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Ishii S, Tanaka T, Akishita M, Ouchi Y, Tuji T, Iijima K. Metabolic syndrome, sarcopenia and role of sex and age: cross-sectional analysis of Kashiwa cohort study. PLoS One 2014; 9:e112718. [PMID: 25405866 PMCID: PMC4236117 DOI: 10.1371/journal.pone.0112718] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/14/2014] [Indexed: 12/25/2022] Open
Abstract
Recent epidemiological evidence suggests that effects of cardiovascular risk factors may vary depending on sex and age. In this study, we assessed the associations of metabolic syndrome (MetS) with sarcopenia and its components in older adults, and examined whether the associations vary by sex and age. We also tested if any one of the MetS components could explain the associations. We conducted a cross-sectional analysis of the baseline data from the cohort study conducted in Kashiwa city, Chiba, Japan in 2012 which included 1971 functionally-independent, community-dwelling Japanese adults aged 65 years or older (977 men, 994 women). Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. MetS was defined based on the National Cholesterol Education Program’s Adult Treatment Panel-III criteria. The prevalence of sarcopenia was 14.2% in men and 22.1% in women, while the prevalence of MetS was 43.6% in men and 28.9% in women. After adjustment for potential confounders, MetS was positively associated with sarcopenia in men aged 65 to 74 years (odds ratio 5.5; 95% confidence interval 1.9–15.9) but not in older men or women. Among the sarcopenia components, MetS was associated with lower muscle mass and grip strength, particularly in men aged 65 to 74 years. The associations of MetS with sarcopenia and its components were mainly driven by abdominal obesity regardless of sex or age. In conclusion, MetS is positively associated with sarcopenia in older men. The association is modified by sex and age, but abdominal obesity is the main contributor to the association across sex and age.
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Affiliation(s)
- Shinya Ishii
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Yasuyoshi Ouchi
- Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-8470, Japan
| | - Tetsuo Tuji
- Institute of Gerontology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- * E-mail:
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Kim CH, Kim HK, Kim EH, Bae SJ, Park JY. Association between changes in body composition and risk of developing Type 2 diabetes in Koreans. Diabet Med 2014; 31:1393-8. [PMID: 24957933 DOI: 10.1111/dme.12527] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/17/2014] [Accepted: 06/19/2014] [Indexed: 01/04/2023]
Abstract
AIMS To examine the effects of longitudinal changes in fat mass or lean body mass on risk of Type 2 diabetes in Korean adults. METHODS Participants included 18 687 Korean adults (aged 20-79 years) who underwent routine medical check-ups in 2007-2008 and again in 2011-2012 with a mean (range) of 4.3 (3.0-5.7) years interval. Total fat, fat-free, and soft fat-free masses were determined using bioelectrical impedance. RESULTS A total of 692 subjects (3.7%) developed Type 2 diabetes during follow-up. Those who developed diabetes had a greater increase in percent body fat (2.9 ± 3.0 vs 2.6 ± 3.2 percentage points, P = 0.043), as well as greater decreases in percent fat-free mass (-3.0 ± 3.3 vs -2.7 ± 3.3 percentage points, P = 0.008) and percent soft fat-free mass (-2.8 ± 3.1 vs -2.4 ± 3.1 percentage points, P = 0.003) compared with those who did not develop diabetes. In multiple logistic regression analysis, an increase in total fat mass of > 10% was associated with an increased odds ratio for diabetes (1.29, 1.05-1.60), and a decreased total fat mass was associated with lower odds ratio (0.75, 0.58-0.96). A loss of total fat-free mass of > 5% (odds ratio 1.08, 0.90-1.30) or an increase in total fat-free mass (odds ratio 0.96, 0.71-1.28) was not significantly associated with the risk of diabetes after adjustments for baseline waist circumference and glucose levels. CONCLUSIONS These results show that changes in total body fat mass, but not lean body mass, are associated with development of Type 2 diabetes, independently of baseline measures of general or central obesity.
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Affiliation(s)
- C-H Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon
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103
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Hyperinsulinemia is associated with the loss of appendicular skeletal muscle mass at 4.6 year follow-up in older men and women. Clin Nutr 2014; 34:931-6. [PMID: 25453394 DOI: 10.1016/j.clnu.2014.09.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 09/01/2014] [Accepted: 09/29/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Homeostasis model assessment as a marker of insulin resistance has been associated with the pronounced loss of appendicular skeletal muscle mass in older adults. In the present study, we hypothesized that hyperinsulinemia as an early predictor of insulin resistance may be associated with the loss of appendicular skeletal muscle mass (ASM). METHODS This is a cohort study that included 147 well-functioning older men and women subjects who were followed for a period of 4.6 ± 1.8 years. Lean tissue in arm and legs, or ASM, was derived from dual-energy X-ray absorptiometry at baseline with follow-up measurements to obtain the relative change. Hyperinsulinemia was defined empirically at the 75th percentile. RESULTS The relative change in ASM was negative and significant throughout the quartiles of fasting insulin levels (p ≤ 0.05); however, the loss of ASM was more pronounced in the later quartiles (-0.7 kg) compared with the relative change in Q1 and Q2 (-0.5 kg and -0.3 kg). The unadjusted analysis indicates a significant association between hyperinsulinemia and the loss of ASM (β = -0.28, 95% CI-0.57-0.009, p = 0.05), an association that remained significant after adjusting for several covariates. CONCLUSION Hyperinsulinemia as an early marker of insulin resistance was associated with the loss of ASM in a cohort study of community-dwelling older men and women subjects without other chronic health conditions. The use of fasting insulin levels >8.4 μU/mL may help clinicians identify individuals in the geriatric population who are at a high risk of loss of appendicular skeletal muscle mass.
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104
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Li Y, Zheng LS, Li Y, Zhao DD, Meng L. Independent association between serum C-peptide levels and fat mass-to-lean mass ratio in the aging process. Geriatr Gerontol Int 2014; 15:918-26. [DOI: 10.1111/ggi.12366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Ying Li
- Department of Social Medicine; School of Public Health; Zhejiang University; Hangzhou China
| | - Lian Shun Zheng
- School of Basic Medical Sciences; Zhejiang University; Hangzhou China
| | - Yue Li
- School of Basic Medical Sciences; Zhejiang University; Hangzhou China
| | - Duo Duo Zhao
- School of Basic Medical Sciences; Zhejiang University; Hangzhou China
| | - Lu Meng
- Department of Social Medicine; School of Public Health; Zhejiang University; Hangzhou China
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105
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Kim JE, Lee YH, Huh JH, Kang DR, Rhee Y, Lim SK. Early-stage chronic kidney disease, insulin resistance, and osteoporosis as risk factors of sarcopenia in aged population: the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009. Osteoporos Int 2014; 25:2189-98. [PMID: 24846317 DOI: 10.1007/s00198-014-2745-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 05/07/2014] [Indexed: 12/17/2022]
Abstract
UNLABELLED Sarcopenia means the progressive loss of skeletal muscle mass and strength with aging. In this study, we found that insulin resistance, chronic kidney disease stage 3, and osteoporosis at the femur neck were closely associated with sarcopenia in elderly men. These conditions modified to slow down the progression of sarcopenia. INTRODUCTION Sarcopenia is known to have multiple contributing factors; however, its modifiable risk factors have not yet been determined. The aim of this study was to identify the most influential and modifiable risk factors for sarcopenia in elderly. METHODS This was a population-based, cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008-2009. This study included 940 men and 1,324 women aged 65 years and older who completed a body composition analysis using dual-energy X-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle mass divided by height(2) of less than 1 standard deviation below the sex-specific mean for a younger reference group. RESULTS Using univariate analysis, age, body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), limitations in daily activities, regular exercise, high-risk drinking, family income, osteoporosis, daily energy, and protein intake were associated with sarcopenia in men; age, BMI, limitations in daily activities, regular exercise, occupation, osteoporosis at the total hip, and daily energy intake were associated with sarcopenia in women. In the multivariate logistic regression analysis, HOMA-IR ≥2.5 (odds ratio [OR] for sarcopenia, 2.27; 95 % confidence interval [CI], 1.21-4.25), chronic kidney disease stage 3 (OR, 3.13; 95 % CI, 1.14-8.61), and osteoporosis at the femur neck (OR, 6.83; 95 % CI, 1.08-43.41) were identified as risk factors for sarcopenia in men. CONCLUSIONS Insulin resistance, chronic kidney disease, and osteoporosis at the femur neck should be modified to prevent the acceleration of skeletal muscle loss in elderly men.
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Affiliation(s)
- J E Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea,
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106
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Association between skeletal muscle mass and radial augmentation index in an elderly Korean population. Arch Gerontol Geriatr 2014; 59:49-55. [DOI: 10.1016/j.archger.2014.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 01/29/2014] [Accepted: 01/31/2014] [Indexed: 12/25/2022]
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107
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Mansour A, Mohajeri-Tehrani MR, Qorbani M, Heshmat R, Larijani B, Hosseini S. Effect of glutamine supplementation on cardiovascular risk factors in patients with type 2 diabetes. Nutrition 2014; 31:119-26. [PMID: 25466655 DOI: 10.1016/j.nut.2014.05.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/22/2014] [Accepted: 05/24/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this study was to assess clinical relevance of long-term oral glutamine supplementation on lipid profile and inflammatory and metabolic factors in patients with diabetes. METHOD Sixty-six patients with type 2 diabetes between the ages of 18 and 65 y were randomized to receive glutamine 30 g/d (10 g powder, three times a day) or placebo, in a double-blind, placebo-controlled trial during a 6-wk treatment period. Fifty-three patients completed the trial. Independent samples t test and analysis of covariance were used. RESULTS After a 6-wk treatment period, a significant difference was observed between the two groups in body fat mass (P = 0.01) and percentage of body fat (P = 0.008). Moreover, a significant reduction in waist circumference (P < 0.001) and a tendency for an increase in fat-free mass (P = 0.03), with no change in body weight and body mass index (BMI) was found. Enhancement in body fat-free mass was mainly attributed to trunk (P = 0.03). There was a downward trend in systolic blood pressure (P = 0.005) but not diastolic. Fasting blood glucose (mmol/L) concentration significantly decreased after the 6-wk intervention (P = 0.04). Mean hemoglobin A1c was significantly different between the groups at week 6 (P = 0.04). No significant difference was detected for fasting insulin, homeostasis model assessment for insulin resistance and quantitative insulin sensitivity index between groups (P > 0.05). No significant difference was observed between groups in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglyceride. No treatment effect on C-reactive protein was found (P = 0.44). CONCLUSION We demonstrated that the 6-wk supplementation with 30 g/d glutamine markedly improved some cardiovascular risk factors, as well as body composition, in patients with type 2 diabetes. Future glutamine dose-response studies are warranted in these areas.
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Affiliation(s)
- Asieh Mansour
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Mohajeri-Tehrani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Hosseini
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Toshikuni N, Arisawa T, Tsutsumi M. Nutrition and exercise in the management of liver cirrhosis. World J Gastroenterol 2014; 20:7286-7297. [PMID: 24966599 PMCID: PMC4064074 DOI: 10.3748/wjg.v20.i23.7286] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 03/22/2014] [Accepted: 05/05/2014] [Indexed: 02/07/2023] Open
Abstract
Liver cirrhosis (LC) patients often have protein-energy malnutrition (PEM) and decreased physical activity. These conditions often lead to sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictors for poor survival in LC patients. Nutrition and exercise management can improve PEM and sarcopenia in those patients. Nutrition management includes sufficient dietary intake and improved nutrient metabolism. With the current high prevalence of obesity, the number of obese LC patients has increased, and restriction of excessive caloric intake without the exacerbation of impaired nutrient metabolism is required for such patients. Branched chain amino acids are good candidates for supplemental nutrients for both obese and non-obese LC patients. Exercise management can increase skeletal muscle volume and strength and improve insulin resistance; however, nutritional status and LC complications should be assessed before an exercise management regimen is implemented in LC patients. The establishment of optimal exercise regimens for LC patients is currently required. In this review, we describe nutritional status and its clinical impact on the outcomes of LC patients and discuss general nutrition and exercise management in LC patients.
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109
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Abstract
The complexity of cell interactions with their microenvironment and their ability to communicate at the autocrine, paracrine, and endocrine levels has gradually but significantly evolved in the last three decades. The musculoskeletal system has been historically recognized to be governed by a relationship of proximity and function, chiefly dictated by mechanical forces and the work of gravity itself. In this review article, we first provide a historical overview of the biomechanical theory of bone- muscle interactions. Next, we expand to detail the significant evolution in our understanding of the function of bones and muscles as secretory organs. Then, we review and discuss new evidence in support of a biochemical interaction between these two tissues. We then propose that these two models of interaction are complementary and intertwined providing for a new frontier for the investigation of how bone-muscle cross talk could be fully explored for the targeting of new therapies for musculoskeletal diseases, particularly the twin conditions of aging, osteoporosis and sarcopenia. In the last section, we explore the bone-muscle cross talk in the context of their interactions with other tissues and the global impact of these multi-tissue interactions on chronic diseases.
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Affiliation(s)
- Janalee Isaacson
- Muscle Biology Research Group-MUBIG, School of Nursing and Health Studies, University of Missouri-Kansas City (UMKC), 2464 Charlotte St, Kansas City, MO 64108, USA; Nursing Program, Johnson County Community College, Overland Park, KS 66210, USA
| | - Marco Brotto
- Muscle Biology Research Group-MUBIG, School of Nursing and Health Studies, University of Missouri-Kansas City (UMKC), 2464 Charlotte St, Kansas City, MO 64108, USA; School of Medicine, UMKC, Kansas City, MO, USA; School of Pharmacy, UMKC, Kansas City, MO, USA
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110
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Kirk-Ballard H, Kilroy G, Day BC, Wang ZQ, Ribnicky DM, Cefalu WT, Floyd ZE. An ethanolic extract of Artemisia dracunculus L. regulates gene expression of ubiquitin-proteasome system enzymes in skeletal muscle: potential role in the treatment of sarcopenic obesity. Nutrition 2014; 30:S21-5. [PMID: 24985101 DOI: 10.1016/j.nut.2014.02.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Obesity is linked to insulin resistance, a primary component of metabolic syndrome and type 2 diabetes. The problem of obesity-related insulin resistance is compounded when age-related skeletal muscle loss, called sarcopenia, occurs with obesity. Skeletal muscle loss results from elevated levels of protein degradation and prevention of obesity-related sarcopenic muscle loss will depend on strategies that target pathways involved in protein degradation. An extract from Artemisia dracunculus, termed PMI 5011, improves insulin signaling and increases skeletal muscle myofiber size in a rodent model of obesity-related insulin resistance. The aim of this study was to examine the effect of PMI 5011 on the ubiquitin-proteasome system, a central regulator of muscle protein degradation. METHODS Gastrocnemius and vastus lateralis skeletal muscle was obtained from KK-A(y) obese diabetic mice fed a control or 1% (w/w) PMI 5011-supplemented diet. Regulation of genes encoding enzymes of the ubiquitin-proteasome system was determined using real-time quantitative reverse transcriptase polymerase chain reaction. RESULTS Although MuRF-1 ubiquitin ligase gene expression is consistently down-regulated in skeletal muscle, atrogin-1, Fbxo40, and Traf6 expression is differentially regulated by PMI 5011. Genes encoding other enzymes of the ubiquitin-proteasome system ranging from ubiquitin to ubiquitin-specific proteases are also regulated by PMI 5011. Additionally, expression of the gene encoding the microtubule-associated protein-1 light chain 3 (LC3), a ubiquitin-like protein pivotal to autophagy-mediated protein degradation, is down-regulated by PMI 5011 in the vastus lateralis. CONCLUSION PMI 5011 alters the gene expression of ubiquitin-proteasome system enzymes that are essential regulators of skeletal muscle mass. This suggests that PMI 5011 has therapeutic potential in the treatment of obesity-linked sarcopenia by regulating ubiquitin-proteasome-mediated protein degradation.
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Affiliation(s)
| | - Gail Kilroy
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Britton C Day
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Zhong Q Wang
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - David M Ribnicky
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - William T Cefalu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Kohara K. Sarcopenic obesity in aging population: current status and future directions for research. Endocrine 2014; 45:15-25. [PMID: 23821364 DOI: 10.1007/s12020-013-9992-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 05/24/2013] [Indexed: 12/25/2022]
Abstract
The combination of sarcopenia and obesity, an age-related change in body composition, is a concern in the aged society. Sarcopenic obesity is not the combination of two conditions, but is more related to cardio-metabolic and functional abnormalities. Sarcopenic obesity is associated with more physical functional decline than simple obesity. Sarcopenic obesity may be more insulin resistant, and have a higher risk for metabolic syndrome and atherosclerosis than simple obesity. However, the prevalence of sarcopenic obesity differs substantially among studies because of the lack of a standard definition. For further understanding of the pathophysiological role of sarcopenic obesity, a standardized definition for both sarcopenia and obesity is necessary.
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Affiliation(s)
- Katsuhiko Kohara
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan,
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112
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Abe T, Thiebaud RS, Loenneke JP, Loftin M, Fukunaga T. Prevalence of site-specific thigh sarcopenia in Japanese men and women. AGE (DORDRECHT, NETHERLANDS) 2014; 36:417-26. [PMID: 23686131 PMCID: PMC3889892 DOI: 10.1007/s11357-013-9539-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 05/02/2013] [Indexed: 05/04/2023]
Abstract
The purpose of this study was to compare the prevalence of severe sarcopenia detected by total skeletal muscle mass (SM) index and of site-specific thigh sarcopenia for differing age groups in men and women. Japanese nonobese men and women aged 20 to 85 (n = 1,994, 55 % women) had muscle thickness (MTH) measured by ultrasound at six sites on the anterior and posterior aspects of the body. SM was estimated from ultrasound-derived prediction equations. Site-specific thigh sarcopenia was calculated using ultrasound-measured MTH at the anterior and posterior aspects of the thigh (MTH ratio, anterior 50 %/posterior 50 % thigh MTH (A50/P50 MTH)). Sarcopenia was defined as a SM index (SM divided by height(2)) of >2 standard deviations (SD) below the mean for young adults. Site-specific thigh sarcopenia was defined as a ratio of A50/P50 MTH of >2 SD below the mean for young adults. Age was inversely correlated to SM index and A50/P50 MTH in men (r = -0.480 and r = -0.522) and women (r = -0.243 and r = -0.516). The prevalence rate of sarcopenia was less than 3 % for women under the age of 60, 7 % for ages 60-69, and 24 % for ages 70-80. In men, the prevalence rate of sarcopenia was less than 7 % under the age of 50, 18 % for ages 50-59, 33 % for ages 60-69, and 47 % for ages 70-85. Compared to the sarcopenia estimated by SM index, there was a higher prevalence of site-specific thigh sarcopenia observed in both sexes. These results suggest that site-specific thigh sarcopenia appears before it is able to be detected at the whole body level.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science & Recreation Management, University of Mississippi, 215 Turner Center, Oxford, MS, 38677, USA,
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Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. Endocr J 2014; 61:61-70. [PMID: 24088600 DOI: 10.1507/endocrj.ej13-0244] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Sarcopenia is an emerging risk factor for metabolic disorders. No study of the association of sarcopenia with insulin resistance, diabetes, and metabolic syndrome (MS) according to age group and obesity status in the general population has been reported. We investigated these associations in the Korean population. Participants included 4558 males and 5874 females, who were ≥20 years of age or older from the fourth and fifth Korea National Health and Nutritional Examination Surveys of the Korean population (2009 and 2010). Age was categorized according to three groups (20-39, 40-59, and ≥ 60 years). Obesity was defined according to body mass index. Sarcopenia was defined as the appendicular skeletal muscle mass (ASM) divided by weight (Wt) (%) of > 2SD below the sex-specific mean for young adults. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. After adjustment for confounding variables, sarcopenia showed a significant association with HOMA-IR in the non-obese group (P<0.001). Sarcopenia was found to be a risk factor for diabetes in the non-obese group (OR, 2.140; 95% CI, 1.549-2.956; P<0.001). Sarcopenia also showed an association with MS in the non-obese group (OR, 2.209; 95% CI, 1.679-2.906; P<0.001), but not in the obese-group. However, these results were not relevant to young age group. In conclusion, sarcopenia showed an association with insulin resistance, diabetes, and MS, in the non-obese population. Sarcopenia may be an early predictor for diabetes and MS susceptibility in the non-obese population, particularly in elderly people.
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Affiliation(s)
- Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, South Korea
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114
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Age-related muscle loss of the anterior and posterior thigh assessed by means of MRI/CT and ultrasound. ACTA ACUST UNITED AC 2014. [DOI: 10.17338/trainology.3.2_47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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115
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Alemán-Mateo H, López Teros MT, Ramírez FA, Astiazarán-García H. Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants. J Gerontol A Biol Sci Med Sci 2013; 69:871-7. [PMID: 24325896 DOI: 10.1093/gerona/glt193] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND It has been hypothesized that insulin resistance plays a role in the development of the loss of skeletal muscle; however, no cohort studies on insulin resistance and low relative appendicular skeletal muscle mass (ASM) have been published to date. Thus, we examined whether insulin resistance is associated with low relative ASM after a 4.6-year follow-up period among apparently healthy older men and women participants. METHODS This is a combined retrospective-prospective cohort study, which includes 147 community-dwelling older men and women participants. ASM was measured by dual-energy x-ray absorptiometry at baseline and follow-up. Participants with a relative change in ASM below the sex-specific 15th value were classified as the low relative ASM group. Homeostatic model assessment was used to quantify insulin resistance. Logistic regression calculated odds ratios and 95% confidence intervals for development of low relative ASM, adjusted for covariates. RESULTS The loss of ASM in the low relative ASM and normal groups was -1.8kg and -0.35kg, respectively (p ≤ .05). The low relative ASM group was older and had higher insulin and homeostatic model assessment of insulin resistance values at baseline. The risk of developing low relative ASM at 4.6-year follow-up was 2.9 times higher (95% CI, 1.00-7.8; p = .04) among the participants with homeostatic model assessment of insulin resistance levels more than 2.3. After adjusting for age, the risk increased to 3.9 times higher (95% CI, 1.3-11.5; p = .03). CONCLUSION Insulin resistance was associated with low relative ASM at 4.6-year follow-up after accounting for several covariates in a cohort of apparently healthy, well-functioning young older men and women.
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Affiliation(s)
- Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México.
| | - Miriam T López Teros
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México
| | - Fátima A Ramírez
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México
| | - Humberto Astiazarán-García
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo A.C., Hermosillo, Sonora, México
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116
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Bijlsma AY, Meskers CGM, van Heemst D, Westendorp RGJ, de Craen AJM, Maier AB. Diagnostic criteria for sarcopenia relate differently to insulin resistance. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2367-2375. [PMID: 23407994 PMCID: PMC3824998 DOI: 10.1007/s11357-013-9516-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/29/2013] [Indexed: 05/31/2023]
Abstract
Skeletal muscle is important in insulin-stimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in relation to insulin resistance in nondiabetics. This cross-sectional study included 301 nondiabetics, mean age 65.9 years. Area under curve (AUC) calculations of insulin and glucose from a 2-h oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were used as measures of insulin resistance. Muscle characteristics were relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height(2) and total lean mass), handgrip strength, and walking speed. All muscle characteristics were standardized and analyzed in linear regression models, stratified by gender. For both males and females, relative muscle mass was inversely associated with AUC insulin, AUC glucose, and HOMA-IR (ALM percentage all p ≤ 0.004). Absolute muscle mass was positively associated with AUC insulin and HOMA-IR (ALM/height(2) all p < 0.001) but not with AUC glucose. Adjustments for fat mass attenuated aforementioned associations. There were no associations between handgrip strength and insulin resistance. Walking speed was inversely associated with AUC insulin in males (p = 0.032). The association between muscle characteristics and insulin resistance was strongest for relative muscle mass. Diagnostic criteria for sarcopenia relate differently to insulin resistance. The role of muscle tissue as an internal glucose-regulating organ is better reflected by relative muscle mass than by absolute muscle mass, muscle strength, or walking speed.
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Affiliation(s)
- A. Y. Bijlsma
- />Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands
- />Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - C. G. M. Meskers
- />Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - D. van Heemst
- />Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - R. G. J. Westendorp
- />Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- />Netherlands Consortium for Healthy Aging, Leiden University Medical Centre, Leiden, The Netherlands
| | - A. J. M. de Craen
- />Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- />Netherlands Consortium for Healthy Aging, Leiden University Medical Centre, Leiden, The Netherlands
| | - A. B. Maier
- />Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands
- />Netherlands Consortium for Healthy Aging, Leiden University Medical Centre, Leiden, The Netherlands
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117
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Abe T, Ogawa M, Thiebaud RS, Loenneke JP, Mitsukawa N. Is muscle strength ratio a criterion for diagnosis of site-specific muscle loss? Geriatr Gerontol Int 2013; 14:837-44. [DOI: 10.1111/ggi.12179] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Takashi Abe
- Department of Kinesiology; School of Public Health; Indiana University; Bloomington Indiana USA
- Active Aging Research Center; Toyo Gakuen University; Nagareyama Japan
| | - Madoka Ogawa
- Active Aging Research Center; Toyo Gakuen University; Nagareyama Japan
| | - Robert S Thiebaud
- Department of Health and Exercise Science; University of Oklahoma; Norman Oklahoma USA
| | - Jeremy P Loenneke
- Department of Health and Exercise Science; University of Oklahoma; Norman Oklahoma USA
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118
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Kendler DL, Borges JLC, Fielding RA, Itabashi A, Krueger D, Mulligan K, Camargos BM, Sabowitz B, Wu CH, Yu EW, Shepherd J. The Official Positions of the International Society for Clinical Densitometry: Indications of Use and Reporting of DXA for Body Composition. J Clin Densitom 2013; 16:496-507. [PMID: 24090645 DOI: 10.1016/j.jocd.2013.08.020] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 08/20/2013] [Indexed: 11/21/2022]
Abstract
The technique of body composition by dual-energy X-ray absorptiometry (DXA) has been used for several years in the research environment. Its ability to accurately and precisely measure lean, fat, and mineral composition in various body compartments has been well validated. Furthermore, the technique is widely available to clinical patients on existing DXA instruments throughout the world through the use of specific software packages and scanning algorithms. There have been few clear statements regarding the clinical indications for body composition measurement in patients outside the research setting. This is in part because of the lack of specific documented interventions that would be affected by body composition test results, beyond usual clinical advice. We have examined a few of the most common, specific scenarios (HIV therapy, sarcopenia, bariatric surgery, obesity) and proposed indications for body composition assessment. We have also discussed contraindications to body composition testing.
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119
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An extract of Artemisia dracunculus L. inhibits ubiquitin-proteasome activity and preserves skeletal muscle mass in a murine model of diabetes. PLoS One 2013; 8:e57112. [PMID: 23437325 PMCID: PMC3577785 DOI: 10.1371/journal.pone.0057112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/17/2013] [Indexed: 12/20/2022] Open
Abstract
Impaired insulin signaling is a key feature of type 2 diabetes and is associated with increased ubiquitin-proteasome-dependent protein degradation in skeletal muscle. An extract of Artemisia dracunculus L. (termed PMI5011) improves insulin action by increasing insulin signaling in skeletal muscle. We sought to determine if the effect of PMI5011 on insulin signaling extends to regulation of the ubiquitin-proteasome system. C2C12 myotubes and the KK-Ay murine model of type 2 diabetes were used to evaluate the effect of PMI5011 on steady-state levels of ubiquitylation, proteasome activity and expression of Atrogin-1 and MuRF-1, muscle-specific ubiquitin ligases that are upregulated with impaired insulin signaling. Our results show that PMI5011 inhibits proteasome activity and steady-state ubiquitylation levels in vitro and in vivo. The effect of PMI5011 is mediated by PI3K/Akt signaling and correlates with decreased expression of Atrogin-1 and MuRF-1. Under in vitro conditions of hormonal or fatty acid-induced insulin resistance, PMI5011 improves insulin signaling and reduces Atrogin-1 and MuRF-1 protein levels. In the KK-Ay murine model of type 2 diabetes, skeletal muscle ubiquitylation and proteasome activity is inhibited and Atrogin-1 and MuRF-1 expression is decreased by PMI5011. PMI5011-mediated changes in the ubiquitin-proteasome system in vivo correlate with increased phosphorylation of Akt and FoxO3a and increased myofiber size. The changes in Atrogin-1 and MuRF-1 expression, ubiquitin-proteasome activity and myofiber size modulated by PMI5011 in the presence of insulin resistance indicate the botanical extract PMI5011 may have therapeutic potential in the preservation of muscle mass in type 2 diabetes.
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120
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Guo YF, Zhang LS, Liu YJ, Hu HG, Li J, Tian Q, Yu P, Zhang F, Yang TL, Guo Y, Peng XL, Dai M, Chen W, Deng HW. Suggestion of GLYAT gene underlying variation of bone size and body lean mass as revealed by a bivariate genome-wide association study. Hum Genet 2013; 132:189-99. [PMID: 23108985 PMCID: PMC3682481 DOI: 10.1007/s00439-012-1236-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 10/08/2012] [Indexed: 12/11/2022]
Abstract
Bone and muscle, two major tissue types of musculoskeletal system, have strong genetic determination. Abnormality in bone and/or muscle may cause musculoskeletal diseases such as osteoporosis and sarcopenia. Bone size phenotypes (BSPs), such as hip bone size (HBS), appendicular bone size (ABS), are genetically correlated with body lean mass (mainly muscle mass). However, the specific genes shared by these phenotypes are largely unknown. In this study, we aimed to identify the specific genes with pleiotropic effects on BSPs and appendicular lean mass (ALM). We performed a bivariate genome-wide association study (GWAS) by analyzing ~690,000 SNPs in 1,627 unrelated Han Chinese adults (802 males and 825 females) followed by a replication study in 2,286 unrelated US Caucasians (558 males and 1,728 females). We identified 14 interesting single nucleotide polymorphisms (SNPs) that may contribute to variation of both BSPs and ALM, with p values <10(-6) in discovery stage. Among them, the association of three SNPs (rs2507838, rs7116722, and rs11826261) in/near GLYAT (glycine-N-acyltransferase) gene was replicated in US Caucasians, with p values ranging from 1.89 × 10(-3) to 3.71 × 10(-4) for ALM-ABS, from 5.14 × 10(-3) to 1.11 × 10(-2) for ALM-HBS, respectively. Meta-analyses yielded stronger association signals for rs2507838, rs7116722, and rs11826261, with pooled p values of 1.68 × 10(-8), 7.94 × 10(-8), 6.80 × 10(-8) for ALB-ABS and 1.22 × 10(-4), 9.85 × 10(-5), 3.96 × 10(-4) for ALM-HBS, respectively. Haplotype allele ATA based on these three SNPs was also associated with ALM-HBS and ALM-ABS in both discovery and replication samples. Interestingly, GLYAT was previously found to be essential to glucose metabolism and energy metabolism, suggesting the gene's dual role in both bone development and muscle growth. Our findings, together with the prior biological evidence, suggest the importance of GLYAT gene in co-regulation of bone phenotypes and body lean mass.
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Affiliation(s)
- Yan-Fang Guo
- Institute of Bioinformatics, School of Basic Medical Science, Southern Medical University, Guangzhou 510515, PR China
| | - Li-Shu Zhang
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Yong-Jun Liu
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, United States of America
| | - Hong-Gang Hu
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Jian Li
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, United States of America
| | - Qing Tian
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, United States of America
| | - Ping Yu
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, United States of America
| | - Feng Zhang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P R China
| | - Tie-Lin Yang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P R China
| | - Yan Guo
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, P R China
| | - Xiang-Lei Peng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Meng Dai
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
| | - Wei Chen
- Center for Cardiovascular Health Department of Epidemiology, School of Public Health and Tropical Medicine Tulane University, New Orleans, LA70112, United States of America
| | - Hong-Wen Deng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing 100044, PR China
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, United States of America
- Center of System Biomedical Sciences, Shanghai University of Science and Technology, Shanghai 200093, PR China
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Abstract
Abstract
It is an undeniable fact that resistance training (RT) is a potent stimulus for muscle hypertrophy and strength gain, but it is less understood whether RT can increase maximal aerobic capacity (VO2max). The purpose of this brief review is to discuss whether or not RT enhances VO2max in young (20–40 years) and older subjects (>60 years). Only 3 of 17 studies involving young subjects have indicated significant increases in VO2max following RT, while six of nine studies in older subjects have reported significant improvements in VO2max following RT. There was a significant negative correlation between the initial VO2max and RT-induced change in VO2max. This result suggests that RT-induced increase in VO2max is dependent upon the subject’s initial VO2max. The RT-induced increase in VO2max may be elicited when their initial relative VO2max is lower than 25 ml/kg/min for older subjects and lower than 40 ml/kg/min for young subjects. Thus, RT can be expected to improve concurrently both muscular and cardiovascular fitnesses within a single mode of RT when young and old persons have initially low fitness levels.
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122
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Kohara K. [Clinical aspect of sarcopenia]. Nihon Ronen Igakkai Zasshi 2013; 50:352-355. [PMID: 23979339 DOI: 10.3143/geriatrics.50.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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123
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Sugimoto K. [The application of life style diseases-animal models to the research for sarcopenia]. Nihon Ronen Igakkai Zasshi 2013; 50:766-9. [PMID: 24622221 DOI: 10.3143/geriatrics.50.766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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124
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Kohara K. [Clinical aspect of sarcopenic obesity]. Nihon Ronen Igakkai Zasshi 2013; 50:773-775. [PMID: 24622223 DOI: 10.3143/geriatrics.50.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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125
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Mitochondria-targeted antioxidants and metabolic modulators as pharmacological interventions to slow ageing. Biotechnol Adv 2012; 31:563-92. [PMID: 23022622 DOI: 10.1016/j.biotechadv.2012.09.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 09/19/2012] [Accepted: 09/21/2012] [Indexed: 02/07/2023]
Abstract
Populations in many nations today are rapidly ageing. This unprecedented demographic change represents one of the main challenges of our time. A defining property of the ageing process is a marked increase in the risk of mortality and morbidity with age. The incidence of cancer, cardiovascular and neurodegenerative diseases increases non-linearly, sometimes exponentially with age. One of the most important tasks in biogerontology is to develop interventions leading to an increase in healthy lifespan (health span), and a better understanding of basic mechanisms underlying the ageing process itself may lead to interventions able to delay or prevent many or even all age-dependent conditions. One of the putative basic mechanisms of ageing is age-dependent mitochondrial deterioration, closely associated with damage mediated by reactive oxygen species (ROS). Given the central role that mitochondria and mitochondrial dysfunction play not only in ageing but also in apoptosis, cancer, neurodegeneration and other age-related diseases there is great interest in approaches to protect mitochondria from ROS-mediated damage. In this review, we explore strategies of targeting mitochondria to reduce mitochondrial oxidative damage with the aim of preventing or delaying age-dependent decline in mitochondrial function and some of the resulting pathologies. We discuss mitochondria-targeted and -localized antioxidants (e.g.: MitoQ, SkQ, ergothioneine), mitochondrial metabolic modulators (e.g. dichloroacetic acid), and uncouplers (e.g.: uncoupling proteins, dinitrophenol) as well as some alternative future approaches for targeting compounds to the mitochondria, including advances from nanotechnology.
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126
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Liao KC, Pu SJ, Lin CH, Chang HJ, Chen YJ, Liu MS. Association between the metabolic syndrome and its components with falls in community-dwelling older adults. Metab Syndr Relat Disord 2012; 10:447-51. [PMID: 22994428 DOI: 10.1089/met.2012.0046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The metabolic syndrome and falls are both serious and common health problems in older adults. However, little is known about whether the metabolic syndrome contributes to falls. We investigated the relationship between the metabolic syndrome and its components with falls in community-dwelling older adults. METHODS We designed and conducted a cross-sectional study. A total of 1165 community-dwelling older adults who received a geriatric health examination, including interviewer-administered questionnaires and physical and biochemical examinations, were retrospectively enrolled from 2008 to 2010 and specifically asked about the history of falls in the preceding year. RESULTS The mean age of the participants was 74.9 ± 6.7 years, and 54.3% were women. The overall prevalence of falls and metabolic syndrome were 17.9% and 27.3%, respectively. Compared with those who did not fall, the participants who fell had a higher prevalence of the metabolic syndrome (45.7% versus 23.3%, P<0.001) and four of its five components, namely, abdominal obesity (51.2% versus 40.2 %, P=0.004), hypertriglyceridemia (32.2% versus 21.8%, P=0.001), hypertension (60.0% versus 50.0%, P=0.009), and impaired glucose tolerance (28.4 % versus 16.0%, P<0.001). After adjusting for age, female sex, the Karnofsky Performance Scale, and the five-item Brief Symptom Rating Scale, the metabolic syndrome was a significant independent risk factor for falls in community-dwelling older adults (odds ratio=2.56, 95% confidence interval 1.86-3.51). Because falling is a multifactorial geriatric syndrome, many potential confounders, such as visual abnormalities, obesity, arthritis, and polypharmacy, were not considered in this study. CONCLUSION The metabolic syndrome is an independent risk factor for falls in community-dwelling older adults and should be addressed with regard to prevention of falls.
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Affiliation(s)
- Kuo-Chen Liao
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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127
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Tucker LA, Tucker JM. Insulin resistance as a predictor of gains in body fat, weight, and abdominal fat in nondiabetic women: a prospective study. Obesity (Silver Spring) 2012; 20:1503-10. [PMID: 22349734 DOI: 10.1038/oby.2012.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose was to determine the relationship between insulin resistance (IR) and risk of gaining body fat percentage (BF%), body weight, and abdominal fat over 18 months. A prospective cohort study was conducted using a sample of 226 women. IR was assessed using fasting blood insulin and glucose levels to calculate homeostatic model assessment (HOMA). Participants were divided into High (4th quartile) Moderate (2nd and 3rd quartiles), and Low (1st quartile) HOMA categories. BF% was estimated using plethysmography (Bod Pod), weight was measured in a standard swimsuit, and abdominal fat was indexed using the average of two circumferences taken at the umbilicus. Participants wore accelerometers and completed weighed food logs for 7 consecutive days to control for the effect of physical activity (PA) and energy intake, respectively. On average, women in the High HOMA group decreased in BF% (-0.48 ± 3.60), whereas those in the Moderate (0.40 ± 3.66) and Low HOMA (1.17 ± 3.15) groups gained BF% (F = 5.4, P = 0.0211). Changes in body weight showed a similar dose-response relationship (F = 4.7, P = 0.0317). However, baseline IR was not predictive of changes in abdominal fat (F = 0.8, P = 0.3635). Controlling for several covariates had little effect on gains in BF% and weight, but adjusting for initial BF% and/or initial weight nullified changes in BF% and weight across the IR groups. In conclusion, women with High HOMA tend to gain significantly less BF% and weight than women with low or moderate HOMA. The decreased risk appears unrelated to several covariates, except initial BF% and weight levels, which seem to play key roles in the relationships.
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Affiliation(s)
- Larry A Tucker
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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128
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Abstract
Aging is characterized by a deterioration in the maintenance of homeostatic processes over time, leading to functional decline and increased risk for disease and death. The aging process is characterized metabolically by insulin resistance, changes in body composition, and physiological declines in growth hormone (GH), insulin-like growth factor-1 (IGF-1), and sex steroids. Some interventions designed to address features of aging, such as caloric restriction or visceral fat depletion, have succeeded in improving insulin action and life span in rodents. Meanwhile, pharmacologic interventions and hormonal perturbations have increased the life span of several mammalian species without necessarily addressing features of age-related metabolic decline. These interventions include inhibition of the mammalian target of rapamycin and lifetime deficiency in GH/IGF-1 signaling. However, strategies to treat aging in humans, such as hormone replacement, have mostly failed to achieve their desired response. We will briefly discuss recent advances in our understanding of the complex role of metabolic pathways in the aging process and highlight important paradoxes that have emerged from these discoveries. Although life span has been the major outcome of interest in the laboratory, a special focus is made in this study on healthspan, as improved quality of life is the goal when translated to humans.
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Affiliation(s)
- Nir Barzilai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
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129
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Abstract
Muscle atrophy—also known as muscle wasting—is a debilitating syndrome that slowly develops with age (sarcopenia) or rapidly appears at the late stages of deadly diseases such as cancer, AIDS, and sepsis (cachexia). Despite the prevalence and the drastic detrimental effects of these two syndromes, there are currently no widely used, effective treatment options for those suffering from muscle wasting. In an attempt to identify potential therapeutic targets, the molecular mechanisms of sarcopenia and cachexia have begun to be elucidated. Growing evidence suggests that inflammatory cytokines may play an important role in the pathology of both syndromes. As one of the key cytokines involved in both sarcopenic and cachectic muscle wasting, tumor necrosis factor α (TNFα) and its downstream effectors provide an enticing target for pharmacological intervention. However, to date, no drugs targeting the TNFα signaling pathway have been successful as a remedial option for the treatment of muscle wasting. Thus, there is a need to identify new effectors in this important pathway that might prove to be more efficacious targets. Inducible nitric oxide synthase (iNOS) has recently been shown to be an important mediator of TNFα-induced cachectic muscle loss, and studies suggest that it may also play a role in sarcopenia. In addition, investigations into the mechanism of iNOS-mediated muscle loss have begun to reveal potential therapeutic strategies. In this review, we will highlight the potential for targeting the iNOS/NO pathway in the treatment of muscle loss and discuss its functional relevance in sarcopenia and cachexia.
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130
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Lee CG, Boyko EJ, Barrett-Connor E, Miljkovic I, Hoffman AR, Everson-Rose SA, Lewis CE, Cawthon PM, Strotmeyer ES, Orwoll ES. Insulin sensitizers may attenuate lean mass loss in older men with diabetes. Diabetes Care 2011; 34:2381-6. [PMID: 21926282 PMCID: PMC3198278 DOI: 10.2337/dc11-1032] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine longitudinal changes in total and appendicular lean body mass in older men with impaired fasting glucose (IFG) or diabetes and to determine whether these changes differ by diabetes treatment. RESEARCH DESIGN AND METHODS A total of 3,752 ambulatory men aged ≥ 65 years at baseline participated in a multicenter longitudinal cohort study. Baseline glycemic status was categorized as normoglycemia, IFG, undiagnosed/untreated diabetes, or treated diabetes. Insulin sensitizer medication use (metformin and/or thiazolidinediones) was assessed by prescription medication inventory. The change in total lean and appendicular lean mass was derived from dual X-ray absorptiometry scans taken at baseline and 3.5 ± 0.7 years later. RESULTS This male cohort included 1,853 individuals with normoglycemia, 1,403 with IFG, 234 with untreated diabetes, 151 with diabetes treated with insulin sensitizers, and 111 with diabetes treated without insulin sensitizers. Men with untreated diabetes, diabetes treated without insulin sensitizers, or IFG had greater percentage loss in total or appendicular lean mass (P ≤ 0.05 in comparison to normoglycemic men). There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors. In contrast, the percentage loss in total or appendicular lean mass in men with diabetes treated with insulin sensitizers was significantly less than that in normoglycemic men in minimally and fully adjusted models. CONCLUSIONS Skeletal muscle loss was accelerated in men with IFG and diabetes, except when the latter was treated with insulin sensitizers. These findings suggest that insulin sensitizers may attenuate muscle loss.
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