551
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Donkers H, Fasmer KE, Mcgrane J, Pijnenborg JMA, Bekkers R, Haldorsen IS, Galaal K. Obesity and visceral fat: Survival impact in high-grade endometrial cancer. Eur J Obstet Gynecol Reprod Biol 2020; 256:425-432. [PMID: 33307325 DOI: 10.1016/j.ejogrb.2020.11.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/14/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity is an important risk factor for the development of endometrial cancer (EC). Recent data showed that body fat distribution might be more relevant than Body Mass Index (BMI). High visceral fat percentage was shown to be an independent predictor for survival in EC, but mainly included grade 1-2 EC. OBJECTIVE To evaluate body fat distribution and its relation to outcome in high-grade endometrial cancer. METHODS Retrospective study in women diagnosed with high-grade EC between February 2006 and August 2017 at the Royal Cornwall Hospital who had abdominal CT-scan as part of routine diagnostic work-up. Subcutaneous abdominal fat volumes and visceral abdominal fat volumes were quantified based on CT-scan measurements, and visceral fat percentage calculated. RESULTS A total of 176 patients with high-grade EC were included. The median age was 70 years and median BMI was 29.4 kg/m2. The majority of patients had non-endometrioid endometrial cancer (NEEC; 62 %). High visceral fat percentage was associated with poor overall- and disease-specific survival (p = 0.006 and p = 0.026 respectively) in NEEC patients, but not in high-grade endometrioid EC (EEC). The most frequent obesity comorbidities hypertension and diabetes mellitus were significantly associated with high BMI and high visceral fat percentage. CONCLUSION In high-grade EC, high visceral fat percentage was an independent predictor of poor survival only in NEEC. The strong correlation between high visceral fat and obesity-related comorbidities might be reflective of an unhealthy macroenvironment.
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Affiliation(s)
- Hannah Donkers
- Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United Kingdom
| | - Kristine E Fasmer
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital Bergen, Bergen, Norway; Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - John Mcgrane
- Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United Kingdom
| | - Johanna M A Pijnenborg
- Department of Obstetrics & Gynecology, Radboud Institute for Health Science, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ruud Bekkers
- Grow School for Oncology and Developmental Biology, Maastricht University, the Netherlands; Catharina Hospital, Eindhoven, the Netherlands
| | - Ingfrid S Haldorsen
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital Bergen, Bergen, Norway; Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Khadra Galaal
- Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United Kingdom.
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552
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Guilbaud A, Mailliez A, Boulanger É. [Aging: a global, multidimensional and preventive approach]. Med Sci (Paris) 2020; 36:1173-1180. [PMID: 33296634 DOI: 10.1051/medsci/2020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aging is physiological and begins very early. It can be accelerated by our lifestyle and by chronic diseases. There are over 300 "theories" of aging and many animal models have been developed ranging from yeast to more complex organisms. Civil age is not a reflection of an individual's physiological age. Starting from the age of 30 a decrease in organ function can be observed. The aging of an individual leads him to 3 states: vigourous, polypathological and dependent or frail. The state of fragility is reversible. We have to be an actor in our aging and no longer suffer it. The centenarians of the blue zones have achieved, culturally, active aging which has led them to successful aging.
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Affiliation(s)
- Axel Guilbaud
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE, F-59000, Lille, France
| | - Aurélie Mailliez
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE, F-59000, Lille, France - Pôle de gérontologie, Centre hospitalier universitaire de Lille, F-59000, Lille, France
| | - Éric Boulanger
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE, F-59000, Lille, France - Pôle de gérontologie, Centre hospitalier universitaire de Lille, F-59000, Lille, France - Département universitaire de gériatrie et biologie du vieillissement, Faculté de médecine de Lille, F-59000, Lille, France
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553
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Fernández-Mincone T, Contreras-Briceño F, Espinosa-Ramírez M, García-Valdés P, López-Fuenzalida A, Riquelme A, Arab JP, Cabrera D, Arrese M, Barrera F. Nonalcoholic fatty liver disease and sarcopenia: pathophysiological connections and therapeutic implications. Expert Rev Gastroenterol Hepatol 2020; 14:1141-1157. [PMID: 32811209 DOI: 10.1080/17474124.2020.1810563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD) is currently one of the most common liver diseases worldwide. Recent data suggest that loss of skeletal muscle mass and function (i.e. sarcopenia) is highly prevalent and frequently overlooked in NAFLD patients. Experimental and clinical data suggest that the relationship between NAFLD and sarcopenia is pathophysiologically complex and bi-directional and there is a growing interest in unveiling how sarcopenia could influence NAFLD development and progression. AREAS COVERED PubMed/MEDLINE was searched for articles related to concomitant occurrence of NAFLD and sarcopenia between January 2013 and April 2020. Areas covered in this review include: (1) updated sarcopenia diagnosis strategy, (2) discussion of current data on pathophysiological connections between NAFLD and sarcopenia, and (3) analysis of current and future therapeutic implications of this knowledge. EXPERT OPINION Clinical studies describe a consistent association between NAFLD and sarcopenia, although a cause-effect relation remains to be determined. Active implementation of current diagnosis algorithms and optimized treatment can prevent sarcopenia related complications in subjects with NAFLD. Pathogenic pathways implicated in this relation are multiple and complex, a better understanding of them can provide novel biomarkers and targeted therapies that will hopefully have an important impact in NAFLD management.
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Affiliation(s)
- Tiziana Fernández-Mincone
- Laboratorio de Fisiología del Ejercicio, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Felipe Contreras-Briceño
- Laboratorio de Fisiología del Ejercicio, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Maximiliano Espinosa-Ramírez
- Laboratorio de Fisiología del Ejercicio, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Patricio García-Valdés
- Laboratorio de Fisiología del Ejercicio, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Antonio López-Fuenzalida
- Laboratorio de Fisiología del Ejercicio, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Arnoldo Riquelme
- Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile.,Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile.,Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Daniel Cabrera
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile.,Facultad de Ciencias Médicas, Universidad Bernardo O Higgins , Santiago, Chile
| | - Marco Arrese
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile.,Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago, Chile
| | - Francisco Barrera
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile , Santiago, Chile
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554
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Morgan PT, Smeuninx B, Breen L. Exploring the Impact of Obesity on Skeletal Muscle Function in Older Age. Front Nutr 2020; 7:569904. [PMID: 33335909 PMCID: PMC7736105 DOI: 10.3389/fnut.2020.569904] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/06/2020] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia is of important clinical relevance for loss of independence in older adults. The prevalence of obesity in combination with sarcopenia ("sarcopenic-obesity") is increasing at a rapid rate. However, whilst the development of sarcopenia is understood to be multi-factorial and harmful to health, the role of obesity from a protective and damaging perspective on skeletal muscle in aging, is poorly understood. Specifically, the presence of obesity in older age may be accompanied by a greater volume of skeletal muscle mass in weight-bearing muscles compared with lean older individuals, despite impaired physical function and resistance to anabolic stimuli. Collectively, these findings support a potential paradox in which obesity may protect skeletal muscle mass in older age. One explanation for these paradoxical findings may be that the anabolic response to weight-bearing activity could be greater in obese vs. lean older individuals due to a larger mechanical stimulus, compensating for the heightened muscle anabolic resistance. However, it is likely that there is a complex interplay between muscle, adipose, and external influences in the aging process that are ultimately harmful to health in the long-term. This narrative briefly explores some of the potential mechanisms regulating changes in skeletal muscle mass and function in aging combined with obesity and the interplay with sarcopenia, with a particular focus on muscle morphology and the regulation of muscle proteostasis. In addition, whilst highly complex, we attempt to provide an updated summary for the role of obesity from a protective and damaging perspective on muscle mass and function in older age. We conclude with a brief discussion on treatment of sarcopenia and obesity and a summary of future directions for this research field.
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Affiliation(s)
- Paul T. Morgan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Cellular & Molecular Metabolism Laboratory, Monash Institute of Pharmacological Sciences, Monash University, Parkville, VIC, Australia
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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555
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O'Donovan A, Leech M. Personalised treatment for older adults with cancer: The role of frailty assessment. Tech Innov Patient Support Radiat Oncol 2020; 16:30-38. [PMID: 33102819 PMCID: PMC7568178 DOI: 10.1016/j.tipsro.2020.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
It is widely accepted in clinical practice that chronological age is a poor predictor of treatment tolerance and outcomes in older adults with cancer. Intrinsic vulnerability is more a function of underlying frailty, rather than chronological age. Frailty is a state of increased vulnerability to stressors, such as cancer and its treatment, which can lead to adverse health outcomes for patients. Capturing this heterogeneity in reserve capacity is the cornerstone of management in geriatricmedicine, but remains poorly understood or adopted in radiation oncology. A two-step approach, using a shorter screening tool, followed by full assessment for those who need it, is the mostresourceful way of implementing frailty assessment in radiotherapy departments. It is important for radiation oncology professionals to identify frailty and to use this information in multidisciplinary decision making in order to develop a personalised radiotherapy approach for the older person. There are many ways we can effectively use this information, such as considering treatment fractionation schedules that would limit the burden of travel for those with social frailty, or reviewing the range of modalities at our disposal, which might limit toxicity in the older person at high risk of deterioration during treatment. Frailty assessment is not carried out in many radiotherapy departments presently, but there are many international models to use as exemplars as to how it may be implemented in clinical practice. There are many opportunities for further research and role development in this field at the current time.
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556
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Anjanappa M, Corden M, Green A, Roberts D, Hoskin P, McWilliam A, Choudhury A. Sarcopenia in cancer: Risking more than muscle loss. Tech Innov Patient Support Radiat Oncol 2020; 16:50-57. [PMID: 33385074 PMCID: PMC7769854 DOI: 10.1016/j.tipsro.2020.10.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia is characterised by progressive and extensive skeletal muscle degeneration and is associated with functional decline. Sarcopenia has primary and secondary aetiology, arising as a result of the ageing process or through chronic cytokine-mediated inflammation (associated with health conditions including cancer), respectively. Diagnosis of sarcopenia is dependent upon detection of reduced skeletal muscle strength, mass and performance. A combination of non-radiological and radiological methods can be used to assess each of these in turn to accurately diagnose sarcopenia. Sarcopenia is known to adversely affect outcomes of patients with various forms of cancer. Early identification of sarcopenia is imperative in improving patient care and overall prognosis. Various interventions, such as resistance exercise, nutritional support, and amino acid and vitamin supplementation have shown promise in the management of sarcopenia. However, further insight into novel interventions and indeed, assessment of the benefits of management of sarcopenia in terms of survival, are required to better support cancer patients.
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Affiliation(s)
- Milan Anjanappa
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK
| | - Michael Corden
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
| | - Andrew Green
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
| | - Darren Roberts
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
| | - Peter Hoskin
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
- Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
| | - Alan McWilliam
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
- Department of Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, UK
| | - Ananya Choudhury
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M20 4BX, UK
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557
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Baker JF, Harris T, Rapoport A, Ziolkowski SL, Leonard MB, Long J, Zemel B, Weber DR. Validation of a description of sarcopenic obesity defined as excess adiposity and low lean mass relative to adiposity. J Cachexia Sarcopenia Muscle 2020; 11:1580-1589. [PMID: 32931633 PMCID: PMC7749601 DOI: 10.1002/jcsm.12613] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/22/2020] [Accepted: 07/22/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND This study aims to assess the construct validity of a body composition-defined definition of sarcopenic obesity based on low appendicular lean mass relative to fat mass (ALMIFMI ) and high fat mass index (FMI) and to compare with an alternative definition using appendicular lean mass index (ALMI) and percent body fat (%BF). METHODS This is a secondary analysis of two cohort studies: the National Health and Examination Survey (NHANES) and the Health, Aging, and Body Composition study (Health ABC). Sarcopenic obesity was defined as low ALMIFMI combined with high FMI and was compared with a widely used definition based on ALMI and %BF cut-points. Body composition Z-scores, self-reported disability, physical functioning, and incident disability were compared across body composition categories using linear and logistic regression and Cox proportional hazards models. RESULTS Among 14, 850 participants from NHANES, patients with sarcopenic obesity defined by low ALMIFMI and high FMI (ALMIFMI -FMI) had above-average FMI Z-scores [mean (standard deviation): 1.00 (0.72)]. In contrast, those with sarcopenic obesity based on low ALMI and high %BF (ALMI-%BF) had below-average FMI Z-scores. A similar pattern was observed for 2846 participants from Health ABC. Participants with sarcopenic obesity based on ALMIFMI -FMI had a greater number of disabilities, worse physical function, and a greater risk of incident disability compared with those defined based on ALMI-%BF. CONCLUSIONS Body composition-defined measures of sarcopenic obesity defined as excess adiposity and lower-than-expected ALMI relative to FMI are associated with functional deficits and incident disability and overcome the limitations of using %BF in estimating obesity in this context.
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Affiliation(s)
- Joshua F. Baker
- Division of RheumatologyPhiladelphia Veterans' Affairs Medical CenterPhiladelphiaPAUSA
- Division of Rheumatology, School of MedicineUniversity of Pennsylvania8 Penn Tower Building,PhiladelphiaPAUSA
- Center for Clinical Epidemiology and BiostatisticsUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research ProgramNIA, NIHBethesdaMDUSA
| | | | | | - Mary B. Leonard
- Department of Medicine and PediatricsStanford UniversityPalo AltoCAUSA
| | - Jin Long
- Department of Medicine and PediatricsStanford UniversityPalo AltoCAUSA
| | - Babette Zemel
- Children's Hospital of PhiladelphiaPhiladelphiaPAUSA
| | - David R. Weber
- Division of Endocrinology and DiabetesGolisano Children's Hospital, University of RochesterRochesterNYUSA
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558
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Welch C, Greig C, Masud T, Wilson D, Jackson TA. COVID-19 and Acute Sarcopenia. Aging Dis 2020; 11:1345-1351. [PMID: 33269092 PMCID: PMC7673845 DOI: 10.14336/ad.2020.1014] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has had a devastating global impact, with older adults being most at risk of death from the disease. However, acute sarcopenia occurs in survivors of COVID-19; older adults and the most critically unwell patients are the most at risk. Acute sarcopenia is an under-recognised condition of acute muscle insufficiency, defined by declines in muscle function and/or quantity within six months, usually following a stressor event. This commentary reviews definition and mechanisms of acute sarcopenia in COVID-19 and suggests recommendations for research and clinical practice. Research should now focus on the longer-term consequences of acute sarcopenia in patients who have suffered from COVID-19. At the same time, clinicians need to be increasingly aware of the condition, and measurements of muscle strength, quantity, and physical performance should be embedded into clinical practice. Clinicians should consider the risks of acute sarcopenia when weighing up the risks and benefits of treatment (e.g. dexamethasone), and instigate multidisciplinary treatment including dietetics input.
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Affiliation(s)
- Carly Welch
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, UK.
- University Hospitals Birmingham NHS Trust, Birmingham, B15 2GW, UK.
| | - Carolyn Greig
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, UK.
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Tahir Masud
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, UK.
- University of Nottingham, Nottingham, UK.
- Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Daisy Wilson
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- University Hospitals Birmingham NHS Trust, Birmingham, B15 2GW, UK.
| | - Thomas A Jackson
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, UK.
- University Hospitals Birmingham NHS Trust, Birmingham, B15 2GW, UK.
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559
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Koutoukidis DA, Jones NR, Taylor CJ, Casadei B, Aveyard P. Obesity, self-reported symptom severity, and quality of life in people with atrial fibrillation: A community-based cross-sectional survey. Nutr Metab Cardiovasc Dis 2020; 30:2221-2229. [PMID: 32917499 DOI: 10.1016/j.numecd.2020.07.009] [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] [Received: 02/20/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Intentional weight loss may reduce symptom severity of atrial fibrillation (AF) in relatively young AF patients with overweight. We examined whether symptom severity and quality of life (QoL) are associated with weight status in the general population with AF. METHODS AND RESULTS Patients with electrocardiogram-confirmed AF completed validated questionnaires: the EuroQol 5 Dimensions QoL questionnaire and the Toronto Atrial Fibrillation Severity Scale (AFSS). The AFSS assessed the AF burden scoring on AF-related symptoms and the total AF burden measured as a combination of duration, frequency, and severity of an irregular heartbeat. Generalized liner models examined the association of body mass index (BMI) with AF severity and QoL adjusting for confounders. Between 2018 and 2019, 882 of 1901 (46%) mailed questionnaires were returned completed. Participants had a mean (SD) age of 74 (10) years old and a BMI of 27.4 (5.6) kg/m2. Sixteen percent reported having never experienced an irregular heartbeat. A 5 kg/m2 higher BMI was associated with a 0.65 (95%CI: 0.25 to 1.06) higher symptom score, where 3 points represent a clinically relevant change in state. A 5 kg/m2 higher BMI was associated with a -1.61 (95%CI: -2.72 to -0.50) lower QoL score. The coefficient of the total AF burden for a 5 kg/m2 higher BMI was 0.17 (95% CI: -0.01 to 0.68). CONCLUSION BMI was positively associated with symptoms and negatively associated with one of the two measures of QoL, but not with the total AF burden. However, the strength of association was small and not clinically meaningful.
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Affiliation(s)
- Dimitrios A Koutoukidis
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK.
| | - Nicholas R Jones
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Clare J Taylor
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Barbara Casadei
- Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK.
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560
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Jungert A, Eichner G, Neuhäuser-Berthold M. Trajectories of Body Composition during Advanced Aging in Consideration of Diet and Physical Activity: A 20-Year Longitudinal Study. Nutrients 2020; 12:nu12123626. [PMID: 33255771 PMCID: PMC7761400 DOI: 10.3390/nu12123626] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/10/2020] [Accepted: 11/21/2020] [Indexed: 12/24/2022] Open
Abstract
This prospective study investigates age-dependent changes in anthropometric data and body composition over a period of two decades in consideration of physical activity and diet in community-dwelling subjects ≥60 years. Overall, 401 subjects with median follow-up time of 12 years were examined. Fat-free mass (FFM) and fat mass (FM) were analyzed using bioelectrical impedance analysis. Physical activity was assessed via a self-administered questionnaire. Dietary intake was examined by 3-day dietary records. Linear mixed-effects models were used to analyze the influence of age, sex, physical activity and energy/protein intake on anthropometric data and body composition by considering year of entry, use of diuretics and diagnosis of selected diseases. At baseline, median values for daily energy and protein intakes were 8.5 megajoule and 81 g and physical activity index was 1.7. After adjusting for covariates, advancing age was associated with parabolic changes indicating overall changes from age 60 to 90 years in women and men in body mass: −4.7 kg, −5.0 kg; body mass index: +0.04 kg/m2, −0.33 kg/m2; absolute FFM: −2.8 kg, −3.5 kg; absolute FM: −1.8 kg, −1.2 kg and waist circumference: +16 cm, +12 cm, respectively. No age-dependent changes were found for upper arm circumference and relative (%) FFM. Dietary and lifestyle factors were not associated with changes in anthropometric or body composition parameters. In summary, the results indicate non-linear age-dependent changes in anthropometric data and body composition, which are largely unaffected by the degree of habitual physical activity and dietary protein intake in well-nourished community-dwelling subjects.
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Affiliation(s)
- Alexandra Jungert
- Institute of Nutritional Science, Justus Liebig University, Goethestr. 55, D-35390 Giessen, Germany;
- Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Justus Liebig University, Heinrich-Buff-Ring 26-32, D-35392 Giessen, Germany
| | - Gerrit Eichner
- Mathematical Institute, Arndtstr. 2, Justus Liebig University, D-35392 Giessen, Germany;
| | - Monika Neuhäuser-Berthold
- Institute of Nutritional Science, Justus Liebig University, Goethestr. 55, D-35390 Giessen, Germany;
- Correspondence: ; Tel.: +49-(0)641-99-39067
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561
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Lee CS, Kim JY, Kim BK, Lee IO, Park NH, Kim SH. Lactobacillus-fermented milk products attenuate bone loss in an experimental rat model of ovariectomy-induced post-menopausal primary osteoporosis. J Appl Microbiol 2020; 130:2041-2062. [PMID: 32920885 DOI: 10.1111/jam.14852] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 01/08/2023]
Abstract
AIM In this study, we investigated the anti-osteoporotic effect of two fermented milk products (FMPs) fermented by Lactobacillus plantarum A41 and Lactobacillus fermentum SRK414 on a rat model of ovariectomy-induced post-menopausal primary osteoporosis. METHODS AND RESULTS The two Lactobacillus FMPs increased the bone volume and bone mineral density (BMD) in ovariectomized (OVX) rats, and normalized the bone biomarkers in the serum. Additionally, they altered the gene expression levels of bone-metabolism-related markers. Furthermore, the two Lactobacillus FMPs downregulated bone-apoptosis-related genes stimulated by ovariectomy. Interestingly, the Lactobacillus FMPs decreased the levels of inflammation markers in the serum, bone, ileum and colon of the rats. Gut bacterial populations were also affected upon FMP treatment due to increase in the abundance of the genus Lactobacillus and Faecalibacterium prausnitzii. CONCLUSIONS Milk products fermented by L. plantarum A41 and L. fermentum SRK414 can exhibit anti-osteoporotic effects on post-menopausal osteoporosis via regulating the expression of bone-metabolism-related markers. SIGNIFICANCE AND IMPACT OF THE STUDY The two Lactobacillus FMPs used in the study can be an ideal method that has its potential of treating post-menopausal osteoporosis instead of drug treatments.
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Affiliation(s)
- C S Lee
- College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea.,Institute of Animal Molecular Biotechnology, Korea University, Seoul, Republic of Korea
| | - J-Y Kim
- College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - B K Kim
- Probiotic Research Laboratory, CKD Bio Research Institute, Ansan, Republic of Korea
| | - I O Lee
- Probiotic Research Laboratory, CKD Bio Research Institute, Ansan, Republic of Korea
| | - N H Park
- Probiotic Research Laboratory, CKD Bio Research Institute, Ansan, Republic of Korea
| | - S H Kim
- College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea.,Institute of Animal Molecular Biotechnology, Korea University, Seoul, Republic of Korea
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Watanabe K, Katagiri S, Takahashi H, Sasaki N, Maekawa S, Komazaki R, Hatasa M, Kitajima Y, Maruyama Y, Shiba T, Komatsu K, Ohsugi Y, Tanaka K, Matsuzawa A, Hirota T, Tohara H, Eguchi Y, Anzai K, Hattori A, Iwata T. Porphyromonas gingivalis
impairs glucose uptake in skeletal muscle associated with altering gut microbiota. FASEB J 2020; 35:e21171. [DOI: 10.1096/fj.202001158r] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/30/2020] [Accepted: 10/26/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Kazuki Watanabe
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Sayaka Katagiri
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology Facility of Medicine Saga University Saga Japan
- Liver Center Saga University Hospital Saga University Saga Japan
| | - Naoki Sasaki
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Shogo Maekawa
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Rina Komazaki
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Masahiro Hatasa
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Yoichiro Kitajima
- Division of Metabolism and Endocrinology Facility of Medicine Saga University Saga Japan
- Department of Radiology Eguchi Hospital Saga Japan
| | - Yusuke Maruyama
- Department of Biology College of Liberal Arts and Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Takahiko Shiba
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Keiji Komatsu
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Yujin Ohsugi
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Kenichi Tanaka
- Division of Metabolism and Endocrinology Facility of Medicine Saga University Saga Japan
| | - Ayumi Matsuzawa
- Department of Epigenetics Medical Research Institute Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Tomomitsu Hirota
- Division of Molecular Genetics Research Center for Medical Science The Jikei University School of Medicine Tokyo Japan
| | - Haruka Tohara
- Dysphagia Rehabilitation Department of Gerontology and Gerodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Yuichiro Eguchi
- Liver Center Saga University Hospital Saga University Saga Japan
| | - Keizo Anzai
- Division of Metabolism and Endocrinology Facility of Medicine Saga University Saga Japan
| | - Atsuhiko Hattori
- Department of Biology College of Liberal Arts and Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Takanori Iwata
- Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
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Obesity and muscle may have synergic effect more than independent effects on brain volume in community-based elderly. Eur Radiol 2020; 31:2956-2966. [PMID: 33196885 DOI: 10.1007/s00330-020-07407-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/26/2020] [Accepted: 10/09/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the individual and combined effects of obesity and muscle mass on brain volume in a community-dwelling healthy older population. METHODS One thousand two hundred nine participants (M:F = 574:635, mean age 63.6 ± 6.9 years) were included. The cross-sectional area of visceral fat (VF), the height-adjusted appendicular skeletal muscle mass (ASM/height2), and the ratio of thigh muscle to visceral fat (TM/VF) represented obesity, muscle mass, and their integrated value, respectively. Linear regression analysis was performed to establish associations between 215 brain compartment volumes and VF, ASM/height2, and TM/VF after adjusting for covariates. RESULTS On regression analysis, TM/VF had a positive correlation to the volumes of temporal lobe and cerebellum. TM/VF was associated with volumes of 10 subcompartments. TM/VF was positively correlated with the volumes of left entorhinal cortex, right temporal pole and inferior temporal gyrus related to cognition (p < 0.05, respectively), and the volumes of cerebellum and right pallidum related to movement (p < 0.05, respectively). However, VF had a negative correlation to temporal lobe volume and ASM/height2 had no significant correlation to any of the brain lobes. VF and ASM/height2 were correlated with volumes of 5 subcompartments and one subcompartment, respectively, CONCLUSIONS: TM/VF reflects the integrated effect of obesity and muscle mass and is associated with the volume of more brain regions compared to indices of obesity or muscle mass alone. The positive effect of muscle mass and the negative effect of obesity change the volumes of brain regions related to cognition and movement which were not significantly affected by obesity or muscle mass alone. KEY POINTS • If obesity and muscle mass were considered together, we could find more significant brain volume changes which were not found in obesity or muscle alone. • The ratio of thigh muscle to visceral fat was positively correlated with the volumes of entorhinal cortex, temporal pole, and inferior temporal gyrus related to cognition. • The ratio of thigh muscle to visceral fat was positively correlated with the volumes of cerebellum and pallidum related to movement.
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Godziuk K, Woodhouse LJ, Prado CM, Forhan M. Clinical screening and identification of sarcopenic obesity in adults with advanced knee osteoarthritis. Clin Nutr ESPEN 2020; 40:340-348. [PMID: 33183561 DOI: 10.1016/j.clnesp.2020.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Sarcopenic obesity (defined as low muscle mass and strength with high adiposity) requires attention in adults with advanced knee osteoarthritis (OA) due to implications on treatment outcomes. This study aimed to identify muscle function measures and patient characteristics associated with the presence of low muscle mass that could be used to screen and detect sarcopenic obesity in patients with knee OA in the clinical setting. METHODS Cross-sectional study of patients with knee OA and a body mass index (BMI) ≥30 kg/m2. Body composition was measured in n = 151 patients (59% female, mean age 65.1 ± 7.9 years) using dual-energy x-ray absorptiometry. Appendicular skeletal muscle mass (ASM) adjusted by BMI and below established sex-specific cut-points was used to differentiate low muscle mass. Muscle function was assessed by 4-m gait speed, 6 min walk test, and maximal grip strength (absolute, and relative, adjusted by BMI). Logistic regression was used to assess the relationship between muscle function measures, patient characteristics, and low muscle mass. Receiver operating characteristic curves and area under the curve (AUC) were used to examine the final model and identify potential clinical cut-points. RESULTS Sex and relative grip strength were associated with low muscle mass (AUC 0.774, p < 0.001). Cut-points for low relative grip strength (<0.65 kg/m2 in females and <1.1 kg/m2 in males) were distinguished and used in combination with low muscle mass to screen and identify sarcopenic obesity. Patients with both low relative grip strength and low muscle mass (sarcopenic obesity) had impaired mobility and quality of life. CONCLUSION Relative grip strength shows promise as a clinical screening measure for sarcopenic obesity in patients with knee OA.
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Affiliation(s)
- Kristine Godziuk
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Linda J Woodhouse
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada.
| | - Mary Forhan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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Li C, Kang B, Zhang T, Gu H, Man Q, Song P, Liu Z, Chen J, Wang X, Xu B, Zhao W, Zhang J. High Visceral Fat Area Attenuated the Negative Association between High Body Mass Index and Sarcopenia in Community-Dwelling Older Chinese People. Healthcare (Basel) 2020; 8:healthcare8040479. [PMID: 33198340 PMCID: PMC7712146 DOI: 10.3390/healthcare8040479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 01/05/2023] Open
Abstract
The association between obesity and sarcopenia remains controversial. The present study was conducted to explore the associations among body mass index (BMI), visceral fat area (VFA), and sarcopenia in older people and analyze their potential mechanisms. This cross-sectional study included 861 community-dwelling older Chinese people from three regions of China. BMI, VFA, muscle mass, muscle strength, physical performance, body composition, and metabolic markers were measured. Muscle mass and muscle strength were positively correlated with BMI, but were negatively correlated with VFA. Simple overweight/obesity was negatively associated with sarcopenia (OR = 0.07, 95% CI = 0.03~0.18), and the OR value was lower than combined obesity (OR = 0.16, 95% CI = 0.09~0.28). Fat free mass and total body protein were positively associated with high BMI but negatively associated with high VFA. Furthermore, high VFA was adversely associated with some metabolic risk factors of sarcopenia. Combination of BMI and VFA increased diagnostic efficiency of low muscle mass and sarcopenia. In conclusion, high BMI was negatively associated with sarcopenia, while high VFA attenuated the negative association between high BMI and sarcopenia. The opposite association may partially be attributed to their different associations with body composition and metabolic risk factors of sarcopenia. Therefore, bedsides BMI, VFA and its interaction with BMI should be considered in sarcopenia prevention.
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Affiliation(s)
- Cheng Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Bingxian Kang
- Wuyuan County Center for Disease Control and Prevention, 105 Shiji Road, Wuyuan, Inner Mongolia 015100, China; (B.K.); (X.W.)
| | - Ting Zhang
- Yuexiu District Center for Disease Control and Prevention, 23 Jiaochang West Road, Guangzhou 510030, China; (T.Z.); (B.X.)
| | - Hongru Gu
- Taicang City Center for Disease Control and Prevention, 36 Xianfu West Street, Taicang 215400, China;
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Pengkun Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Zhen Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Jingyi Chen
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Xile Wang
- Wuyuan County Center for Disease Control and Prevention, 105 Shiji Road, Wuyuan, Inner Mongolia 015100, China; (B.K.); (X.W.)
| | - Bin Xu
- Yuexiu District Center for Disease Control and Prevention, 23 Jiaochang West Road, Guangzhou 510030, China; (T.Z.); (B.X.)
| | - Wenhua Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (C.L.); (Q.M.); (P.S.); (Z.L.); (J.C.); (W.Z.)
- Correspondence: ; Tel.: +86-10-6623-7174
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Cross-Talk between Diet-Associated Dysbiosis and Hand Osteoarthritis. Nutrients 2020; 12:nu12113469. [PMID: 33198220 PMCID: PMC7696908 DOI: 10.3390/nu12113469] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Hand osteoarthritis (OA) is a degenerative joint disease which leads to pain and disability. Recent studies focus on the role of obesity and metabolic syndrome in inducing or worsening joint damage in hand OA patients, suggesting that chronic low-grade systemic inflammation may represent a possible linking factor. The gut microbiome has a crucial metabolic role which is fundamental for immune system development, among other important functions. Intestinal microbiota dysbiosis may favour metabolic syndrome and low-grade inflammation-two important components of hand OA onset and evolution. The aim of this narrative is to review the recent literature concerning the possible contribution of dysbiosis to hand OA onset and progression, and to discuss the importance of gut dysbiosis on general health and disease.
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Prevalence and risk factors of primary sarcopenia in community-dwelling outpatient elderly: a cross-sectional study. Sci Rep 2020; 10:19551. [PMID: 33177536 PMCID: PMC7658996 DOI: 10.1038/s41598-020-75250-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/13/2020] [Indexed: 01/01/2023] Open
Abstract
No previous study has investigated the prevalence and risk factors for primary sarcopenia in outpatient setting. This study aims to evaluate the prevalence and factors associated with primary sarcopenia in outpatient elderly. Additionally, we compared the severity of sarcopenia based on the 2014 and 2019 Asian Working Group for Sarcopenia (AWGS) criteria. This cross-sectional study was performed in 330 subjects aged over 60 years in an outpatient setting. The muscle strength, muscle performance and muscle mass were assessed using the handheld dynamometer, 6-m gait speed, and bioelectrical impedance analysis, respectively. The prevalence of sarcopenia was 10% as per the 2014 and 2019 AWGS criteria. The development of sarcopenia was positively correlated with the age with an odds ratio (OR) of 6.87 [95% confidence interval (CI) 1.63–28.88] in the middle-old group (70–79 years), and 13.71 (95%CI 3.66–51.41; p = 0.009) in the very old group (≥ 80 years). Prefrailty and low physical activity were significantly associated with sarcopenia with an OR of 4.75 (95%CI 1.90—11.89) in prefrailty, 15.35 (95%CI 1.69–139.47) in the middle activity group, and 17.99 (95%CI 1.95–165.73) in the lowest activity group. In conclusion, primary sarcopenia was found in one-tenth of outpatient elderly. Age, prefrailty, and low activity were independent factors associated with sarcopenia.
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Batsis JA, Haudenschild C, Roth RM, Gooding TL, Roderka MN, Masterson T, Brand J, Lohman MC, Mackenzie TA. Incident Impaired Cognitive Function in Sarcopenic Obesity: Data From the National Health and Aging Trends Survey. J Am Med Dir Assoc 2020; 22:865-872.e5. [PMID: 34248422 DOI: 10.1016/j.jamda.2020.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives The prevalence of obesity with sarcopenia is increasing in adults aged ≥65 years. This geriatric syndrome places individuals at risk for synergistic complications that leads to long-term functional decline. We ascertained the relationship between sarcopenic obesity and incident long-term impaired global cognitive function in a representative US population. Design A longitudinal, secondary data set analysis using the National Health and Aging Trends Survey. Setting Community-based older adults in the United States. Participants Participants without baseline impaired cognitive function aged ≥65 years with grip strength and body mass index measures. Methods Sarcopenia was defined using the Foundation for the National Institutes of Health Sarcopenia Project grip strength cut points (men <35.5 kg; women <20 kg), and obesity was defined using standard body mass index (BMI) categories. Impaired global cognition was identified as impairment in the Alzheimer's Disease-8 score or immediate/delayed recall, orientation, clock-draw test, date/person recall. Proportional hazard models ascertained the risk of impaired cognitive function over 8 years (referent = neither obesity or sarcopenia). Results Of the 5822 participants (55.7% women), median age category was 75 to 80, and mean grip strength and BMI were 26.4 kg and 27.5 kg/m2, respectively. Baseline prevalence of sarcopenic obesity was 12.9%, with an observed subset of 21.2% participants having impaired cognitive function at follow-up. Compared with those without sarcopenia or obesity, the risk of impaired cognitive function was no different in obesity alone [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82-1.16]), but was significantly higher in sarcopenia (HR 1.60; 95% CI 1.42-1.80) and sarcopenic obesity (HR 1.20; 95% CI 1.03-1.40). There was no significant interaction term between sarcopenia and obesity. Conclusions Both sarcopenia and sarcopenic obesity are associated with an increased long-term risk of impaired cognitive function in older adults.
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Affiliation(s)
- John A Batsis
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christian Haudenschild
- Geisel School of Medicine at Dartmouth, Hanover, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Robert M Roth
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Neuropsychology Program, Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Tyler L Gooding
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | | | - John Brand
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Todd A Mackenzie
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
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Gonzalez A, Huerta-Salgado C, Orozco-Aguilar J, Aguirre F, Tacchi F, Simon F, Cabello-Verrugio C. Role of Oxidative Stress in Hepatic and Extrahepatic Dysfunctions during Nonalcoholic Fatty Liver Disease (NAFLD). OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1617805. [PMID: 33149804 PMCID: PMC7603619 DOI: 10.1155/2020/1617805] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a pathology that contains a broad liver dysfunctions spectrum. These alterations span from noninflammatory isolated steatosis until nonalcoholic steatohepatitis (NASH), a more aggressive form of the disease characterized by steatosis, inflammatory status, and varying liver degrees fibrosis. NAFLD is the most prevalent chronic liver disease worldwide. The causes of NAFLD are diverse and include genetic and environmental factors. The presence of NASH is strongly associated with cirrhosis development and hepatocellular carcinoma, two conditions that require liver transplantation. The liver alterations during NAFLD are well described. Interestingly, this pathological condition also affects other critical tissues and organs, such as skeletal muscle and even the cardiovascular, renal, and nervous systems. Oxidative stress (OS) is a harmful state present in several chronic diseases, such as NAFLD. The purpose of this review is to describe hepatic and extrahepatic dysfunctions in NAFLD. We will also review the influence of OS on the physiopathological events that affect the critical function of the liver and peripheral tissues.
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Affiliation(s)
- Andrea Gonzalez
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Camila Huerta-Salgado
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Josué Orozco-Aguilar
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Francisco Aguirre
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Franco Tacchi
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Felipe Simon
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Millennium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Universidad de Chile, Chile
- Laboratory of Integrative Physiopathology, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
| | - Claudio Cabello-Verrugio
- Laboratory of Muscle Pathology, Fragility and Aging, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
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Genario R, Cipolla-Neto J, Bueno AA, Santos HO. Melatonin supplementation in the management of obesity and obesity-associated disorders: A review of physiological mechanisms and clinical applications. Pharmacol Res 2020; 163:105254. [PMID: 33080320 DOI: 10.1016/j.phrs.2020.105254] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/11/2020] [Accepted: 10/11/2020] [Indexed: 02/08/2023]
Abstract
Despite the evolving advances in clinical approaches to obesity and its inherent comorbidities, the therapeutic challenge persists. Among several pharmacological tools already investigated, recent studies suggest that melatonin supplementation could be an efficient therapeutic approach in the context of obesity. In the present review, we have amalgamated the evidence so far available on physiological effects of melatonin supplementation in obesity therapies, addressing its effects upon neuroendocrine systems, cardiometabolic biomarkers and body composition. Most studies herein appraised employed melatonin supplementation at dosages ranging from 1 to 20 mg/day, and most studies followed up participants for periods from 3 weeks to 12 months. Overall, it was observed that melatonin plays an important role in glycaemic homeostasis, in addition to modulation of white adipose tissue activity and lipid metabolism, and mitochondrial activity. Additionally, melatonin increases brown adipose tissue volume and activity, and its antioxidant and anti-inflammatory properties have also been demonstrated. There appears to be a role for melatonin in adiposity reduction; however, several questions remain unanswered, for example melatonin baseline levels in obesity, and whether any seeming hypomelatonaemia or melatonin irresponsiveness could be clarifying factors. Supplementation dosage studies and more thorough clinical trials are needed to ascertain not only the relevance of such findings but also the efficacy of melatonin supplementation.
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Affiliation(s)
- Rafael Genario
- School of Medicine, University of Sao Paulo (USP), São Paulo, Brazil.
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Allain A Bueno
- College of Health, Life and Environmental Sciences, University of Worcester, Worcester, United Kingdom
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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571
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Gába A, Pelclová J, Štefelová N, Přidalová M, Zając-Gawlak I, Tlučáková L, Pechová J, Svozilová Z. Prospective study on sedentary behaviour patterns and changes in body composition parameters in older women: A compositional and isotemporal substitution analysis. Clin Nutr 2020; 40:2301-2307. [PMID: 33109393 DOI: 10.1016/j.clnu.2020.10.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/06/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS The aims of this study were to examine the prospective compositional associations between sedentary behaviour (SB) patterns and longitudinal changes in body composition parameters, and to use compositional isotemporal substitution modelling to analyse the longitudinal changes in body composition parameters associated with time reallocation from SB to physical activity (PA) in older women. METHODS The study included women aged 60 years and older (n = 182) with valid data at baseline and at the subsequent 7-year follow-up. For both time points, the ActiGraph GT1M accelerometer was used for SB and PA assessments and multi-frequency bioimpedance analysis was used to assess the body composition parameters related to adiposity and muscle mass. Compositional regression models were used to analyse the associations between proportion of time spent in sedentary bouts of different duration and longitudinal changes in body composition parameters. A compositional isotemporal substitution model was created to estimate the differences in body composition parameters associated with one-to-one time reallocations between baseline SB and PA. RESULTS A significant increase in fat mass index (βilr1 = 0.61, 95% confidence interval [CI]: 0.18, 1.04) and visceral adipose tissue (βilr1 = 6.01, 95% CI: 1.52, 10.5) was associated with a higher baseline proportion of time spent in long sedentary bouts (i.e. sedentary bout of ≥30 min). Reallocating 1 h/week and 3.5 h/week from the time spent in long sedentary bouts in favour of light PA was associated with a significant decrease in fat mass index by 0.78% (95% CI: 0.24, 1.32) and 3.13% (95% CI: 0.97, 5.29), respectively. No association was found for indicators of muscle mass. CONCLUSIONS This study suggests that long-term adiposity status could be improved by increasing the proportion of time spent in light PA at the expense of time spent in prolonged SB. This finding may help in designing more effective and feasible interventions for the maintenance of healthy body composition in advanced age.
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Affiliation(s)
- Aleš Gába
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
| | - Jana Pelclová
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
| | - Nikola Štefelová
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
| | - Miroslava Přidalová
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
| | - Izabela Zając-Gawlak
- The Jerzy Kukuczka Academy of Physical Education, Mikołowska 72A, 40-065, Katowice, Poland.
| | - Lenka Tlučáková
- University of Presov, 17. Novembra 3724/15, 080 01, Prešov, Slovak Republic.
| | - Jana Pechová
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
| | - Zuzana Svozilová
- Palacký University Olomouc, Třída Míru 117, Olomouc, 771 00, Czech Republic.
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572
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Abstract
The population worldwide is aging and prevalence of obesity in this population is increasing. The range of consequences that effect these at-risk patients include increased risk of falls, fractures, reduced quality of life, and cognitive decline. This article describes the epidemiology of obesity, risks and benefits of weight loss, and importance of treating obesity to help promote healthy aging. Health care professionals should encourage older adults with obesity to implement healthy lifestyle behaviors including exercise and diet routine. Treating obesity in older adults mitigates the significant public health crisis, and reduces health care utilization and risk of long-term adverse events.
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Affiliation(s)
- Meredith N Roderka
- Section of Weight & Wellness, Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Sadhana Puri
- Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, USA
| | - John A Batsis
- Section of Weight & Wellness, Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA; Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, USA; The Dartmouth Institute for Health & Clinical Practice, 1 Medical Center Drive, Lebanon, NH 03756, USA; Dartmouth Centers for Health and Aging Hitchcock Loop Road, Lebanon, NH 03766, USA; Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
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573
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Are body fat and inflammatory markers independently associated with age-related muscle changes? Clin Nutr 2020; 40:2009-2015. [PMID: 33008653 DOI: 10.1016/j.clnu.2020.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/18/2020] [Accepted: 09/13/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS A growing number of studies have shown that body fat and inflammation are associated with age-related changes in body muscle composition. However, most of these studies did not control for potential confounders. The aim was to determine whether there is an association between body fat and inflammatory cytokines with muscle mass/strength decline in community-dwelling older adults. METHODS Anthropometric, physical and functionality variables were collected. Nutritional status was assessed by the MNA form. Dynapenia was assessed with handgrip strength on the dominant hand using a dynamometer. Sarcopenia was determined using adapted criteria from the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Inflammatory cytokines were evaluated in plasma using a multiplex assay. Associations to muscle mass/strength decline were analyzed using a multinominal logistic regression, adjusted for potential confounders. RESULTS We recruited a convenience sample of 311 adults aged 60 years or older. Most of subjects were sufficiently active females with a median age of 68 years (interquartile range [IQR], 64-74 years), whereas about a half (46.3%) were at risk of malnutrition. The prevalence of dynapenia was 38.3%, whereas sarcopenia was 13.2%. After controlling for potential confounders, we found that relative fat mass index is independently associated with sarcopenia. Loss of strength was independently associated only with female sex, lower physical activity, worse nutrition and IL-10/TNF-α ratio, whereas female sex, an insufficiently active lifestyle and relative fat mass index were the key determinants of sarcopenia. CONCLUSIONS These findings highlight the importance of physical activity and healthy diet as effective interventions to prevent muscle mass/strength decline, and points to IL-10/TNF-α ratio and body fat as independently associated factors for dynapenia and sarcopenia, respectively.
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574
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Yoshimura Y, Wakabayashi H, Nagano F, Bise T, Shimazu S, Kudo M, Shiraishi A. Sarcopenic Obesity Is Associated With Activities of Daily Living and Home Discharge in Post-Acute Rehabilitation. J Am Med Dir Assoc 2020; 21:1475-1480. [DOI: 10.1016/j.jamda.2020.03.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
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575
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Watanabe M, Tuccinardi D, Ernesti I, Basciani S, Mariani S, Genco A, Manfrini S, Lubrano C, Gnessi L. Scientific evidence underlying contraindications to the ketogenic diet: An update. Obes Rev 2020; 21:e13053. [PMID: 32648647 PMCID: PMC7539910 DOI: 10.1111/obr.13053] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/31/2022]
Abstract
First identified as a feasible treatment for intractable epilepsy, the ketogenic diet (KD) has recently gained popularity thanks to growing evidence on applications such as weight loss, most importantly, but also NAFLD, cancer, neurologic conditions and chronic pain. As with any treatment, whether pharmacologic or not, the KD might not be an appropriate intervention for every individual, and a number of contraindications have been proposed, now deeply rooted into clinical practice, excluding de facto many patients that could benefit from its use. However, many of these concerns were expressed due to the absence of clinical studies conducted on fragile populations, and an assessment of lately emerged evidence relative to KD safety is currently lacking and much needed. We herein provide a critical revision of the literature behind each safety alert, in order to guide through the treatment options in the case of subjects with an indication to the KD and a borderline safe situation. Based on available evidence, the possible use of this diet as a therapeutic intervention should be assessed on a patient-to-patient basis by adequately skilled medical doctors, keeping in mind current recommendations, but reading them through the knowledge of the current state of the art.
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Affiliation(s)
- Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Dario Tuccinardi
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Ilaria Ernesti
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy.,Department of Surgical Sciences, Surgical Endoscopy Unit, Sapienza University of Rome, Rome, Italy
| | - Sabrina Basciani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Stefania Mariani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Alfredo Genco
- Department of Surgical Sciences, Surgical Endoscopy Unit, Sapienza University of Rome, Rome, Italy
| | - Silvia Manfrini
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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576
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Neuhouser ML, Hunt RP, Van Horn L, Shikany JM, Stefanick ML, Johnson KC, Brunner R, Cannell B, Hatsu IE, Tinker LF. Barriers to eating are associated with poor physical function in older women. Prev Med 2020; 139:106234. [PMID: 32795644 PMCID: PMC7494579 DOI: 10.1016/j.ypmed.2020.106234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/20/2020] [Accepted: 08/06/2020] [Indexed: 01/06/2023]
Abstract
Older adults have physical and social barriers to eating but whether this affects functional status is unknown. We examined associations between eating barriers and physical function in the Women's Health Initiative (WHI). In 2012-14, a subset of alive and participating women (n = 5910) completed an in-home examination including the Short Physical Performance Battery (SPPB) (grip strength, balance, timed walking speed, chair stand). WHI participants complete annual mailed questionnaires; the 2013-14 questionnaire included items on eating alone, eating < two meals/day, dentition problems affecting eating, physical difficulties with cooking/shopping and monetary resources for food. Linear regression tested associations of these eating barriers with SPPB, adjusting for BMI, age, race/ethnicity, and medical multimorbidities. Over half (56.8%) of participants were ≥ 75 years, 98.8% had a BMI ≥ 25.0 kg/m2 and 66% had multimorbidities. Eating barriers, excluding eating alone, were associated with significantly lower total (all p < .001) and component-specific, multivariate-adjusted SPPB scores (all p < .05). Compared to no barriers, eating < two meals/day (7.83 vs. 8.38, p < .0002), dentition problems (7.69 vs. 8.38, p < .0001), inability to shop/prepare meals (7.74 vs. 8.38, p < .0001) and insufficient resources (7.84 vs. 8.37 p < .001) were significantly associated with multivariate-adjusted mean SPPB score < 8. Models additionally adjusting for Healthy Eating Index-2010 had little influence on scores. As barriers increased, scores declined further for grip strength (16.10 kg for 4-5 barriers, p = .001), timed walk (0.58 m/s for 4-5 barriers, p = .001) and total SPPB (7.27 for 4-5 barriers, p < .0001). In conclusion, in this WHI subset, eating barriers were associated with poor SPPB scores.
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Affiliation(s)
- Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4B402, Seattle, WA 98109-1024, USA.
| | - Rebecca P Hunt
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4B402, Seattle, WA 98109-1024, USA.
| | - Linda Van Horn
- Departrment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 North Lake Shore Drive #1400, Chicago, IL 60611, USA.
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave. S., MT 619, Birmingham, AL 35294-4410, USA.
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Medical School Office Building, 1265 Welch Rd, Room X308, Stanford, CA 94305, USA.
| | - Karen C Johnson
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline, suite 633, Memphis, TN 38163, USA.
| | - Robert Brunner
- School of Medicine, University of Nevada, Reno, 1664 N Virginia St, Reno, NV 89557, USA.
| | - Brad Cannell
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, Dallas Campus, University of Texas Health Science Center, 6011 Harry Hines Blvd, Suite V8, Dallas, TX 75390, USA.
| | - Irene E Hatsu
- Human Nutrition, 341 Campbell Hall, 1787 Neil Ave, The Ohio State University, Columbus, OH, 43210, USA.
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4B402, Seattle, WA 98109-1024, USA.
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577
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Li L, Chen Y, Wei Z, Cai Z, Jerban S, Zha Y, Ma YJ. 3D UTE bicomponent imaging of cortical bone using a soft-hard composite pulse for excitation. Magn Reson Med 2020; 85:1581-1589. [PMID: 32989787 DOI: 10.1002/mrm.28528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/27/2020] [Accepted: 08/31/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE To evaluate 3D UTE bicomponent imaging of cortical bone ex vivo and in vivo using a newly designed soft-hard composite pulse for excitation. METHODS Chemical shift artifacts, presenting as fat-water oscillation or combination-induced signal oscillation, significantly reduce the accuracy of quantitative UTE bicomponent analysis of cortical bone. To achieve fat suppression for more reliable bicomponent analysis, a newly developed soft-hard excitation pulse was used with UTE imaging and compared with a single rectangular pulse excitation without and with a conventional fat saturation (FatSat) module. These 3 sequences were applied to 8 bovine bone samples without marrow fat, 3 bovine bone samples with marrow fat, and tibial midshafts of 5 healthy human volunteers. Bicomponent analyses were performed in both ex vivo and in vivo studies. RESULTS The soft-hard pulse provided comparable fat suppression, but much reduced bone signal attenuation compared with the FatSat module. Better bicomponent T 2 ∗ fitting was also achieved with the soft-hard excitation pulse because it greatly reduced chemical shift artifacts and outperformed the single rectangular pulse without or with FatSat. Although the FatSat module reduced fat signals and related fat-water oscillation, the water signals were significantly attenuated with more than 40% reduction due to direction saturation. For the inner layer of tibial midshaft in healthy volunteers, fitting errors increased from 3.78% for the soft-hard pulse to 11.43% and 5.16%, respectively, for the single rectangular pulse without and with the FatSat module. CONCLUSION The 3D UTE sequence with a new soft-hard excitation pulse allows more reliable bicomponent imaging of cortical bone.
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Affiliation(s)
- Liang Li
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.,Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Yanjun Chen
- Department of Radiology, University of California San Diego, San Diego, California, USA.,Department of Medical Imaging Center, The Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Zhao Wei
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Zhenyu Cai
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, San Diego, California, USA
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578
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Batsis JA, Petersen CL, Cook SB, Al-Nimr RI, Pidgeon D, Mackenzie TA, Bartels SJ. A Community-Based Feasibility Study of Weight-Loss in Rural, Older Adults with Obesity. J Nutr Gerontol Geriatr 2020; 39:192-204. [PMID: 32907522 DOI: 10.1080/21551197.2020.1817226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study was a 12-week feasibility weight-loss intervention consisting of caloric restriction and aerobic/resistance exercise in older adults with obesity (body mass index ≥ 30 kg/m2) in a geographically isolated area. Primary outcomes assessed weight and physical function. Mean age was 71.0 ± 5.1 years (67% female). Individuals completed 100% of all assessments, attended 88% of the physical therapy classes and 89% of the nutrition sessions. Level of satisfaction (5-point Likert) was high (5.0, 1 - low; 5 - high). Weight decreased from 93.7 ± 9.7 to 89.4 ± 4.0 kg (p < 0.001). Mean BMI and waist circumference decreased, respectively, from 35.4 ± 3.4 to 33.6 ± 3.7 (p < 0.001), and 116.3 ± 7.5 to 108.7 ± 9.2 cm (p = 0.002). Grip strength, gait speed, and 5-times sit-to-stand time all improved from 29.2 ± 7.5 to 35.2 ± 6.7 kg (p = 0.006), 1.16 ± 0.21 to 1.35 ± 0.23 m/s (p = 0.004), and 12.5 ± 4.0 to 9.6 ± 1.7s (p = 0.02). The intervention was feasible and acceptable, and holds promise in promoting weight loss with a concomitant improvement in physical function in older adults.
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Affiliation(s)
- John A Batsis
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, The Dartmouth Institute for Health Policy, Lebanon, NH, USA
| | - Curtis L Petersen
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, The Dartmouth Institute for Health Policy, Lebanon, NH, USA.,Mayo Clinic Rochester, Rochester, MN, USA
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Rima I Al-Nimr
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, The Dartmouth Institute for Health Policy, Lebanon, NH, USA
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579
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Ponce de León-Ballesteros G, Sánchez-Aguilar HA, Velázquez-Fernández D, Nava-Ponce T, Herrera MF. Roux-en-Y Gastric Bypass in Patients >60 Years of Age: Morbidity and Short-Term Outcomes. Obes Surg 2020; 30:5033-5040. [PMID: 32902775 DOI: 10.1007/s11695-020-04957-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Obesity is a common disease in the elderly population, and bariatric surgery is the most effective intervention to achieve significant and sustainable weight loss. Many bariatric programs have established an arbitrary cutoff at the age of 60 to 65 years. The aim of this study was to evaluate the safety and short-term outcomes of Roux-en-Y gastric bypass (RYGB) in patients older than 60 years. PATIENTS AND METHODS We conducted a retrospective cohort study of patients who underwent RYGB from 2004 to 2019 in a single center. Logistic and linear multivariate regressions were made to compare complications and short-term outcomes between patients aged > 60 years and < 60 years. The statistical significance was set at p ≤ 0.05. RESULTS From 849 patients who underwent a primary RYGB, 57 were > 60 years of age. Overall, early and late complications were similar in both groups, except for unexpected intensive care unit (ICU) admission which was more frequent in the > 60 years group. Excess body weight loss (%EWL) and percentage total weight loss (%TWL) at 1 year in patients > 60 years old were 76.6 ± 21.8% and 30.73 ± 6.8%, respectively. Figures for the same parameters in the control group were 81.7 ± 19.9% (p = 0.09) and 34.3 ± 7.2 (p = 0.001), respectively. CONCLUSIONS In our experience, an age > 60 is not related to higher rates of overall early and late complications after RYGB. Comorbidity remission rates are similar to those in younger patients. Elderly patients had lower total weight loss at 1 year, but the %EWL was similar in both groups.
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Affiliation(s)
| | - Hugo A Sánchez-Aguilar
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico
| | - David Velázquez-Fernández
- Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Tania Nava-Ponce
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico
| | - Miguel F Herrera
- Clinic for Nutrition and Obesity, ABC Medical Center, 116, Sur 136, Las Américas, Álvaro Obregón, 01120, Mexico City, Mexico. .,Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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580
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Abstract
PURPOSE OF REVIEW Bariatric surgery is the most effective treatment for severe and complex obesity; however, the risk of developing nutrient deficiencies varies based upon the type of surgery, degree of malabsorption, and level of nutrition intervention. There are numerous factors that can impact the nutrition status of a patient during their pre- and postoperative journey. We review the critical components and considerations needed in order to provide optimal nutrition care for patients with bariatric surgery. RECENT FINDINGS A dietitian, specializing in bariatric surgery, is the best equipped healthcare provider to prepare and support patients in achieving and maintaining optimal nutrition status. We present best practices for both the pre- and postoperative nutrition-related phases of a patient's journey. The dietitian specialist is integral in the assessment and ongoing nutrition care of patients with bariatric surgery. Further consideration should be given to enable access for lifelong follow-up and monitoring.
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Affiliation(s)
- Julie M Parrott
- Metabolic and Bariatric Surgery Program, Penn Medicine, Clinical Practices of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | | | | | - Mary O'Kane
- Department of nutrition and dietetics, The General Infirmary at Leeds, Great George Street, Leeds, West Yorkshire, LS1 3EX, UK.
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581
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Lim WS, Lim JP, Chew J, Tan AWK. Calf Circumference as a Case-Finding Tool for Sarcopenia: Influence of Obesity on Diagnostic Performance. J Am Med Dir Assoc 2020; 21:1359-1361. [DOI: 10.1016/j.jamda.2020.03.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 01/10/2023]
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582
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Kusakabe T, Yokota S, Shimizu M, Inoue T, Tanaka M, Ohue-Kitano R, Muranaka K, Yamakage H, Wada H, Hasegawa K, Satoh-Asahara N. Differential effects of sodium-glucose cotransporter 2 inhibitor and low-carbohydrate diet on body composition and metabolic profile in obese diabetic db/db mice. BMJ Open Diabetes Res Care 2020; 8:8/1/e001303. [PMID: 32883687 PMCID: PMC7473664 DOI: 10.1136/bmjdrc-2020-001303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/12/2020] [Accepted: 07/18/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Treatment using sodium-glucose cotransporter (SGLT) 2 inhibitor and low-carbohydrate diet (LCD) for obesity and type 2 diabetes are similar in terms of carbohydrate limitation. However, their mechanisms of action differ, and the effects on the body remain unclear. We investigated the effects of SGLT2 inhibitor and LCD on body composition and metabolic profile using the db/db mouse model for obesity and type 2 diabetes. RESEARCH DESIGN AND METHODS Eight-week-old male db/db mice were divided into four groups: mice receiving normal diet and vehicle or canagliflozin (Cana) administration and mice receiving LCD and vehicle or Cana administration for 8 weeks. Consumed calories were adjusted to be equal among the groups. RESULTS Both Cana administration and LCD feeding resulted in significant weight gain. Cana administration significantly decreased plasma glucose levels and increased plasma insulin levels with preservation of pancreatic β cells. However, LCD feeding did not improve plasma glucose levels but deteriorated insulin sensitivity. LCD feeding significantly reduced liver weight and hepatic triglyceride content; these effects were not observed with Cana administration. Combined treatment with LCD did not lead to an additive increase in blood β-ketone levels. CONCLUSIONS SGLT2 inhibitors and LCD exert differential effects on the body. Their combined use may achieve better metabolic improvements in obesity and type 2 diabetes.
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Affiliation(s)
- Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Shigefumi Yokota
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Mika Shimizu
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Takayuki Inoue
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Masashi Tanaka
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Ryuji Ohue-Kitano
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Kazuya Muranaka
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Hiromichi Wada
- Division of Translational Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Koji Hasegawa
- Division of Translational Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organisation Kyoto Medical Center, Kyoto, Japan
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583
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Fanjul V, Jorge I, Camafeita E, Macías Á, González‐Gómez C, Barettino A, Dorado B, Andrés‐Manzano MJ, Rivera‐Torres J, Vázquez J, López‐Otín C, Andrés V. Identification of common cardiometabolic alterations and deregulated pathways in mouse and pig models of aging. Aging Cell 2020; 19:e13203. [PMID: 32729659 PMCID: PMC7511870 DOI: 10.1111/acel.13203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/10/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022] Open
Abstract
Aging is the main risk factor for cardiovascular and metabolic diseases, which have become a global concern as the world population ages. These diseases and the aging process are exacerbated in Hutchinson–Gilford progeria syndrome (HGPS or progeria). Here, we evaluated the cardiometabolic disease in animal models of premature and normal aging with the aim of identifying alterations that are shared or specific to each condition. Despite differences in body composition and metabolic markers, prematurely and normally aging mice developed heart failure and similar cardiac electrical abnormalities. High‐throughput proteomics of the hearts of progeric and normally aged mice revealed altered protein oxidation and glycation, as well as dysregulated pathways regulating energy metabolism, proteostasis, gene expression, and cardiac muscle contraction. These results were corroborated in the hearts of progeric pigs, underscoring the translational potential of our findings, which could help in the design of strategies to prevent or slow age‐related cardiometabolic disease.
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Affiliation(s)
- Víctor Fanjul
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Departamento de Bioquímica y Biología Molecular Facultad de Medicina Instituto Universitario de Oncología Universidad de Oviedo Oviedo Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Inmaculada Jorge
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Emilio Camafeita
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Álvaro Macías
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Cristina González‐Gómez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Ana Barettino
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Beatriz Dorado
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - María Jesús Andrés‐Manzano
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - José Rivera‐Torres
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Jesús Vázquez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
| | - Carlos López‐Otín
- Departamento de Bioquímica y Biología Molecular Facultad de Medicina Instituto Universitario de Oncología Universidad de Oviedo Oviedo Spain
- Centro de Investigación Biomédica en Red Enfermedades Cáncer (CIBERONC) Spain
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV) Spain
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584
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Morris A. Age-related muscle loss - novel target identified. Nat Rev Endocrinol 2020; 16:472-473. [PMID: 32636472 DOI: 10.1038/s41574-020-0388-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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585
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Goisser S, Kiesswetter E, Schoene D, Torbahn G, Bauer JM. Dietary weight-loss interventions for the management of obesity in older adults. Rev Endocr Metab Disord 2020; 21:355-368. [PMID: 32829454 DOI: 10.1007/s11154-020-09577-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The obesity epidemic has reached old age in most industrialized countries, but trials elucidating the benefits and risks of weight reduction in older adults above 70 years of age with obesity remain scarce. While some findings demonstrate a reduced risk of mortality and other negative health outcomes in older individuals with overweight and mild obesity (i.e. body mass index (BMI) < 35 kg/m2), other recent research indicates that voluntary weight loss can positively affect diverse health outcomes in older individuals with overweight and obesity (BMI > 27 kg/m2), especially when combined with exercise. However, in this age group weight reduction is usually associated with a reduction of muscle mass and bone mineral density. Since uncertainty persists as to which level overweight or obesity might be tolerable (or even beneficial) for older persons, current recommendations are to consider weight reducing diets only for older persons that are obese (BMI ≥ 30 kg/m2) and have weight-related health problems. Precise treatment modalities (e.g. appropriate level of caloric restriction and indicated dietary composition, such as specific dietary patterns or optimal protein content) as well as the most effective and safest way of adding exercise are still under research. Moreover, the long-term effects of weight-reducing interventions in older individuals remain to be clarified, and dietary concepts that work for older adults who are unable or unwilling to exercise are required. In conclusion, further research is needed to elucidate which interventions are effective in reducing obesity-related health risks in older adults without causing relevant harm in this vulnerable population.
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Affiliation(s)
- Sabine Goisser
- Centre for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany.
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany.
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | - Gabriel Torbahn
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Jürgen M Bauer
- Centre for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
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586
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Chen L, Zheng JJY, Li G, Yuan J, Ebert JR, Li H, Papadimitriou J, Wang Q, Wood D, Jones CW, Zheng M. Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading. J Orthop Translat 2020; 24:66-75. [PMID: 32695606 PMCID: PMC7349942 DOI: 10.1016/j.jot.2020.05.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/28/2020] [Accepted: 05/02/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity-related osteoarthritis (OA) is a complex, multifactorial condition that can cause significant impact on patients' quality of life. Whilst chronic inflammation, adipocytokines and metabolic factors are considered to be important pathogenic factors in obesity related OA, there has been limited investigation into the biomechanical impact of obesity on OA development. This review aims to demonstrate that mechanical factors are the major pathological cause of obesity-related OA. The effect of obesity on pathological changes to the osteochondral unit and surrounding connective tissues in OA is summarized, as well as the impact of obesity-related excessive and abnormal joint loading, concomitant joint malalignment and muscle weakness. An integrated therapeutic strategy based on this multi-factorial presentation is presented, to assist in the management of obesity related OA. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Despite the high prevalence of obesity-related OA, there is no specific guideline available for obesity-related OA management. In this review, we demonstrated the pathological changes of obesity-related OA and summarized the impact of biomechanical factors by proposing a hypothetical model of obesity-related OA change. Therapeutic strategies based on adjusting abnormal mechanical effects are presented to assist in the management of obesity-related OA.
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Affiliation(s)
- Lianzhi Chen
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | | | - Guangyi Li
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jun Yuan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
| | - Jay R. Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Hengyuan Li
- Department of Orthopedics, Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, China
| | - John Papadimitriou
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Pathwest Laboratories, Perth, Western Australia, Australia
| | - Qingwen Wang
- Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - David Wood
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher W. Jones
- Fiona Stanley Hospital Group, Perth, Western Australia, Australia
- Curtin University Medical School, Perth, Western Australia, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
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587
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Molocea CE, Tsokanos FF, Herzig S. Exploiting common aspects of obesity and cancer cachexia for future therapeutic strategies. Curr Opin Pharmacol 2020; 53:101-116. [PMID: 32871469 DOI: 10.1016/j.coph.2020.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 12/17/2022]
Abstract
Obesity and cancer cachexia are diseases at opposite ends of the BMI. However, despite the apparent dichotomy, these pathologies share some common underlying mechanisms that lead to profound metabolic perturbations. Insulin resistance, adipose tissue lipolysis, skeletal muscle atrophy and systemic inflammation are key players in both diseases. Several strategies for pharmacological treatments have been employed in obesity and cancer cachexia but demonstrated only limited effects. Therefore, there is still a need to develop novel, more effective strategies. In this review we summarize existing therapies and discuss potential novel strategies that could arise by bridging common aspects between obesity and cachexia. We discuss the potential role of macrophage manipulation and the modulation of inflammation by targeting Nuclear Receptors (NRs) as potential novel therapeutic strategies.
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Affiliation(s)
- Claudia-Eveline Molocea
- Institute for Diabetes and Cancer, Helmholtz Center Munich, Neuherberg, Germany; Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany; Deutsches Zentrum für Diabetesforschung, Neuherberg, Germany
| | - Foivos-Filippos Tsokanos
- Institute for Diabetes and Cancer, Helmholtz Center Munich, Neuherberg, Germany; Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany; Deutsches Zentrum für Diabetesforschung, Neuherberg, Germany
| | - Stephan Herzig
- Institute for Diabetes and Cancer, Helmholtz Center Munich, Neuherberg, Germany; Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany; Deutsches Zentrum für Diabetesforschung, Neuherberg, Germany; Chair Molecular Metabolic Control, Technical University, Munich, Germany.
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588
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Effect of Angiotensin System Inhibitors on Physical Performance in Older People - A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2020; 22:1215-1221.e2. [PMID: 32859513 PMCID: PMC8189253 DOI: 10.1016/j.jamda.2020.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/22/2020] [Accepted: 07/09/2020] [Indexed: 01/08/2023]
Abstract
Objective Preclinical and observational data suggest that angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may be able to improve physical performance in older people via direct and indirect effects on skeletal muscle. We aimed to summarize current evidence from randomised controlled trials in this area. Design Systematic review and meta-analysis. Setting and Participants Randomized controlled trials enrolling older people, comparing ACEi or ARB to placebo, usual care or another antihypertensive agent, with outcome data on measures of physical performance. Methods We searched multiple electronic databases without language restriction between inception and the end of February 2020. Trials were excluded if the mean age of participants was <65 years or treatment was targeting specific diseases known to affect muscle function (for example heart failure). Data were sought on measures of endurance and strength. Standardized mean difference (SMD) treatment effects were calculated using random-effects models with RevMan software. Results Eight trials (952 participants) were included. Six trials tested ACEi, 2 trials tested ARBs. The mean age of participants ranged from 66 to 79 years, and the duration of treatment ranged from 2 months to 1 year. Trials recruited healthy older people and people with functional impairment; no trials specifically targeted older people with sarcopenia. Risk of bias for all trials was low to moderate. No significant effect was seen on endurance outcomes [6 trials, SMD 0.04 (95% CI –0.22 to 0.29); P = .77; I2 = 53%], strength outcomes [6 trials, SMD –0.02 (95% CI –0.18 to 0.14), P = .83, I2 = 21%] or the short physical performance battery [3 trials, SMD –0.04 (95% CI –0.19 to 0.11), P = .60, I2 = 0%]. No evidence of publication bias was evident on inspection of funnel plots. Conclusions and Implications Existing evidence does not support the use of ACE inhibitors or angiotensin receptor blockers as a single intervention to improve physical performance in older people.
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589
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Martínez-Arnau FM, Buigues C, Fonfría-Vivas R, Cauli O. Respiratory Muscle Strengths and Their Association with Lean Mass and Handgrip Strengths in Older Institutionalized Individuals. J Clin Med 2020; 9:E2727. [PMID: 32847002 PMCID: PMC7563242 DOI: 10.3390/jcm9092727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
The study of reduced respiratory muscle strengths in relation to the loss of muscular function associated with ageing is of great interest in the study of sarcopenia in older institutionalized individuals. The present study assesses the association between respiratory muscle parameters and skeletal mass content and strength, and analyzes associations with blood cell counts and biochemical parameters related to protein, lipid, glucose and ion profiles. A multicenter cross-sectional study was performed among patients institutionalized in nursing homes. The respiratory muscle function was evaluated by peak expiratory flow, maximal respiratory pressures and spirometry parameters, and skeletal mass function and lean mass content with handgrip strength, walking speed and bioimpedance, respectively. The prevalence of reduced respiratory muscle strength in the sample ranged from 37.9% to 80.7%. Peak expiratory flow significantly (p < 0.05) correlated to handgrip strength and gait speed, as well as maximal inspiratory pressure (p < 0.01). Maximal expiratory pressure significantly (p < 0.01) correlated to handgrip strength. No correlation was obtained with muscle mass in any of parameters related to reduced respiratory muscle strength. The most significant associations within the blood biochemical parameters were observed for some protein and lipid biomarkers e.g., glutamate-oxaloacetate transaminase (GOT), urea, triglycerides and cholesterol. Respiratory function muscle parameters, peak expiratory flow and maximal respiratory pressures were correlated with reduced strength and functional impairment but not with lean mass content. We identified for the first time a relationship between peak expiratory flow (PEF) values and GOT and urea concentrations in blood which deserves future investigations in order to manage these parameters as a possible biomarkers of reduced respiratory muscle strength.
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Affiliation(s)
- Francisco Miguel Martínez-Arnau
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
| | - Cristina Buigues
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Rosa Fonfría-Vivas
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (C.B.); (R.F.-V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
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590
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Matsushita T, Nishioka S, Taguchi S, Yamanouchi A, Nakashima R, Wakabayashi H. Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8030255. [PMID: 32781673 PMCID: PMC7551564 DOI: 10.3390/healthcare8030255] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open
Abstract
Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, -16.157 to -5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.
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Affiliation(s)
- Tatsuya Matsushita
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan
- Correspondence: ; Tel.: +81-95-818-2002
| | - Shiori Taguchi
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Anna Yamanouchi
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Ryusei Nakashima
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo 162-8666, Japan;
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591
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Barazzoni R, Sulz I, Schindler K, Bischoff SC, Gortan Cappellari G, Hiesmayr M. A negative impact of recent weight loss on in-hospital mortality is not modified by overweight and obesity. Clin Nutr 2020; 39:2510-2516. [DOI: 10.1016/j.clnu.2019.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/23/2019] [Accepted: 11/02/2019] [Indexed: 01/06/2023]
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592
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Batsis JA, Petersen CL, Crow RS, Cook SB, Stevens CJ, Seo LM, Brooks E, Mackenzie TA. Weight change and risk of the foundation of National Institute of Health Sarcopenia-defined low lean mass: Data from the National Health and Nutrition examination surveys 1999-2004. Clin Nutr 2020; 39:2463-2470. [PMID: 31727381 PMCID: PMC7196520 DOI: 10.1016/j.clnu.2019.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 09/16/2019] [Accepted: 10/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Self-reported weight change may lead to adverse outcomes. We evaluated weight change with cutpoints of low lean mass (LLM) in older adults. METHODS Of 4984 subjects ≥60 years from NHANES 1999-2004, we applied LLM cutoffs of appendicular lean mass (ALM):body mass index (BMI) males<0.789, females<0.512. Self-reported weight was assessed at time of survey, and questions asked participants their weight one and 10 years earlier, and at age 25. Weight changes were categorized as greater/less/none than 5%. Logistic regression assessed weight change (gain, loss, no change) on LLM, after adjustment. RESULTS Of 4984 participants (56.5% female), mean age and BMI were 71.1 years and 28.2 kg/m2. Mean ALM was 19.7 kg. In those with LLM, 13.5% and 16.3% gained/lost weight in the past year, while 48.9% and 19.4% gained/lost weight in the past decade. Compared to weight at age 25, 85.2 and 6.1% of LLM participants gained and lost ≥5% of their weight, respectively. Weight gain over the past year was associated with a higher risk of LLM (OR 1.35 [0.99,1.87]) compared to weight loss ≥5% over the past year (0.89 [0.70,1.12]). Weight gain (≥5%) over 10-years was associated with a higher risk of LLM (OR 2.03 [1.66, 2.49]) while weight loss (≥5%) was associated with a lower risk (OR 0.98 [0.76,1.28]). Results were robust compared to weight at 25 years (gain OR 2.37 [1.76,3.20]; loss OR 0.95 [0.65,1.39]). CONCLUSION Self-reported weight gain suggests an increased risk of LLM. Future studies need to verify the relationship with physical function.
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Affiliation(s)
- John A Batsis
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States; Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States; The Dartmouth Institute for Health Policy, Lebanon, NH, United States.
| | - Curtis L Petersen
- The Dartmouth Institute for Health Policy, Lebanon, NH, United States
| | - Rebecca S Crow
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States; Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | - Summer B Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | | | - Lillian M Seo
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Emma Brooks
- Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | - Todd A Mackenzie
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States; Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States; The Dartmouth Institute for Health Policy, Lebanon, NH, United States
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593
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Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review. Clin Nutr 2020; 39:2368-2388. [DOI: 10.1016/j.clnu.2019.11.024] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022]
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594
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Wang X, Li D, Liu F, Cui Y, Li X. Dietary citrus and/or its extracts intake contributed to weight control: Evidence from a systematic review and meta-analysis of 13 randomized clinical trials. Phytother Res 2020; 34:2006-2022. [PMID: 32182635 DOI: 10.1002/ptr.6673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/06/2020] [Accepted: 03/01/2020] [Indexed: 12/14/2022]
Abstract
Randomized controlled trials, being published in English and investigating the associations of at least 4 weeks intervention of citrus and/or its extracts on weight loss among adults, were searched from PubMed, Web of Science, Scopus, and Cochrane by June 2019 to conduct a meta-analysis. Thirteen articles, including 921 participants, were selected and evaluated by modified Jadad scale. Pooled results by the random-effects model showed that citrus and/or its extracts administration significantly reduced 1.280 kg body weight (95% CI: -1.818 to -0.741, p = 0.000, I2 = 81.4%), 0.322 kg/m2 BMI (95% CI: -0.599 to -0.046, p = 0.022, I2 = 87.0%), 2.185 cm WC (95% CI: -3.804 to -0.566, p = 0.008, I2 = 98.3%), and 2.137 cm HC (95% CI: -3.775 to -0.500, p = 0.011, I2 = 96.2%), respectively, but no significantly decreased effects on WHR and body fat were observed. Subgroup analysis deduced the different effects of study location, intervention duration on body weight associated indices. No publication bias was observed. Our meta-analysis supported the beneficial effects of citrus and/or its extracts supplement on body weight control, and future well-designed studies are required to firmly establish the clinical efficacy of citrus and/or its extracts intervention on body weight.
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Affiliation(s)
- Xinjing Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Deming Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Fang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yuan Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Xinli Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
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595
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Kirk B, Feehan J, Lombardi G, Duque G. Muscle, Bone, and Fat Crosstalk: the Biological Role of Myokines, Osteokines, and Adipokines. Curr Osteoporos Rep 2020; 18:388-400. [PMID: 32529456 DOI: 10.1007/s11914-020-00599-y] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Skeletal muscle and bone are connected anatomically and physiologically, and play a crucial role in human locomotion and metabolism. Historically, the coupling between muscle and bone has been viewed in light of mechanotransduction, which dictates that the mechanical forces applied to muscle are transmitted to the skeleton to initiate bone formation. However, these organs also communicate through the endocrine system, orchestrated by a family of cytokines namely myokines (derived from myocytes) and osteokines (derived from bone cells). A third player in this biochemical crosstalk is adipose tissue and the secretion of adipokines (derived from adipocytes). In this review, we discuss the bidirectional effects of myokines and osteokines on muscle and bone metabolism, and the impact of adipokines on both of these secretory organs. RECENT FINDINGS Several myokines, notably, IL6, irisin, IGF-1, BDNF, myostatin, and FGF2 exert anabolic/catabolic effects on bone, while the osteokines osteocalcin and sclerostin have shown to induce muscle anabolism and catabolism, respectively. Adipokines, such as leptin, resistin, adiponectin, and TNFα (released from adipose tissue), can also modulate muscle and bone metabolism. Contrarily, exercise-mediated release of lipolytic myokines (IL6, irisin, and LIF) stimulates thermogenesis by promoting the browning of adipocytes. Myokines, osteokines, and adipokines exert autocrine/paracrine effects locally as well as through the endocrine system, to regulate muscle, bone, and fat metabolism. Reductions in physical activity and increases in energy intake, both linked with aging, leads to adipocyte hypertrophy and the recruitment of immunological cells (macrophages). In turn, this releases pro-inflammatory adipokines which induces chronic low-grade inflammation (LGI), a key player in the pathology of several diseases. However, exercise-induced stimulation of bioactive cytokines, through muscle-bone-fat crosstalk, increases muscle anabolism, bone formation, mitochondrial biogenesis, glucose utilization, and fatty acid oxidation, and attenuates chronic LGI.
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Affiliation(s)
- Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Jack Feehan
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, VIC, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia.
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596
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Sanz-Requena R, Martínez-Arnau FM, Pablos-Monzó A, Flor-Rufino C, Barrachina-Igual J, García-Martí G, Martí-Bonmatí L, Pérez-Ros P. The Role of Imaging Biomarkers in the Assessment of Sarcopenia. Diagnostics (Basel) 2020; 10:diagnostics10080534. [PMID: 32751452 PMCID: PMC7460125 DOI: 10.3390/diagnostics10080534] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/14/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The diagnosis of sarcopenia through clinical assessment has some limitations. The literature advises studies that include objective markers along with clinical assessment in order to improve the sensitivity and specificity of current diagnostic criteria. The decrease of muscle quality precedes the loss of quantity, so we studied the role magnetic resonance imaging biomarkers as indicators of the quantity and quality of muscle in sarcopenia patients. METHODS a cross-sectional analysis was performed to analyze what MR-derived imaging parameters correlate better with sarcopenia diagnostic criteria in women of 70 years of age and over (independent walking and community-dwelling women who were sarcopenic in accordance with EWGSOP criteria with muscle mass adjusted to Spanish population were chosen). RESULTS The study included 26 women; 81 ± 8 years old. A strong correlation was obtained between cineanthropometric variables (BMI; thigh perimeter and fat mass) and imaging biomarkers (muscle/fat ratio, fatty infiltration, muscle T2*, water diffusion coefficient, and proton density fat fraction) with coefficients around 0.7 (absolute value). CONCLUSIONS Knowing the correlation of clinical parameters and imaging-derived muscle quality indicators can help to identify older women at risk of developing sarcopenia at an early stage. This may allow taking preventive actions to decrease disability, morbidity, and mortality in sarcopenia patients.
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Affiliation(s)
- Roberto Sanz-Requena
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Francisco Miguel Martínez-Arnau
- Department of Physiotherapy, Universitat de Valencia, 46010 Valencia, Spain;
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-963-983853 (ext. 51227)
| | - Ana Pablos-Monzó
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, 46900 Valencia, Spain;
| | | | | | - Gracián García-Martí
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Luis Martí-Bonmatí
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Pilar Pérez-Ros
- Nursing Department, Universidad Católica de Valencia San Vicente Mártir, 46007 Valencia, Spain;
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597
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Impact of Protein Intake in Older Adults with Sarcopenia and Obesity: A Gut Microbiota Perspective. Nutrients 2020; 12:nu12082285. [PMID: 32751533 PMCID: PMC7468805 DOI: 10.3390/nu12082285] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
The continuous population increase of older adults with metabolic diseases may contribute to increased prevalence of sarcopenia and obesity and requires advocacy of optimal nutrition treatments to combat their deleterious outcomes. Sarcopenic obesity, characterized by age-induced skeletal-muscle atrophy and increased adiposity, may accelerate functional decline and increase the risk of disability and mortality. In this review, we explore the influence of dietary protein on the gut microbiome and its impact on sarcopenia and obesity. Given the associations between red meat proteins and altered gut microbiota, a combination of plant and animal-based proteins are deemed favorable for gut microbiota eubiosis and muscle-protein synthesis. Additionally, high-protein diets with elevated essential amino-acid concentrations, alongside increased dietary fiber intake, may promote gut microbiota eubiosis, given the metabolic effects derived from short-chain fatty-acid and branched-chain fatty-acid production. In conclusion, a greater abundance of specific gut bacteria associated with increased satiation, protein synthesis, and overall metabolic health may be driven by protein and fiber consumption. This could counteract the development of sarcopenia and obesity and, therefore, represent a novel approach for dietary recommendations based on the gut microbiota profile. However, more human trials utilizing advanced metabolomic techniques to investigate the microbiome and its relationship with macronutrient intake, especially protein, are warranted.
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598
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Sex-Specific Energy Intakes and Physical Activity Levels According to the Presence of Metabolic Syndrome in Korean Elderly People: Korean National Health and Nutrition Examination Survey 2016-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155416. [PMID: 32731363 PMCID: PMC7432031 DOI: 10.3390/ijerph17155416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
This study aimed to analyze the differences in energy intake and physical activity (PA) levels according to sex and the presence of metabolic syndrome (MetS) among elderly people in Korea. Data of 3720 elderly people (aged >65 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016–2018). We analyzed PA levels (occupational and recreational PA) and energy intakes (carbohydrate, protein, and fat). The MetS group showed lower levels of moderate intensity recreational PA and place movement than the non-MetS group (p < 0.05); in the MetS group, PA levels were significantly lower in women than in men (p < 0.05). The intakes of total energy, carbohydrate, fat, and protein were lower in the MetS group than in the non-MetS group (p < 0.001). Both the non-MetS and MetS groups showed lower energy intakes in women than men (p < 0.001). Our study shows that elderly people, especially women, with MetS have significantly lower total PA levels and total energy intakes. We confirmed the importance of increased PA and proper nutritional intake in elderly people. Therefore, it is believed that practical measures such as nutrition education and nutrition guidance and PA education are urgently needed to reduce the incidence of MetS among the elderly.
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599
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Agosti E, De Feudis M, Angelino E, Belli R, Alves Teixeira M, Zaggia I, Tamiso E, Raiteri T, Scircoli A, Ronzoni FL, Muscaritoli M, Graziani A, Prodam F, Sampaolesi M, Costelli P, Ferraro E, Reano S, Filigheddu N. Both ghrelin deletion and unacylated ghrelin overexpression preserve muscles in aging mice. Aging (Albany NY) 2020; 12:13939-13957. [PMID: 32712599 PMCID: PMC7425472 DOI: 10.18632/aging.103802] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
Abstract
Sarcopenia, the decline in muscle mass and functionality during aging, might arise from age-associated endocrine dysfunction. Ghrelin is a hormone circulating in both acylated (AG) and unacylated (UnAG) forms with anti-atrophic activity on skeletal muscle. Here, we show that not only lifelong overexpression of UnAG (Tg) in mice, but also the deletion of ghrelin gene (Ghrl KO) attenuated the age-associated muscle atrophy and functionality decline, as well as systemic inflammation. Yet, the aging of Tg and Ghrl KO mice occurs with different dynamics: while old Tg mice seem to preserve the characteristics of young animals, Ghrl KO mice features deteriorate with aging. However, young Ghrl KO mice show more favorable traits compared to WT animals that result, on the whole, in better performances in aged Ghrl KO animals. Treatment with pharmacological doses of UnAG improved muscle performance in old mice without modifying the feeding behavior, body weight, and adipose tissue mass. The antiatrophic effect on muscle mass did not correlate with modifications of protein catabolism. However, UnAG treatment induced a strong shift towards oxidative metabolism in muscle. Altogether, these data confirmed and expanded some of the previously reported findings and advocate for the design of UnAG analogs to treat sarcopenia.
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Affiliation(s)
- Emanuela Agosti
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Marilisa De Feudis
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Elia Angelino
- Division of Oncology, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milano, Italy.,Molecular Biotechnology Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - Roberta Belli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Ivan Zaggia
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Edoardo Tamiso
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Tommaso Raiteri
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Andrea Scircoli
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Flavio L Ronzoni
- Department of Public Health, Experimental and Forensic Medicine, Institute of Human Anatomy, University of Pavia, Pavia, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Andrea Graziani
- Division of Oncology, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milano, Italy.,Molecular Biotechnology Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Maurilio Sampaolesi
- Department of Public Health, Experimental and Forensic Medicine, Institute of Human Anatomy, University of Pavia, Pavia, Italy.,Center for Health Technologies (CHT), University of Pavia, Pavia, Italy.,Stem Cell Institute, KU Leuven, Leuven, Belgium.,Istituto Interuniversitario di Miologia (IIM)
| | - Paola Costelli
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.,Istituto Interuniversitario di Miologia (IIM)
| | - Elisabetta Ferraro
- Division of Orthopaedics and Traumatology, Hospital "Maggiore della Carità", Novara, Italy
| | - Simone Reano
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Nicoletta Filigheddu
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Istituto Interuniversitario di Miologia (IIM)
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600
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Guo A, Li K, Xiao Q. Sarcopenic obesity: Myokines as potential diagnostic biomarkers and therapeutic targets? Exp Gerontol 2020; 139:111022. [PMID: 32707318 DOI: 10.1016/j.exger.2020.111022] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023]
Abstract
Sarcopenic obesity (SO) is a condition characterized by the occurrence of both sarcopenia and obesity and imposes a heavy burden on the health of the elderly. Controversies and challenges regarding the definition, diagnosis and treatment of SO still remain because of its complex pathogenesis and limitations. Over the past few decades, numerous studies have revealed that myokines secreted from skeletal muscle play significant roles in the regulation of muscle mass and function as well as metabolic homeostasis. Abnormalities in myokines may trigger and promote the pathogenesis underlying age-related and metabolic diseases, including obesity, sarcopenia, type 2 diabetes (T2D), and SO. This review mainly focuses on the role of myokines as potential biomarkers for the early diagnosis and therapeutic targets in SO.
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Affiliation(s)
- Ai Guo
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Kai Li
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Qian Xiao
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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