indicators of inflammation, myokine-adipokine profile. Statistical parameters were calculated using Statistica 10.0.1011.0 programme.
Results. Dinapenia is present in 32.5% of UC patients. Risk factors for the formation of dinapenia in UC patients include female sex (p = 0.0003); nutritional insufficiency (p = 0.021); low physical activity (p = 0.010); artificial feeding in infancy (p = 0.024); inflammation, namely C-reactive protein, autoantibodies of class G against double-stranded DNA (p = 0.006; p = 0.002 respectively). Patients with UC with dinapenia significantly more often gave a positive answer to the questionnaire question “Does daily activity cause you a lot of stress?” (p = 0.048). In the group of UC patients with dinapenia, the level of cortisol in evening saliva was significantly higher than in the comparison group (p = 0.005).
Conclusions. Sarcopenia and UC are multifactorial conditions with common developmental mechanisms that can burden each other. Dynamometry is not technically difficult and is justified from an economic point of view. The timely detection of dinapenia and its correction will additionally affect the mechanisms of UC pathogenesis in order to improve the quality of life and prognosis of patients.
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Yang Z, Wei J, Liu H, Zhang H, Liu R, Tang N, Yang X. Changes in muscle strength and risk of cardiovascular disease among middle-aged and older adults in China: Evidence from a prospective cohort study. Chin Med J (Engl) 2024; 137:1343-1350. [PMID: 38407330 PMCID: PMC11191030 DOI: 10.1097/cm9.0000000000002968] [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: 10/22/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Evidence indicates that low muscle strength is associated with an increased cardiovascular diseases (CVDs) risk. However, the association between muscle strength changes based on repeated measurements and CVD incidence remains unclear. METHODS The study used data from the China Health and Retirement Longitudinal Study in 2011 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Low muscle strength was defined as handgrip strength <28 kg for men or <18 kg for women, or chair-rising time ≥12 s. Based on changes in muscle strength from Waves 1 to 2, participants were categorized into four groups of Normal-Normal, Low-Normal, Normal-Low, and Low-Low. CVD events, including heart disease and stroke, were recorded using a self-reported questionnaire during Waves 3 and 4 visits. Cox proportional hazards models were used to investigate the association between muscle strength changes and CVD incidence after multivariable adjustments. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated with the Normal-Normal group as the reference. RESULTS A total of 1164 CVD cases were identified among 6608 participants. Compared to participants with sustained normal muscle strength, the CVD risks increased progressively across groups of the Low-Normal (HR = 1.20, 95% CI: 1.01-1.43), the Normal-Low (HR = 1.35, 95% CI: 1.14-1.60), and the Low-Low (HR = 1.76, 95% CI: 1.49-2.07). Similar patterns were observed for the significant associations between muscle strength status and the incidence risks of heart disease and stroke. Subgroup analyses showed that the significant associations between CVD and muscle strength changes were consistent across age, sex, and body mass index (BMI) categories. CONCLUSIONS The study found that muscle strength changes were associated with CVD risk. This suggests that continuous tracking of muscle status may be helpful in screening cardiovascular risk.
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Affiliation(s)
- Ze Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Jiemin Wei
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Hongbo Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Honglu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Ruifang Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
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Liu D, Wang S, Liu S, Wang Q, Che X, Wu G. Frontiers in sarcopenia: Advancements in diagnostics, molecular mechanisms, and therapeutic strategies. Mol Aspects Med 2024; 97:101270. [PMID: 38583268 DOI: 10.1016/j.mam.2024.101270] [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: 10/28/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
The onset of sarcopenia is intimately linked with aging, posing significant implications not only for individual patient quality of life but also for the broader societal healthcare framework. Early and accurate identification of sarcopenia and a comprehensive understanding of its mechanistic underpinnings and therapeutic targets paramount to addressing this condition effectively. This review endeavors to present a cohesive overview of recent advancements in sarcopenia research and diagnosis. We initially delve into the contemporary diagnostic criteria, specifically referencing the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group on Sarcopenia (AWGS) 2019 benchmarks. Additionally, we elucidate comprehensive assessment techniques for muscle strength, quantity, and physical performance, highlighting tools such as grip strength, chair stand test, dual-energy X-ray Absorptiometry (DEXA), bioelectrical impedance analysis (BIA), gait speed, and short physical performance battery (SPPB), while also discussing their inherent advantages and limitations. Such diagnostic advancements pave the way for early identification and unequivocal diagnosis of sarcopenia. Proceeding further, we provide a deep-dive into sarcopenia's pathogenesis, offering a thorough examination of associated signaling pathways like the Myostatin, AMP-activated protein kinase (AMPK), insulin/IGF-1 Signaling (IIS), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways. Each pathway's role in sarcopenia mediation is detailed, underscoring potential therapeutic target avenues. From a mechanistic perspective, the review also underscores the pivotal role of mitochondrial dysfunction in sarcopenia, emphasizing elements such as mitochondrial oxidative overload, mitochondrial biogenesis, and mitophagy, and highlighting their therapeutic significance. At last, we capture recent strides made in sarcopenia treatment, ranging from nutritional and exercise interventions to potential pharmacological and supplementation strategies. In sum, this review meticulously synthesizes the latest scientific developments in sarcopenia, aiming to enhance diagnostic precision in clinical practice and provide comprehensive insights into refined mechanistic targets and innovative therapeutic interventions, ultimately contributing to optimized patient care and advancements in the field.
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Affiliation(s)
- Dequan Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shijin Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shuang Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Qifei Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Xiangyu Che
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
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Al-Azizi K, Moubarak G, Dib C, Sayfo S, Szerlip M, Thomas S, Hale S, Zyl JV, Settele RM, Gonzalez OR, Ventura SJ, DiMaio JM, Mack MJ, Potluri S. Distal Versus Proximal Radial Artery Access for Cardiac Catheterization: 1-Year Outcomes. Am J Cardiol 2024; 220:102-110. [PMID: 38432334 DOI: 10.1016/j.amjcard.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/02/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
Proximal radial artery (PRA) access for cardiac catheterization is safe but can jeopardize subsequent use of the artery because of occlusion. Distal radial artery (DRA) access in the anatomical snuffbox preserves the RA but safety and potential detrimental effects on hand function are unknown. We aimed to assess hand function and complications after DRA and PRA. In this single-center trial, 300 patients were randomly allocated 1:1 to cardiac catheterization through DRA or PRA. The primary end point of change in hand function from baseline to 1 year was a composite of the Quick Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, hand grip test, and thumb-forefinger pinch test. The secondary end points included access feasibility and complications. Of 216 patients with 1-year completed follow-up, 112 were randomly allocated to DRA and 104 to PRA, with balanced demographics and procedural characteristics. Both groups had similar access site bleeding rates (DRA 0% vs PRA 1.4%, p = 0.25). Radial artery occlusion occurred in 1 PRA patient versus 2 in DRA. There was no significant difference in change of hand function, median (interquartile range) hand grip (DRA 0.7 [-3 to 4.5] vs PRA 1.3 [-2 to 4.3] kg, p = 0.57), pinch grip (DRA -0.1 [-1.1 to 1] vs PRA -0.3 [-1 to 0.7] kg, p = 0.66), and Quick DASH (DRA 0 [-6.6 to 2.3] vs PRA 0 [-4.6 to 2.9] points, p = 0.58). The composite of hand function was comparable between PRA and DRA. In conclusion, DRA is a safe strategy for cardiac catheterization, with a low complication rate. Compared with PRA, there is no increased risk of hand dysfunction or radial artery occlusion at 1 year.
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Affiliation(s)
- Karim Al-Azizi
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas.
| | | | - Chadi Dib
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Sameh Sayfo
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Molly Szerlip
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas; Baylor Scott and White Research Institute, Plano, Texas
| | - Sibi Thomas
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Sarah Hale
- Baylor Scott and White Research Institute, Plano, Texas
| | | | | | | | | | - J Michael DiMaio
- Baylor Scott and White Research Institute, Plano, Texas; Department of Cardiothoracic Surgery, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Michael J Mack
- Baylor Scott and White Research Institute, Plano, Texas; Department of Cardiothoracic Surgery, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Srinivasa Potluri
- Department of Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas
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Kennedy F, Ní Cheallaigh C, Romero-Ortuno R, Doyle SL, Broderick J. Outcomes of the LEAP feasibility trial-A low-threshold, exercise programme with protein supplementation to target frailty and poor physical functioning in people experiencing homelessness and addiction issues. PLoS One 2024; 19:e0301926. [PMID: 38820432 PMCID: PMC11142616 DOI: 10.1371/journal.pone.0301926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 03/25/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND People experiencing homelessness are more likely to experience poor health with physical functioning deficits and frailty commonly reported. It is not well known how strategies to target physical functioning deficits and frailty work in practice in this group. The primary aim of this study was to explore the feasibility of an exercise intervention with protein supplementation to target physical functioning and frailty in people experiencing homelessness evaluated by recruitment and retention rates, adherence to the exercise sessions and protein supplement, adverse effects, programme feedback and characteristics of non-returners, sporadic and frequent attenders. The secondary aim was to evaluate changes in effectiveness outcomes of grip strength, muscle mass, lower extremity physical function, pain, frailty, and risk of malnutrition. METHOD This prospective single-arm study evaluated the feasibility of a 16-week rolling, low-threshold, 'drop-in' once weekly exercise programme with protein supplementation. The main recruitment site was a day-service centre for people who are homeless. Feasibility was assessed by the recruitment and retention rates, adherence to the exercise sessions and protein supplement as well as adverse effects, programme feedback and evaluation of characteristics of non-returners, sporadic (≤50% of available sessions) and frequent attenders (≥50% of available sessions). Effectiveness outcomes included pain (Visual Analogue Scale), physical functioning and performance (hand-grip dynamometry, limb circumference, the Short Physical Performance Battery), frailty (SHARE-FI and Clinical Frailty Scale) and nutritional status (Mini Nutritional Assessment). RESULTS Thirty-one participants were recruited mean (SD) age 45(16) years. There was a recruitment rate of a median (IQR) of 2(1-3) new participants per week. The retention rate was 45% (n = 14) to the main recruitment site. Adherence to the exercise sessions and nutritional intervention was 90% and 100% respectively. Three adverse events were recorded during 74 interventions over the 16-week programme. The acceptability of the programme was highlighted in participant feedback. Characteristics of frequent returners (≥50%) were older age, female, more stably housed and more stable in addiction. The programme did not induce any changes in effectiveness outcomes. CONCLUSION The feasibility of this programme was demonstrated. Overall, the programme was well received with higher retention rates in older participants, females, those more stably housed and those stable in addiction. A higher powered, more intense programme is needed to demonstrate programme effectiveness.
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Affiliation(s)
- Fiona Kennedy
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Clíona Ní Cheallaigh
- St James’s Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Roman Romero-Ortuno
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - Suzanne L. Doyle
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - Julie Broderick
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Karatrantou K, Pappas K, Batatolis C, Ioakimidis P, Gerodimos V. A 3-Month Modified Basketball Exercise Program as a Health-Enhancing Sport Activity for Middle-Aged Individuals. Life (Basel) 2024; 14:709. [PMID: 38929692 PMCID: PMC11205037 DOI: 10.3390/life14060709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Recreational team sports have received great acceptance lately, in different populations, indicating encouraging results in health-related quality of life. This study examined the efficacy of a 3-month basketball exercise program on selected indices of health (body mass-BM, body fat-BF, blood pressure-BP), functional capacity (flexibility of lower and upper limbs, balance), and physical fitness (maximum strength of lower limbs, trunk and handgrip, aerobic capacity) in middle-aged individuals. Forty middle-aged individuals (males and females; 40-55 years old) were randomly divided into (a) exercise (EG; n = 20) and (b) control groups (CG; n = 20). The EG followed a 3-month modified basketball exercise program (2 times/week; 24 training units), including different basketball drills with and without the ball (dribbling, passing, pivot, stops, etc.), to improve participants' health and physical fitness. Repeated measures ANOVA showed that the EG significantly increased their flexibility (17.23-74.88%; p < 0.001), static balance (44.76-54.69%; p < 0.001), and strength of lower limbs and trunk (11.67-13.13%; p < 0.001), while reducing BP (7.31-12%; p < 0.001), heart rate and RPE (5.30-34.37%; p < 0.001), and time during time-up-and-go test (-10.91%; p < 0.001). Handgrip strength, BM, and BF did not change following the program in the EG (p > 0.05). In the CG, the above variables remained stable. In conclusion, this program may be used to eliminate the detrimental effects of aging on health, functional capacity, and physical fitness parameters.
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Affiliation(s)
| | | | | | | | - Vassilis Gerodimos
- Department of Physical Education and Sports Science, University of Thessaly, 42100 Trikala, Greece; (K.K.); (K.P.); (C.B.); (P.I.)
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Zhong P, Yang S, Liu R, Zhu Z, Zhang Y, Cheng W, Wang W. Handgrip strength and risks of diabetic vascular complications: Evidence from Guangzhou Diabetic Eye Study and UK cohorts. Br J Ophthalmol 2024:bjo-2023-324893. [PMID: 38816182 DOI: 10.1136/bjo-2023-324893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The purpose is to investigate the association between handgrip strength (HGS) and the risk of future diabetic complications in multicountry cohorts. METHODS The association between HGS and diabetic complications was evaluated using cox models among 84 453 patients with pre-diabetes and diabetes from the UK Biobank with a 12-year follow-up. The association between HGS and longitudinal microcirculatory damage rates was assessed among 819 patients with diabetes from the Guangzhou Diabetic Eye Study (GDES) with a 3-year follow-up. Participants were divided into three age groups (<56, 56-65 and ≥65 years), and each group was further subdivided into three HGS tertiles. RESULTS A 5 kg reduction in HGS was associated with increased risk for all-cause mortality (women, HR=1.10, 95% CI: 1.05 to 1.14; p<0.001; men, HR=1.13, 95% CI: 1.11 to 1.15; p<0.001). Women and men in the lowest HGS group exhibited 1.6-times and 1.3-1.5-times higher risk of myocardial infarction and stroke compared with the highest HGS group. In men, there was a higher risk of developing end-stage renal disease (HR=1.83, 95% CI: 1.30 to 2.57; p=0.001), while this was not observed in women. Both sexes in the lowest HGS group had a 1.3-times higher risk of diabetic retinopathy compared with the highest HGS group. In the GDES group, individuals with the lowest HGS showed accelerated microcirculatory damage in retina (all p<0.05). CONCLUSIONS Reduced HGS is significantly associated with a higher risk of diabetic complications and accelerated microvascular damage. HGS could serve as a practical indicator of vascular health in patients with pre-diabetes and diabetes.
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Affiliation(s)
- Pingting Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shaopeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Riqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ziyu Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yongjie Zhang
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Weijing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan Province, China
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Khalil M, Di Ciaula A, Jaber N, Grandolfo R, Fiermonte F, Portincasa P. Multidimensional Assessment of Sarcopenia and Sarcopenic Obesity in Geriatric Patients: Creatinine/Cystatin C Ratio Performs Better than Sarcopenia Index. Metabolites 2024; 14:306. [PMID: 38921440 PMCID: PMC11205317 DOI: 10.3390/metabo14060306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are novel indicators for sarcopenia, but their accuracy may depend on various confounders. To assess CCR and SI diagnostic accuracy, we studied the clinical and biophysical parameters associated with sarcopenia or sarcopenic obesity. A total of 79 elderly patients (65-99 yrs, 33 females) underwent clinical, anthropometric, body composition, geriatric performance, and blood chemistry evaluation. The CCR and SI accuracy were assessed to identify sarcopenia. Sarcopenia was confirmed in 40.5%, and sarcopenic obesity in 8.9% of the subjects. Sarcopenic patients showed an increased Charlson comorbidity index, cardiovascular disease (CVD) rates and frailty, and decreased physical performance than non-sarcopenic subjects. Patients with sarcopenic obesity had increased body fat and inflammatory markers compared to obese subjects without sarcopenia. Sarcopenia was associated with a decreased CCR and SI. However, when the logistic regression models were adjusted for possible confounders (i.e., age, gender, Charlson comorbidity index, presence of CVD, and frailty score), a significant OR was confirmed for the CCR (OR 0.021, 95% CI 0.00055-0.83) but not for the SI. The AUC for the CCR for sarcopenia discrimination was 0.72. A higher performance was observed in patients without chronic kidney diseases (CKD, AUC 0.83). CCR, more than the SI, is a useful, non-invasive, and cost-effective tool to predict sarcopenia, irrespective of the potential confounders, particularly in subjects without CKD.
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Affiliation(s)
| | | | | | | | | | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.K.); (A.D.C.); (N.J.); (R.G.); (F.F.)
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