51
|
Berg HB, Alavi DT, Beichmann B, Pesonen M, Henriksen C, Paur I, Bøhn SK, Lauritzen PM, Blomhoff R, Henriksen HB. The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients. Clin Nutr ESPEN 2024; 60:17-23. [PMID: 38479906 DOI: 10.1016/j.clnesp.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS Low muscle strength, low muscle mass, and sarcopenia have a negative impact on health outcomes in colorectal cancer (CRC) patients. Different diagnostic modalities are used to identify these conditions but it is unknown how well the modalities agree. The aim of this study was to compare different diagnostic modalities by means of calculating the proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients, and to investigate the agreement for sarcopenia between the various modalities. METHODS Men and women participating in the Norwegian Dietary Guidelines and colorectal cancer Survival (CRC-NORDIET) study were included in the analyses. Cut-off values for low muscle strength, low muscle mass, and sarcopenia were defined according to the second consensus set by the European Working Group on Sarcopenia in Older People (EWGSOP2). The diagnostic modalities used to assess muscle strength were handgrip strength and the sit-to-stand test. For muscle mass, computed tomography, dual-energy X-ray absorptiometry (DXA), multi-frequency bioelectrical impedance analysis (MF-BIA), and single-frequency BIA (SF-BIA) were applied. Cohen's kappa was calculated to determine the agreement for low muscle strength and confirmed sarcopenia between diagnostic modalities. RESULTS Five hundred and three men and women (54 % men, mean age of 66 (range 50-80) years old) were included in the analysis. As much as 99 % (n = 70) of the population was identified with low muscle mass by MF-BIA, while the other modalities identified 9-49 % as having low muscle mass. Handgrip strength identified a lower proportion of low muscle strength as compared with the sit-to-stand test (4 % vs. 8 %). When applying various combinations of diagnostic modalities for low muscle strength and low muscle mass, the proportion of sarcopenia was found to be between 0.3 and 11.4 %. There was relatively poor agreement between the different diagnostic modalities with Cohen's Kappa ranging from 0.0 to 0.55, except for the agreement between SF-BIASergi and MF-BIASergi, which was 1. CONCLUSION The proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients varied considerably depending on the diagnostic modalities used. Further studies are needed to provide modality-specific cut-off values, adjusted to sex, age and body size.
Collapse
Affiliation(s)
- Hedda Beate Berg
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Dena Treider Alavi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Benedicte Beichmann
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Maiju Pesonen
- Oslo Centre for Biostatistics & Epidemiology (OCBE), Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Christine Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Norwegian Advisory Unit on Disease-related Undernutrition, P.O. Box 4950 Nydalen, 0424 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Siv Kjølsrud Bøhn
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, P.O. Box 5003 NO-1432 Ås, Norway.
| | - Peter Mæhre Lauritzen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo and Department of Life Sciences and Health, Oslo Metropolitan University, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway; Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern 0317 Oslo, Norway.
| |
Collapse
|
52
|
Duarte MP, Almeida LS, Neri SG, Oliveira JS, Wilkinson TJ, Ribeiro HS, Lima RM. Prevalence of sarcopenia in patients with chronic kidney disease: a global systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2024; 15:501-512. [PMID: 38263952 PMCID: PMC10995263 DOI: 10.1002/jcsm.13425] [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: 07/10/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 01/25/2024] Open
Abstract
Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random-effect models. A total of 140 studies (42 041 patients) across 25 countries were included in this systematic review and meta-analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9-28.3) and did not differ among stages (P = 0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P = 0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7-32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6-37.1) compared to non-dialysis (3.0%, 95% CI: 0-11.1; P < 0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5-21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0-51.9), low muscle mass in 29.1% (95% CI: 23.9-34.5), and low physical performance in 38.6 (95% CI: 30.9-46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7-57.4) compared to non-dialysis (19.6%, 95% CI: 12.8-27.3; P < 0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.
Collapse
Affiliation(s)
- Marvery P. Duarte
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
- Faculty of Health SciencesUniversity of BrasiliaBrasíliaBrazil
| | - Lucas S. Almeida
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
| | - Silvia G.R. Neri
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
| | - Juliana S. Oliveira
- Institute for Musculoskeletal HealthThe University of Sydney and Sydney Local Health DistrictSydneyAustralia
- School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | | | - Heitor S. Ribeiro
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
- Faculty of Health SciencesUniversity of BrasiliaBrasíliaBrazil
| | - Ricardo M. Lima
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
| |
Collapse
|
53
|
Zheng Y, Feng J, Yu Y, Ling M, Wang X. Advances in sarcopenia: mechanisms, therapeutic targets, and intervention strategies. Arch Pharm Res 2024; 47:301-324. [PMID: 38592582 DOI: 10.1007/s12272-024-01493-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
Sarcopenia is a multifactorial condition characterized by loss of muscle mass. It poses significant health risks in older adults worldwide. Both pharmacological and non-pharmacological approaches are reported to address this disease. Certain dietary patterns, such as adequate energy intake and essential amino acids, have shown positive outcomes in preserving muscle function. Various medications, including myostatin inhibitors, growth hormones, and activin type II receptor inhibitors, have been evaluated for their effectiveness in managing sarcopenia. However, it is important to consider the variable efficacy and potential side effects associated with these treatments. There are currently no drugs approved by the Food and Drug Administration for sarcopenia. The ongoing research aims to develop more effective strategies in the future. Our review of research on disease mechanisms and drug development will be a valuable contribution to future research endeavors.
Collapse
Affiliation(s)
- Youle Zheng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Jin Feng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Yixin Yu
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Min Ling
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| |
Collapse
|
54
|
Verstraeten LMG, van Wijngaarden JP, Meskers CGM, Maier AB. High Sarcopenia Awareness Contrasts a Lack of Clinical Implementation Among Geriatric Rehabilitation Health Care Professionals in the Netherlands: EMPOWER-GR. J Geriatr Phys Ther 2024; 47:67-76. [PMID: 36827678 DOI: 10.1519/jpt.0000000000000379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND AND PURPOSE Despite being associated with serious adverse outcomes, such as mortality, sarcopenia remains largely undiagnosed in older individuals. This study aimed to assess the awareness, practices, and barriers and enablers to clinical implementation of sarcopenia diagnosis and treatment among geriatric rehabilitation health care professionals in the Netherlands. METHODS As part of EMPOWER-GR, a cross-sectional survey among geriatric rehabilitation health care professionals working in the Netherlands was undertaken between September 23, 2020, and January 28, 2021. Professionals were recruited via a geriatric rehabilitation care provider, health care professional associations, professional networks of the research team, and social media. Descriptive statistics were used to assess the study outcomes. RESULTS AND DISCUSSION Of the 501 geriatric rehabilitation health care professionals, 12.2% were physicians, 23.0% physical therapist/occupational therapists, 30.3% dietitians, 19.6% nurses, and 11.0% health care assistants. The concept of sarcopenia was known by 83.8% of the participants, 92.5% correctly identified sarcopenia as low muscle mass and strength (and low physical performance), and 73.8% identified sarcopenia as very important in the management of older adults admitted for rehabilitation. Although 26.2% and 18.9% of the participants reported screening and diagnosing sarcopenia, respectively, in their current practice, only 3.0% adequately used the (revised) definition of the European Working Group on Sarcopenia in Older People. When sarcopenia has been diagnosed, 65.0% reported initiating treatment consisting of resistance exercise training (78.7%), food fortification/high-energy or protein diet (85.4%), and oral nutritional supplements (70.4%). Most important barriers to screening and diagnosis were lack of knowledge, access to tools, and equipment and time, while enablers were protocol implementation, access to training, and clear responsibilities. CONCLUSIONS Sarcopenia awareness is high among geriatric rehabilitation health care professionals in the Netherlands, but adequate screening and diagnosis is almost nonexistent in current clinical practice, which hampers interventions. Better knowledge, clear responsibilities, and access to tools and protocols, as well as prioritization, are needed for sarcopenia to be diagnosed and treated in geriatric rehabilitation in the Netherlands.
Collapse
Affiliation(s)
- Laure M G Verstraeten
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | | | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Center for Healthy Longevity, @AgeSingapore, National University Health System, Singapore
| |
Collapse
|
55
|
Pan J, Wu T, Ma JD, Jia PW, Zou YW, Ouyang ZM, Zheng HW, Lin JZ, Zhang Q, Lu Y, Chen LF, Yang ZH, Zhu YY, Song QY, Su Y, Su LW, Dai W, Dai J, Dai L. Geriatric nutrition risk index: a more powerful index identifying muscle mass loss in patients with rheumatoid arthritis. Clin Rheumatol 2024; 43:1299-1310. [PMID: 38433147 DOI: 10.1007/s10067-024-06918-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 11/29/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To explore the association of geriatric nutrition risk index (GNRI), a traditional albumin-body weight calculation, with myopenia in patients with rheumatoid arthritis (RA) and compare its ability to identify myopenia with protein indicators. METHODS This cross-sectional study was carried out based on a Chinese RA cohort. Clinical data and protein indicators (including albumin, globulin, albumin to globulin ratio, prealbumin, hemoglobin) were collected. GNRI was estimated by serum albumin and body weight. Myopenia was indicated as muscle mass loss measured by bioelectric impedance analysis. RESULTS There were 789 RA patients included with mean age 52.6 ± 12.6 years and 77.6% female. There were 41.3%, 18.0%, 27.5%, 13.2% patients with no (GNRI > 98), low (GNRI 92 to ≤ 98), moderate (GNRI 82 to < 92), and major nutrition-related risk (GNRI < 82). There were 406 (51.5%) RA patients with myopenia, RA patients with major nutrition-related risk had the highest prevalence of myopenia (87.5% vs. 73.3% vs. 50.0% vs. 26.1%). Multivariate logistic analysis showed that compared with no risk, RA patients with low (OR = 3.23, 95% CI: 1.86-5.61), moderate (OR = 9.56, 95% CI: 5.70-16.01), and major nutrition-related risk (OR = 28.91, 95% CI: 13.54-61.71) were associated with higher prevalence of myopenia. Receiver operating characteristic curves showed that GNRI (AUC = 0.79) performed a better identifiable ability toward myopenia than serum albumin (AUC = 0.66) or others indicators (AUC range 0.59 to 0.65), respectively. CONCLUSION GNRI, an objective and convenient albumin-weight index, may be preferable for identifying myopenia in RA patients. Key Points • We firstly elucidated the association of GNRI with muscle mass loss among RA patients, and compared its ability to identify muscle mass loss with serum albumin or other protein indicators. • Major nutrition-related risk identified by GNRI showed the highest risk of muscle mass loss, GNRI demonstrated a greater ability to identify myopenia in RA patients. which indicated GNRI was an objective and convenient albumin-weight index to identify myopenia in RA patients.
Collapse
Affiliation(s)
- Jie Pan
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Tao Wu
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Jian-Da Ma
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Pei-Wen Jia
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Yao-Wei Zou
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Zhi-Ming Ouyang
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Hu-Wei Zheng
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | | | - Qian Zhang
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Ye Lu
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Le-Feng Chen
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Ze-Hong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Ying-Ying Zhu
- Division of Clinical Research Design, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China
| | - Qing-Yang Song
- Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan Road II, Guangzhou, Guangdong, People's Republic of China
| | - Yun Su
- Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan Road II, Guangzhou, Guangdong, People's Republic of China
| | - Lin-Wang Su
- Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan Road II, Guangzhou, Guangdong, People's Republic of China
| | - Wei Dai
- Department of Biostatistics, School of Public Health, Yale University, College Street, P.O. Box 20803460, New Haven, CT, 06520-0834, USA
| | - Jun Dai
- Department of Public Health, College of Health Sciences, Des Moines University, 8025 Grand Avenue, West Des Moines, IA, 50266, USA.
| | - Lie Dai
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People's Republic of China.
| |
Collapse
|
56
|
Yang Y, Chen WM, Wu SY, Zhang J. Persistence of analgesic usage and opioid consumption in sarcopenic patients undergoing neuraxial anesthesia: a nationwide retrospective cohort study. Pain Rep 2024; 9:e1129. [PMID: 38469029 PMCID: PMC10927332 DOI: 10.1097/pr9.0000000000001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 03/13/2024] Open
Abstract
Introduction This study investigates the association between chronic postsurgical pain (CPSP) and long-term postsurgical analgesic usage in patients undergoing neuraxial anesthesia, with a specific focus on the presence or absence of sarcopenia. Objectives To assess the rate of analgesic prescription, including opioids, at 3 and 6 months postsurgery for patients with and without preoperative sarcopenia, and to determine the impact of sarcopenia on analgesic use after neuraxial anesthesia surgery. Methods Patients undergoing surgery under neuraxial anesthesia were categorized into sarcopenic and nonsarcopenic groups based on preoperative diagnosis using the ICD-10-CM code M62.84. Propensity score matching in a 1:4 ratio was applied for group matching. Analgesic prescription rates were evaluated at 3 and 6 months postsurgery, and multivariable logistic regression was used to analyze analgesic use, comparing patients with and without preoperative sarcopenia. Results Among 3805 surgical patients, 761 had sarcopenia, while 3044 did not. At 3 months postsurgery, 62.3% of sarcopenic patients received analgesics, with 2.9% receiving opioids, compared to 57.1% of nonsarcopenic patients receiving analgesics and 0.8% receiving opioids. At 6 months postsurgery, 30.8% of sarcopenic patients received analgesics (1.7% opioids), while 26.3% of non-sarcopenic patients received analgesics (0.3% opioids). Multivariable logistic regression analysis revealed that preoperative sarcopenia was significantly associated with higher analgesic prescription rates at both 3 months (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.05-1.53) and 6 months (aOR, 1.17; 95% CI, 1.07-1.42) postsurgery. Furthermore, sarcopenic patients exhibited significantly higher opioid prescription rates at 3 months (aOR, 1.11; 95% CI, 1.05-2.45) and 6 months (aOR, 1.89; 95% CI, 1.12-4.96) postsurgery. Conclusion Sarcopenia emerges as an independent risk factor for prolonged analgesic use after neuraxial anesthesia surgery and significantly elevates the risk of developing CPSP.
Collapse
Affiliation(s)
- Yitian Yang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Management, College of Management, Fo Guang University, Yilan, Taiwan
| | - Jiaqiang Zhang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
57
|
He S, Wei M, Meng D, Wang Z, Yang G, Wang Z. Self-determined sequence exercise program for elderly with sarcopenia: A Randomized controlled trial with clinical assistance from explainable artificial intelligence. Arch Gerontol Geriatr 2024; 119:105317. [PMID: 38176122 DOI: 10.1016/j.archger.2023.105317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
To improve and even reverse sarcopenia in elderly people, this study developed a self-determined sequence exercise program consisting of strength training exercise, Yijinjing exercise (a traditional Chinese exercise), and hybrid strength training with Yijinjing exercise. Ninety-four community-dwelling older adults screened for sarcopenia using the Asian Working Group for Sarcopenia criteria were randomly assigned to 24 weeks of a control group (CG, n = 30), self-determined sequence exercise program group (SDSG, n = 34) or strength training group (STG, n = 30). The study examined the effects of three interventions on participantsL3 skeletal muscle fat density, L3 skeletal muscle fat area, L3 skeletal muscle density, L3 skeletal muscle area, muscle fat infiltration, relative skeletal muscle mass index, and grip strength using a repeated-measures ANOVA to evaluate the experimental data. To evaluate the real effect of this model in reversing sarcopenia after the intervention, nine classification models were trained. Significant interaction effects were observed with grip strength, RSMI, L3 SMD, and L3 SMA. At the 24th week, participants' grip strength, L3 SMFA, L3 SMA, and RSMI were improved significantly in the SDSG and STG. The SDSG achieved significantly greater RSMI and grip strength than the STG and CG after the intervention. The self-determined sequence exercise program exhibited better performance than the single type of exercise modality in reversing sarcopenia and improving older adults' skeletal muscle area. Consequently, the stacking model is feasible to make a prediction as to whether or not sarcopenia may be reversed in older adults.
Collapse
Affiliation(s)
- Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziyi Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China; AI group, Intelligent Lancet LLC, Sacramento, California, 95816 CA, United States of America; Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Saitama, Japan.
| |
Collapse
|
58
|
Lerena VS, Coronello EC, Torres Barrón IC, Lucas SP, Diaz AG. [Sarcopenia: is a clinical diagnosis possible?]. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2024; 81:83-95. [PMID: 38537093 PMCID: PMC11110660 DOI: 10.31053/1853.0605.v81.n1.42334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
Introducción La sarcopenia aumenta el riesgo de caídas y fracturas, además de relacionarse con diversas enfermedades y aumento de la mortalidad. Distintos grupos de investigación proponen diferentes definiciones para el diagnóstico de sarcopenia, que incluyen la medición de la masa muscular por DEXA y la valoración de la fuerza de prensión palmar a través de un dinamómetro de mano. Sin embargo, estos 2 instrumentos no están habitualmente disponibles en los consultorios médicos. Objetivos: Determinar la utilidad diagnóstica de 2 pruebas de rendimiento físico: velocidad de marcha e incorporarse de una silla, como herramientas para la detección de pacientes con probable sarcopenia. Metodología Se incluyeron 706 mujeres, entre 50 y 85 años, a las que se realizó las pruebas funcionales y DXA (n=376) para medir la masa muscular. Resultados El 26,1% registró una velocidad de marcha disminuida mientras que el 55,3% presentó alteración en la realización de la prueba de incorporarse de una silla. La prevalencia de sarcopenia varió desde un 4,5% hasta un 35% según los criterios utilizados. Ambas pruebas presentaron un alto valor predictivo negativo (>70%) para el diagnóstico de sarcopenia, mientras que la prueba de incorporarse de una silla mostró además, una alta sensibilidad (> 66%) para dicho diagnóstico. Conclusión La implementación en el consultorio de estas pruebas sencillas y sin costo, simplificaría la detección de pacientes con probable sarcopenia.
Collapse
Affiliation(s)
- Vanina Soledad Lerena
- Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas José de San Martín.
| | | | | | - Sabrina Paola Lucas
- Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas José de San Martín.
| | - Adriana Graciela Diaz
- Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas José de San Martín.
| |
Collapse
|
59
|
Nascimento PMC, Rodrigues Junior LF, Felix Mediano MF, Gonçalves da Silva V, Tura BR, Nogueira FCS, Domont G, Carvalho AB, de Carvalho ACC, Kasai-Brunswick TH, Mesquita CT, Junior HV, Rey HCV. Prevalence and impact of sarcopenia in individuals with heart failure with reduced ejection fraction (the SARC-HF study): A prospective observational study protocol. PLoS One 2024; 19:e0300918. [PMID: 38512827 PMCID: PMC10956824 DOI: 10.1371/journal.pone.0300918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
Sarcopenia, a clinical syndrome primarily associated with reduced muscle mass in the elderly, has a negative impact on quality of life and survival. It can occur secondarily to other diseases such as heart failure (HF), a complex clinical syndrome with high morbidity and mortality. The simultaneous occurrence of these two conditions can worsen the prognosis of their carriers, especially in the most severe cases of HF, as in patients with reduced left ventricular ejection fraction (LVEF). However, due to the heterogeneous diagnostic criteria for sarcopenia, estimates of its prevalence present a wide variation, leading to new criteria having been recently proposed for its diagnosis, emphasizing muscle strength and function rather than skeletal muscle mass. The primary objective of this study is to evaluate the prevalence of sarcopenia and/or dynapenia in individuals with HF with reduced LVEF according to the most recent criteria, and compare the gene and protein expression of those patients with and without sarcopenia. The secondary objectives are to evaluate the association of sarcopenia and/or dynapenia with the risk of clinical events and death, quality of life, cardiorespiratory capacity, ventilatory efficiency, and respiratory muscle strength. The participants will answer questionnaires to evaluate sarcopenia and quality of life, and will undergo the following tests: handgrip strength, gait speed, dual-energy X-ray absorptiometry, respiratory muscle strength, cardiopulmonary exercise, as well as genomic and proteomic analysis, and dosage of N-terminal pro-B-type natriuretic peptide and growth differentiation factor-15. An association between sarcopenia and/or dynapenia with unfavorable clinical evolution is expected to be found, in addition to reduced quality of life, cardiorespiratory capacity, ventilatory efficiency, and respiratory muscle strength.
Collapse
Affiliation(s)
| | - Luiz Fernando Rodrigues Junior
- National Institute of Cardiology, Rio de Janeiro, Brazil
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | - Gilberto Domont
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Bastos Carvalho
- National Institute of Cardiology, Rio de Janeiro, Brazil
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Taís Hanae Kasai-Brunswick
- National Institute of Cardiology, Rio de Janeiro, Brazil
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | |
Collapse
|
60
|
Mahato NK, Davis A, Simon JE, Clark BC. Assessing muscular power in older adults: evaluating the predictive capacity of the 30-second chair rise test. FRONTIERS IN AGING 2024; 5:1302574. [PMID: 38510571 PMCID: PMC10950899 DOI: 10.3389/fragi.2024.1302574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
Background: Timed chair rise tests are frequently used as a substitute for assessing leg muscle strength or power. To determine if timed chair rise tests are an indicator of lower extremity muscle power, we examined the relationship between the repetitions completed in a 30-s chair rise test and the power generated during the test. Methods: Seventy-five individuals participated in this study (n = 30 < 65 years and 45 ≥ 65 years). Participants underwent a 30-s chair rise test while instrumented with a power analyzer. Handgrip strength was also evaluated. Results: The relationship between chair rise repetitions and average chair rise power was R 2 = 0.32 (p < 0.001). Chair rise repetitions when regressed on a total (i.e., summed) chair rise power, it yielded R 2 = 0.70 with data from all participants combined (p < 0.001). A mediation analysis indicated that anthropometrics partially mediates the relationship between chair rise repetitions and total chair rise power accounting for 2.8%-6.9% of the variance. Conclusion: Our findings indicate that in older adults, the overall performance of chair rises offers limited information about the average power per rise but is more indicative of the cumulative power exerted. Thus, the total number of chair rises in a 30-s test is likely a more comprehensive metric of overall muscular power, reflecting endurance aspects as well. Additionally, we found that personal physical attributes, such as height and weight, partially influence the link between chair rise count and total power, highlighting the importance of factoring in individual body metrics in assessments of muscular performance.
Collapse
Affiliation(s)
- Niladri Kumar Mahato
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, United States
| | - Alexandria Davis
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
| | - Janet E. Simon
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- School of Applied Health and Wellness, Ohio University, Athens, OH, United States
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| |
Collapse
|
61
|
Balazs I, Stelzer M, Traub J, Horvath A, Feldbacher N, Stadlbauer V. Primary sarcopenia is associated with elevated spontaneous NET formation. Front Cell Dev Biol 2024; 12:1347495. [PMID: 38505257 PMCID: PMC10948394 DOI: 10.3389/fcell.2024.1347495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction: Sarcopenia is a frequent complication of liver cirrhosis, but it can also occur independently as a result of any underlying cause. The immune system plays an important role in the pathogenesis of both liver cirrhosis and sarcopenia. Neutrophil function, including neutrophil extracellular trap (NET) formation, is linked to chronic inflammation; however, it has not been extensively studied in patients with sarcopenia. Here, we aim to study if main neutrophil functions, such as phagocytosis, reactive oxygen species (ROS) production, and NET formation, are altered in patients with sarcopenia with or without liver cirrhosis. Methods: Neutrophils from 92 patients (52 patients with liver cirrhosis and sarcopenia, 25 patients with liver cirrhosis without sarcopenia, and 15 patients with sarcopenia without liver cirrhosis) and 10 healthy controls were isolated and stimulated with heat-inactivated E. coli (250 bacteria/cell), phorbol 12-myristate 13-acetate (PMA) (100 nM), or incubation medium in duplicates for 2 h at 37°C. Cells were fixed with paraformaldehyde and stained with 4',6-diamidino-2-phenylindole (DAPI). Pictures of 10 random fields of vision per slide were taken with an Olympus BX51 fluorescence microscope (Olympus, Shinjuku, Tokyo, Japan) at 600x total magnification. The DNA Area and NETosis Analysis (DANA) algorithm was used to quantify the percentage of NET formation per patient. Phagocytosis and ROS production were assessed with the PhagotestTM kit and PhagoburstTM kit (Glycotope, Heidelberg, Germany) in 92 patients and 21 healthy controls, respectively. Results: Spontaneous NET formation was significantly elevated in patients with only sarcopenia compared to patients with cirrhosis and sarcopenia (p = 0.008) and healthy controls (p = 0.039). NET formation in response to PMA was significantly decreased in patients with cirrhosis (p = 0.007), cirrhosis and sarcopenia (p < 0.001), and sarcopenia (p = 0.002) compared to healthy controls. There was no significant difference in NET formation in response to E. coli between the groups. The DANA algorithm was successfully optimized and validated for assessment of clinical samples. There were no significant changes in neutrophil phagocytosis between patients' groups compared to healthy controls. A significantly lower percentage of neutrophils produced ROS in response to N-formylmethionine-leucyl-phenylalanine (fMLF) in patients compared to healthy controls. Discussion: Spontaneous NET formation might contribute to chronic inflammation and sarcopenia pathogenesis. This, however, does not result in the impairment of the NET formation function of neutrophils in response to a bacterial stimulus and, therefore, cannot be not linked with the increased risk of bacterial infections neither in sarcopenia nor in cirrhosis. The semi-automated NET formation analysis can be successfully implemented to analyze the vast amount of data generated within clinical studies. This approach opens up the possibilities to develop an NET formation-based biomarker in different diseases including sarcopenia and implement NET formation analysis into clinical settings. Phagocytosis and ROS production were not affected in patients with sarcopenia. Further research is needed to explore the mechanism of NET formation in patients with sarcopenia and its potential as a biomarker in sarcopenia.
Collapse
Affiliation(s)
- Irina Balazs
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Manuel Stelzer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Julia Traub
- Department of Clinical Medical Nutrition, Medical University of Graz, Graz, Austria
| | - Angela Horvath
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Nicole Feldbacher
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Vanessa Stadlbauer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| |
Collapse
|
62
|
Pan D, Yang L, Yang X, Xu D, Wang S, Gao H, Liu H, Xia H, Yang C, Lu Y, Sun J, Wang Y, Sun G. Potential nutritional strategies to prevent and reverse sarcopenia in aging process: Role of fish oil-derived ω-3 polyunsaturated fatty acids, wheat oligopeptide and their combined intervention. J Adv Res 2024; 57:77-91. [PMID: 37061218 PMCID: PMC10918331 DOI: 10.1016/j.jare.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/24/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023] Open
Abstract
INTRODUCTION Nutritional support is potentially considered an essential step to prevent muscle loss and enhance physical function in older adults. OBJECTIVES This study aimed to assess the role of potential nutritional strategies, i.e., fish oil-derived ω-3 polyunsaturated fatty acids (PUFAs), wheat oligopeptide and their combined intervention, in preventing and reversing sarcopenia in aging process. METHODS One hundred 25-month-old Sprague-Dawley rats were randomly divided into 10 groups, and 10 newly purchased 6-month-old rats were included in young control group (n = 10). Fish oil (200, 400 or 800 mg/kg body weight), wheat oligopeptide (100, 200 or 400 mg/kg body weight), fish oil + wheat oligopeptide (800 + 100, 400 + 200 or 200 + 400 mg/kg body weight) or the equal volume of solvent were administered daily by gavage for 10 weeks. The effects of these interventions on natural aging rats were evaluated. RESULTS All intervention groups had a significant increase in muscle mass and grip strength and reduction in perirenal fat weight when compared to the aged control group (P < 0.05). The results of biochemical parameters, magnetic resonance imaging, proteomics and western blot suggested that the combination of wheat oligopeptide and fish oil-derived ω-3 PUFA, especially group WFM 2 (400 + 200 mg/kg body weight fish oil + wheat oligopeptide), was found to be more effective against aging-associated muscle loss than single intervention. Additionally, the interventions ameliorated fatty infiltration, muscle atrophy, and congestion in the intercellular matrix, and inflammatory cell infiltration in muscle tissue. The interventions also improved oxidative stress, anabolism, hormone levels, and inflammatory levels of skeletal muscle. CONCLUSIONS The combination of fish oil-derived ω-3 PUFA and wheat oligopeptide was found to be a promising nutritional support to prevent and reverse sarcopenia. The potential mechanism involved the promotion of protein synthesis and muscle regeneration, as well as the enhancement of muscle strength.
Collapse
Affiliation(s)
- Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Ligang Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Xian Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China; School of Medicine, Xizang Minzu University, 712082 Xianyang, PR China
| | - Han Gao
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland
| | - Hechun Liu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China; Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, 210009 Nanjing, PR China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Chao Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China; Wuxi School of Medicine, Jiangnan University, 214122 Wuxi, PR China
| | - Yifei Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Jihan Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009 Nanjing, PR China.
| |
Collapse
|
63
|
Zheng ZF, Lin GT, Zhong Q, Wu D, Lu J, Wang JB, Chen QY, Lin JX, Cao LL, Lin M, Zheng SP, Xie JW, Zheng CH, Huang CM, Li P. Effect of sarcopenia on short-term and long-term outcomes of older patients with locally advanced gastric cancer: a multicenter study. Surg Endosc 2024; 38:1151-1162. [PMID: 38082017 DOI: 10.1007/s00464-023-10638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/29/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC). METHODS Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2 for men and less than 28.4 cm2/m2 for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data. RESULTS A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P < 0.05). Kaplan-Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (P both < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (P both < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P = 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P = 0.022). CONCLUSION Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized.
Collapse
Affiliation(s)
- Zi-Fang Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
- Department of General Surgery, Affiliated Hospital of Putian University, Putian, China
| | - Guang-Tan Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Qing Zhong
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Dong Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jun Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jia-Bin Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Qi-Yue Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jian-Xian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Long-Long Cao
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Mi Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Shu-Ping Zheng
- Public Technology Service Center, Fujian Medical University, Fuzhou, China
| | - Jian-Wei Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
| | - Ping Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
| |
Collapse
|
64
|
Jauffret C, Périchon R, Lamer A, Cortet B, Chazard E, Paccou J. Association between sarcopenia and risk of major adverse cardiac and cerebrovascular events-UK Biobank database. J Am Geriatr Soc 2024; 72:693-706. [PMID: 37945290 DOI: 10.1111/jgs.18664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/06/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Few studies on the risk of incident major adverse cardiac and cerebrovascular events (MACCEs) in sarcopenia have been reported. The objective was to assess the association between presarcopenia and sarcopenia and a higher risk of MACCEs. METHODS This study on the UK Biobank prospective cohort, used data collected between 2006 and 2021. Community-dwelling Caucasian participants aged 37 to 73 years were included if values for Handgrip Strength (HGS) and Skeletal Muscle Index (SMI) were available and if no history of MACCEs was reported. Exposure was assessed using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was measured using HGS, and muscle mass using the SMI. Presarcopenia was defined through the two definitions available in the literature, as low HGS with normal SMI and as normal HGS with low SMI, whereas sarcopenia was defined as low HGS with low SMI. The main outcome was to determine whether presarcopenia and/or sarcopenia were predictors of MACCEs (composite events). RESULTS A total of 406,411 included participants (women: 55.7%) were included. At baseline, there were 18,257 (4.7%) presarcopenics-subgroup n°1 (low HGS only), 7940 (2.1%) presarcopenics-subgroup n°2 (low SMI only), and 1124 (0.3%) sarcopenics. Over a median follow-up of 12.1 years (IQR: [11.4; 12.8]), 28,300 participants (7.0%) were diagnosed with at least one event. Compared to NonSarc, presarcopenic (subgroups n°1 and n°2) and sarcopenic status were significantly associated with a higher risk of MACCEs (respectively fully adjusted HRs: HR = 1.25 [95% CI: 1.19; 1.31], HR = 1.33 [95% CI: 1.23; 1.45] and HR = 1.62 [95% CI: 1.34; 1.95]). CONCLUSIONS In a community-dwelling population, the risk of MACCEs was higher in both presarcopenic and sarcopenic participants.
Collapse
Affiliation(s)
- Charlotte Jauffret
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| | - Renaud Périchon
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Antoine Lamer
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Bernard Cortet
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| | - Emmanuel Chazard
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Julien Paccou
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| |
Collapse
|
65
|
Ramoo K, Hairi NN, Yahya A, Choo WY, Hairi FM, Ismail N, Peramalah D, Kandiben S, Ali ZM, Ahmad N, Abdul Razak I, Bulgiba A. Sarcopenia and All-Cause Mortality Risk in Community-Dwelling Rural Malaysian Older Adults. Asia Pac J Public Health 2024; 36:225-231. [PMID: 38482589 DOI: 10.1177/10105395241237811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
Collapse
Affiliation(s)
- Karthikeyanathan Ramoo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Public Health, Universitas Airlangga, Surabaya City, Indonesia
| | - Abqariyah Yahya
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Devi Peramalah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shathanapriya Kandiben
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - NurSakinah Ahmad
- Mental Health, Injury Prevention, Violence and Substance Abuse Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Awang Bulgiba
- Academy of Sciences Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
66
|
Marini E, Sulis S, Vorobel'ová L, Stagi S. Specific bioelectrical vectors pattern in individuals with sarcopenic obesity. Clin Nutr 2024; 43:620-628. [PMID: 38306890 DOI: 10.1016/j.clnu.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sarcopenic obesity is a common condition in the elderly associated with excessive adiposity and low muscle mass and strength. AIMS This study aims to establish a method for detecting bioelectrical characteristics in individuals with sarcopenic obesity through specific Bioelectrical Impedance Vector Analysis (specific BIVA), while considering the characteristics of individuals with healthy, sarcopenic, and obese conditions. METHODS The sample was composed by 915 Italian adults over 50 years of age (men: 74.6 ± 8.8 y; women:76.3 ± 8.8 y) living in Sardinia (Italy). A dataset of 1590 US adults aged 21 - 49 years retrieved from the 2003 - 2004 National Health and Nutrition Examination Survey was also considered in a final step of the study. Anthropometric (stature, weight, waist, arm, and calf circumferences) and whole-body bioelectrical variables were taken. In the Italian sample, bioelectrical impedance was applied to estimate the relative content of fat mass and skeletal muscle mass. Groups with healthy body composition (NS-NO), or consistent with sarcopenia (S), sarcopenic obesity (S-O), and obesity (O) were defined based on the cut-offs suggested by European expert guidelines (EWGSOP2 and ESPEN-EASO). Specific BIVA was applied to compare groups and to identify the area for sarcopenic obesity within young-adults tolerance ellipses. The position of the specific vector of US individuals with S-O, selected on the basis of DXA measurements, was also considered. RESULTS In both sexes of the Italian sample, the bioelectrical characteristics of the four groups were different (p < 0.001). The differences were mainly related to vector length, indicative of higher fat mass, which was longer in the O and S-O groups, and phase angle, a proxy of intracellular/extracellular water and muscle mass, lower in the sarcopenic groups. Bioelectrical vectors of the S-O group fell in the right quadrant, outside of the 95 % tolerance ellipses of young adults. The mean vector of the US sample with S-O fell in the same area. Within the S-O area, women had similar bioelectrical values, while men showed phase angle variability, which was related to the severity of the condition. CONCLUSIONS Specific BIVA detects body composition peculiarities of individuals with sarcopenic obesity, thus allowing their diagnosis when associated with low handgrip strength values.
Collapse
Affiliation(s)
- Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy.
| | - Simona Sulis
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Lenka Vorobel'ová
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy
| |
Collapse
|
67
|
Kirk B, Cawthon PM, Arai H, Ávila-Funes JA, Barazzoni R, Bhasin S, Binder EF, Bruyere O, Cederholm T, Chen LK, Cooper C, Duque G, Fielding RA, Guralnik J, Kiel DP, Landi F, Reginster JY, Sayer AA, Visser M, von Haehling S, Woo J, Cruz-Jentoft AJ. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age Ageing 2024; 53:afae052. [PMID: 38520141 PMCID: PMC10960072 DOI: 10.1093/ageing/afae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Indexed: 03/25/2024] Open
Abstract
IMPORTANCE Sarcopenia, the age-related loss of muscle mass and strength/function, is an important clinical condition. However, no international consensus on the definition exists. OBJECTIVE The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia. DESIGN The GLIS steering committee was formed in 2019-21 with representatives from all relevant scientific societies worldwide. During this time, the steering committee developed a set of statements on the topic and invited members from these societies to participate in a two-phase International Delphi Study. Between 2022 and 2023, participants ranked their agreement with a set of statements using an online survey tool (SurveyMonkey). Statements were categorised based on predefined thresholds: strong agreement (>80%), moderate agreement (70-80%) and low agreement (<70%). Statements with strong agreement were accepted, statements with low agreement were rejected and those with moderate agreement were reintroduced until consensus was reached. RESULTS 107 participants (mean age: 54 ± 12 years [1 missing age], 64% men) from 29 countries across 7 continents/regions completed the Delphi survey. Twenty statements were found to have a strong agreement. These included; 6 statements on 'general aspects of sarcopenia' (strongest agreement: the prevalence of sarcopenia increases with age (98.3%)), 3 statements on 'components of sarcopenia' (muscle mass (89.4%), muscle strength (93.1%) and muscle-specific strength (80.8%) should all be a part of the conceptual definition of sarcopenia)) and 11 statements on 'outcomes of sarcopenia' (strongest agreement: sarcopenia increases the risk of impaired physical performance (97.9%)). A key finding of the Delphi survey was that muscle mass, muscle strength and muscle-specific strength were all accepted as 'components of sarcopenia', whereas impaired physical performance was accepted as an 'outcome' rather than a 'component' of sarcopenia. CONCLUSION AND RELEVANCE The GLIS has created the first global conceptual definition of sarcopenia, which will now serve to develop an operational definition for clinical and research settings.
Collapse
Affiliation(s)
- Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, VIC, Australia
| | - Peggy M Cawthon
- California Pacific Medical Center, Research Institute, 550 16th Street, Second Floor, San Francisco, CA 94143 USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi Japan
| | - José A Ávila-Funes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux F-33000, France
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Shalender Bhasin
- Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Ellen F Binder
- Division of General Medicine and Geriatrics, School of Medicine, Washington University in St. Louis, St. Louis MO, USA
| | - Olivier Bruyere
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
- Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Epidemiology, University of Oxford, Oxford, OX UK
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Dr Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Roger A Fielding
- Nutrition Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA USA
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD USA
| | - Douglas P Kiel
- Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA USA
| | - Francesco Landi
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome 00168, Italy
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals and Faculty of Medical Sciences Newcastle University, Newcastle, UK
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Jean Woo
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | | |
Collapse
|
68
|
Ganggaya KS, Vanoh D, Ishak WRW. Prevalence of sarcopenia and depressive symptoms among older adults: a scoping review. Psychogeriatrics 2024; 24:473-495. [PMID: 38105398 DOI: 10.1111/psyg.13060] [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: 05/25/2023] [Revised: 09/19/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Sarcopenia causes a loss of skeletal muscle mass and decreases muscle strength and function. Depressive symptoms are a common cause of distress among geriatrics, significantly affecting the quality of life of older adults. Recently, studies have shown that a correlation exists between sarcopenia and depression. To determine the prevalence of sarcopenia and depressive symptoms and identify the factors associated with sarcopenia, we systematically searched the SCOPUS, Science Direct, and PubMed databases for papers on sarcopenia and depressive symptoms published from 2012 to 2022. We reviewed the literature on sarcopenia, depressive symptom prevalence, the prevalence of subjects with both sarcopenia and depressive symptoms, and the factors associated with sarcopenia. Only cross-sectional studies were included. Nineteen articles met the inclusion criteria for review, with overall sarcopenia prevalence ranging from 3.9% to 41.7%. The prevalence of depressive symptoms was reported in seven studies, ranging from 8.09% to 40%. The most commonly used tools to diagnose sarcopenia and depressive symptoms were the European Working Group on Sarcopenia in Older People consensus and the Geriatric Depression Scale, respectively. Being aged, malnourished, obese, having comorbidities (hypertension and diabetes), having impaired cognitive function, and having polypharmacy were found to be the factors associated with sarcopenia. Sarcopenia and depressive symptoms have been found to cause adverse health outcomes among older people. Appropriate nutritional assessments and interventions should be taken to manage these two geriatric conditions. Further studies should be planned, considering multidomain intervention strategies to improve sarcopenia and older people's mental health.
Collapse
Affiliation(s)
- Keerthana Sree Ganggaya
- Nutrition Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Divya Vanoh
- Dietetics Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Wan Rosli Wan Ishak
- Nutrition Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| |
Collapse
|
69
|
Qian S, Zhang S, Lu M, Chen S, Liu L, Liu S, Jiang F, Zhang J. The accuracy of screening tools for sarcopenia in older Chinese adults: a systematic review and meta-analysis. Front Public Health 2024; 12:1310383. [PMID: 38375338 PMCID: PMC10876058 DOI: 10.3389/fpubh.2024.1310383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Objective This review aimed to analyze and compare the accuracy of eight screening tools for sarcopenia in older Chinese adults according to different diagnostic criteria. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched between the publication of the first expert consensus on sarcopenia in 2010 and April 2023 using relevant MeSH terms. We evaluated the risk bias of the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The pooled result of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and plot the summary receiver operating characteristic curve (SROC) were calculated by using a bivariate random-effects model. The accuracies of sensitivity and specificity of the screening tools were compared using the Z-test. Results A total of 30 studies (23,193 participants) were included, except for calf circumference (CC), Ishii, and Finger-ring Test; Screening tools for sarcopenia in older Chinese adults have consistently shown low to moderate sensitivity and moderate to high specificity. Regional and sex differences affect the accuracy of the screening tools. In terms of sensitivity and specificity, the CC, Ishii, and Finger-ring Test were superior to the other screening tools. Conclusion The Asian Working Group on Sarcopenia (AWGS) 2019 criteria are more appropriate for the diagnosis of sarcopenia in older Chinese adults. According to the AWGS 2019, CC and Ishii are recommended for sarcopenia screening in older Chinese adults.
Collapse
Affiliation(s)
- Siyu Qian
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Siqing Zhang
- School of Physical Education, Huazhong University of Science and Technology, Wuhan, China
| | - Mengchen Lu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Shuhang Chen
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Liyao Liu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Siqi Liu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Fanglin Jiang
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Jisheng Zhang
- School of Physical Education, Hunan Normal University, Changsha, China
| |
Collapse
|
70
|
Dreessen L, Debain A, Lieten S, Bravenboer B, Vermeiren S, Vella-Azzopardi R, Knoop V, Costenoble A, Smeys C, Iranyeza RA, Van der Meulen KEY, Vanderhelst E, Schuermans D, Bautmans I. Respiratory Muscle Strength Is Related to Handgrip Performance in Community-Dwelling Persons Aged 80+ from the BUTTERFLY Study. Gerontology 2024; 70:526-535. [PMID: 38316117 DOI: 10.1159/000536361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION This study aimed to evaluate the association of respiratory muscle strength with sarcopenia and its indicators in the oldest old. METHODS Maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and sarcopenia-related factors (handgrip strength and appendicular lean mass) were evaluated in a cohort of n = 286 (45.5% female) non-frail, community-dwelling persons aged 83.6 ± 3.0 years (age range 80-97 years). RESULTS The sample presented a sarcopenia prevalence of 32.2%. Sarcopenic subjects showed comparable MIP and MEP as non-sarcopenic ones (female: MIP 43.9 ± 18.9 vs. 50.3 ± 19.5, p = 0.053; MEP 63.0 ± 23.0 vs. 69.2 ± 19.1, p = 0.067; male: MIP, 65.1 ± 24.4 vs. 64.4 ± 23.9, p = 0.433; MEP 87.7 ± 33.3 vs. 93.8 ± 30.9, p = 0.124). Statistically significant but very low associations were found between grip strength and MIP (r = 0.193 for male, p < 0.05 and r = 0.257 for female participants, p < 0.01) and MEP (r = 0.200 for male, p < 0.01 and r = 0.191 for female participants, p < 0.05). Lean mass was significantly correlated to MIP and MEP in female (r = 0.253, p < 0.01 and r = 0.343, p < 0.01, respectively), whereas this association was not found in male participants. Grip strength was the only statistically significant predictor of MEP (r2 = 0.212, p < 0.001), while MIP was independently predicted by age, male sex, and grip strength (r2 = 0.177, p < 0.001). CONCLUSIONS Peripheral muscle strength is a statistically significant, albeit weak predictor for respiratory muscle strength in well-functioning, community-dwelling persons aged 80+. When confronted to a low grip strength, one should be aware of concomitant respiratory muscle weakness, as this is a known risk factor for atelectasis and pneumonia. Given the relatively low association with handgrip strength, respiratory muscle strength testing might be indicated.
Collapse
Affiliation(s)
- Lisa Dreessen
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Aziz Debain
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Siddhartha Lieten
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Bert Bravenboer
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sofie Vermeiren
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Roberta Vella-Azzopardi
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Veerle Knoop
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Axelle Costenoble
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Celeste Smeys
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rock-Ange Iranyeza
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kristof E Y Van der Meulen
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Eef Vanderhelst
- Department of Respiratory Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Daniel Schuermans
- Department of Respiratory Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Ivan Bautmans
- Department of Geriatric Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Gerontology Department and Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
71
|
Martone AM, Ciciarello F, Galluzzo V, Calvani R, Zazzara MB, Tosato M, Coelho‐Junior HJ, Marzetti E, Landi F. A simple medical device development according to normative values of calf circumference across ages: results from the Italian Longevity Check-up 7+ (Lookup 7+) project. J Cachexia Sarcopenia Muscle 2024; 15:36-44. [PMID: 38053516 PMCID: PMC10834319 DOI: 10.1002/jcsm.13286] [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: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Wide consensus exists on the notion that low muscle mass is a predictor of negative health-related events, such as disability, morbidity, and mortality. Indeed, the European Working Group on Sarcopenia in Older People 2 had identified muscle mass as the key component to confirm the diagnosis of sarcopenia. However, the lack of normative values for muscle mass across ages hampers the practical assessment of this important parameter. The aim of the present study was to produce cross-sectional centile and normative values for calf circumference (a surrogate estimation of muscle mass) across a wide spectrum of ages using a large and unselected sample of community-dwellers enrolled in the Longevity Check-up 7+ (Lookup 7+) project. METHODS This is a cross-sectional study using the data of Lookup 7+ project, an ongoing study started in June 2015 and conducted in unconventional settings (i.e., exhibitions, malls, and health promotion campaigns). Candidate participants were considered eligible for enrolment if they were at least 45 years of age and provided written informed consent. Calf circumference was measured using an inextensible but flexible plastic tape in a sitting position with the knee and ankle at a right angle and the feet resting on the floor. Normative values for calf circumference from ages 45 to 80 + years were generated. RESULTS A total of 11 814 participants were enrolled from 1 June 2015 to 30 September 2022. The mean age of participants included in the analyses was 61.8 years (standard deviation; 10.2 years; range: 45-98 years), and 6686 (57%) were women. Normative values for calf circumference were obtained for men and women, stratified by age groups. Accordingly, a calf circumference tape, with colour bands that demarcate the centiles range into which the patient falls, was created and validated. CONCLUSIONS Our study established age- and gender-specific centile reference values for calf circumference. The calf circumference tape can be used to easily interpret the assessment in every-day practice for the early detection of individuals with or at risk of sarcopenia and malnutrition.
Collapse
Affiliation(s)
- Anna Maria Martone
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
- Department of Geriatrics, Orthopedics and RheumatologyUniversità Cattolica del Sacro CuoreRomeItaly
| | | | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
| | - Riccardo Calvani
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
- Department of Geriatrics, Orthopedics and RheumatologyUniversità Cattolica del Sacro CuoreRomeItaly
| | | | - Matteo Tosato
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
| | - Hélio José Coelho‐Junior
- Department of Geriatrics, Orthopedics and RheumatologyUniversità Cattolica del Sacro CuoreRomeItaly
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
- Department of Geriatrics, Orthopedics and RheumatologyUniversità Cattolica del Sacro CuoreRomeItaly
| | - Francesco Landi
- Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCSRomeItaly
- Department of Geriatrics, Orthopedics and RheumatologyUniversità Cattolica del Sacro CuoreRomeItaly
| |
Collapse
|
72
|
Wang M, Tang H, Chen X, Liu J, Hu N, Cui W, Zhang C, Xie C, Chen X. Opportunistic Muscle Evaluation During Chest CT Is Associated With Vertebral Compression Fractures in Old Adults: A Longitudinal Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad162. [PMID: 37422853 DOI: 10.1093/gerona/glad162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Sarcopenia and bone loss are both common in older individuals. However, the association between sarcopenia and bone fractures has not been evaluated longitudinally. In this study, we evaluated the association between computed tomography (CT)-based erector spinae muscle area and attenuation and vertebral compression fracture (VCF) in elderly individuals in a longitudinal study. METHODS This study recruited individuals 50 years of age and older, who did not have VCF and underwent CT imaging for lung cancer screening during January 2016 to December 2019. Participants were followed up annually until January 2021. Muscle CT value and muscle area of the erector spinae were determined for muscle assessment. Genant score was used to define new-onset VCF. Cox proportional hazards models were used to assess the association between muscle area/attenuation and VCF. RESULTS Of the 7 906 included participants, 72 developed new VCF over a median follow-up of 2 years. Large area of the erector spinae (adjusted hazard ratio [HR] = 0.2, 95% confidence interval [CI]: 0.1-0.7) and high bone attenuation (adjusted HR = 0.2, 95% CI: 0.1-0.5) were independently associated with VCF. High muscle attenuation was associated with severe VCF (adjusted HR = 0.46, 95% CI: 0.24-0.86). The addition of muscle area improved the area under the curve of bone attenuation from 0.79 (95% CI: 0.74-0.86) to 0.86 (95% CI: 0.82-0.91; p = .001). CONCLUSIONS CT-based muscle area/attenuation of the erector spinae was associated with VCF in elderly individuals, independently of bone attenuation. The addition of muscle area improved the performance of bone attenuation in predicting VCF.
Collapse
Affiliation(s)
- Miaomiao Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongye Tang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xin Chen
- Department of Radiology, Longhua Hospital Shanghai University of Chinese Traditional Medicine, Shanghai, China
| | - Jingjing Liu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Nandong Hu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenjing Cui
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Zhang
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Xie
- Center for Musculoskeletal Research, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
73
|
Ji S, Jung HW, Baek JY, Jang IY, Lee E. Sarcopenia as the Mobility Phenotype of Aging: Clinical Implications. J Bone Metab 2024; 31:1-12. [PMID: 38485236 PMCID: PMC10940105 DOI: 10.11005/jbm.2024.31.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/02/2023] [Accepted: 12/19/2023] [Indexed: 03/17/2024] Open
Abstract
Sarcopenia, which is characterized by an age-related decline in muscle mass and function, poses significant challenges to geriatric care. Its definition has evolved from muscle-specific criteria to include muscle mass, muscle function, and physical performance, recognizing sarcopenia as a physical frailty. Sarcopenia is associated with adverse outcomes, including mortality, falls, fractures, cognitive decline, and admission to long-term care facilities. Neuromechanical factors, protein-energy balance, and muscle protein synthesis-breakdown mechanisms contribute to its pathophysiology. The identification of sarcopenia involves screening tests and a comprehensive assessment of muscle mass, strength, and physical function. Clinical approaches aligned with the principles of comprehensive geriatric assessment prioritize patient-centered care. This assessment aids in identifying issues related to activities of daily living, cognition, mood, nutrition, and social support, alongside other aspects. The general approach to factors underlying muscle loss and functional decline in patients with sarcopenia includes managing chronic diseases and evaluating administered medications, with interventions including exercise and nutrition, as well as evolving pharmacological options. Ongoing research targeting pathways, such as myostatin-activin and exercise mimetics, holds promise for pharmacological interventions. In summary, sarcopenia requires a multifaceted approach, acknowledging its complex etiology and tailoring interventions to individual patient needs.
Collapse
Affiliation(s)
- Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
74
|
Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging 2024; 41:83-112. [PMID: 38315328 DOI: 10.1007/s40266-023-01093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized decline in muscle mass and function. Although it is mostly known as an age-related disorder, it can also occur secondary to systemic diseases such as malignancy or organ failure. It has demonstrated a significant relationship with adverse outcomes, e.g., falls, disabilities, and even mortality. Several breakthroughs have been made to find a pharmaceutical therapy for sarcopenia over the years, and some have come up with promising findings. Yet still no drug has been approved for its treatment. The key factor that makes finding an effective pharmacotherapy so challenging is the general paradigm of standalone/single diseases, traditionally adopted in medicine. Today, it is well known that sarcopenia is a complex disorder caused by multiple factors, e.g., imbalance in protein turnover, satellite cell and mitochondrial dysfunction, hormonal changes, low-grade inflammation, senescence, anorexia of aging, and behavioral factors such as low physical activity. Therefore, pharmaceuticals, either alone or combined, that exhibit multiple actions on these factors simultaneously will likely be the drug of choice to manage sarcopenia. Among various drug options explored throughout the years, testosterone still has the most cumulated evidence regarding its effects on muscle health and its safety. A mas receptor agonist, BIO101, stands out as a recent promising pharmaceutical. In addition to the conventional strategies (i.e., nutritional support and physical exercise), therapeutics with multiple targets of action or combination of multiple therapeutics with different targets/modes of action appear to promise greater benefit for the prevention and treatment of sarcopenia.
Collapse
Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Hatay Training and Research Hospital, Hatay, 31040, Turkey
| |
Collapse
|
75
|
Beaudart C, Tilquin N, Abramowicz P, Baptista F, Peng DJ, de Souza Orlandi F, Drey M, Dzhus M, Fábrega-Cuadros R, Fernandez-Garrido J, Laurindo LF, Gasparik AI, Geerinck A, Emin G, Iacob S, Kilaitė J, Kumar P, Lee SC, Lou VWQ, Mahmoodi M, Matijevic R, Matveeva MV, Merle B, Montero-Errasquín B, Bhattoa HP, Safonova Y, Şimşek H, Topinkova E, Tsekoura M, Erdoğan T, Yoo JI, Yu R, Hiligsmann M, Reginster JY, Bruyère O. Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data. Maturitas 2024; 180:107902. [PMID: 38142467 DOI: 10.1016/j.maturitas.2023.107902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL.
Collapse
Affiliation(s)
- Charlotte Beaudart
- Departement of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, Namur, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands.
| | - Noémie Tilquin
- Department of Biomedical Sciences, Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Pawel Abramowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Fátima Baptista
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Dao Juan Peng
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Dalian Road, Huichuan District, Zunyi, Guizhou, China
| | | | - Michael Drey
- Department of Medicine IV, LMU University Hospital, LMU Munich, Germany
| | - Marta Dzhus
- Bogomolets National Medical University, Department of Internal Medicine, Kyiv, Ukraine
| | | | | | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), Marília 17525-902, São Paulo, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), Marília 17519-030, São Paulo, Brazil
| | - Andrea-Ildiko Gasparik
- Department of Public Health and Health Management, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania
| | - Anton Geerinck
- Departement of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, Namur, Belgium
| | - Gyulnaz Emin
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Physical Medicine and Rehabilitation Department, Istanbul, Turkey
| | - Speranta Iacob
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Fundeni Clinical Institute, Bucharest, Romania
| | - Justina Kilaitė
- Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Prabal Kumar
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka 576104, India
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taiwan
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - Marzieh Mahmoodi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Radmila Matijevic
- University of Novi Sad, Faculty of Medicine in Novi Sad, Serbia, Orthopaedic and Trauma Clinic, Novi Sad, Serbia
| | - Mariia V Matveeva
- Siberian State Medical University, Department of Pediatrics with Course of Enoccrinology, Department of Outpatient Therapy, Tomsk, Russian Federation
| | - Blandine Merle
- INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437 Lyon, France
| | | | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Hungary
| | - Yuliya Safonova
- Department of Geriatrics, North Western State Medical University, named after I.I. Mechnikov, Russian Federation
| | - Hilal Şimşek
- Hilal Simsek: Department of Nutrition and Dietetics, Graduate School of Health Sciences, Ankara University, Ankara, Turkey
| | - Eva Topinkova
- Department of Geriatric Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - Tuğba Erdoğan
- Internal Medicine and Geriatrics Clinic, Tekirdağ Dr. Ismail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, 27, Inhang-Ro, Jun-Gu, Incheon 22332, Republic of Korea
| | - Ruby Yu
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Mickael Hiligsmann
- Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| |
Collapse
|
76
|
Liao L, Shi S, Ding B, Zhang R, Tu J, Zhao Y, Guo Q, Liao Y. The relationship between serum creatinine/cystatin C ratio and mortality in hypertensive patients. Nutr Metab Cardiovasc Dis 2024; 34:369-376. [PMID: 37949717 DOI: 10.1016/j.numecd.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/07/2023] [Accepted: 09/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIMS Sarcopenia is a disease characterized by loss of skeletal muscle mass and function that is closely associated with cardiovascular disease. The serum creatinine/cystatin C (Cr/CysC) ratio has been shown to be a simplified indicator for identifying low muscle mass (LMM) or sarcopenia. The aim of this study was to investigate whether the Cr/CysC ratio helps to predict prognostic information in hypertensive patients. METHODS AND RESULTS This cohort study included 2509 patients with hypertension from the National Health and Nutrition Survey 1999-2002. To evaluate the association between Cr/CysC ratio and mortality, we used Kaplan Meier estimates to calculate cumulative survival probabilities for all-cause mortality and cardiovascular mortality, Cox regression analyses, and hazard ratio (HR) and 95% confidence interval (CI) were calculated. Over a median follow-up of 11.76 years, lower Cr/CysC ratio was associated with lower risk of all-cause mortality (per 0.1 increase, HR:0.81, 95% CI: 0.77-0.85, P < 0.001) and cardiovascular mortality (per 0.1 increase, HR:0.80, 95% CI: 0.72-0.89, P < 0.001). Compared with patients with normal muscle mass, all-cause mortality, and cardiovascular mortality HR for patients with LMM diagnosed by Cr/CysC ratio were 1.57 (95% CI: 1.36-1.82, P < 0.001) and 1.64 (95% CI: 1.12-2.42, P = 0.012), respectively. CONCLUSION We found that low muscle mass shown by lower Cr/CysC ratio was an independent risk factor for poor prognosis in hypertensive patients. We recommend routine screening of Cr/CysC ratio in hypertensive patients and early intervention for low muscle mass or sarcopenia.
Collapse
Affiliation(s)
- Lihua Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Shanshan Shi
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Bo Ding
- Respiratory Department of Jinan Fourth People's Hospital, Jinan, 250000, China
| | - Rongting Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Jiabin Tu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Yukun Zhao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Qian Guo
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China; The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350000, China
| | - Ying Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| |
Collapse
|
77
|
Borda MG, Duque G, Pérez-Zepeda MU, Baldera JP, Westman E, Zettergren A, Samuelsson J, Kern S, Rydén L, Skoog I, Aarsland D. Using magnetic resonance imaging to measure head muscles: An innovative method to opportunistically determine muscle mass and detect sarcopenia. J Cachexia Sarcopenia Muscle 2024; 15:189-197. [PMID: 38050325 PMCID: PMC10834349 DOI: 10.1002/jcsm.13362] [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: 05/12/2023] [Revised: 08/04/2023] [Accepted: 09/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Sarcopenia is associated with multiple adverse outcomes. Traditional methods to determine low muscle mass for the diagnosis of sarcopenia are mainly based on dual-energy X-ray absorptiometry (DXA), whole-body magnetic resonance imaging (MRI) and bioelectrical impedance analysis. These tests are not always available and are rather time consuming and expensive. However, many brain and head diseases require a head MRI. In this study, we aim to provide a more accessible way to detect sarcopenia by comparing the traditional method of DXA lean mass estimation versus the tongue and masseter muscle mass assessed in a standard brain MRI. METHODS The H70 study is a longitudinal study of older people living in Gothenburg, Sweden. In this cross-sectional analysis, from 1203 participants aged 70 years at baseline, we included 495 with clinical data and MRI images available. We used the appendicular lean soft tissue index (ALSTI) in DXA images as our reference measure of lean mass. Images from the masseter and tongue were analysed and segmented using 3D Slicer. For the statistical analysis, the Spearman correlation coefficient was used, and concordance was estimated with the Kappa coefficient. RESULTS The final sample consisted of 495 participants, of which 52.3% were females. We found a significant correlation coefficient between both tongue (0.26) and masseter (0.33) with ALSTI (P < 0.001). The sarcopenia prevalence confirmed using the alternative muscle measure in MRI was calculated using the ALSTI (tongue = 2.0%, masseter = 2.2%, ALSTI = 2.4%). Concordance between sarcopenia with masseter and tongue versus sarcopenia with ALSTI as reference has a Kappa of 0.989 (P < 0.001) for masseter and a Kappa of 1 for the tongue muscle (P < 0.001). Comorbidities evaluated with the Cumulative Illness Rating Scale were significantly associated with all the muscle measurements: ALSTI (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07-1.26, P < 0.001), masseter (OR 1.16, 95% CI 1.07-1.26, P < 0.001) and tongue (OR 1.13, 95% CI 1.04-1.22, P = 0.002); the higher the comorbidities, the higher the probability of having abnormal muscle mass. CONCLUSIONS ALSTI was significantly correlated with tongue and masseter muscle mass. When performing the sarcopenia diagnostic algorithm, the prevalence of sarcopenia calculated with head muscles did not differ from sarcopenia calculated using DXA, and almost all participants were correctly classified using both methods.
Collapse
Affiliation(s)
- Miguel German Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Dirección de Investigación, Ciudad de México, México
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan, México
| | - Jonathan Patricio Baldera
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Escuela de Estadística de la Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Zettergren
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jessica Samuelsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lina Rydén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| |
Collapse
|
78
|
Chew STH, Nguyen HTT, Joshi S, Kamaruzzaman SB, Landi F, Manuel MV, Moral PG, Muangpaisan W, Nangia V, Setiati S, Yoshimura Y, Yu S, Maier AB. The rising tsunami of poor muscle health and sarcopenia in Asia-Pacific: Time for focused attention and targeted interventions. Arch Gerontol Geriatr 2024; 117:105275. [PMID: 37988852 DOI: 10.1016/j.archger.2023.105275] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Affiliation(s)
- Samuel T H Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; SingHealth Duke-NUS Medicine Academic Clinical Programme, Singapore
| | | | - Shashank Joshi
- Department of Diabetology and Endocrinology, Lilavati Hospital and Research Centre, Mumbai, India
| | | | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome 00168, Italy
| | - Maria Victoria Manuel
- St. Luke's Medical Center-Quezon City, Quezon City, Philippines; St. Luke's Medical Center-Global City, Taguig, Philippines
| | - Patrick Gerard Moral
- Center for Respiratory Medicine, University of Santo Tomas Hospital, Manila, Philippines
| | - Weerasak Muangpaisan
- Division of Geriatrics, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vivek Nangia
- Medanta Institute of Digestive and Hepatobiliary Sciences, Gurugram, India
| | - Siti Setiati
- Geriatric Division, Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Nutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Solomon Yu
- Aged and Extended Care Services (AECS), Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia; Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrea B Maier
- Centre for Healthy Longevity, @AgeSingapore, National University of Singapore, Singapore; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| |
Collapse
|
79
|
Yin Z, Cheng Q, Wang C, Wang B, Guan G, Yin J. Influence of sarcopenia on surgical efficacy and mortality of percutaneous kyphoplasty in the treatment of older adults with osteoporotic thoracolumbar fracture. Exp Gerontol 2024; 186:112353. [PMID: 38159782 DOI: 10.1016/j.exger.2023.112353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Sarcopenia is an age-related condition that causes loss of skeletal muscle mass and disability. Sarcopenia is closely related to the prognosis of patients suffering osteoporotic thoraco-lumbar compression fractures (OTLCF). The purpose of this study was to investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty (PKP) in the treatment of older adults with OTLCF surgery and postoperative mortality. METHODS From February 2016 to June 2019, 101 patients who met the inclusion and exclusion criteria were included in this study. The grip strength of the dominant hand was measured using an electronic grip tester. The diagnostic cutoff value of grip strength for sarcopenia was <27 kg for males and <16 kg for females. The cross-sectional area (cm2) of the musculature at the level of the pedicle of the thoracic 12th vertebra (T12) was measured by chest CT. The skeletal muscle index (SMI) was calculated by dividing the muscle cross-sectional area at the T12 pedicle level by the square of the height. The diagnostic cut-off value of SMI at T12 level is 42.6 cm2/m2 for males and 30.6 cm2/m2 for females. Sarcopenia was diagnosed when the grip strength and SMI values were both lower than the diagnostic cut-off value. All included patients received PKP treatment for OTLCF. The age, gender, operation time, bleeding volume, time to ground, length of hospital stay, visual analog scale (VAS) score before operation and one month after operation, Oswestry Disability Index (ODI) one month after operation and the incidence of refracture within 36 months after operation were compared between the two groups. The survival curves of the two groups were analyzed by Kaplan Meier. Chi-square test was used to compare the differences in survival rates between the two groups at 12, 24, and 36 months after operation. Univariate and multivariate Cox regression analysis compared multivariate factors on OTLCF postoperative mortality. RESULTS There was no significant difference in gender, operation time, blood loss and preoperative VAS score between the two groups (χ2 = 1.750, p = 0.186; t = 1.195, p = 0.235; t = -0.582, p = 0.562; t = -1.513, p = 0.133), respectively. The patients in the sarcopenia group were older (t = 3.708, p = 0.000), and had longer postoperative grounding time and hospitalization time (t = 4.360, p = 0.000; t = 6.458, p = 0.000). The VAS scores and ODI scores one month postoperatively were also higher in sarcopenia group (t = 5.900, p = 0.000; t = 7.294, p = 0.000), and there was a statistical difference between the two groups. Interestingly, there was no significant difference in the incidence of spinal refracture within 36 months between the two groups (χ2 = 1.510, p = 0.219). The sarcopenia group had a higher mortality rate at 36 months after operation, and the difference was statistically significant (p = 0.002). Sarcopenia is an independent risk factor for long-term mortality in OTLCF patients received PKP surgery. CONCLUSIONS Patients with sarcopenia combined with OTLCF have poor postoperative recovery of limb function and a high risk of death in the long-term (36 months) after surgery. Active and effective intervention for sarcopenia is required during treatment.
Collapse
Affiliation(s)
- Zhaoyang Yin
- Department of Orthopedics, the Affiliated Lianyungang Hospital of Xuzhou Medical University (The First People's Hospital of Lianyungang), Lianyungang 222000, China
| | - Qinghua Cheng
- Department of Orthopedics, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, China
| | - Chao Wang
- Department of Orthopedics, the Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, China
| | - Bin Wang
- Department of Orthopedics, the Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, China
| | - Guoping Guan
- Department of Orthopedics, the Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, China.
| | - Jian Yin
- Department of Orthopedics, the Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, China.
| |
Collapse
|
80
|
Veronese N, Smith L, Koyanagi A, Hoffman J, Snoussi M, Prokopidis K, Dominguez LJ, Barbagallo M. Prevalence of sarcopenia in Africa: a systematic review and meta-analysis of observational studies. Aging Clin Exp Res 2024; 36:12. [PMID: 38281246 PMCID: PMC10822818 DOI: 10.1007/s40520-023-02671-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/21/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Existing literature suggests that sarcopenia is a highly prevalent condition in older people. However, most studies to date reporting data on its prevalence have been mainly carried out in Western countries, while data on sarcopenia in Africa is scarce. With this systematic review and meta-analysis, we aimed to determine the prevalence of sarcopenia in African countries and to explore potential factors that could explain higher or lower prevalence of this condition in Africa. METHODS Major databases for studies reporting data on sarcopenia in African countries were searched from inception to June 2023. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of sarcopenia in Africa, applying a random effect model. Several sensitivity and meta-regression analyses were run. RESULTS Among 147 articles initially screened, six articles (with seven cohorts) including a total of 10,656 participants were included. Mean age of participants was 66.9 years, and the majority were female (58.1%). The weighted prevalence of sarcopenia in the selected countries of Africa was 25.72% (95%CI: 18.90-32.55). This outcome was characterized by a high heterogeneity (I2 = 99%) and by publication bias. Among the factors investigated, sarcopenia was lower when assessed using only one anthropometric measure, or in South Africa. CONCLUSION Sarcopenia is a prevalent condition in Africa and thus research regarding this topic is a public health priority. Future studies that cover African countries for which data are not available and using standardized criteria are needed.
Collapse
Affiliation(s)
- Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy.
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Jaco Hoffman
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | - Mouna Snoussi
- Department of Internal Medicine, Hedi Chaker Hospital, Medical School of Sfax, Sfax, Tunisia
| | - Konstantinos Prokopidis
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ligia J Dominguez
- Faculty of Medicine and Surgery, University Kore of Enna, 94100, Enna, Italy
| | - Mario Barbagallo
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| |
Collapse
|
81
|
Hou Y, Xiang J, Wang B, Duan S, Song R, Zhou W, Tan S, He B. Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 14:1263650. [PMID: 38260146 PMCID: PMC10801049 DOI: 10.3389/fendo.2023.1263650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Sarcopenia and diabetes are two age-related diseases that are common in the elderly population, and have a serious effect on their general health and quality of life. Sarcopenia refers to the progressive loss of muscle mass, strength and function, whereas diabetes is a chronic disease characterized by elevated blood sugar levels. The comorbidity of sarcopenia and diabetes is particularly concerning, as people with diabetes have a higher risk of developing sarcopenia due to the combination of insulin resistance, chronic inflammation and reduced physical activity. In contrast, sarcopenia destroyed blood sugar control and exacerbated the development of people with diabetes, leading to the occurrence of a variety of complications. Fortunately, there are a number of effective treatment strategies for sarcopenia in people with diabetes. Physical exercise and a balanced diet with enough protein and nutrients have been proved to enhance the muscular quality and strength of this population. Additionally, pharmacological therapies and lifestyle changes can optimize blood sugar control, which can prevent further muscle loss and improve overall health outcomes. This review aims to summarize the pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes, which help healthcare professionals recognize their intimate connection and provide a new vision for the treatment of diabetes and its complications in this population. Through early identification and comprehensive treatment, it is possible to improve the muscle function and general quality of life of elderly with diabetes and sarcopenia.
Collapse
Affiliation(s)
- Yang Hou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Jia Xiang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Bo Wang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Shoufeng Duan
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Rouxuan Song
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Wenhu Zhou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Songwen Tan
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Binsheng He
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
| |
Collapse
|
82
|
Chen L, Huang H, Jiang S, Yao H, Xu L, Huang Q, Xiao M, Zhao Q. Facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia: A qualitative meta-synthesis. Int J Nurs Sci 2024; 11:18-30. [PMID: 38352282 PMCID: PMC10859587 DOI: 10.1016/j.ijnss.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/02/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
Objectives With the acceleration of an aging society, the prevalence of age-related chronic diseases such as physical frailty and sarcopenia is gradually increasing with numerous adverse effects. Dietary nutrition is an important modifiable risk factor for the management of physical frailty and sarcopenia, but there are many complex influences on its implementation in community settings. This study aimed to summarize the facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia, and to provide a reference for the formulation of relevant health management programs. Methods Searches were conducted in databases including PubMed, Web of Science, Medline (Ovid), Embase (Ovid), and Cochrane Library from inception to January 2023. Searches were completed for a combination of MeSH terms and free terms. The Critical Appraisal Skills Program (CASP) instrument was used to appraise quality. Coding and analysis of the extracted information were performed using the socio-ecological modeling framework. The study protocol for this review was registered on the PROSPERO ( CRD42022381339). Results A total of 10 studies were included. Of these, four were nutrition-only focused interventions, and six were dietary nutrition and exercise interventions. The facilitators and barriers were summarized based on the socio-ecological model that emerged at three levels: individual trait level, external environment level, and intervention-related level, containing ten subthemes. Conclusion Individual internal motivation and external support should be integrated with the implementation of diet- and nutrition-related interventions in community-living aged people with physical frailty and sarcopenia. Develop "tailored" interventions for participants and maximize available human and physical resources.
Collapse
Affiliation(s)
- Lijuan Chen
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Siqi Jiang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haiyan Yao
- Library, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Xu
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Huang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
83
|
Lin S, Zhang C, Chen C, Fan Y, Yang F. Exploring the causal relationship between inflammatory bowel disease and sarcopenia-related traits: a two-sample Mendelian randomization analysis. Aging (Albany NY) 2023; 16:799-819. [PMID: 38165807 PMCID: PMC10817405 DOI: 10.18632/aging.205421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/01/2023] [Indexed: 01/04/2024]
Abstract
Previous observational studies have shown an association between inflammatory bowel disease (IBD) and sarcopenia. However, the causal relationship between IBD (including ulcerative colitis and Crohn's disease) and sarcopenia remains unclear. Thus, this study investigated whether genetically predicted IBD play a function in the occurrence of sarcopenia using Mendelian randomization (MR) analysis. This study used independent single nucleotide polymorphisms (SNPs) significantly associated with IBD as instrument variables (IVs). Sarcopenia-related components (hand grip strength, walking space, and appendicular lean mass (ALM)) were investigated as outcome factors, with summary-level data regarding these components of sarcopenia obtained from the UK Biobank. The IVW-MR analysis revealed that there were significant negative associations between IBD and hand grip strength (both left and right) as well as ALM. Besides, the results of IVW-MR analysis provided strong evidence of a causal relationship between genetically predicted Crohn's disease and hand grip strength and ALM. However, there were no significant associations found between ulcerative colitis and sarcopenia-related traits. Sensitivity tests confirmed the accuracy and robustness of the above MR analysis. Conclusions: Our MR analysis showed the causal effect of Crohn's disease on hand grip strength and ALM. This suggests that Crohn's disease may be a potential risk factor for sarcopenia.
Collapse
Affiliation(s)
- Shangjin Lin
- Department of Orthopedics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai 200040, China
| | - Chaobao Zhang
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai 200040, China
| | - Cong Chen
- Department of Orthopedics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Yongqian Fan
- Department of Orthopedics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Fengjian Yang
- Department of Orthopedics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| |
Collapse
|
84
|
He Y, Cui W, Fang T, Zhang Z, Zeng M. Metabolites of the gut microbiota may serve as precise diagnostic markers for sarcopenia in the elderly. Front Microbiol 2023; 14:1301805. [PMID: 38188577 PMCID: PMC10768011 DOI: 10.3389/fmicb.2023.1301805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Sarcopenia, a disease recognized by the World Health Organization, has posed a great challenge to the world in the current aging society. The vital role of the gut microbiome through the gut-muscle axis in sarcopenia is increasingly recognized. However, the working mechanisms by which the gut microbiota functions have not been fully explored in the multi-omics field. Here, we designed a cross-sectional study that recruited patients (n = 32) with sarcopenia and healthy old adults (n = 31). Diagnosis of sarcopenia was based on the Asian Working Group for Sarcopenia (AWGS) in 2019 criteria. Muscle mass was represented by appendicular skeletal muscle mass measured by using direct segmental multi-frequency bioelectrical impedance and muscle strength was evaluated using the handgrip strength. The Short Physical Performance Battery, the 5-time Chair Stand Test, and the 4-metre Walk Test were used to assess physical performance. Shotgun metagenomic sequencing was used to profile the gut microbiome in order to identify its construction and function. Metabolome based on untargeted metabolomics was applied to describe the features and structure of fecal metabolites. In clinical indexes including triglycerides and high-density lipoprotein cholesterol, we noted a significant decrease in triglycerides (TG) and a significant increase in high-density lipoprotein cholesterol (HDL-C) in patients with sarcopenia. Appendicular skeletal muscle mass of patients with sarcopenia was lower than the health group. Based on intestinal metagenomic and fecal metabolomic profiles, we found that the gut microbiome and metabolome were disturbed in patients with sarcopenia, with significant decreases in bacteria such as Bifidobacterium longum, Bifidobacterium pseudocatenulatum, and Bifidobacterium adolescentis, as well as metabolites such as shikimic acid. Also, we plotted supervised classification models at the species level of gut bacteria (AUC = 70.83-88.33) and metabolites (AUC = 92.23-98.33) based on machine learning, respectively. Based on the gut-muscle axis network, a potential mechanism is proposed along the gut microbiome - key metabolites - clinical index, that Phascolarctobacterium faecium affects appendicular skeletal muscle mass, calf circumference, handgrip strength, and BMI via Shikimic acid metabolites. This study elucidates the potential mechanisms by which the gut microbiome influences the progress of sarcopenia through metabolites and provides a meaningful theoretical foundation for reference in the diagnosis and treatment of sarcopenia.
Collapse
Affiliation(s)
- Yangli He
- Center of Geriatrics, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
| | - Weipeng Cui
- School of Food Science and Engineering, Key Laboratory of Food Nutrition and Functional Food of Hainan Province, Hainan University, Haikou, Hainan, China
| | - Tuanyu Fang
- Department of Endocrine, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
| | - Zeng Zhang
- School of Food Science and Engineering, Key Laboratory of Food Nutrition and Functional Food of Hainan Province, Hainan University, Haikou, Hainan, China
| | - Min Zeng
- Center of Geriatrics, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
| |
Collapse
|
85
|
Fernández-Martínez J, Ramírez-Casas Y, Yang Y, Aranda-Martínez P, Martínez-Ruiz L, Escames G, Acuña-Castroviejo D. From Chronodisruption to Sarcopenia: The Therapeutic Potential of Melatonin. Biomolecules 2023; 13:1779. [PMID: 38136651 PMCID: PMC10741491 DOI: 10.3390/biom13121779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Sarcopenia is an age-related condition that involves a progressive decline in muscle mass and function, leading to increased risk of falls, frailty, and mortality. Although the exact mechanisms are not fully understood, aging-related processes like inflammation, oxidative stress, reduced mitochondrial capacity, and cell apoptosis contribute to this decline. Disruption of the circadian system with age may initiate these pathways in skeletal muscle, preceding the onset of sarcopenia. At present, there is no pharmacological treatment for sarcopenia, only resistance exercise and proper nutrition may delay its onset. Melatonin, derived from tryptophan, emerges as an exceptional candidate for treating sarcopenia due to its chronobiotic, antioxidant, and anti-inflammatory properties. Its impact on mitochondria and organelle, where it is synthesized and crucial in aging skeletal muscle, further highlights its potential. In this review, we discuss the influence of clock genes in muscular aging, with special reference to peripheral clock genes in the skeletal muscle, as well as their relationship with melatonin, which is proposed as a potential therapy against sarcopenia.
Collapse
Affiliation(s)
- José Fernández-Martínez
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
| | - Yolanda Ramírez-Casas
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
| | - Yang Yang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences and Medicine, Northwest University, Xi’an 710069, China;
| | - Paula Aranda-Martínez
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
| | - Laura Martínez-Ruiz
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
| | - Germaine Escames
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Darío Acuña-Castroviejo
- Centro de Investigación Biomédica, Facultad de Medicina, Departamento de Fisiología, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain; (J.F.-M.); (Y.R.-C.); (P.A.-M.); (L.M.-R.); (G.E.)
- Instituto de Investigación Biosanitaria (Ibs.Granada), Hospital Universitario San Cecilio, 18016 Granada, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- UGC de Laboratorios Clínicos, Hospital Universitario San Cecilio, 18016 Granada, Spain
| |
Collapse
|
86
|
Xiao L, Dai M, Zhao F, Shen Y, Kwan RYC, Salvador JT, Zhang L, Luo Y, Liu Q, Yang P. Assessing the risk factors associated with sarcopenia in patients with liver cirrhosis: a case-control study. Sci Rep 2023; 13:21845. [PMID: 38071233 PMCID: PMC10710435 DOI: 10.1038/s41598-023-48955-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Sarcopenia is a disease characterized by decreased muscle mass and strength, affecting 20-70% of patients with cirrhosis, and is associated with poor prognosis, complications, and high mortality. At present, the epidemiological investigation of sarcopenia in patients with liver cirrhosis is relatively limited, and because of the differences in population characteristics, regions, diagnostic criteria and diagnostic tools, the prevalence of sarcopenia in various studies varies greatly. The definition of sarcopenia in this study adopted the criteria of the Asian Working Group on Sarcopenia (AWGS 2019), including muscle mass and muscle strength / physical performance. A total of 271 patients with liver cirrhosis were included in this cross-sectional study to explore the influencing factors of sarcopenia in patients with liver cirrhosis. The prevalence of sarcopenia was 27.7%, 27.3% in male and 28.4% in female. The results of binary logistic regression analysis showed that age, physical activity, BMI, mid-upper arm muscle circumference, hepatic encephalopathy, nutritional status, alkaline phosphatase, albumin and total cholesterol were significantly correlated with the occurrence of sarcopenia in patients with liver cirrhosis. After adjusting for the potential influencing factors, it was found that the correlation between age and sarcopenia was weakened (OR = 0.870, 95% CI 0.338-2.239). The current findings show that sarcopenia is common in patients with cirrhosis and is independently associated with age, physical activity, BMI, nutritional status, and albumin, and serum alkaline phosphatase and total cholesterol are associated with the development of sarcopenia. Regular exercise may help maintain the grip strength of patients with cirrhosis and delay the deterioration of liver function.
Collapse
Affiliation(s)
- LeYao Xiao
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - Mei Dai
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - Fei Zhao
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - YouShu Shen
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | | | - Jordan Tovera Salvador
- Philippine Women's University, Manila, Philippines
- Nursing Education Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Li Zhang
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China.
| | - YaWen Luo
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Qian Liu
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
- Nursing Department of the Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ping Yang
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China.
- Nursing Department of the Affiliated Hospital of Zunyi Medical University, Zunyi, China.
- Philippine Women's University, Manila, Philippines.
| |
Collapse
|
87
|
Shin HE, Won CW, Kim M. Development of multiple biomarker panels for prediction of sarcopenia in community-dwelling older adults. Arch Gerontol Geriatr 2023; 115:105115. [PMID: 37422966 DOI: 10.1016/j.archger.2023.105115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND It is required to consider multiple biomarkers simultaneously to predict sarcopenia and to understand its complex pathological mechanisms. This study aimed to develop multiple biomarker panels for predicting sarcopenia in older adults and to further examine its association with the incidence of sarcopenia. METHODS A total of 1,021 older adults were selected from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019 criteria. Among the 14 biomarker candidates at baseline, eight biomarkers that could optimally detect individuals with sarcopenia were selected to develop a multi-biomarker risk score (range from 0 to 10). The utility of developed multi-biomarker risk score in discriminating sarcopenia was investigated using receiver operating characteristic (ROC) analysis. RESULTS The multi-biomarker risk score had an area under the ROC curve (AUC) of 0.71 with an optimal cut-off of 1.76 score, which was significantly higher than all single biomarkers with AUC of <0.7 (all, p<0.01). During the two-year follow-up, the incidence of sarcopenia was 11.1%. Continuous multi-biomarker risk score was positively associated with incidence of sarcopenia after adjusting confounders (odds ratio [OR]=1.63; 95% confidence interval [CI]=1.23-2.17). Participants with a high risk score had higher odds of sarcopenia than those with a low risk score (OR=1.82; 95% CI=1.04-3.19). CONCLUSIONS Multi-biomarker risk score, which was a combination of eight biomarkers with different pathophysiologies, better discriminated the presence of sarcopenia than a single biomarker, and it could further predict the incidence of sarcopenia over two years in older adults.
Collapse
Affiliation(s)
- Hyung Eun Shin
- Department of Biomedical Science and Technology, College of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea.
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Korea.
| |
Collapse
|
88
|
Knoedler S, Schliermann R, Knoedler L, Wu M, Hansen FJ, Matar DY, Obed D, Vervoort D, Haug V, Hundeshagen G, Paik A, Kauke-Navarro M, Kneser U, Pomahac B, Orgill DP, Panayi AC. Impact of sarcopenia on outcomes in surgical patients: a systematic review and meta-analysis. Int J Surg 2023; 109:4238-4262. [PMID: 37696253 PMCID: PMC10720826 DOI: 10.1097/js9.0000000000000688] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/04/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Surgeons have historically used age as a preoperative predictor of postoperative outcomes. Sarcopenia, the loss of skeletal muscle mass due to disease or biological age, has been proposed as a more accurate risk predictor. The prognostic value of sarcopenia assessment in surgical patients remains poorly understood. Therefore, the authors aimed to synthesize the available literature and investigate the impact of sarcopenia on perioperative and postoperative outcomes across all surgical specialties. METHODS The authors systematically assessed the prognostic value of sarcopenia on postoperative outcomes by conducting a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching the PubMed/MEDLINE and EMBASE databases from inception to 1st October 2022. Their primary outcomes were complication occurrence, mortality, length of operation and hospital stay, discharge to home, and postdischarge survival rate at 1, 3, and 5 years. Subgroup analysis was performed by stratifying complications according to the Clavien-Dindo classification system. Sensitivity analysis was performed by focusing on studies with an oncological, cardiovascular, emergency, or transplant surgery population and on those of higher quality or prospective study design. RESULTS A total of 294 studies comprising 97 643 patients, of which 33 070 had sarcopenia, were included in our analysis. Sarcopenia was associated with significantly poorer postoperative outcomes, including greater mortality, complication occurrence, length of hospital stay, and lower rates of discharge to home (all P <0.00001). A significantly lower survival rate in patients with sarcopenia was noted at 1, 3, and 5 years (all P <0.00001) after surgery. Subgroup analysis confirmed higher rates of complications and mortality in oncological (both P <0.00001), cardiovascular (both P <0.00001), and emergency ( P =0.03 and P =0.04, respectively) patients with sarcopenia. In the transplant surgery cohort, mortality was significantly higher in patients with sarcopenia ( P <0.00001). Among all patients undergoing surgery for inflammatory bowel disease, the frequency of complications was significantly increased among sarcopenic patients ( P =0.007). Sensitivity analysis based on higher quality studies and prospective studies showed that sarcopenia remained a significant predictor of mortality and complication occurrence (all P <0.00001). CONCLUSION Sarcopenia is a significant predictor of poorer outcomes in surgical patients. Preoperative assessment of sarcopenia can help surgeons identify patients at risk, critically balance eligibility, and refine perioperative management. Large-scale studies are required to further validate the importance of sarcopenia as a prognostic indicator of perioperative risk, especially in surgical subspecialties.
Collapse
Affiliation(s)
- Samuel Knoedler
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, USA
| | - Rainer Schliermann
- Faculty of Social and Health Care Sciences, University of Applied Sciences Regensburg, Regensburg
| | - Leonard Knoedler
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, USA
| | - Mengfan Wu
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Frederik J. Hansen
- Department of General and Visceral Surgery, Friedrich-Alexander University Erlangen, Erlangen
| | - Dany Y. Matar
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
| | - Doha Obed
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Valentin Haug
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
| | - Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Angie Paik
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, USA
| | - Martin Kauke-Navarro
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, USA
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Bohdan Pomahac
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, USA
| | - Dennis P. Orgill
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
| | - Adriana C. Panayi
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston
| |
Collapse
|
89
|
Hyun J, Lee SY, Ryu B, Jeon YJ. A Combination Study of Pre- and Clinical Trial: Seaweed Consumption Reduces Aging-Associated Muscle Loss! Aging Dis 2023:AD.2023.0927. [PMID: 38029400 DOI: 10.14336/ad.2023.0927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Seaweed consumption in Asian food cultures may benefit longevity and age-related conditions like sarcopenia with aging. However, sarcopenia lacks a definitive treatment, and pharmaceutical options have limitations in efficacy and safety. Recent studies on aging female mice found that Ishige okamurae (IO), a brown algae, and its active compound diphloroethohydroxycarmalol improved sarcopenia. Further research is needed to understand the effects of seaweed consumption on sarcopenia in humans. This clinical trial divided participants into a test group (receiving 500 mg/kg IO supplementation, mean±SD; age 62.73±7.18 years, n=40) and a control group (age 63.10±7.06 years, n=40). Hazard analysis assessed vital signs and muscle strength improvement during the trial. Additionally, 12-month-old mice were oral-fed IO at different doses (50, 100, 200 mg/kg) for 6-weeks. Aging and muscle-wasting related markers were evaluated, including grip strength, body weight and compositions, serum-parameters, and molecular-changes. The clinical trial found no significant changes in toxicity-parameters between the groups (p<0.05) after 12-weeks of IO supplementation. The IO group exhibited a remarkable increase in lower-limb quadriceps muscle-strength compared to the control (p=0.002). Furthermore, IO treatment improved age-related decline in quadriceps strength in the subgroup; under 61-years-old (p=0.004), without significant differences in foot-dominancy between groups (p=0.171). In 12-month-old male mice, IO administration improved age-related deficiencies in grip strength (p>0.0001) and testosterone (p=0.0001). Muscular regeneration parameters, such as lean-mass (p>0.0001), inhibition of proteolysis (measured by changes in myogenin and atrogin-1 protein expressions), cross-sectional myofiber area (p>0.0001), number of satellite cells (p=0.0001), and increased mitochondrial oxidative phosphorylation complexes in muscle tissue indicative of mitochondrial biogenesis, were also improved by IO administration. This trial is the first to explore the positive association between consuming brown-algae IO and age-related decreases in muscle strength. IO treatment helps maintain muscle mass and delays muscle wasting during aging, suggesting it as a potent nutritional strategy to protect against aging-associated sarcopenia.
Collapse
Affiliation(s)
- Jimin Hyun
- Department of Marine Life Sciences, Jeju National University, Jeju, Republic of Korea
| | - Sang Yeoup Lee
- Integrated Research Institute for Natural Ingredients and Functional Foods, Department of Family Medicine, Biomedical Research Institute, and Integrated Research Institute for Natural Ingredients and Functional Foods, Pusan National University Yangsan Hospital, Republic of Korea
- Department of Medical Education, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Bomi Ryu
- Department of Food Science & Nutrition, Pukyong National University, Busan, Republic of Korea
| | - You-Jin Jeon
- Department of Marine Life Sciences, Jeju National University, Jeju, Republic of Korea
| |
Collapse
|
90
|
Liu Y, Tian L. Research progress on the predictive role of sarcopenia in the course and prognosis of inflammatory bowel disease. PeerJ 2023; 11:e16421. [PMID: 38025672 PMCID: PMC10676082 DOI: 10.7717/peerj.16421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Sarcopenia is a syndrome characterized by a progressive and extensive decrease in skeletal muscle quality and function. With the development of imaging technology in recent years, the understanding and research on the pathogenesis, diagnosis, and evaluation of sarcopenia have gradually improved. More than one-third of patients with inflammatory bowel disease (IBD) have sarcopenia (Ryan et al., 2019), and as a new and unique body composition evaluation index, it is critical for predicting the clinical course, prognosis and postoperative complications of patients with IBD. However, there are limited research summarizing the prevalence of sarcopenia among IBD. Furthermore, there is a scarcity of studies establishing the precise criteria for diagnosing sarcopenia in these patients. This article summarizes the evaluation of sarcopenia and its recent advancements in predicting the course and prognosis of IBD.
Collapse
Affiliation(s)
- Yang Liu
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Linglin Tian
- Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| |
Collapse
|
91
|
Kim HJ, Jung DW, Williams DR. Age Is Just a Number: Progress and Obstacles in the Discovery of New Candidate Drugs for Sarcopenia. Cells 2023; 12:2608. [PMID: 37998343 PMCID: PMC10670210 DOI: 10.3390/cells12222608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Sarcopenia is a disease characterized by the progressive loss of skeletal muscle mass and function that occurs with aging. The progression of sarcopenia is correlated with the onset of physical disability, the inability to live independently, and increased mortality. Due to global increases in lifespan and demographic aging in developed countries, sarcopenia has become a major socioeconomic burden. Clinical therapies for sarcopenia are based on physical therapy and nutritional support, although these may suffer from low adherence and variable outcomes. There are currently no clinically approved drugs for sarcopenia. Consequently, there is a large amount of pre-clinical research focusing on discovering new candidate drugs and novel targets. In this review, recent progress in this research will be discussed, along with the challenges that may preclude successful translational research in the clinic. The types of drugs examined include mitochondria-targeting compounds, anti-diabetes agents, small molecules that target non-coding RNAs, protein therapeutics, natural products, and repositioning candidates. In light of the large number of drugs and targets being reported, it can be envisioned that clinically approved pharmaceuticals to prevent the progression or even mitigate sarcopenia may be within reach.
Collapse
Affiliation(s)
| | - Da-Woon Jung
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
| | - Darren Reece Williams
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
| |
Collapse
|
92
|
Duchesneau ED, Shmuel S, Faurot KR, Park J, Musty A, Pate V, Kinlaw AC, Stürmer T, Yang YC, Funk MJ, Lund JL. Translation of a Claims-Based Frailty Index From the International Classification of Diseases, Ninth Revision, Clinical Modification to the Tenth Revision. Am J Epidemiol 2023; 192:2085-2093. [PMID: 37431778 PMCID: PMC10988220 DOI: 10.1093/aje/kwad151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/31/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023] Open
Abstract
The Faurot frailty index (FFI) is a validated algorithm that uses enrollment and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-based billing information from Medicare claims data as a proxy for frailty. In October 2015, the US health-care system transitioned from the ICD-9-CM to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Applying the Centers for Medicare and Medicaid Services General Equivalence Mappings, we translated diagnosis-based frailty indicator codes from the ICD-9-CM to the ICD-10-CM, followed by manual review. We used interrupted time-series analysis of Medicare data to assess the comparability of the pre- and posttransition FFI scores. In cohorts of beneficiaries enrolled in January 2015-2017 with 8-month frailty look-back periods, we estimated associations between the FFI and 1-year risk of aging-related outcomes (mortality, hospitalization, and admission to a skilled nursing facility). Updated indicators had similar prevalences as pretransition definitions. The median FFI scores and interquartile ranges (IQRs) for the predicted probability of frailty were similar before and after the International Classification of Diseases transition (pretransition: median, 0.034 (IQR, 0.02-0.07); posttransition: median, 0.038 (IQR, 0.02-0.09)). The updated FFI was associated with increased risks of mortality, hospitalization, and skilled nursing facility admission, similar to findings from the ICD-9-CM era. Studies of medical interventions in older adults using administrative claims should use validated indices, like the FFI, to mitigate confounding or assess effect-measure modification by frailty.
Collapse
Affiliation(s)
- Emilie D Duchesneau
- Correspondence to Emilie Duchesneau, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Campus Box 7435, Chapel Hill, NC 27599-7435 (e-mail: )
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
93
|
Wen ZQ, Lin J, Xie WQ, Shan YH, Zhen GH, Li YS. Insights into the underlying pathogenesis and therapeutic potential of endoplasmic reticulum stress in degenerative musculoskeletal diseases. Mil Med Res 2023; 10:54. [PMID: 37941072 PMCID: PMC10634069 DOI: 10.1186/s40779-023-00485-5] [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: 09/14/2022] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Degenerative musculoskeletal diseases are structural and functional failures of the musculoskeletal system, including osteoarthritis, osteoporosis, intervertebral disc degeneration (IVDD), and sarcopenia. As the global population ages, degenerative musculoskeletal diseases are becoming more prevalent. However, the pathogenesis of degenerative musculoskeletal diseases is not fully understood. Previous studies have revealed that endoplasmic reticulum (ER) stress is a stress response that occurs when impairment of the protein folding capacity of the ER leads to the accumulation of misfolded or unfolded proteins in the ER, contributing to degenerative musculoskeletal diseases. By affecting cartilage degeneration, synovitis, meniscal lesion, subchondral bone remodeling of osteoarthritis, bone remodeling and angiogenesis of osteoporosis, nucleus pulposus degeneration, annulus fibrosus rupture, cartilaginous endplate degeneration of IVDD, and sarcopenia, ER stress is involved in the pathogenesis of degenerative musculoskeletal diseases. Preclinical studies have found that regulation of ER stress can delay the progression of multiple degenerative musculoskeletal diseases. These pilot studies provide foundations for further evaluation of the feasibility, efficacy, and safety of ER stress modulators in the treatment of musculoskeletal degenerative diseases in clinical trials. In this review, we have integrated up-to-date research findings of ER stress into the pathogenesis of degenerative musculoskeletal diseases. In a future perspective, we have also discussed possible directions of ER stress in the investigation of degenerative musculoskeletal disease, potential therapeutic strategies for degenerative musculoskeletal diseases using ER stress modulators, as well as underlying challenges and obstacles in bench-to-beside research.
Collapse
Affiliation(s)
- Ze-Qin Wen
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Jun Lin
- Department of Orthopaedics, Suzhou Dushu Lake Hospital, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou, 215001, China
| | - Wen-Qing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Yun-Han Shan
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ge-Hua Zhen
- Department of Orthopaedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - Yu-Sheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China.
| |
Collapse
|
94
|
Jiao X, Wu WY, Zhan SF, Liu JB, Zhang XJ. A bidirectional Mendelian randomization study of sarcopenia-related traits and inflammatory bowel diseases. Front Immunol 2023; 14:1240811. [PMID: 38022582 PMCID: PMC10666781 DOI: 10.3389/fimmu.2023.1240811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Background There is increasing evidence pointing to a close relationship between sarcopenia and inflammatory bowel disease. However, it remains unclear whether or in which direction causal relationships exist, because these associations could be confounded. Methods We conducted a two-sample bidirectional mendelian randomization analysis using data from European genome-wide association studies of the appendicular lean mass(n = 450,243), walking pace(n = 459,915), grip strength (left hand, n = 461,026; right hand, n = 461,089), inflammatory bowel disease (25,042 patients and 34,915 controls), ulcerative colitis (12,366 patients and 33,609 controls), and Crohn's disease (12,194 patients and 28,072 controls) to investigate the causal relationship between sarcopenia-related traits and inflammatory bowel disease and its subtypes on each other. The inverse-variance weighted method was used as the primary analysis method to assess the causality, and a comprehensive sensitivity test was conducted. Results Genetically predicted appendicular lean mass was significantly associated with inflammatory bowel disease (OR = 0.916, 95%CI: 0.853-0.984, P = 0.017), ulcerative colitis (OR =0.888, 95%CI: 0.813-0.971, P = 0.009), and Crohn's disease (OR = 0.905, 95%CI: 0.820-0.999, P = 0.049). Similar results also revealed that the usual walking pace was causally associated with Crohn's disease (OR = 0.467, 95%CI: 0.239-0.914, P = 0.026). Reverse mendelian randomization analysis results found that genetic susceptibility to inflammatory bowel disease, and Crohn's disease were associated with lower appendicular lean mass. A series of sensitivity analyses ensured the reliability of the present research results. Conclusion The mendelian randomization study supports a bidirectional causality between inflammatory bowel disease, Crohn's disease and appendicular lean mass, but no such bidirectional causal relationship was found in ulcerative colitis. In addition, genetically predicted usual walking pace may reduce the risk of Crohn's disease. These findings have clinical implications for sarcopenia and inflammatory bowel disease management.
Collapse
Affiliation(s)
- Xin Jiao
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-yu Wu
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shao-feng Zhan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian-bo Liu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian-jin Zhang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
95
|
Sheng R, Cao M, Song M, Wang M, Zhang Y, Shi L, Xie T, Li Y, Wang J, Rui Y. Muscle-bone crosstalk via endocrine signals and potential targets for osteosarcopenia-related fracture. J Orthop Translat 2023; 43:36-46. [PMID: 38021216 PMCID: PMC10654153 DOI: 10.1016/j.jot.2023.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/14/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Osteosarcopenia is a syndrome coexisting sarcopenia and osteopenia/osteoporosis, with a high fracture risk. Recently, skeletal muscle and bone have been recognized as endocrine organs capable of communication through secreting myokines and osteokines, respectively. With a deeper understanding of the muscle-bone crosstalk, these endocrine signals exhibit an important role in osteosarcopenia development and fracture healing. Methods This review summarizes the role of myokines and osteokines in the development and treatment of osteosarcopenia and fracture, and discusses their potential for osteosarcopenia-related fracture treatment. Results Several well-defined myokines (myostatin and irisin) and osteokines (RANKL and SOST) are found to not only regulate skeletal muscle and bone metabolism but also influence fracture healing processes. Systemic interventions targeting these biochemical signals has shown promising results in improving the mass and functions of skeletal muscle and bone, as well as accelerating fracture healing processes. Conclusion The regulation of muscle-bone crosstalk via biochemical signals presents a novel and promising strategy for treating osteosarcopenia and fracture by simultaneously enhancing bone and muscle anabolism. We propose that myostatin, irisin, RANKL, and SOST may serve as potential targets to treat fracture patients with osteosarcopenia. The translational potential of this article Osteosarcopenia is an emerging geriatric syndrome where sarcopenia and osteoporosis coexist, with high fracture risk, delayed fracture healing, and increased mortality. However, no pharmacological agent is available to treat fracture patients with osteosarcopenia. This review summarizes the role of several myokines and osteokines in the development and treatment of osteosacropenia and fracture, as well as discusses their potential as intervention targets for osteosarcopenia-related fracture, which provides a novel and promising strategy for future osteosarcopenia-related fracture treatment.
Collapse
Affiliation(s)
- Renwang Sheng
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Mumin Cao
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Mingyuan Song
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Mingyue Wang
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Yuanwei Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Liu Shi
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Tian Xie
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Yingjuan Li
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Jinyu Wang
- Department of Rehabilitation, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| | - Yunfeng Rui
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
- Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, PR China
- Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China
| |
Collapse
|
96
|
Murakami M, Hirano H, Iwasaki M, Shirobe M, Edahiro A, Obuchi S, Kawai H, Fujiwara Y, Ihara K, Motokawa K. Development of a multiple masticatory function model based on the evaluation of sarcopenia: A cross-sectional survey of the Otassha study. Arch Oral Biol 2023; 155:105803. [PMID: 37738909 DOI: 10.1016/j.archoralbio.2023.105803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE The masticatory function is intricately linked to several factors like natural teeth count, occlusion, masticatory muscles, and tongue coordination. This study's goal was to formulate a comprehensive masticatory function model, considering sarcopenia's conceptual structure, and subsequently validate its measurement efficacy. DESIGN The study encompassed 753 participants (59.1 % women; mean age: 73.0 ± 5.1 years) from an urban community. The model amalgamated masseter muscle mass, occlusal force, and mixing ability. Based on the Asian Working Group for Sarcopenia 2019 classification, participants were categorized into a multiple masticatory dysfunction (MMD) or severe MMD (S-MMD) group. Logistic regression analysis gauged the model's validity, using serum albumin levels and self-reported chewing difficulties as dependent variables. RESULTS Of the total, 61 (8.1 %) participants exhibited MMD, while 24 (3.2 %) had S-MMD. S-MMD was correlated with low serum albumin levels (odds ratio: 3.62; 95 % confidence interval: 1.07-12.29) and heightened self-reported chewing difficulties (odds ratio: 2.82; 95 % confidence interval: 1.09-7.28). CONCLUSIONS Our multiple masticatory function model offers a straightforward approach for assessing MMD. Furthermore, the study establishes a link between S-MMD, nutritional vulnerability, and self-reported chewing challenges, thus affirming the model's credibility.
Collapse
Affiliation(s)
- Masaharu Murakami
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Masanori Iwasaki
- Hokkaido University School of Dental Medicine Graduate School of Dental Medicine, Kita13 Nishi7, Kita-ku, Sapporo, Hokkaido 060-8586, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kazushige Ihara
- Hirosaki University Graduate School of Medicine, 5 Zaifu, Hirosaki, Aomori 036-8562, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| |
Collapse
|
97
|
Zhang Y, Zhao Y, Rong J, Liu K, Zhan Y, Chai Y, Ning J, Yuan W. A bibliometric analysis of inflammation in sarcopenia from 2007 to 2022. Exp Gerontol 2023; 183:112316. [PMID: 37862732 DOI: 10.1016/j.exger.2023.112316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE In recent years, the impact of inflammation regulation on the progression of sarcopenia has garnered significant attention in research. However, there has been a lack of bibliometric analysis on the literature pertaining to inflammation in sarcopenia. This study was designed for the purpose of exploring the current research trends in this field as well as general situations and hot spots through bibliometric analysis. METHODS Searches were performed on the Web of Science Core Collection for articles related to inflammation in sarcopenia from 2007 to 2022, and selected in compliance with PRISMA guidelines. A variety of data were analyzed and visualized using VOSviewer and CiteSpace, including countries, institutions, authors, keywords, journals, and publications. RESULTS 1833 articles were obtained in the last 16 years in all. The number of publications and citations increased from 2007 to 2022, with a notable rise occurring after 2016. Based on the results, the United States, the University of Melbourne, Nutrients, and Marzetti Emanuele were the most productive countries, institutions, journals, and authors, respectively. The primary keywords were oxidative stress and insulin resistance, and the burst detection analysis of keywords found that there is a possibility that future research will focus on "Inflammatory Bowel Disease". CONCLUSION This is the first bibliometric analysis of inflammation in sarcopenia. The interaction between oxidative stress, insulin resistance and inflammation in sarcopenia is regarded as the current research priorities. As sarcopenia becomes more prevalent, a focus will be placed on determining the molecular mechanisms and therapeutic targets for regulating inflammation to intervene in sarcopenia.
Collapse
Affiliation(s)
- Yujie Zhang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ye Zhao
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiaqi Rong
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Kaoqiang Liu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yunfan Zhan
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yongli Chai
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiawei Ning
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Wei'an Yuan
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| |
Collapse
|
98
|
Bikbavova GR, Livzan MA, Tikhonravova DV. All you need to know about sarcopenia: a short guide for an internal medicine physician in questions and answers. BULLETIN OF SIBERIAN MEDICINE 2023; 22:88-97. [DOI: 10.20538/1682-0363-2023-3-88-97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Sarcopenia is associated with social, economic, and individual burdens, including loss of independence, poor quality of life, and disability. In a short period of time, ideas about sarcopenia transformed from geriatric syndrome to disease. Initially, sarcopenia was considered in the context of gradual age-related deterioration in the functioning of all physiological systems. Over the years, it became clear that it can develop a second time, as a consequence of various diseases and pathological conditions.To date, there have been no generally accepted diagnostic criteria for sarcopenia. There are several tests and tools available for screening sarcopenia, the choice of which depends on physical capabilities of the patient, capabilities of the medical institution, and the purpose for which it is detected (research or clinical practice).From the point of view of human health, sarcopenia increases the risk of falls and fractures; impairs the ability to perform daily activities; is associated with the progression of major diseases and cognitive impairments; leads to movement disorders; contributes to a decrease in the quality of life, loss of independence or a need for long-term care. The presence of sarcopenia increases both the risk of hospitalization and hospitalization costs.The aim of the literature review is to provide an analysis of up-to-date information on the causes, pathogenesis, screening, diagnosis, treatment, and consequences of sarcopenia, myosteatosis, and sarcopenic obesity. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar by the following keywords: sarcopenia, dynapenia, myosteatosis, sarcopenic obesity, nutritional status, malnutrition.
Collapse
|
99
|
Megasari IM, Mat S, Singh DKA, Tan MP. Prospective sarcopenia outcomes associated with physical performance in individuals aged 55 years and over in Malaysia. Front Public Health 2023; 11:1226642. [PMID: 37900031 PMCID: PMC10613088 DOI: 10.3389/fpubh.2023.1226642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background While the potential of physical performance tests as screening tools for sarcopenia is evident, limited information on relevant reference values for sarcopenia detection. In this study, we aimed to establish the prospective relationship between physical performance tests, including time up and go (TUG), functional reach (FR), gait speed (GS), and hand grip strength (HGS) with five-year sarcopenia risk and to determine suitable cut-off values for screening activities. Method This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs. Result Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia. Conclusion The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.
Collapse
Affiliation(s)
- Intan Meinar Megasari
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness, Physiotherapy program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
| |
Collapse
|
100
|
Qu Q, Guo Q, Sun J, Lu X, Cheang I, Zhu X, Yao W, Li X, Zhang H, Zhou Y, Liao S, Gao R. Low lean mass with obesity in older adults with hypertension: prevalence and association with mortality rate. BMC Geriatr 2023; 23:619. [PMID: 37789259 PMCID: PMC10546679 DOI: 10.1186/s12877-023-04326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The influence of sarcopenic obesity (SO) on overall survival in older adults with hypertension has not been addressed. The aim of this study was to investigate the prevalence and mortality predictive value of various body composition phenotypes, focusing mainly on SO, in older adults with hypertension. METHODS We included 1105 hypertensive patients aged ≥ 60 years from the National Health and Nutrition Examination Survey 1999-2004. Sarcopenia was broadly defined based on low lean mass (LLM; as measured by dual-energy X-ray absorptiometry), and was defined using appendicular lean mass (ALM) divided by height squared (ALM/height2), weight (ALM/weight), and body mass index (BMI; ALM/BMI), respectively. Obesity was defined as BMI ≥ 30 kg/m2, body fat percentage ≥ 30/42%, or waist circumference ≥ 102/88 cm. The prevalence of LLM with obesity was estimated according to each ALM index (ALMI). Multivariable Cox regression analysis and sensitivity analysis were used to examine the association between various body composition phenotypes and all-cause mortality. RESULTS In older adults with hypertension, the prevalence of LLM with obesity by the ALM/height2 index (9.8%) was lower relative to the ALM/weight (11.7%) and ALM/BMI indexes (19.6%). After a median follow-up of 15.4 years, 642 deaths occurred. In the fully adjusted models, LLM with obesity was significantly associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.14-2.49, P = 0.008; HR 1.48, 95% CI 1.04-2.10, P = 0.028; HR 1.30, 95% CI 1.02-1.66, P = 0.037; respectively) compared with the normal body phenotype, with no statistical differences found in individuals with LLM or obesity alone. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS The prevalence of LLM with obesity markedly differed in older adults with hypertension according to the 3 different ALMIs, varying from 9.8%, 11.7%, to 19.6%. Patients with both LLM and obesity had a higher risk of all-cause mortality. Further large, prospective, cohort studies are warranted to validate these findings and uncover underlying mechanisms.
Collapse
Affiliation(s)
- Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qixin Guo
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jinyu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinyi Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Haifeng Zhang
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Street, Suzhou, 215002, China
- Department of Cardiology, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Rongrong Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| |
Collapse
|