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Kagaya T, Miki A, Watanabe J, Kanamaru R, Matsumoto S, Kurashina K, Saito S, Teratani T, Hosoya Y, Sakuma Y, Kitayama J, Sata N. Preoperative osteopenia is associated with prognosis in patients after resection of esophageal cancer. World J Surg 2024; 48:1912-1920. [PMID: 38923062 DOI: 10.1002/wjs.12264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Osteopenia reflects frailty and has been shown to be associated with outcomes in cancer patients. This study was undertaken to examine whether osteopenia is an independent prognostic factor in patients with esophageal cancer after resection. METHODS A total of 214 patients who underwent surgery for esophageal cancer were analyzed retrospectively. Bone mineral density (BMD) of the 11th thoracic vertebra was measured by computed tomography scan, and patients classified into osteopenia and normal BMD groups with BMD <160 Hounsfield units as the cutoff. Clinicopathological data and prognosis were analyzed. RESULTS The 5-year survival rate was 55.4% for the osteopenia group and 74.7% for the normal BMD group with a significantly worse prognosis in the osteopenia group (p = 0.0080). In multivariable analysis, osteopenia was a significant independent risk factor associated with overall survival (hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.27-3.34, and p = 0.0151) along with R1/2 resection (HR 3.02, 95% CI 1.71-5.18, and p = 0.0002). CONCLUSION In patients with esophageal cancer undergoing resection, osteopenia may be a surrogate marker for frailty and an independent predictor of prognosis.
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Affiliation(s)
- Takehiro Kagaya
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Atsushi Miki
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Jun Watanabe
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Rihito Kanamaru
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Shiro Matsumoto
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Kentaro Kurashina
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Shin Saito
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Takumi Teratani
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Yoshinori Hosoya
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Yasunaru Sakuma
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Joji Kitayama
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Naohiro Sata
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
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Mauldin K, Pignotti GAP, Gieng J. Measures of nutrition status and health for weight-inclusive patient care: A narrative review. Nutr Clin Pract 2024; 39:751-771. [PMID: 38796769 DOI: 10.1002/ncp.11158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/07/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024] Open
Abstract
In healthcare, weight is often equated to and used as a marker for health. In examining nutrition and health status, there are many more effective markers independent of weight. In this article, we review practical and emerging clinical applications of technologies and tools used to collect non-weight-related data in nutrition assessment, monitoring, and evaluation in the outpatient setting. The aim is to provide clinicians with new ideas about various types of data to evaluate and track in nutrition care.
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Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
- Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Giselle A P Pignotti
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
| | - John Gieng
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
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53
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Sato S, Sezaki R, Shinohara H. Significance of preoperative evaluation of modified advanced lung cancer inflammation index for patients with resectable non-small cell lung cancer. Gen Thorac Cardiovasc Surg 2024; 72:527-534. [PMID: 38246904 DOI: 10.1007/s11748-023-02003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/17/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES Body composition and systemic inflammation/nutrition have been identified as important clinical factors in cancer patients. The modified advanced lung cancer inflammation index (mALI), which combines body composition and systemic inflammation/nutrition, is defined as appendicular skeletal muscle index × serum albumin/neutrophil-lymphocyte ratio. This retrospective study aimed to investigate associations between preoperative mALI and surgical outcomes in non-small cell lung cancer (NSCLC) patients. METHODS We examined 665 patients with resectable stage I-III NSCLC who underwent pulmonary resection. Patients were divided into low-mALI (n = 168) and high-mALI (n = 497) based on the lower quartile. Kaplan-Meier curves and Cox regression analysis were used to assess the prognostic value of mALI. We then performed 1:1 propensity score matching (PSM) for high- and low-mALI to further investigate impacts on survival. RESULTS Overall survival (OS) and recurrence-free survival (RFS) were both significantly poorer in the low-mALI group than in the high-mALI group (58.2% vs. 79.6%, P < 0.001; 48.8% vs. 66.7%, P < 0.001, respectively). Multivariate analysis revealed low-mALI as an independent predictor of OS (hazard ratio [HR], 2.116; 95% confidence interval (CI) 1.458-3.070; P < 0.001) and RFS (HR, 1.634; 95% CI 1.210-2.207; P = 0.001). After PSM, low-mALI remained as an independent predictor of OS (HR, 2.446; 95% CI 1.263-4.738; P = 0.008) and RFS (HR 1.835; 95% CI 1.074-3.137; P = 0.026). CONCLUSION Preoperative mALI appears to offer an independent predictor of poor surgical outcomes as a simple, routinely available, and inexpensive biomarker in patients with resectable NSCLC.
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Affiliation(s)
- Seijiro Sato
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.
| | - Ryo Sezaki
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
| | - Hirohiko Shinohara
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
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Shida T, Hatanaka S, Ohta T, Osuka Y, Kojima N, Motokawa K, Iwasaki M, Miyamae F, Okamura T, Hirano H, Awata S, Sasai H. Proposal and validation of an equation to identify sarcopenia using bioelectrical impedance analysis-derived parameters. Nutrition 2024; 124:112453. [PMID: 38669830 DOI: 10.1016/j.nut.2024.112453] [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: 01/21/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This study aimed to develop a simpler approach for diagnosing sarcopenia by using only bioelectrical impedance vector analysis parameters. METHODS The study design was a cross-sectional study. The research was conducted based on the Itabashi Longitudinal Study on Aging, a community-based cohort study, with data collected from the 2022 and 2023 surveys in Itabashi Ward, Tokyo, Japan. The development cohort consisted of 1146 participants from the 2022 survey, and the validation cohort included 656 participants from the 2023 survey. Both cohorts were comprised of community-dwelling older adults with similar inclusion criteria. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. The logistic model utilized height divided by impedance at 50 kHz and phase angle to establish a new regression equation to identify sarcopenia. Regression equations were generated for the development cohort and validated for the validation cohort. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC) for men and women. RESULTS The prevalence of sarcopenia was 20.7% and 14.8% in the development and validation cohort, respectively. The AUC (95% confidence interval) of the logistic model in discriminating sarcopenia was 0.92 (0.88, 0.95) for men and 0.82 (0.78, 0.86) for women in the development cohort and 0.85 (0.78, 0.91) for men and 0.90 (0.86, 0.95) for women in the validation cohort. CONCLUSION The study demonstrated that a simple formula using bioelectrical parameters at 50 kHz proved useful in identifying sarcopenia in the older adult population.
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Affiliation(s)
- Takashi Shida
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Sho Hatanaka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahisa Ohta
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Yildiz Y, Can B, Tufan A. Measurement of muscle mass for diagnosing sarcopenia: Is it enough? Clin Nutr 2024; 43:1814. [PMID: 38955057 DOI: 10.1016/j.clnu.2024.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Affiliation(s)
- Yasin Yildiz
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Turkey.
| | - Busra Can
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Turkey
| | - Asli Tufan
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Turkey
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von Renteln-Kruse W, Püschel K. [Mobility, driving, and functional competence in older people-selected results from the Longitudinal Urban Cohort Ageing Study (LUCAS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:877-883. [PMID: 39017711 PMCID: PMC11281963 DOI: 10.1007/s00103-024-03921-6] [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: 02/21/2024] [Accepted: 06/18/2024] [Indexed: 07/18/2024]
Abstract
Mobility is crucial for independent living in old age. Older people with reduced physical ability (frailty) begin to limit their personal range of activities to their immediate living environment and ultimately to their immediate home. Diseases of the musculoskeletal system as well as neurological, psychological, cognitive, sensory, and circulatory disorders can limit functional competence (ability to live independently).In the Longitudinal Urban Cohort Ageing Study (LUCAS), from which selected results are reported in this article, participants were categorized into different functional classes (Robust, postRobust, preFrail, Frail) using the LUCAS functional index. The results show that losses in functional competence were associated with impaired mobility and reduced car driving. Impaired mobility led to restricted radius of action.The aim of healthcare in old age is to preserve independence and quality of life as long as possible. Car driving is an important part of older peoples' activities of daily living. Therefore, primary care physicians should address car driving regularly because preventive measures to strengthen functional health also strengthen car driving ability in older persons.
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Affiliation(s)
| | - Klaus Püschel
- Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf (UKE), Butenfeld 34, 22529, Hamburg, Deutschland.
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Kitano M, Yasumatsu R. The impact of sarcopenia in the treatment for patients with head and neck cancer. Auris Nasus Larynx 2024; 51:717-723. [PMID: 38805807 DOI: 10.1016/j.anl.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
Sarcopenia is a disease in which a decline in muscle mass with age is associated with a decline in physical performance. In the field of otorhinolaryngology, head and neck surgery, sarcopenia is gaining attention as a cause of swallowing disorders and as a problem in the treatment of head and neck cancer. Head and neck cancer occurs in anatomical sites related to swallowing, so patients with head and neck cancer are prone to swallowing disorders and "nutrition-related sarcopenia." Since it is a cancer, it also becomes a "disease-related sarcopenia," making it easy for patients to develop secondary sarcopenia. Medical intervention against sarcopenia is important in order to decrease the number of adverse events related to treatments for cases with sarcopenia, with reports stating that proactive exercise and nutritional therapy prior to treatment for cases with sarcopenia contributes to a decrease in serious complications as well as improving the survival rate. It is the same for head and neck cancer patients with sarcopenia, so intervention prior to treatment of head and neck cancer is an area that is expected to see reports in the future. However, if the disease is malignant, it is highly likely that sarcopenia cannot be sufficiently improved due to the short period of time from diagnosis to the beginning of treatment. In this case, choosing a treatment that takes sarcopenia into consideration is another way to handle it. Assessing sarcopenia prior to treatment may help avoid post-treatment pneumonia related to sarcopenia, postoperative complications including fistula, radiation-induced toxicity including swallowing disorders, and chemotherapy-related toxicity, and it is believed to greatly contribute to the prognosis of the overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS).
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Affiliation(s)
- Mutsukazu Kitano
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.
| | - Ryuji Yasumatsu
- Department of Otolaryngology-Head and neck surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
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Aminianfar A, Hashemi R, Emami F, Heshmat R, Motlagh AD, Esmaillzadeh A. Associations between dietary total antioxidant capacity and sarcopenia: a cross-sectional study. Nutr J 2024; 23:87. [PMID: 39085886 PMCID: PMC11290090 DOI: 10.1186/s12937-024-00933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 02/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND No study has investigated the relationship between dietary total antioxidant capacity and sarcopenia so far. OBJECTIVE This study aimed to investigate the association between dietary Total Antioxidant Capacity (d-TAC) and sarcopenia in elderly adults. METHODS In this cross-sectional study we enrolled 300 elderly people (150 men and 150 women) aged ≥ 55 years using cluster random sampling method. Sarcopenia was defined based on European Working Group on Sarcopenia (EWGSOP) definition. A DXA scanner, a squeeze bulb dynamometer and a 4-Meter walk gait speed test was used to measure Appendicular Skeletal Muscle (ASM), muscle strength and muscle performance respectively. We also used a Block-format 117-item food frequency questionnaire (FFQ) to assess dietary intakes of participants. Multivariable logistic regression models were applied to examine the association between d-TAC and sarcopenia. RESULTS Mean ± SD age of study participants and their BMI was 66.8 ± 7.72 year and 27.3 ± 4.2 kg/m2, respectively. People in the highest tertile of d-TAC had the greatest hand grip strength (11.9 ± 3.63 vs. 10.4 ± 3.55 psi, p = 0.009) and had lower odds of sarcopenia compared with those in the lowest tertile, either before (OR = 0.39; 95% CI: 0.17, 0.88) or after adjustment for potential confounders (OR = 0.33; 95% CI: 0.11, 0.95). No other significant association was seen between d-TAC and components of sarcopenia. CONCLUSION We found an inverse association between dietary total antioxidant capacity and odds of sarcopenia. No significant association was seen between d-TAC and individual components of sarcopenia. Further studies are needed to confirm our findings.
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Affiliation(s)
- Azadeh Aminianfar
- Students' scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Rezvan Hashemi
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Emami
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
- Ebne Sina Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular - Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Chronic Diseases Research Center (CDRC), Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Li Y, Sheng Q, Li J, Liu W, Ma L, Han L, He J, Zhao T, Chu Y. Sarcopenia is a prognostic factor in lymphoma patients: a systematic review and meta-analysis. Leuk Lymphoma 2024:1-14. [PMID: 39086237 DOI: 10.1080/10428194.2024.2371500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024]
Abstract
Findings regarding the relationship between sarcopenia and lymphoma have been inconsistent across studies. This study investigated the association between sarcopenia and lymphoma. We systematically searched the Embase, Science Direct, Cochrane Library, and PubMed databases from inception to 31 March 2024 to identify relevant studies. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Twenty-six studies with 3659 participants were included. Sarcopenic lymphoma patients had poor overall survival (OS) (HR = 1.88; 95% CI: 1.47-2.41; p < 0.001). The heterogeneity was high (I2=80%). However, the result of the Egger test indicated a significant publication bias (p < 0.001). After employing the trim and fill method to adjust for this bias, the HR of OS became non-significant (p > 0.05). The progression-free survival (PFS) was worse in sarcopenic patients (HR = 1.77; 95% CI: 1.37-2.29; p < 0.001; I2=70%). There was no significant publication bias (p > 0.05). In the subgroup analyses, sarcopenia was a negative predictor of OS in lymphoma patients who undergo hematopoietic cell transplantation (HCT) (HR = 1.61;95% CI: 1.19-2.18; I2=30%). Male lymphoma patients with sarcopenia had a significantly worse OS (HR = 2.29; 95% CI:1.24-4.24; p = 0.009). Among patients with primary central nervous system lymphoma (PCNSL), those with sarcopenia defined by temporal muscle thickness (TMT) exhibited significantly worse OS (HR = 2.20; 95% CI:1.04-4.65; p = 0.039; I2=68%). Sarcopenia is associated with worse PFS in lymphoma patients. Subgroup analyses indicate that sarcopenia is a negative predictor of OS after HCT, and male lymphoma patients who suffer from sarcopenia have higher mortality. Sarcopenia defined by TMT is also a negative predictor of OS for patients with PCNSL.
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Affiliation(s)
- Yixuan Li
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Qi Sheng
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jiayao Li
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenyu Liu
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Li Ma
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lei Han
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Juan He
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Ting Zhao
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuning Chu
- Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Mansouri F, Shateri Z, Jahromi SE, Mahmudi-Zadeh M, Nouri M, Babajafari S. Association between pro-vegetarian dietary pattern and the risk of protein-energy wasting and sarcopenia in patients with chronic kidney disease. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:110. [PMID: 39085942 PMCID: PMC11293009 DOI: 10.1186/s41043-024-00606-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Chronic kidney disease (CKD) is characterized by structural abnormalities in nephrons, loss of functional nephrons, and impaired renal excretory function. A pro-vegetarian dietary pattern (PDP) is a gradual and progressive approach to vegetarianism. The current study aimed to assess the association between PDP and the odds of protein-energy wasting (PEW) and sarcopenia in patients with CKD. METHODS The present cross-sectional study was conducted on kidney disease patients (n = 109) referred to two clinics in Shiraz, Iran. The diagnosis of sarcopenia and PEW was made according to the guidelines of the Asian Working Group for Sarcopenia (AWGS) and the International Society of Renal Nutrition and Metabolism (ISRNM) criteria, respectively. The participants' dietary intake was evaluated using a 168-item semi-quantitative food frequency questionnaire (FFQ). For PDP index calculation, plant and animal food sources were categorized into 12 subgroups. The association between sarcopenia and PEW with PDP was evaluated using logistic regression. RESULTS The PDP was significantly associated with a lower risk of PEW in the second tertile compared to the first in the crude model (odds ratio (OR) = 0.225; confidence interval (CI): 0.055-0.915; p-value = 0.037). After adjusting for potential confounders, lower significant odds of PEW were observed in the second and last tertiles of PDP compared to the first (T2: OR = 0.194; CI: 0.039-0.962; p-value = 0.045, and T3: OR = 0.168; CI: 0.030-0.950; p-value = 0.044). In contrast, no significant relationship was observed between PDP and the odds of sarcopenia (p-value ˃ 0.05). CONCLUSIONS Overall, the findings indicated that greater adherence to PDP was negatively associated with the odds of PEW. Additionally, the results showed no association between PDP and the odds of sarcopenia. Further studies are needed to support these findings.
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Affiliation(s)
- Fatemeh Mansouri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Shahrokh Ezzatzadegan Jahromi
- Department of Medicine, School of Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Melika Mahmudi-Zadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Siavash Babajafari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Nutrition research center, Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran.
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Silva ACR, Antunes-Correa LDM, Juliani FL, Carrilho LAO, Costa FO, Martinez CAR, Mendes MCS, Carvalheira JBC. Assessing the role of prognostic nutritional index in predicting outcomes for rectal cancer surgery. Clin Nutr ESPEN 2024; 63:644-650. [PMID: 39094853 DOI: 10.1016/j.clnesp.2024.07.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/18/2024] [Accepted: 07/27/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND & AIMS The association of Prognostic Nutritional Index (PNI) with prognosis has been established for various cancer types, including rectal cancer. However, the precise relationship between PNI and body composition characteristics in patients with non-metastatic rectal cancer remain unclear. This study aimed to investigate the impact of PNI on overall survival and disease-free survival in non-metastatic rectal cancer patients undergoing total surgical resection. Additionally, it sought to assess the inflammatory status and body composition in patients across different PNI levels. METHODS Patients with non-metastatic rectal cancer who underwent total surgical resection, were consecutively enrolled. PNI was calculated using the formula: PNI = (10 × serum albumin [g/dl]) + (0.005 × lymphocytes/μL). Body composition was assessed using CT-derived measurements and laboratory tests performed at diagnosis were used to calculate inflammatory indices. Univariate and multivariate logistic regression analyses as well as Kaplan-Meier curves were used to determine prognostic values. RESULTS A total of 298 patients were included. Patients with low PNI demonstrated significantly reduced overall survival and disease-free survival compared to those with high PNI (Hazard ratio [HR] 1.85; Confidence interval [CI] 1.30-2 0.62; p = 0.001). Moreover, patients with low PNI exhibited heightened systemic inflammatory status and reduced skeletal muscle index, increased muscle radiodensity, as well as a decrease in subcutaneous adipose tissue area, subcutaneous fat index, and low attenuation of both subcutaneous and visceral adipose tissue. CONCLUSION The PNI, assessed prior to treatment initiation, serves as a prognostic biomarker for non-metastatic rectal cancer patients undergoing total surgical resection and is linked with both inflammation and alterations in body composition.
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Affiliation(s)
- Amanda Cristina Ribeiro Silva
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - Lígia de Moraes Antunes-Correa
- Universidade Estadual de Campinas (UNICAMP), Escola de Educação Física, Érico Veríssimo Avenue, 701 - Barão Geraldo, 13083-851, Campinas, SP, Brazil
| | - Fabiana Lascala Juliani
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - Larissa Ariel Oliveira Carrilho
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - Felipe Osório Costa
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - Carlos Augusto Real Martinez
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - Maria Carolina Santos Mendes
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil
| | - José Barreto Campello Carvalheira
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Divisão de Oncologia, Departamento de Anestesiologia, Oncologia e Radiologia, Tessália Vieira de Camargo Street, 126. Cidade Universitária "Zeferino Vaz", 13083-887, Campinas, SP, Brazil.
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Li Z, He Q, Yang X, Zhu T, Li X, Lei Y, Tang W, Peng S. A clinical-radiomics nomogram for the prediction of the risk of upper gastrointestinal bleeding in patients with decompensated cirrhosis. Front Med (Lausanne) 2024; 11:1308435. [PMID: 39144667 PMCID: PMC11322063 DOI: 10.3389/fmed.2024.1308435] [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: 10/06/2023] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Objective To develop a model that integrates radiomics features and clinical factors to predict upper gastrointestinal bleeding (UGIB) in patients with decompensated cirrhosis. Methods 104 decompensated cirrhosis patients with UGIB and 104 decompensated cirrhosis patients without UGIB were randomized according to a 7:3 ratio into a training cohort (n = 145) and a validation cohort (n = 63). Radiomics features of the abdominal skeletal muscle area (SMA) were extracted from the cross-sectional image at the largest level of the third lumbar vertebrae (L3) on the abdominal unenhanced multi-detector computer tomography (MDCT) images. Clinical-radiomics nomogram were constructed by combining a radiomics signature (Rad score) with clinical independent risk factors associated with UGIB. Nomogram performance was evaluated in calibration, discrimination, and clinical utility. Results The radiomics signature was built using 11 features. Plasma prothrombin time (PT), sarcopenia, and Rad score were independent predictors of the risk of UGIB in patients with decompensated cirrhosis. The clinical-radiomics nomogram performed well in both the training cohort (AUC, 0.902; 95% CI, 0.850-0.954) and the validation cohort (AUC, 0.858; 95% CI, 0.762-0.953) compared with the clinical factor model and the radiomics model and displayed excellent calibration in the training cohort. Decision curve analysis (DCA) demonstrated that the predictive efficacy of the clinical-radiomics nomogram model was superior to that of the clinical and radiomics model. Conclusion Clinical-radiomics nomogram that combines clinical factors and radiomics features has demonstrated favorable predictive effects in predicting the occurrence of UGIB in patients with decompensated cirrhosis. This helps in early diagnosis and treatment of the disease, warranting further exploration and research.
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Affiliation(s)
- Zhichun Li
- Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qian He
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Tingting Zhu
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xinghui Li
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yan Lei
- Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wei Tang
- Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Song Peng
- Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
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Wang SK, Wang QJ, Zhao X, Wang P, Li XY, Wang W, Lu SB. Therapeutic targets for muscle weakness in older adults: proteome-wide Mendelian randomization and colocalization analyses. J Nutr Health Aging 2024; 28:100325. [PMID: 39083861 DOI: 10.1016/j.jnha.2024.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Recent research highlights the importance of muscular strength as a key factor in physical fitness, a strong indicator of overall mortality risk, and a vital target for preventing chronic diseases. This study used a proteome-wide Mendelian randomization analysis plus colocalization analysis for low hand grip strength to explore potential therapeutic targets for muscle weakness. METHODS We conducted two two-sample Mendelian randomization analyses from four cohorts to identify and validate the causal relationship between plasma proteins and low grip strength. We also employed bidirectional Mendelian randomization analysis with Steiger filtering, Bayesian co-localization, and phenotype scanning to detect reverse causality, thereby consolidating our Mendelian randomization findings. Downstream analyses were also undertaken of identified proteins, including knockout models, enrichment analyses, and protein-protein interaction networks. Finally, we assessed the druggability of the identified proteins. RESULTS At Bonferroni significance (P < 6.82 × 10-5), Mendelian randomization analysis revealed that three proteins were causally associated with low grip strength. Increased MGP (OR = 0.85) and HP (OR = 0.96) decreased the risk of low grip strength, whereas elevated ART4 (OR = 1.06) increased the risk of low grip strength. None of the three proteins had reverse causality with low grip strength. Bayesian co-localization suggested that MGP shared the same variant with low grip strength (coloc.abf-PPH4 = 0.826). Further downstream analyses showed that MGP, which is highly expressed in musculoskeletal system, is a potential novel target for muscle weakness. CONCLUSIONS The proteome-wide Mendelian randomization investigation identified three proteins associated with the risk of muscle weakness. MGP, HP, and ART4 deserve further investigation as potential therapeutic targets for muscle weakness.
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Affiliation(s)
- Shuai-Kang Wang
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Qi-Jun Wang
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Xuan Zhao
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Peng Wang
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Xiang-Yu Li
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Wei Wang
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
| | - Shi-Bao Lu
- Department of Orthopedics and Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China; National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
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Olmos Martínez JM, Hernández Martínez P, González Macías J. Frailty, Sarcopenia and Osteoporosis. Med Clin (Barc) 2024; 163:e17-e23. [PMID: 38724319 DOI: 10.1016/j.medcli.2024.03.004] [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: 07/16/2023] [Revised: 02/17/2024] [Accepted: 03/07/2024] [Indexed: 07/16/2024]
Abstract
Frailty, sarcopenia and osteoporosis are entities specific to the elderly, who share some risk factors. For this reason, their relationship has been studied in different works, which have provided disparate results, probably because these studies have not always focused on the same aspects. This article reviews the relationship of frailty and sarcopenia with osteoporosis.
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Affiliation(s)
- José Manuel Olmos Martínez
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Cantabria, España; Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Cantabria, España; Instituto de Investigación Valdecilla (IDIVAL), Cantabria, España.
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Xu L, Zhou H. The association between weight-adjusted-waist index and muscle strength in adults: a population-based study. Front Public Health 2024; 12:1429244. [PMID: 39131578 PMCID: PMC11310117 DOI: 10.3389/fpubh.2024.1429244] [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: 05/07/2024] [Accepted: 07/18/2024] [Indexed: 08/13/2024] Open
Abstract
Background The relationship between the weight-adjusted-waist index (WWI) and grip strength, a crucial marker in assessing sarcopenia, lacks clarity. We aimed to explore the relationship between WWI and muscle strength across genders. Methods The cross-sectional study involved adults with complete data on WWI and grip strength from the 2011-2014 National Health and Nutrition Examination Survey. WWI was derived by dividing waist circumference by the square root of weight. Weighted multivariable logistic regression and smooth curve fitting techniques were used to examine the independent association and potential non-linear relationship between WWI and grip strength. A two-piecewise linear regression model was utilized to determine the threshold effect. Additionally, subgroup analyses and interaction tests were conducted. Results The study encompassed 9,365 participants, including 4,661 males and 4,704 females. Multivariate logistic regression analysis revealed a negative correlation between WWI and grip strength among males (β = -11.49, 95% CI: -12.38, -10.60, p < 0.001) as well as females (β = -2.53, 95% CI: -2.98, -2.08, p < 0.001). Subgroup analysis showed that the negative correlation of WWI with grip strength remained consistent across various age groups and levels of obesity for both males and females. Conclusion An increase in WWI correlates with reduced muscle strength in both males and females. WWI was negatively associated not only with muscle mass but also with muscle strength. WWI may serve as an assessment tool for sarcopenia, but further large-scale studies are needed to clarify causality.
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Affiliation(s)
- Lihan Xu
- School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Haojing Zhou
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Li Y, Xu Z. The relationship of body composition with bone mineral density and 10-year probability of hip fracture in postmenopausal women. Geriatr Nurs 2024; 59:250-255. [PMID: 39067086 DOI: 10.1016/j.gerinurse.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/23/2024] [Accepted: 07/03/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Postmenopausal osteoporosis and fractures are widely prevalent. However, the relationship of body composition with bone health in this population remains unclear. The aim of this study was to investigate the association of body composition with bone mineral density (BMD) and 10-year probability of hip fracture in postmenopausal women. MATERIALS AND METHODS This is a cross-sectional study. A total of 1285 subjects were included in our study. Body composition and BMD were assessed using dual-energy X-ray densitometry. The 10-year probability of hip fracture of participants was calculated. All participants were categorized into four groups: sarcopenic-obese (SO) group, sarcopenic-nonobese (S) group, nonsarcopenic-obese (O) group, or nonsarcopenic-nonobese control (C) group. Multivariate analyses and binary logistic regression were conducted to explore the relationship of body composition with BMD and 10-year probability of hip fracture. RESULTS Participants in S group were 2.8, 4.7 and 4.8 times more likely to develop osteoporosis in the lumbar spine, the total hip and femoral neck sites, respectively. Lean mass was positively correlated with BMD, wherein lumbar spine BMD was significantly affected by appendicular lean mass, while total hip BMD and femoral neck BMD were mainly influenced by trunk lean mass. Total fat mass was positively associated with total hip and femoral neck BMD, but not with lumbar spine BMD. A significant correlation was observed between lean mass and 10-year probability of hip fracture. CONCLUSION Changes in body composition in postmenopausal women could affect bone health. A decrease in regional lean mass may be associated with an increased risk of osteoporosis and fractures.
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Affiliation(s)
- Yan Li
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Zhenbin Xu
- Department of Orthopaedics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.
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Boshnjaku A, Krasniqi E. Diagnosing sarcopenia in clinical practice: international guidelines vs. population-specific cutoff criteria. Front Med (Lausanne) 2024; 11:1405438. [PMID: 39131085 PMCID: PMC11310033 DOI: 10.3389/fmed.2024.1405438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024] Open
Affiliation(s)
- Arben Boshnjaku
- Faculty of Medicine, University “Fehmi Agani” in Gjakova, Gjakovë, Kosovo
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Yang Z, Li X, Song W, Zhang Y. Associations between meeting 24-h movement guidelines and sarcopenia risk among adults aged ≥ 55 years in five low- and middle-income countries. Complement Ther Clin Pract 2024; 57:101887. [PMID: 39084129 DOI: 10.1016/j.ctcp.2024.101887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE To diminish the negative influence of sarcopenia on senior adults, the study aimed to investigate the association between adherence to 24-h movement behavior guidelines (physical activity, sedentary behavior, sleep duration) and the risk of sarcopenia among individuals aged ≥55 years in five low- and middle-income countries (LMICs). METHODS A total of 16,503 adults aged ≥55 years were included in this cross-sectional study. The study utilized data from Global Aging and Adult Health Survey (SAGE). Participants reported their information about physical activity, sedentary behavior, and sleep duration using the questionnaire. Sarcopenia was identified as low skeletal muscle mass with a diminished gait speed or weakened handgrip strength. Multiple logistic regression models were used to investigate the association between adherence to 24-h movement behavior guidelines and the risk of sarcopenia. RESULTS Merely 32.73 % of participants met all three 24-h movement behavior guidelines (physical activity, less sedentary behavior, sleep). Meeting all three guidelines (p < 0.01) was significantly associated with a lower risk of sarcopenia. Meeting physical activity only (p < 0.05), or meeting both physical activity and sedentary behaivor (p < 0.05), or meeting both physical activity and sleep duration (p < 0.01) guidelines were also associated with a reduced risk of sarcopenia. Moreover, adults aged 65+ years who adhered to 24-h movement behavior guidelines exhibited a significantly reduced risk of developing sarcopenia. CONCLUSION The findings suggest that the adherence to 24-h movement behavior guidelines for regular physical activity, limited sedentary behavior, and sufficient sleep duration was associated with a reduced risk of sarcopenia in adults aged ≥55 years in five LMICs.
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Affiliation(s)
- Ziyi Yang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, China; Physical Activity and Health Promotion Laboratory, The Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Xinxing Li
- Department of Physical Education, Seoul National University, Seoul, 08826, South Korea; Institute on Aging, Seoul National University, Seoul, 08826, South Korea.
| | - Wook Song
- Department of Physical Education, Seoul National University, Seoul, 08826, South Korea; Institute on Aging, Seoul National University, Seoul, 08826, South Korea; Institute of Sport Science, Seoul National University, 08826, Seoul Korea
| | - Yanjie Zhang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, China; Physical Activity and Health Promotion Laboratory, The Chinese University of Hong Kong, Shenzhen, 518172, China.
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Nam S, Yun HY, Kim O. Risk factors for pressure injuries in individuals with spinal cord injuries who have sarcopenic obesity: A comparison of time-dependent changes in sacral region pressure between individuals with and without sarcopenic obesity. J Spinal Cord Med 2024:1-9. [PMID: 39047200 DOI: 10.1080/10790268.2024.2379068] [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] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity. DESIGN An experimental time series study. SETTING Single-center hospital. PARTICIPANTS Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022. INTERVENTIONS Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm2) of the sacral region were measured using the pressure-mapping system. RESULTS Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index. CONCLUSION Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.
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Affiliation(s)
- Sumin Nam
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
| | - Hye Yeong Yun
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
| | - Onyoo Kim
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
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Osaki K, Fukushima T, Suzuki K, Kamimura A, Yanai S, Morishita S. Current status of research on sarcopenia in post-treatment cancer survivors in Japan:A narrative review. Fukushima J Med Sci 2024; 70:119-131. [PMID: 38925958 PMCID: PMC11330266 DOI: 10.5387/fms.23-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/13/2024] [Indexed: 06/28/2024] Open
Abstract
Sarcopenia is prevalent among 11-25% of adult cancer survivors, depending on the cancer type, although the available data on post-treatment survivors in Japan are limited. If cancer patients develop cachexia, they may experience sustained weight loss as a result, ultimately leading to sarcopenia. Conversely, some patients experience post-treatment weight gain, resulting in sarcopenic obesity. Both sarcopenia and obesity elevate the risk of cardiovascular diseases and mortality; therefore, the importance of sarcopenia prevention and management is undeniable. The Guidelines for Exercise for Cancer Survivors recommend continued physical activity. Recent studies have reported the effectiveness of multimodal interventions, combining pharmacological, nutritional, and exercise approaches, necessitating multidisciplinary care for post-treatment sarcopenia. Innovative health interventions using mobile devices have also gained attention. However, studies on sarcopenia in post-treatment cancer survivors, especially those regarding exercise interventions, remain scarce in Japan, primarily due to limited insurance coverage for such post-treatment interventions and workforce challenges. It is clear that some cancer survivors have sarcopenia, which can lead to worse survival and secondary illness. While the benefits of exercise are clear, a comprehensive approach to sarcopenia is a further challenge for the future.
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Affiliation(s)
- Keiichi Osaki
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | | | | | - Akiho Kamimura
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | - Saki Yanai
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University
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Gravholt A, Fernandez B, Bessaguet H, Millet GY, Buizer AI, Lapole T. Motor function and gait decline in individuals with cerebral palsy during adulthood: a narrative review of potential physiological determinants. Eur J Appl Physiol 2024:10.1007/s00421-024-05550-y. [PMID: 39042142 DOI: 10.1007/s00421-024-05550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Abstract
Cerebral palsy (CP) is the most common childhood-onset disability. The evolution of gait according to severity is well known amongst children and thought to peak between 8 and 12 years of age among those walking without assistive devices. However, among adults, clinical experience as well as scientific studies report, through clinical assessments, questionnaires and interviews, increasing walking difficulties leading to an increased dependency of assistive devices in everyday ambulation. For many individuals with CP, this change will occur around 30-40 years, with the risk of losing mobility increasing with age. This narrative review aims to first provide objective evidence of motor function and gait decline in adults with CP when ageing, and then to offer mechanistic hypotheses to explain those alterations. Many studies have compared individuals with CP to the typically developing population, yet the evolution with ageing has largely been understudied. Comorbid diagnoses comprise one of the potential determinants of motor function and gait decline with ageing in people with CP, with the first manifestations happening at an early age and worsening with ageing. Similarly, ageing appears to cause alterations to the neuromuscular and cardiovascular systems at an earlier age than their typically developing (TD) peers. Future studies should, however, try to better understand how the physiological particularities of CP change with ageing that could pave the way for better strategies for maintaining function and quality of life in people with CP.
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Affiliation(s)
- Anders Gravholt
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de La Motricité, 42023, Saint-Etienne, France
| | - Bruno Fernandez
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de La Motricité, 42023, Saint-Etienne, France
| | - Hugo Bessaguet
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de La Motricité, 42023, Saint-Etienne, France
| | - Guillaume Y Millet
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de La Motricité, 42023, Saint-Etienne, France
- Institut Universitaire de France (IUF), Paris, France
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, Netherlands
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thomas Lapole
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de La Motricité, 42023, Saint-Etienne, France.
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Jäger J, Callensee L, Albayrak-Rena S, Esser S, Witzke O, Schönfeld A. Prevalence of sarcopenia among people living with HIV defined by the revised European working group on sarcopenia in older people. Int J STD AIDS 2024:9564624241262549. [PMID: 39033398 DOI: 10.1177/09564624241262549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
BACKGROUND Sarcopenia is a progressive and systemic skeletal muscle disorder associated with an increased risk of hospitalization and adverse effects on survival. This study aims to investigate the prevalence and related risk factors of sarcopenia in people living with HIV using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) definition. METHODS This cross-sectional study comprising 379 patients with confirmed HIV infection evaluated the appendicular skeletal muscle mass by employing the bioelectrical impedance analysis method. Muscle strength and functional mobility were analyzed using the five-time sit-to-stand test and the timed "Up and Go" test. RESULTS The prevalence rates of pre-sarcopenia and sarcopenia among people living with HIV were 3.4 % and 2.1 % according to the revised EWGSOP2 definition. Advanced age (Odds Ratio 1.07, p = .03), lower body mass index (Odds Ratio 0.79, p = .012) and CD4+ T-cell count below 500/μl (Odds Ratio 2.22, p = .007) were identified as significant factors associated with sarcopenia. Sarcopenia was also identified as a significant correlate of frailty (p < .001). CONCLUSION This is the first study examining the prevalence of sarcopenia in people living with HIV according to the revised EWGSOP2 clinical algorithm. Advanced age, lower body mass index and a poor immune status are determined as promoting factors of sarcopenia. Sarcopenia significantly correlates with frailty. Standardized clinical algorithms are essential for reliable sarcopenia diagnosis in people living with HIV in order to promote intervention strategies and to prevent adverse health outcomes.
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Affiliation(s)
- Jasmin Jäger
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Leonie Callensee
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sarah Albayrak-Rena
- Department of Dermatology, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Stefan Esser
- Department of Dermatology, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Schönfeld
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Yang Y, Zheng B, Lin X, Zhang M, Ye Y, Chen H, Zhou X. Low skeletal muscle mass is associated with inferior preoperative and postoperative shoulder function in elderly rotator cuff tear patients. BMC Geriatr 2024; 24:620. [PMID: 39033299 PMCID: PMC11265009 DOI: 10.1186/s12877-024-05209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 07/08/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND The age-related loss of skeletal muscle mass is an important characteristic of sarcopenia, an increasingly recognized condition with systemic implications. However, its association with shoulder function in elderly patients with rotator cuff tears (RCT) remains unknown. This study aimed to investigate the relationship between low skeletal muscle mass and shoulder function in elderly RCT patients. METHODS A retrospective analysis was conducted on RCT patients who underwent chest computed tomography (CT) scans for clinical evaluation. Preoperative CT scan images of the chest were used to calculate the cross-sectional area (CSA) of thoracic muscle at the T4 level. The medical records were reviewed. Shoulder function was assessed using the ASES score and CMS score both preoperatively and at the final follow-up. Data on the preoperative range of motion (ROM) for the affected shoulder, were collected for analysis. Subgroup analyses by sex were also performed. RESULTS A total of 283 RCT patients, consisting of 95 males and 188 females, with a mean age of 66.22 ± 4.89(range, 60-95 years) years were included in this retrospective study. The low muscle mass group showed significantly higher level of c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) compared to the normal group(3.75 ± 6.64 mg/L vs. 2.17 ± 2.30 mg/L, p = 0.021; 19.08 ± 12.86 mm/H vs.15.95 ± 10.76 mm/H, p = 0.038; respectively). In the normal group, pre-operative passive ROM, including forward elevation, abduction, lateral rotation, and abductive external rotation, was significantly better than that in the low muscle mass group (127.18 ± 34.87° vs. 89.76 ± 50.61°; 119.83 ± 45.76° vs. 87.16 ± 53.32°; 37.96 ± 28.33° vs. 25.82 ± 27.82°; 47.71 ± 23.56° vs. 30.87 ± 27.76°, all p < 0.01, respectively). Similar results were found in the active ROM of the shoulder. The female low muscle mass group exhibited significantly poorer passive and active ROM (p < 0.05). The post-operative ASES scores and CMS scores of the female low muscle mass group were also statistically worse than those of the female normal group (p < 0.05). CONCLUSIONS The results of present study revealed that the low skeletal muscle mass is associated with inferior ROM of the shoulder and per- and post-operative shoulder function, especially for elderly female patients.
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Affiliation(s)
- Yang Yang
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China
| | - Binbin Zheng
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China
| | - Xiaofang Lin
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China
| | - Mengqin Zhang
- Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China
| | - Yongzhi Ye
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China
| | - Haixiao Chen
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China.
| | - Xiaobo Zhou
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai City, 317000, Zhejiang Province, China.
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Hongkanjanapong S, Pongkulkiat P, Mahakkanukrauh A, Suwannaroj S, Foocharoen C. Clinical outcomes and associated factors with mortality in systemic sclerosis patients with sarcopenia. Am J Med Sci 2024:S0002-9629(24)01361-2. [PMID: 39033816 DOI: 10.1016/j.amjms.2024.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Despite the high incidence of sarcopenia in systemic sclerosis (SSc) patients, there is currently limited evidence on their outcomes. OBJECTIVES Our study aimed to determine clinical courses, outcomes, and identify factors associated with mortality in the SSc patients with sarcopenia. METHODS A historical cohort study was conducted in 180 adult SSc patients diagnosed with sarcopenia according to the criteria of Asian Working Group for Sarcopenia 2019, who were attending the Scleroderma Clinic at Khon Kaen University between July 2019 and November 2021. RESULTS Forty-one were diagnosed with sarcopenia. A total of 443.8 persons-year, the respective mortality rate for SSc patients with and without sarcopenia was 5.05 and 5.22 per 100-person-years, showing no statistical difference (p = 0.58). Sarcopenia was not a significant mortality risk in SSc patients with a hazard ratio (HR) of 1.34, 95 % CI 0.48-3.75. The survival rate from the baseline evaluation of sarcopenia to the last follow-up of the patients with sarcopenia at 6-, 12-, 18-, and 24-months were 97.6 %, 95.1 %, 92.7 %, and 87.8 %. Hospitalization was the sole factor significantly associated with the mortality risk, with a HR of 14.21 (95 % CI 2.36-85.60). Sarcopenia itself did not appear to be a significant predictor of disease progression, it did contribute significantly to the progression of salt and pepper skin (p=0.01). CONCLUSIONS The mortality rate of SSc patients with sarcopenia increased after a 2-year follow-up but no difference from non-sarcopenic patients. Once these patients required hospitalization, the mortality risk increased by over 10 times. Further long-term follow-up in a large cohort is suggested.
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Affiliation(s)
- Sirada Hongkanjanapong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Patnarin Pongkulkiat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Ajanee Mahakkanukrauh
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Siraphop Suwannaroj
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Chingching Foocharoen
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
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Liu Z, Lei T, Guo Y, Zheng C. The impact of sarcopenia on the efficacy of PD-1 inhibitors in non-small cell lung cancer and potential strategies to overcome resistance. Front Pharmacol 2024; 15:1377666. [PMID: 39101140 PMCID: PMC11294093 DOI: 10.3389/fphar.2024.1377666] [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: 01/28/2024] [Accepted: 06/18/2024] [Indexed: 08/06/2024] Open
Abstract
Recent studies have revealed that sarcopenia can adversely affect the efficacy of PD-1 inhibitors in the treatment of non-small cell lung cancer (NSCLC). PD-1 inhibitors are immune checkpoint inhibitors widely used in the treatment of various cancers. However, NSCLC patients may have poorer outcomes when receiving PD-1 inhibitor treatment, and sarcopenia may affect the efficacy of PD-1 inhibitors through immune and metabolic mechanisms. In this article, we summarize the reported negative impact of sarcopenia on the effectiveness of PD-1 inhibitors in the treatment of NSCLC in recent years. Based on existing research results, we analyze the possible mechanisms by which sarcopenia affects the efficacy of PD-1 inhibitors and discuss possible strategies to address this issue. This could help to understand the impact of sarcopenia on the treatment of PD-1 inhibitors and provide more accurate expectations of treatment outcomes for clinicians and patients. Additionally, we present tailored intervention strategies for sarcopenic patients undergoing PD-1 inhibitor therapy, aiming to optimize treatment efficacy and enhance patient quality of life. Nevertheless, further research is warranted to elucidate the mechanisms through which sarcopenia impacts PD-1 inhibitors and to identify more efficacious intervention approaches for improving the effectiveness of PD-1 inhibitor treatment in sarcopenic patients.
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Affiliation(s)
- Zhenchao Liu
- School of Pharmacy, Qingdao University, Qingdao, Shandong, China
| | - Tianxiang Lei
- Institute of Integrative Medicine, Qingdao University, Qingdao, Shandong, China
| | - Yunliang Guo
- Institute of Integrative Medicine, Qingdao University, Qingdao, Shandong, China
| | - Chongwen Zheng
- Department of Neurology, The 2nd Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Yang J, Liu C, Zhao S, Wang L, Wu G, Zhao Z, Li C. The association between the triglyceride-glucose index and sarcopenia: data from the NHANES 2011-2018. Lipids Health Dis 2024; 23:219. [PMID: 39030624 PMCID: PMC11264742 DOI: 10.1186/s12944-024-02201-1] [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: 04/14/2024] [Accepted: 06/28/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND The Triglyceride-glucose (TyG) index is a marker of insulin resistance, but its role in sarcopenia is controversial. The purpose of this study was to investigate the association of the TyG index with sarcopenia. METHODS 4030 participants aged 20 years and above were selected from National Health and Nutrition Examination Survey for cross sectional study. Weighted logistic regression model was used to estimate the association between TyG index and sarcopenia. Threshold effect analysis and restricted cubic spline were employed to describe nonlinear link, with interaction tests and subgroup analyses performed. RESULTS It was found in the fully adjusted model that the TyG index was positively associated with sarcopenia (per 1-unit increase in the TyG index: OR = 1.31, 95%CI: 1.07, 1.60). This association was further highlighted in groups characterized by the absence of MetS or diabetes, as well as the absence of vigorous or moderate work activity. Furthermore, analysis of the curve fitting and threshold effects indicated a nonlinear relationship, which exhibited a turning point at 9.14. CONCLUSION The study results indicated that the TyG index was positively associated with sarcopenia. Enhancing the management of insulin resistance could help reduce the risk of developing sarcopenia.
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Affiliation(s)
- Jiju Yang
- Beijing University of Chinese Medicine, Beijing, China
| | - Cong Liu
- Beijing University of Chinese Medicine, Beijing, China
| | - Sihao Zhao
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Lixiang Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Guanwei Wu
- Beijing University of Chinese Medicine, Beijing, China
| | - Ziyi Zhao
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
| | - Chungen Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
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Wang X, Wu M, Liu Q, He W, Tian Y, Zhang Y, Li C, Liu Y, Yu A, Jin H. Impact of osteopenia and osteosarcopenia on the outcomes after surgery of hepatobiliary-pancreatic cancers. Front Oncol 2024; 14:1403822. [PMID: 39099698 PMCID: PMC11294096 DOI: 10.3389/fonc.2024.1403822] [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: 03/20/2024] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Objective The purpose of this study is to investigate potential associations between osteopenia, osteosarcopenia, and postoperative outcomes in patients with hepatobiliary-pancreatic cancer (HBPC). Methods Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between osteopenia, osteosarcopenia, and outcomes of surgical treatment of HBPC patients from the start of each database to September 29, 2023. The Newcastle-Ottawa Scale was used to rate the quality of the studies. Results This analysis included a total of 16 articles with a combined patient cohort of 2,599 individuals. The results demonstrated that HBPC patients with osteopenia had significantly inferior OS (HR: 2.27, 95% CI: 1.70-3.03, p < 0.001) and RFS (HR: 1.96, 95% CI: 1.42-2.71, p < 0.001) compared to those without osteopenia. Subgroup analysis demonstrated that these findings were consistent across univariate and multivariate analyses, as well as hepatocellular carcinoma, biliary tract cancer, and pancreatic cancer. The risk of postoperative major complications was significantly higher in patients with osteopenia compared to those without osteopenia (OR: 1.66, 95% CI: 1.19-2.33, p < 0.001). Besides, we also found that the presence of osteosarcopenia in HBPC patients was significantly related to poorer OS (HR: 3.31, 95% CI: 2.00-5.48, p < 0.001) and PFS (HR: 2.50, 95% CI: 1.62-3.84, p < 0.001) in comparison to those without osteosarcopenia. Conclusion Preoperative osteopenia and osteosarcopenia can predict poorer OS and RFS with HBPC after surgery.
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Affiliation(s)
- Xiaofeng Wang
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Min Wu
- Department of Oncology, Third People’s Hospital of Honghe Prefecture, Gejiu, China
| | - Qian Liu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Wei He
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yong Tian
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yan Zhang
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Cuiping Li
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yanni Liu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Anqi Yu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Hongyan Jin
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
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Marrone G, Murri A, Urciuoli S, Di Lauro M, Grazioli E, Vignolini P, Cornali K, Tranchita E, Masci C, Cerulli C, Di Marco L, Mitterhofer AP, Parisi A, Noce A. Functional Foods and Adapted Physical Activity as New Adjuvant Therapy for Chronic Kidney Disease Patients. Nutrients 2024; 16:2325. [PMID: 39064768 PMCID: PMC11279472 DOI: 10.3390/nu16142325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) will become the fifth leading cause of death in the world by 2040. It is fundamental to prevent and treat this pathology to reduce its impact on national health costs. This trial's aim is to evaluate the effects induced by a combination of consumed functional foods (FFs) with adapted physical activity (APA) on the progression of CKD-related comorbidities. METHODS The study lasted 12 weeks. We divided 40 CKD patients into four groups: mixed (FF + APA), APA, FF and control group (usual care). The FFs were characterized by their total antioxidant capacity and antiradical activity. The APA was performed though an online training protocol, three times per week, 1 h each session. RESULTS At the end of the study, we observed, in the mixed group, a decrease in azotemia (p = 0.0272), diastolic blood pressure (p = 0.0169), and C-reactive protein (p = 0.0313), with increases in the FORD test (p = 0.0203) and fat free mass (p = 0.0258). The APA group showed a reduction in total cholesterol (p = 0.0039). CONCLUSIONS The combination of FFs and APA can help counteract several CKD-related comorbidities, such as arterial hypertension, dyslipidemia and uremic sarcopenia, and improve the CKD patients' quality of life.
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Affiliation(s)
- Giulia Marrone
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
| | - Arianna Murri
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, 00135 Rome, Italy
| | - Silvia Urciuoli
- Department of Statistics, Computer Science and Application—PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis), University of Florence, Sesto Fiorentino, 50019 Florence, Italy; (S.U.); (P.V.)
| | - Manuela Di Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
| | - Elisa Grazioli
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, 00135 Rome, Italy
| | - Pamela Vignolini
- Department of Statistics, Computer Science and Application—PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis), University of Florence, Sesto Fiorentino, 50019 Florence, Italy; (S.U.); (P.V.)
| | - Kevin Cornali
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
| | - Eliana Tranchita
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, 00135 Rome, Italy
| | - Claudia Masci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
| | - Claudia Cerulli
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, 00135 Rome, Italy
| | - Luca Di Marco
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
| | - Anna Paola Mitterhofer
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133, Rome, Italy
| | - Attilio Parisi
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, 00135 Rome, Italy
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (K.C.); (C.M.); (L.D.M.); (A.P.M.); (A.N.)
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133, Rome, Italy
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Yang N, Zhou P, Lyu J, Ren J, Nie X, Zhao S, Ye Y. Prognostic value of sarcopenia and myosteatosis alterations on survival outcomes for esophageal squamous cell carcinoma before and after radiotherapy. Nutrition 2024; 127:112536. [PMID: 39182329 DOI: 10.1016/j.nut.2024.112536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE We assessed the impact and prognostic significance of alterations in muscle quality and quantity (myosteatosis and sarcopenia, respectively) in patients with esophageal cancer treated with radiotherapy (RT). METHODS We retrospectively pooled 258 patients with esophageal squamous cell cancer who underwent RT. Myosteatosis and sarcopenia were determined based on the skeletal muscle index derived from the muscle area and attenuation at the L3 level from computed tomography images. Subgroups were formed as 2 subgroups of non-sarcopenia/myosteatosis and sarcopenia/myosteatosis (with or without other muscle status) at either timepoint of RT, 3 subgroups of only-sarcopenia, only myosteatosis (without other muscle status), and the co-presence of sarcopenia and myosteatosis at either timepoint of RT, as well as 4 subgroups of continuous sarcopenia/myosteatosis, developed sarcopenia/myosteatosis, reduced sarcopenia/myosteatosis and non-sarcopenia/myosteatosis according to alterations of muscle status at both timepoints of RT. Overall survival (OS) was compared. Univariate and multivariate analyses based on Cox regression identified independent risk factors for prognosis. RESULTS Either pre- or post-RT, patients with sarcopenia and myosteatosis (with or without other muscle status) had poor OS. Patients with only myosteatosis (without other muscle status) showed the best OS (1352 days pre-RT vs. 1648 days post-RT), while patients with concurrent myosteatosis and sarcopenia had the worst OS (907 days pre-RT vs. 706 days post-RT). The ascending order of OS for sarcopenia alterations was as follows: continuous sarcopenia (1093 days), non-sarcopenia (1740 days), developed sarcopenia (2187 days), and reduced sarcopenia (2208 days) (P = 0.002). The ascending order of OS for myosteatosis alterations was ranked as follows: continuous myosteatosis (1165 days), reduced myosteatosis (1275 days), developed myosteatosis (1783 days), and non-myosteatosis (1942 days) (P = 0.061). Univariate and multivariate Cox regression analyses revealed that increased age, longer tumor length, developed myosteatosis, and continuous myosteatosis were independent prognostic factors for OS. CONCLUSIONS Muscle mass status at presentation and alterations in patients with esophageal cancer before and after RT should be considered prognostic indicators.
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Affiliation(s)
- Ningjing Yang
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Peng Zhou
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
| | - Jiahua Lyu
- Department of Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Ren
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyu Nie
- Department of Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Sijia Zhao
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yihong Ye
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
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Xu Y, Wang D, Chen P, Qi B, Li X, Xie C, Wu J, Li L, Gao G, Geng S, Yang D. Factors associated with skeletal muscle mass in middle-aged men living with HIV. J Cachexia Sarcopenia Muscle 2024. [PMID: 39015948 DOI: 10.1002/jcsm.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/19/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Despite extensive research on muscle loss in people living with HIV (PLWH), the prevalence and contributing factors specifically among middle-aged men remain unclear. This study aimed to determine the prevalence of low muscle mass within this demographic and to identify associated factors. METHODS A total of 378 men living with HIV were enrolled in the study. They were classified into low muscle mass group if they displayed a skeletal muscle index (SMI) <7.00 kg/m2 or fell within the lowest quintile of SMI based on the criteria established by the Asian Working Group for Sarcopenia 2019. RESULTS Out of the 378 men living with HIV enrolled, 351 had normal muscle mass, while 27 (7.1%) had low muscle mass. Antiretroviral drugs Zidovudine (AZT) (OR = 0.246, P = 0.022) and higher serum albumin levels (OR = 0.899, P = 0.026) were found to be protective factors against low muscle mass according to quintile grouping. Strong positive associations between SMI and body mass index (BMI), nutritional risk index (NRI), oedema index and fat-free mass index (FFMI) (R > 0.5, P < 0.001) were observed. In addition, both BMI (sensitivity = 0.741, specificity = 0.906) and NRI (sensitivity = 0.963, specificity = 0.601) had high sensitivity and specificity in diagnosing low muscle mass, with critical values of 19.85 and 114.177 for BMI and NRI, respectively. The oedema index was the most effective measure of body composition in detecting abnormal fluid retention with high sensitivity (92.6%) and moderate specificity (71.8%) in identifying individuals with low muscle mass. Notably, PLWH with low muscle mass participants had a significantly higher prevalence (92.6%) of a high oedema index compared with those with normal muscle mass (28.2%). This observation indicates that individuals with HIV who experience reduced muscle mass is commonly accompanied with abnormal fluid retention within the body. CONCLUSIONS Antiretroviral medication types, specifically Zidovudine, BMI and NRI can be independent risk factors for low muscle mass in men with HIV. These factors, along with BMI, could be used conveniently to predict low muscle mass. Furthermore, the association between the oedema index and muscle mass suggests that observing signs of oedema may indicate a risk of low muscle mass in PLWH.
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Affiliation(s)
- Yide Xu
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dongdong Wang
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Pei Chen
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Clinical Nutrition, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Bufeng Qi
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaoting Li
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chunfeng Xie
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jieshu Wu
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lin Li
- Department of Health Management Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Gu Gao
- Department of Health Management Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shanshan Geng
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dandan Yang
- Department of Sexually Transmitted Diseases and AIDS, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China
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Pereira B, Monteiro D, Matos R, Jacinto M, Amaro N, Antunes R, Rodrigues F. Effect of a 12-Week Strength Training Program on Muscle Strength Measures of Institutionalized Older Adults-A Pilot Study. Healthcare (Basel) 2024; 12:1428. [PMID: 39057570 PMCID: PMC11275893 DOI: 10.3390/healthcare12141428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/01/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Institutionalized older adults are characterized by high levels of dependence and low levels of physical activity compared to those living in the community. This combination of factors leads to an increased risk of loss of muscle mass. Sarcopenia can be countered through strength training. The aim of the present study was to evaluate the effect of a strength training program on the physical fitness of institutionalized older adults. This study included a sample of 31 institutionalized older adults (20 females, 11 males) aged between 65 and 96 years (M = 81.64, SD = 8.67). Participants reported an average institutionalization duration of 2.43 years (SD = 2.20), ranging from half a year to ten years. A 12-week strength training program was implemented, with sessions held twice a week. Strength fitness was assessed through the following parameters: handgrip strength, upper limb muscular endurance, lower limb muscular endurance, agility and balance, body mass index, and waist circumference. The results demonstrated that a 12-week strength training program improved physical fitness in terms of lower limb muscular endurance, upper limb muscular endurance, agility, and dynamic balance (p < 0.05).
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Affiliation(s)
- Bernardo Pereira
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
| | - Diogo Monteiro
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Rui Matos
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Miguel Jacinto
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Nuno Amaro
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Raúl Antunes
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Filipe Rodrigues
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (B.P.); (D.M.); (R.M.); (M.J.); (N.A.); (R.A.)
- Research Center in Sport, Health, and Human Development (CIDESD), 5000-558 Vila Real, Portugal
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82
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Macêdo SGGF, de Souza Macêdo PR, Barbosa WS, Maciel ÁCC. Use of the Ishii Test for screening sarcopenia in older adults: a systematic review with meta-analysis of diagnostic test accuracy (DTA) studies. BMC Geriatr 2024; 24:609. [PMID: 39014328 PMCID: PMC11253494 DOI: 10.1186/s12877-024-05155-2] [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: 01/02/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND The Ishii Test is recommended by the European Working Group on Sarcopenia in Older People (EWGSOP2), however the use of this technique is still little explored in the clinical context and the scientific literature. OBJECTIVE We aimed to verify the use of the Test of Ishii in screening for sarcopenia in older adults. METHODS We searched three electronic databases and two reviewers independently screened and assessed the studies. Studies with older adults (60 years or more) of both genders, no year or language restriction and which aimed to evaluate sarcopenia using the Ishii Test and another diagnostic criteria were selected. A summary of the ROC curve, sensitivity and specificity were performed using the MedCalc and SPSS software programs, respectively. RESULTS A total of 3,298 references were identified in the database, 278 by manually searching, and finally 11 studies were included for the review. The screening test showed good sensitivity and specificity in both genders. All studies showed values above the considered value for the Area Under the Curve (AUC) results, without discriminating power (0.500). Four studies used the original values, and five studies developed a new cut-off point. A summary of the AUC curve showed the diamond close to one, indicating that the Ishii test has good performance for screening sarcopenia (I2=83,66%; p<0.001; 95%CI: 69.38 to 91.28 for men; and I2=60.04%; p<0.001; 95%CI: 13.06 to 81.63 for women). CONCLUSION The Ishii Test can be considered a useful tool for the early identification of sarcopenia in older adults. However, further studies are still needed to understand the behavior of this screening tool. TRIAL REGISTRATION CRD42023424392.
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Affiliation(s)
- Sabrina Gabrielle Gomes Fernandes Macêdo
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil.
| | - Pedro Rafael de Souza Macêdo
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
| | - Weslley Sales Barbosa
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
| | - Álvaro Campos Cavalcanti Maciel
- Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Lagoa Nova, Rio Grande do Norte, 59078-970, Brazil
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83
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Pabla P, Jones E, Piasecki M, Phillips B. Skeletal muscle dysfunction with advancing age. Clin Sci (Lond) 2024; 138:863-882. [PMID: 38994723 PMCID: PMC11250095 DOI: 10.1042/cs20231197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/13/2024]
Abstract
As a result of advances in medical treatments and associated policy over the last century, life expectancy has risen substantially and continues to increase globally. However, the disconnect between lifespan and 'health span' (the length of time spent in a healthy, disease-free state) has also increased, with skeletal muscle being a substantial contributor to this. Biological ageing is accompanied by declines in both skeletal muscle mass and function, termed sarcopenia. The mechanisms underpinning sarcopenia are multifactorial and are known to include marked alterations in muscle protein turnover and adaptations to the neural input to muscle. However, to date, the relative contribution of each factor remains largely unexplored. Specifically, muscle protein synthetic responses to key anabolic stimuli are blunted with advancing age, whilst alterations to neural components, spanning from the motor cortex and motoneuron excitability to the neuromuscular junction, may explain the greater magnitude of function losses when compared with mass. The consequences of these losses can be devastating for individuals, their support networks, and healthcare services; with clear detrimental impacts on both clinical (e.g., mortality, frailty, and post-treatment complications) and societal (e.g., independence maintenance) outcomes. Whether declines in muscle quantity and quality are an inevitable component of ageing remains to be completely understood. Nevertheless, strategies to mitigate these declines are of vital importance to improve the health span of older adults. This review aims to provide an overview of the declines in skeletal muscle mass and function with advancing age, describes the wide-ranging implications of these declines, and finally suggests strategies to mitigate them, including the merits of emerging pharmaceutical agents.
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Affiliation(s)
- Pardeep Pabla
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Eleanor J. Jones
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
| | - Bethan E. Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
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Kosoku A, Iwai T, Kabei K, Nishide S, Machida Y, Ishihara T, Uchida J. Sarcopenia as a predictor of mortality in kidney transplant recipients: A 5-year prospective cohort study with propensity score matching. Int J Urol 2024. [PMID: 39010785 DOI: 10.1111/iju.15539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Sarcopenia is known to bring about adverse outcomes in elderly populations and dialysis patients. However, whether it is a risk factor in kidney transplant recipients (KTRs) has not yet been established. In the present study, the association of sarcopenia with mortality was investigated in KTRs. METHODS We conducted a single-center prospective cohort study and recruited KTRs who were more than 1-year posttransplant from August 2017 to January 2018. The participants were followed for 5 years, and the Kaplan-Meier method and Cox proportional hazards model were used to assess patient survival. RESULTS A total of 212 KTRs with a median age of 54 years and median transplant vintage of 79 months were enrolled in this study. Among them, 33 (16%) had sarcopenia according to the Asia Working Group for Sarcopenia 2019 at baseline. During the 5-year follow-up period, 20 (9.4%) died, 5 returned to dialysis after graft loss, and 4 were lost to follow-up. The 5-year overall survival rate was 90%. After 1:1 propensity score matching, a matched cohort with 60 KTRs was generated. The overall survival rate was significantly lower in the sarcopenia group compared to the non-sarcopenia group (p = 0.025, log-rank test). Furthermore, mortality risk was significantly higher in the sarcopenia group compared to the non-sarcopenia group (hazard ratio = 7.57, 95% confidence interval = 0.94-62). CONCLUSION Sarcopenia was a predictor of mortality in KTRs. KTRs with suboptimal muscle status who were at risk for poor survival could have a clinical benefit by interventions for sarcopenia.
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Affiliation(s)
- Akihiro Kosoku
- Department of Urology, Meijibashi Hospital, Matsubara, Japan
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tomoaki Iwai
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Kabei
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shunji Nishide
- Department of Urology, Osaka City General Hospital, Osaka, Japan
| | - Yuichi Machida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Junji Uchida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Nagayama A, Inokuchi T, Ashida K, Inada C, Homma T, Miyazaki H, Adachi T, Iwata S, Motomura S, Nomura M. Assessing the Metabolic and Physical Effects of Combined DPP4 and SGLT2 Inhibitor Therapy in Patients with Type-2 Diabetes Mellitus: An Observational Prospective Pilot Study. JMA J 2024; 7:387-400. [PMID: 39114607 PMCID: PMC11301034 DOI: 10.31662/jmaj.2023-0214] [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: 12/27/2023] [Accepted: 03/06/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction This study aimed to assess the efficacy of combined administration of dipeptidyl peptide-4 (DPP4) and sodium-glucose cotransporter-2 (SGLT2) inhibitors on metabolic disorders and their preferable and complementary effects. Methods The effectiveness of a 24-week intervention on metabolic parameters (including glucose profile), physical functions (grip strength and calf circumference), and health-related quality of life (HR-QOL) was analyzed using the International Physical Activity Questionnaire and Geriatric Depression Scale 5. A total of 39 patients with type-2 diabetes mellitus (T2DM) treated with the combination of DPP4 and SGLT2 inhibitors were included in this multicenter pilot study. Results Combination therapy significantly reduced the HbA1c level (median [interquartile range]) after 24 weeks (pretreatment: 7.7% [7.3-8.2] vs. posttreatment: 7.1% [6.6-7.9], P < 0.001). The grip strength significantly increased after 24 weeks (1.7 ± 2.7 kg, P < 0.001), while the mean calf circumference and body mass index significantly decreased. In particular, administration of the SGLT2 inhibitor significantly increased total physical activity in participants aged ≥65 years (P = 0.003), while psychological QOL did not significantly improve. Conclusions Combination therapy with DPP4 and SGLT2 inhibitors decreased HbA1c levels and improved physical function in patients with T2DM. This study confirmed the effectiveness of combination therapy for metabolic disorders and suggested its beneficial and complementary effects. Therefore, advances in treatment plans to achieve further improvements in glucose profiles using DPP4 and SGLT2 inhibitors are recommended to enhance the QOL of patients with T2DM. Clinical trial number: University Hospital Medical Information Network Center: UMIN000045375.
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Affiliation(s)
- Ayako Nagayama
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Tomoki Homma
- Homma Clinic of Cardiology and Internal Medicine, Kurume, Japan
| | - Hiroshi Miyazaki
- Miyazaki Clinic of Cardiology and Internal Medicine, Kurume, Japan
| | | | - Shimpei Iwata
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Seiichi Motomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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86
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Aparicio P, Navarrete-Villanueva D, Gómez-Cabello A, López-Royo T, Santamaría E, Fernández-Irigoyen J, Ausín K, Arruebo M, Sebastian V, Vicente-Rodríguez G, Osta R, Manzano R. Proteomic profiling of human plasma extracellular vesicles identifies PF4 and C1R as novel biomarker in sarcopenia. J Cachexia Sarcopenia Muscle 2024. [PMID: 39009419 DOI: 10.1002/jcsm.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Sarcopenia, the gradual and generalized loss of muscle mass and function with ageing, is one of the major health problems in older adults, given its high prevalence and substantial socioeconomic implications. Despite the extensive efforts to reach consensus on definition and diagnostic tests and cut-offs for sarcopenia, there is an urgent and unmet need for non-invasive, specific and sensitive biomarkers for the disease. Extracellular vesicles (EVs) are present in different biofluids including plasma, whose cargo reflects cellular physiology. This work analysed EV proteome in sarcopenia and robust patients in the search for differentially contained proteins that can be used to diagnose the disease. METHODS Plasma small EVs (sEVs) from a total of 29 robust controls (aged 73.4 ± 5.6 years; 11 men and 18 women) and 49 sarcopenic patients (aged 82.3 ± 5.4 years; 15 men and 34 women) aged 65 years and older were isolated and their cargo was analysed by proteomics. Proteins whose concentration in sEVs was different between sarcopenic and robust patients were further validated using ELISA. The concentration of these candidates was correlated to the EWGSOP2 sarcopenia tests for low muscle strength and low physical performance, and receiver operating characteristic (ROC) curve analyses were carried out to evaluate their diagnostic power, sensitivity and specificity. RESULTS Proteomic analysis identified 157 sEVs proteins in both sarcopenic and robust samples. Among them, 48 proteins had never been reported in the ExoCarta nor Vesiclepedia databases. Statistical analysis revealed eight proteins whose concentration was significantly different between groups: PF4 (log2 FC = 4.806), OIT3 (log2 FC = -1.161), MMRN1 (log2 FC = -1.982), MASP1 (log2 FC = -0.627), C1R (log2 FC = 1.830), SVEP1 (log2 FC = 1.295), VCAN (FC = 0.937) and SPTB (log2 FC = 1.243). Among them, platelet factor 4 (PF4) showed the lowest concentration while Complement C1r subcomponent (C1R) increased the most in sarcopenic patients, being these results confirmed by ELISA (P = 1.07E-09 and P = 0.001287, respectively). The concentrations of candidate proteins significantly correlated with EWGSOP2 tests currently used. ROC curve analysis showed an area under the curve of 0.8921 and 0.7476 for PF4 and C1R, respectively. Choosing the optimal for PF4, 80% sensitivity and 85.71% specificity was reached while the optimal cut-off value of C1R would allow sarcopenia diagnosis with 75% sensitivity and 66.67% specificity. CONCLUSIONS Our results support the determination of EV PF4 and C1R as plasma diagnostic biomarkers in sarcopenia and open the door to investigate the role of the content of these vesicles in the pathogeny of the disease.
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Affiliation(s)
- Paula Aparicio
- LAGENBIO Laboratory, Faculty of Veterinary, University of Zaragoza, Zaragoza, Spain
- Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- AgroFood Institute of Aragon (IA2), Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - David Navarrete-Villanueva
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
- EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health Science, University of Zaragoza, Zaragoza, Spain
| | - Alba Gómez-Cabello
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
- EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Defense University Center, Zaragoza, Spain
| | - Tresa López-Royo
- LAGENBIO Laboratory, Faculty of Veterinary, University of Zaragoza, Zaragoza, Spain
- Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- AgroFood Institute of Aragon (IA2), Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - Enrique Santamaría
- Proteomics Platform, Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Joaquín Fernández-Irigoyen
- Proteomics Platform, Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Karina Ausín
- Proteomics Platform, Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Manuel Arruebo
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza, Spain
- Department of Chemical and Environmental Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, Zaragoza, Spain
| | - Victor Sebastian
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza, Spain
- Department of Chemical and Environmental Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Madrid, Spain
| | - Germán Vicente-Rodríguez
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
- EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Rosario Osta
- LAGENBIO Laboratory, Faculty of Veterinary, University of Zaragoza, Zaragoza, Spain
- Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- AgroFood Institute of Aragon (IA2), Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
| | - Raquel Manzano
- LAGENBIO Laboratory, Faculty of Veterinary, University of Zaragoza, Zaragoza, Spain
- Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- AgroFood Institute of Aragon (IA2), Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain
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Sasako T. Exploring mechanisms of insulin action and strategies to treat diabetes. Endocr J 2024; 71:651-660. [PMID: 38811207 DOI: 10.1507/endocrj.ej24-0003] [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] [Indexed: 05/31/2024] Open
Abstract
Insulin is a hormone that positively regulates anabolism and cell growth, whereas diabetes mellitus is a disease characterized by hyperglycemia associated with impaired insulin action. My colleagues and I have elucidated multifaceted insulin action in various tissues mainly by means of model mice. In the liver, insulin regulates endoplasmic reticulum (ER) stress response during feeding, whereas ER stress 'response failure' contributes to the development of steatohepatitis comorbid with diabetes. Not only the liver but also the proximal tubules of the kidney are important in the regulation of gluconeogenesis, and we revealed that insulin suppresses gluconeogenesis in accordance with absorbed glucose in the latter tissue. In skeletal muscle, another important insulin-targeted tissue, impaired insulin/IGF-1 signaling leads not only to sarcopenia, an aging-related disease of skeletal muscle, but also to osteopenia and shorter longevity. Aging is regulated by adipokines as well, and it should be considered that aging could be accelerated by 'imbalanced adipokines' in patients with a genetic background of progeria. Moreover, we reported the effects of intensive multifactorial intervention on diabetic vascular complications and mortality in patients with type 2 diabetes in a large-scale clinical trial, the J-DOIT3, and the results of subsequent sub-analyses of renal events and fracture events. Various approaches of research enable us of endocrinologists to elucidate the physiology of hormone signaling, the mechanisms underlying the development of endocrine diseases, and the appropriate treatment measures. These approaches also raise fundamental questions, but addressing them in an appropriate manner will surely contribute to the further development of endocrinology.
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Affiliation(s)
- Takayoshi Sasako
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Santangelo E, Wozniak H, Herridge MS. Meeting complex multidimensional needs in older patients and their families during and beyond critical illness. Curr Opin Crit Care 2024:00075198-990000000-00198. [PMID: 39150056 DOI: 10.1097/mcc.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE OF REVIEW To highlight the emerging crisis of critically ill elderly patients and review the unique burden of multidimensional morbidity faced by these patients and caregivers and potential interventions. RECENT FINDINGS Physical, psychological, and cognitive sequelae after critical illness are frequent, durable, and robust across the international ICU outcome literature. Elderly patients are more vulnerable to the multisystem sequelae of critical illness and its treatment and the resultant multidimensional morbidity may be profound, chronic, and significantly affect functional independence, transition to the community, and quality of life for patients and families. Recent data reinforce the importance of baseline functional status, health trajectory, and chronic illness as key determinants of long-term functional disability after ICU. These risks are even more pronounced in older patients. SUMMARY The current article is an overview of the outcomes of older survivors of critical illness, putative interventions to mitigate the long-term morbidity of patients, and the consequences for families and caregivers. A multimodal longitudinal approach designed to follow patients for one or more years may foster a better understanding of multidimensional morbidity faced by vulnerable older patients and families and provides a detailed understanding of recovery trajectories in this unique population to optimize outcome, goals of care directives, and ongoing informed consent to ICU treatment.
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Affiliation(s)
- Erminio Santangelo
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Hannah Wozniak
- Division of Critical Care, Department of Acute Medicine, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Margaret S Herridge
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
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Sánchez-Torralvo FJ, Pérez-del-Río V, Navas Vela LI, García-Olivares M, Porras N, Abuín Fernández J, Bravo Bardají MF, García de Quevedo D, Olveira G. Phase Angle as a Predictor of Mortality in Older Patients with Hip Fracture. Nutrients 2024; 16:2221. [PMID: 39064663 PMCID: PMC11279825 DOI: 10.3390/nu16142221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
The aim of our study is to determine if there is an association between phase angle obtained by bioelectrical impedance analysis (BIA) and mortality in older patients with fragility hip fractures. A prospective study of patients over 65 years old and hospitalized with a diagnosis of hip fracture was conducted. BIA was performed 24 to 48 h after surgery. Mortality was recorded, and the optimal phase angle cut-off value for predicting mortality was determined by using receiver operating characteristic (ROC) curves. A total of 262 patients were included. Of the patients studied, 10 (3.8%), 21 (8%), 39 (14.9%) and 53 (20.2%) died at 1, 3, 6 and 12 months after surgery, respectively. The phase angle cut-off for mortality at 12 months was 4.05° in women and 4.65° in men. A total of 94 patients (35.9%) were considered to have a low phase angle. After adjustment for possible confounders, mortality in patients with a low phase angle was 5.1 times higher at 1 month, 3.1 times higher at 3 months, 2.9 times higher at 6 months, and 2.8 times higher at 12 months. Phase angle is associated with prognosis in patients admitted for hip fracture regardless of age and comorbidities and can be positioned as a prognostic tool for mortality at 1, 3, 6 and 12 months.
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Affiliation(s)
- Francisco José Sánchez-Torralvo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Malaga, Spain;
| | - Verónica Pérez-del-Río
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Malaga, Spain;
- Unidad de Gestión Clínica de Cirugía Ortopédica y Traumatología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Luis Ignacio Navas Vela
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
| | - María García-Olivares
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
| | - Nuria Porras
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
| | - Jose Abuín Fernández
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
| | - Manuel Francisco Bravo Bardají
- Unidad de Gestión Clínica de Cirugía Ortopédica y Traumatología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - David García de Quevedo
- Unidad de Gestión Clínica de Cirugía Ortopédica y Traumatología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Gabriel Olveira
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain; (F.J.S.-T.); (G.O.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Malaga, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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90
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Chen L, Li Q, Huang X, Li Z. Association between sleep duration and possible sarcopenia in middle-aged and elderly Chinese individuals: evidence from the China health and retirement longitudinal study. BMC Geriatr 2024; 24:594. [PMID: 38992611 PMCID: PMC11241889 DOI: 10.1186/s12877-024-05168-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 06/23/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Sarcopenia is a common cause of disability in the aging population, and managing sarcopenia is an important step in building intrinsic capacity and promoting healthy aging. A growing body of evidence suggests that sleep deprivation may be a mediator of the development of sarcopenia. The purpose of this study was to explore the longitudinal association between sleep duration and possible sarcopenia using data from a national sample. METHODS Two waves of data from the CHARLS database for 2011 and 2015 were used in this study. All possible sarcopenia participants met the Asia Working Group for Sarcopenia 2019 (AWGS 2019) diagnostic criteria. Sleep duration was assessed using a self-report questionnaire, and sleep duration was categorized as short (≤ 6 h), medium (6-8 h), or long (> 8 h) based on previous studies. Longitudinal associations between sleep duration and possible sarcopenia will be calculated by univariate and multifactorial logistic regression analyses and expressed as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 5654 individuals participated in the follow-up study, with a prevalence of possible sarcopenia of 53.72% (578) in the short sleep duration group, 38.29% (412) in the medium sleep duration group, and 7.99% (86) in the long sleep duration group. According to the crude model of the second-wave follow-up study, short sleep durations were significantly more strongly associated with possible sarcopenia than were medium and long sleep durations (OR: 1.35, 95% CI: 1.17-1.55, P = 0.000). The association between short sleep duration and possible sarcopenia was maintained even after adjustment for covariates such as age, gender, residence, education level, BMI, smoking status, alcohol consumption and comorbidities (OR: 1.18, 95% CI: 1.02-1.36, P = 0.029). In the subgroup analysis, short sleep duration was associated with low grip strength (OR: 1.20, 95% CI: 1.02-1.41, P = 0.031). CONCLUSIONS Sleep deprivation may be closely associated with the development of possible sarcopenia in middle-aged and elderly people, which provides new insights and ideas for sarcopenia intervention, and further studies are needed to reveal the underlying mechanisms involved.
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Affiliation(s)
- Linfeng Chen
- Department of Neurology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Qingyun Li
- Guangdong Medical University, Zhanjiang, 524023, China
| | - Xiaoyun Huang
- Guangdong Medical University, Zhanjiang, 524023, China.
| | - Zhong Li
- Department of Neurology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
- Key Laboratory of Human Microbiome and Chronic Diseases (Sun Yat-sen University), Ministry of Education, Guangzhou, 510655, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
- Shenzhen Research Institute, Sun Yat-Sen University, Shenzhen, 518000, China.
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, 510080, China.
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91
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Taskent I, Ece B, Aydin S. Assessment of Psoas Muscle Index in Middle-Aged Type 2 Diabetes Patients: Impact of Insulin Therapy on Sarcopenia. Tomography 2024; 10:1054-1063. [PMID: 39058051 PMCID: PMC11280959 DOI: 10.3390/tomography10070079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/08/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE Sarcopenia, characterized by progressive skeletal muscle loss, poses significant health risks, including physical impairment and mortality. The relationship between sarcopenia and insulin resistance suggests insulin therapy's potential in preserving muscle mass, particularly in Type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate the Psoas Muscle Index (PMI) via computed tomography (CT) in middle-aged T2DM patients on insulin therapy versus oral antidiabetic drugs (OAD) and controls. METHODS This retrospective study included 107 middle-aged T2DM patients undergoing non-contrast CT scans and 58 age-matched controls. CT images were analyzed to calculate PMI. Statistical analysis included Chi-square tests, independent samples t-tests, Mann-Whitney U tests, and correlation analyses. RESULTS Insulin-treated patients exhibited higher PMI than OAD users (p < 0.001), while OAD users had lower PMI than controls (p < 0.001). No significant difference was found between insulin-treated patients and controls (p = 0.616). Negative correlations were observed between T2DM duration/age and PMI across all groups, with a positive correlation between T2DM duration and BMI observed in the OAD group. CONCLUSIONS Insulin therapy in T2DM patients, regardless of age or disease duration, positively impacts muscle mass, highlighting its potential in preserving muscular health and advocating for tailored treatment strategies in T2DM management.
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Affiliation(s)
- Ismail Taskent
- Department of Radiology, Kastamonu University, 37150 Kastamonu, Turkey;
| | - Bunyamin Ece
- Department of Radiology, Kastamonu University, 37150 Kastamonu, Turkey;
| | - Sonay Aydin
- Department of Radiology, Erzincan University, 24100 Erzincan, Turkey;
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92
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Abdullah G, Akpan A, Phelan MM, Wright HL. New insights into healthy ageing, inflammageing and frailty using metabolomics. FRONTIERS IN AGING 2024; 5:1426436. [PMID: 39044748 PMCID: PMC11263002 DOI: 10.3389/fragi.2024.1426436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024]
Abstract
Human ageing is a normal process and does not necessarily result in the development of frailty. A mix of genetic, environmental, dietary, and lifestyle factors can have an impact on ageing, and whether an individual develops frailty. Frailty is defined as the loss of physiological reserve both at the physical and cellular levels, where systemic processes such as oxidative stress and inflammation contribute to physical decline. The newest "omics" technology and systems biology discipline, metabolomics, enables thorough characterisation of small-molecule metabolites in biological systems at a particular time and condition. In a biological system, metabolites-cellular intermediate products of metabolic reactions-reflect the system's final response to genomic, transcriptomic, proteomic, epigenetic, or environmental alterations. As a relatively newer technique to characterise metabolites and biomarkers in ageing and illness, metabolomics has gained popularity and has a wide range of applications. We will give a comprehensive summary of what is currently known about metabolomics in studies of ageing, with a focus on biomarkers for frailty. Metabolites related to amino acids, lipids, carbohydrates, and redox metabolism may function as biomarkers of ageing and/or frailty development, based on data obtained from human studies. However, there is a complexity that underpins biological ageing, due to both genetic and environmental factors that play a role in orchestrating the ageing process. Therefore, there is a critical need to identify pathways that contribute to functional decline in people with frailty.
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Affiliation(s)
- Genna Abdullah
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Asangaedem Akpan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- Division of Internal Medicine, University of Western Australia, Bunbury, WA, Australia
- Faculty of Health Sciences, Curtis University, Bunbury, WA, Australia
- Department of Geriatric Medicine, Bunbury Regional Hospital, Bunbury, WA, Australia
| | - Marie M. Phelan
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- High Field NMR Facility, Liverpool Shared Research Facilities University of Liverpool, Liverpool, United Kingdom
| | - Helen L. Wright
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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93
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Zhou J, Liu Y, Yang F, Jing M, Zhong X, Wang Y, Liu Y, Ming W, Li H, Zhao T, He L. Risk Factors of Sarcopenia in COPD Patients: A Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2024; 19:1613-1622. [PMID: 39011123 PMCID: PMC11246983 DOI: 10.2147/copd.s456451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
Objective Sarcopenia is a common complication of COPD associated with an age-related reduction in skeletal muscle mass associated with decreased muscle strength and / or reduced mobility. The incidence of sarcopenia in patients with COPD is twice that of non-COPD patients and is associated with poor prognosis, this study aimed to investigate the influencing factors of sarcopenia in COPD patients. Methods Selected studies from PubMed, Embase, Web of Science, Cochrane Library, Wanfang, Wanfang, CNKI, CBM, and Wanfang databases as of November 12023. Patients aged 18 were selected; data were then independently extracted by two reviewers using a standard data collection form. Results In total, 17 articles reporting on 5408 patients were included. Age (OR = 1.083; 95% CI, 1.024-1.145), ALB (OR = 0.752; 95% CI, 0.724-0.780), BMI(OR = 0.701; 95% CI, 0.586-0.838), smoking (OR = 1.859; 95% CI, 1.037-3.334), diabetes (OR = 1.361; 95% CI, 1.095-1.692), qi deficiency (OR = 9.883; 95% CI, 2.052, 47.593), GOLD C (OR =2.232; 95% CI, 1.866, 2.670) and GOLD D (OR = 2.195; 95% CI, 1.826-2.637) were factors affecting muscle loss in COPD patients. Conclusion Sarcopenia is more prevalent in patients with COPD. Age, body mass index, smoking, diabetes mellitus, qi deficiency, ALB, and GOLD grade were the contributing factors for sarcopenia in patients with chronic obstructive pulmonary disease. In the future, medical staff should not only pay attention to the early screening of sarcopenia in high-risk groups, but also provide relevant prevention information.
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Affiliation(s)
- Jingru Zhou
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Yanjun Liu
- Department of Infection, Mianzhu People’s Hospital, Mianzhu, Sichuan, 618000, People’s Republic of China
| | - Fang Yang
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Meiling Jing
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Xiaoli Zhong
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Yanfen Wang
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Yan Liu
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Wenwen Ming
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Huangyan Li
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Tianxia Zhao
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
| | - Lin He
- Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, 618200, People’s Republic of China
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Castellote-Caballero Y, Carcelén Fraile MDC, Aibar-Almazán A, Afanador-Restrepo DF, González-Martín AM. Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial. BMC Med 2024; 22:281. [PMID: 38972988 PMCID: PMC11229192 DOI: 10.1186/s12916-024-03469-x] [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: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. METHODS A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. RESULTS The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. CONCLUSION A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults. TRIAL REGISTRATION NCT05503641.
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Affiliation(s)
- Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | - María Del Carmen Carcelén Fraile
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, 23071, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
| | | | - Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Plaza de San Martín, 4, Madrid, 28013, Spain
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95
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He S, Meng D, Wei M, Guo H, Yang G, Wang Z. Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia. BMC Geriatr 2024; 24:586. [PMID: 38977995 PMCID: PMC11232209 DOI: 10.1186/s12877-024-05188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (NCT05767710).
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Affiliation(s)
- Shichun He
- 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
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Hongzhi Guo
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA
- Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan
| | - 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, CA, 95816, USA.
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan.
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Golder AM, Ferguson M, McMillan P, Mansouri D, Horgan PG, Roxburgh CS, Dolan RD, McGovern J, McMillan DC. CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer. Sci Rep 2024; 14:15673. [PMID: 38977870 PMCID: PMC11231341 DOI: 10.1038/s41598-024-65871-y] [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: 10/25/2023] [Accepted: 06/25/2024] [Indexed: 07/10/2024] Open
Abstract
Low skeletal muscle index/density (SMI/SMD) is prevalent in cancer, adversely prognostic and associated with tumour stage and the systemic inflammatory response (SIR). Age and SMI/SMD has not been widely studied. The present study analyses the association between age and SMI/SMD after adjustment for other clinicopathological factors. Patients undergoing resectional surgery for TNM Stage I-III disease within the West of Scotland between 2011 and 2014 were identified. A single CT slice was obtained from each patients staging CT scan. SMI and SMD were stratified normal/abnormal. The SIR was stratified using Systemic Inflammatory Grade (SIG). When stratified by age (< 50/50s/60s/70s/80+), 39%/38%/48%/62%/74% and 27%/48%/64%/82%/92% of patients had a low SMI and SMD respectively (both p < 0.001). Older age (OR 1.47, p < 0.001), female sex (OR 1.32, p = 0.032), lower socioeconomic deprivation (OR 1.15, p = 0.004), higher ASA (OR 1.30, p = 0.019), emergency presentation (OR 1.82, p = 0.003), lower BMI (OR 0.67, p < 0.002) and higher SIG (OR 1.23, p < 0.001) were independently associated with low SMI. Older age (OR 2.28, p < 0.001), female sex (OR 1.38, p = 0.038), higher ASA (OR 1.92, p < 0.001), emergency presentation (OR 1.71, p = 0.023), and higher SIG (OR 1.37, p < 0.001) were independently associated with lower SMD. Tumour factors were not independently associated with either SMI/SMD. Age was a major factor associated with low SMI/SMD in patients with colon cancer. Therefore, in these patients it is likely that this represents largely constitutional body composition as opposed to being a disease mediated effect. Adjustment for age is required when considering the cancer mediated effect on SMI/SMD in patients with colon cancer.
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Affiliation(s)
- Allan M Golder
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK.
| | - Michael Ferguson
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Paul McMillan
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - David Mansouri
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Paul G Horgan
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Campbell S Roxburgh
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Ross D Dolan
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Josh McGovern
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Donald C McMillan
- Academic Unit of Surgery, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
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Yang TR, Ji P, Deng X, Feng XX, He ML, Wang RR, Li XH. Ct-based diagnosis of sarcopenia as a prognostic factor for postoperative mortality after elective open-heart surgery in older patients: a cohort-based systematic review and meta-analysis. Front Public Health 2024; 12:1378462. [PMID: 39040869 PMCID: PMC11261807 DOI: 10.3389/fpubh.2024.1378462] [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: 01/29/2024] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
Background Cardiac open-heart surgery, which usually involves thoracotomy and cardiopulmonary bypass, is associated with a high incidence of postoperative mortality and adverse events. In recent years, sarcopenia, as a common condition in older patients, has been associated with an increased incidence of adverse prognosis. Methods We conducted a search of databases including PubMed, Embase, and Cochrane, with the search date up to January 1, 2024, to identify all studies related to elective cardiac open-heart surgery in older patients. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Results A total of 12 cohort studies were included in this meta-analysis for analysis. This meta-analysis revealed that patients with sarcopenia had a higher risk of postoperative mortality. Furthermore, the total length of hospital stay and ICU stay were longer after surgery. Moreover, there was a higher number of patients requiring further healthcare after discharge. Regarding postoperative complications, sarcopenia patients had an increased risk of developing renal failure and stroke. Conclusion Sarcopenia served as a tool to identify high-risk older patients undergoing elective cardiac open-heart surgery. By identifying this risk factor early on, healthcare professionals took targeted steps to improve perioperative function and made informed clinical decisions.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023426026.
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Affiliation(s)
- Tao-Ran Yang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peng Ji
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiao Deng
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Xi-Xia Feng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meng-Lin He
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ru-Rong Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Anesthesiology, Chengdu Shang Jin Nan Fu Hospital/Shang Jin Hospital of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue-Han Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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98
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Matsuo H, Yoshimura Y, Maeno Y, Tanaka S. Possible sarcopenia and its association with hospital-associated dysphagia and decline in physical function: Findings from a heart failure patients prospective cohort study. Clin Nutr ESPEN 2024; 63:364-370. [PMID: 38971404 DOI: 10.1016/j.clnesp.2024.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND & AIMS There is limited evidence regarding the association of sarcopenia with dysphagia and physical function in patients with heart failure. This study examined the association between possible sarcopenia and both swallowing and physical function in individuals with acute heart failure (AHF). METHODS This prospective cohort study included hospitalized patients with AHF. Possible sarcopenia was assessed on admission using calf circumference and grip strength according to an international diagnostic criteria. The primary outcome was dysphagia at discharge using the Food Intake Level Scale (FILS), and the secondary outcome was physical function at discharge using the Barthel Index (BI). Multiple regression analysis and logistic regression, adjusted for potential confounders, were used to examine the association between possible sarcopenia at admission and FILS and BI at discharge. RESULTS A total of 320 patients (mean age 81.5 years; 170 women) were included in the analysis; 199 (59.4%) were diagnosed with possible sarcopenia. Multivariate analysis showed that possible sarcopenia at admission was significantly associated with FILS at discharge (β = -0.1204; p = 0.039). Possible sarcopenia at admission was not significantly associated with BI at discharge (OR = 2.066; 95% CI, 0.910-4.692, p = 0.083). CONCLUSIONS Possible sarcopenia was associated with decline in swallowing function during hospitalization in patients with AHF. These findings highlight the need for early detection and treatment of possible sarcopenia in this setting.
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Affiliation(s)
- Haruyo Matsuo
- Department of Nursing, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto, 869-1106, Japan.
| | - Yuichi Maeno
- Department of Rehabilitation, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
| | - Sayoko Tanaka
- Department of Nutritional Management, Kagoshima Medical Association Hospital, 7-1 Kamoikeshinmachi, Kagoshima-County, Kagoshima, 890-0064, Japan.
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99
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Anandavadivelan P, Mijwel S, Wiklander M, Kjoe PLM, Luijendijk M, Bergh J, Rundqvist H, Wengstrom Y. Five-year follow-up of the OptiTrain trial on concurrent resistance and high-intensity interval training during chemotherapy for patients with breast cancer. Sci Rep 2024; 14:15333. [PMID: 38961182 PMCID: PMC11222517 DOI: 10.1038/s41598-024-65436-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024] Open
Abstract
The protocol predefined aim of this study is to assess sustained effects of the OptiTrain trial on several health outcomes, 5 years after the baseline assessment. The OptiTrain study was a prospective, randomised controlled trial with 240 patients with breast cancer undergoing adjuvant chemotherapy that compared the effects of 16 weeks of two exercise programs, RT-HIIT and AT-HIIT, with usual care (UC). After a 5-year follow-up, eligible participants were evaluated for the primary outcome of cancer-related fatigue (CRF) and secondary outcomes including quality of life, symptoms, muscle strength, cardiorespiratory fitness, body mass, physical activity, and sedentary behavior. Statistical analysis was conducted using linear mixed models adjusted for baseline values. Tumour profile and menopausal status were additionally adjusted for CRF. Mean differences (MD), 95% confidence intervals (CIs), and standardized effect sizes (ES) were reported. At the 5-year follow-up, there were no statistically significant differences in total CRF between the intervention groups and the UC group. RT-HIIT reported significantly reduced pain sensitivity at the gluteus MD = 79.00 (95% CI 10.17, 147.83, ES = 0.55) compared to UC. Clinically meaningful differences for an increase in cognitive CRF and cardiorespiratory fitness were observed for the AT-HIIT versus UC group, and for lower limb strength for the RT-HIIT versus UC group, albeit without statistical significance. Engaging in targeted exercise during adjuvant chemotherapy for breast cancer provides short-term benefits in reducing fatigue and maintaining physical function. However, our 5-year follow-up indicates that these effects are limited in the long term. This underscores the need to support breast cancer survivors maintain their PA levels throughout their survivorship journey.
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Affiliation(s)
- Poorna Anandavadivelan
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
| | - Sara Mijwel
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Maria Wiklander
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | - Philippe Lee Meeuw Kjoe
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek, Amsterdam, The Netherlands
| | - Maryse Luijendijk
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek, Amsterdam, The Netherlands
| | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Breast Center, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Stockholm, Sweden
| | - Helene Rundqvist
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Wengstrom
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Breast Center, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Stockholm, Sweden
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100
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Zhu F, Guo J, Zheng W. Associations between sarcopenia and depression in middle-aged and older adults: the moderating effect of smoking. Sci Rep 2024; 14:15187. [PMID: 38956420 PMCID: PMC11219743 DOI: 10.1038/s41598-024-65343-3] [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: 01/22/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
The aim of this study were to estimate associations of sarcopenic status with depressive symptoms. We used mixed-effects linear model to estimate longitudinal association between sarcopenic status and rate of change in 10-item Center for Epidemiologic Studies Depression (CES-D) scores, and used Cox regression model to estimate the association between sarcopenic status and incident depression (CES-D ≥ 10). Stratification analyses were performed when the interactions between sarcopenic status and covariates were significant. A total of 6522 participants were ultimately included. After adjusting for covariates, participants with possible sarcopenia (β = 0.117; 95% CI 0.067 to 0.166; P < 0.001) and sarcopenia (β: 0.093; 95% CI 0.027-0.159; P < 0.001) had a faster increase in CES-D scores compared with normal individuals. Interactions between smoking and sarcopenic status were significant (Pinteraction < 0.05). We found significantly positive associations of sarcopenic status with CES-D scores in nonsmokers, but not in current and past smokers. Besides, compared with normal participants, those with possible sarcopenia (HR 1.15; 95% CI 1.05 to 1.27) and sarcopenia (HR 1.28; 95% CI 1.12 to 1.46) (Ptrend < 0.001) had elevated risks of incident depression. Sarcopenia is associated with a faster increase in CES-D scores and increased risks of depression among Chinese middle-aged and older adults. Stronger associations between sarcopenia and trajectory of CES-D scores were found in nonsmokers than in smokers.
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Affiliation(s)
- Feiyun Zhu
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China
| | - Jing Guo
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China.
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