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Das S, Preethi B, Kushwaha S, Shrivastava R. Therapeutic strategies to modulate gut microbial health: Approaches for sarcopenia management. Histol Histopathol 2024; 39:1395-1425. [PMID: 38497338 DOI: 10.14670/hh-18-730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Sarcopenia is a progressive and generalized loss of skeletal muscle and functions associated with ageing with currently no definitive treatment. Alterations in gut microbial composition have emerged as a significant contributor to the pathophysiology of multiple diseases. Recently, its association with muscle health has pointed to its potential role in mediating sarcopenia. The current review focuses on the association of gut microbiota and mediators of muscle health, connecting the dots between the influence of gut microbiota and their metabolites on biomarkers of sarcopenia. It further delineates the mechanism by which the gut microbiota affects muscle health with progressing age, aiding the formulation of a multi-modal treatment plan involving nutritional supplements and pharmacological interventions along with lifestyle changes compiled in the review. Nutritional supplements containing proteins, vitamin D, omega-3 fatty acids, creatine, curcumin, kefir, and ursolic acid positively impact the gut microbiome. Dietary fibres foster a conducive environment for the growth of beneficial microbes such as Bifidobacterium, Faecalibacterium, Ruminococcus, and Lactobacillus. Probiotics and prebiotics act by protecting against reactive oxygen species (ROS) and inflammatory cytokines. They also increase the production of gut microbiota metabolites like short-chain fatty acids (SCFAs), which aid in improving muscle health. Foods rich in polyphenols are anti-inflammatory and have an antioxidant effect, contributing to a healthier gut. Pharmacological interventions like faecal microbiota transplantation (FMT), non-steroidal anti-inflammatory drugs (NSAIDs), ghrelin mimetics, angiotensin-converting enzyme inhibitors (ACEIs), and butyrate precursors lead to the production of anti-inflammatory fatty acids and regulate appetite, gut motility, and microbial impact on gut health. Further research is warranted to deepen our understanding of the interaction between gut microbiota and muscle health for developing therapeutic strategies for ameliorating sarcopenic muscle loss.
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Affiliation(s)
- Shreya Das
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani Campus, Pilani, Rajasthan, India
| | - B Preethi
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani Campus, Pilani, Rajasthan, India
| | - Sapana Kushwaha
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Raebareli, Lucknow, India.
| | - Richa Shrivastava
- Department of Pharmacy, Birla Institute of Technology and Science (BITS), Pilani Campus, Pilani, Rajasthan, India.
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Holwerda AM, Dirks ML, Barbeau P, Goessens J, Gijsen A, van Loon LJ, Holloway GP. Mitochondrial bioenergetics are not associated with myofibrillar protein synthesis rates. J Cachexia Sarcopenia Muscle 2024; 15:1811-1822. [PMID: 39007407 PMCID: PMC11446679 DOI: 10.1002/jcsm.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/13/2024] [Accepted: 06/03/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Mitochondria represent key organelles influencing cellular homeostasis and have been implicated in the signalling events regulating protein synthesis. METHODS We examined whether mitochondrial bioenergetics (oxidative phosphorylation and reactive oxygen species (H2O2) emission, ROS) measured in vitro in permeabilized muscle fibres represent regulatory factors for integrated daily muscle protein synthesis rates and skeletal muscle mass changes across the spectrum of physical activity, including free-living and bed-rest conditions: n = 19 healthy, young men (26 ± 4 years, 23.4 ± 3.3 kg/m2) and following 12 weeks of resistance-type exercise training: n = 10 healthy older men (70 ± 3 years, 25.2 ± 2.1 kg/m2). Additionally, we evaluated the direct relationship between attenuated mitochondrial ROS emission and integrated daily myofibrillar and sarcoplasmic protein synthesis rates in genetically modified mice (mitochondrial-targeted catalase, MCAT). RESULTS Neither oxidative phosphorylation nor H2O2 emission were associated with muscle protein synthesis rates in healthy young men under free-living conditions or following 1 week of bed rest (both P > 0.05). Greater increases in GSSG concentration were associated with greater skeletal muscle mass loss following bed rest (r = -0.49, P < 0.05). In older men, only submaximal mitochondrial oxidative phosphorylation (corrected for mitochondrial content) was positively associated with myofibrillar protein synthesis rates during exercise training (r = 0.72, P < 0.05). However, changes in oxidative phosphorylation and H2O2 emission were not associated with changes in skeletal muscle mass following training (both P > 0.05). Additionally, MCAT mice displayed no differences in myofibrillar (2.62 ± 0.22 vs. 2.75 ± 0.15%/day) and sarcoplasmic (3.68 ± 0.35 vs. 3.54 ± 0.35%/day) protein synthesis rates when compared with wild-type mice (both P > 0.05). CONCLUSIONS Mitochondrial oxidative phosphorylation and reactive oxygen emission do not seem to represent key factors regulating muscle protein synthesis or muscle mass regulation across the spectrum of physical activity.
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Affiliation(s)
- Andrew M. Holwerda
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
- Department of Human Health and Nutritional SciencesUniversity of GuelphGuelphCanada
| | - Marlou L. Dirks
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
- Department of Public Health and Sport Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Pierre‐Andre Barbeau
- Department of Human Health and Nutritional SciencesUniversity of GuelphGuelphCanada
| | - Joy Goessens
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| | - Annemie Gijsen
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| | - Luc J.C. van Loon
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| | - Graham P. Holloway
- Department of Human Health and Nutritional SciencesUniversity of GuelphGuelphCanada
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Sayer AA, Cooper R, Arai H, Cawthon PM, Ntsama Essomba MJ, Fielding RA, Grounds MD, Witham MD, Cruz-Jentoft AJ. Sarcopenia. Nat Rev Dis Primers 2024; 10:68. [PMID: 39300120 DOI: 10.1038/s41572-024-00550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 09/22/2024]
Abstract
Sarcopenia is the accelerated loss of skeletal muscle mass and function commonly, but not exclusively, associated with advancing age. It is observed across many species including humans in whom it can lead to decline in physical function and mobility as well as to increased risk of adverse outcomes including falls, fractures and premature mortality. Although prevalence estimates vary because sarcopenia has been defined in different ways, even using a conservative approach, the prevalence is between 5% and 10% in the general population. A life course framework has been proposed for understanding not only the occurrence of sarcopenia in later life but also influences operating at earlier life stages with potentially important implications for preventive strategies. Harnessing progress in understanding the hallmarks of ageing has been key to understanding sarcopenia pathophysiology. Considerable convergence in approaches to diagnosis of sarcopenia has occurred over the last 10 years, with a growing emphasis on the central importance of muscle strength. Resistance exercise is currently the mainstay of treatment; however, it is not suitable for all. Hence, adjunctive and alternative treatments to improve quality of life are needed. An internationally agreed approach to definition and diagnosis will enable a step change in the field and is likely to be available in the near future through the Global Leadership Initiative in Sarcopenia.
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Affiliation(s)
- Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Rachel Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Peggy M Cawthon
- California Pacific Medical Center, Research Institute, San Francisco, CA, USA
- University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Marie-Josiane Ntsama Essomba
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Miranda D Grounds
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Miles D Witham
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Ding Q, Tu Y. Sarcopenia Is Associated with Neoplasm of Bone and Articular Cartilage: Findings from Mendelian Randomized Study. Rejuvenation Res 2024. [PMID: 39225155 DOI: 10.1089/rej.2024.0044] [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: 09/04/2024] Open
Abstract
Exploring the causal relationship between sarcopenia and neoplasm of bone and articular cartilage (NBAC) by bidirectional Mendelian randomization (MR). Genome-wide association study (GWAS) data on sarcopenia-associated traits including appendicular lean mass, low handgrip strength (including criteria from the European Working Group on Sarcopenia in Older People and the Foundation for the National Institutes of Health), and usual walking speeds were obtained from the UK Biobank. GWAS data for NBAC (benign and malignant) were provided by the Finnish Genetic Database. Three different methods of MR analysis, including inverse-variance weighted, Mendelian randomized Egger regression, and weighted median methods, were utilized. MR analysis showed that high appendicular lean mass was positively associated with the risk of developing benign NBAC (odds ratio and 95% confidence interval = 1.236 (1.026,1.489), p = 0.025). At the same time, there is no statistically significant association was found between traits related to sarcopenia and malignant neoplasm of bone and articular cartilage. There was also no reverse causal correlation between NBAC and traits related to sarcopenia. In European populations, better appendicular lean body mass is positively associated with the risk of benign neoplasm of bone and articular cartilage, representing the possibility that sarcopenia may be a protective factor against neoplasm of bone and articular cartilage.
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Affiliation(s)
- Qin Ding
- Department of Gastroenterology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yajun Tu
- Department of Gastroenterology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Jiang H, Li L, Zhang X, He J, Chen C, Sun R, Chen Y, Xia L, Wen L, Chen Y, Liu J, Zhang L, Lv W. Novel insights into the association between genetically proxied inhibition of proprotein convertase subtilisin/kexin type 9 and risk of sarcopenia. J Cachexia Sarcopenia Muscle 2024. [PMID: 39254080 DOI: 10.1002/jcsm.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/20/2024] [Accepted: 07/29/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The effects of lipid-lowering drugs [including statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors] on hyperlipidaemia have been established. Some may have treatment effects beyond their reported properties, offering potential opportunities for drug repurposing. Epidemiological studies have reported conflicting findings on the relationship between lipid-lowering medication use and sarcopenia risk. METHODS We performed a two-sample Mendelian randomization (MR) study to investigate the causal association between the use of genetically proxied lipid-lowering drugs (including statins, ezetimibe, and PCSK9 inhibitors, which use low-density lipoprotein as a biomarker), and sarcopenia risk. The inverse-variance weighting method was used with pleiotropy-robust methods (MR-Egger regression and weighted median) and colocalization as sensitivity analyses. RESULTS According to the positive control analysis, genetically proxied inhibition in lipid-lowering drug targets was associated with a lower risk of coronary heart disease [PCSK9 (OR, 0.67; 95% CI, 0.61 to 0.72; P = 7.7E-21); 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR; OR, 0.68; 95% CI, 0.57 to 0.82; P = 4.6E-05), and Niemann-Pick C1-like 1 (NPC1L1; OR, 0.53; 95% CI, 0.40 to 0.69; P = 3.3E-06)], consistent with drug mechanistic actions and previous trial evidence. Genetically proxied inhibition of PCSK9 (beta, -0.040; 95% CI, -0.068 to -0.012; P = 0.005) and circulating PCSK9 levels (beta, -0.019; 95% CI, -0.033 to -0.005; P = 0.006) were associated with reduced appendicular lean mass (ALM) with concordant estimates in terms of direction and magnitude. Validation analyses using a second instrument for PCSK9 yielded consistent results in terms of direction and magnitude [(PCSK9 to ALM; beta, -0.052; 95% CI, -0.074 to -0.032; P = 7.1E-7); (PCSK9 protein to ALM; beta, -0.060; 95% CI, -0.106 to -0.014; P = 0.010)]. Genetically proxied inhibition of PCSK9 gene expression in the liver may be associated with reduced ALM (beta, -0.013; 95% CI, -0.035 to 0.009; P = 0.25), consistent with the results of PCSK9 drug-target and PCSK9 protein MR analyses, but the magnitude was less precise. No robust association was found between HMGCR inhibition (beta, 0.048; 95% CI, -0.015 to 0.110; P = 0.14) or NPC1L1 (beta, 0.035; 95% CI, -0.074 to 0.144; P = 0.53) inhibition and ALM, and validation and sensitivity MR analyses showed consistent estimates. CONCLUSIONS This MR study suggested that PCSK9 is involved in sarcopenia pathogenesis and that its inhibition is associated with reduced ALM. These findings potentially pave the way for future studies that may allow personalized selection of lipid-lowering drugs for those at risk of sarcopenia.
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Affiliation(s)
- Hongyan Jiang
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Lulu Li
- Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Xue Zhang
- Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Jia He
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Chuanhuai Chen
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Ruimin Sun
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Ying Chen
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Lijuan Xia
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Lei Wen
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Yunxiang Chen
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Junxiu Liu
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Lijiang Zhang
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
| | - Wanqiang Lv
- Center of Safety Evaluation and Research, Key Laboratory of Drug Safety Evaluation and Research of Zhejiang Province, Hangzhou Medical College, Zhejiang, China
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Ji J, Mi S, Hou Z, Zhang Z, Qiu G, Jin Z, Huang J. Impact of imaging-diagnosed sarcopenia on outcomes in patients with biliary tract cancer after surgical resection: a systematic review and meta-analysis. World J Surg Oncol 2024; 22:229. [PMID: 39218917 PMCID: PMC11367777 DOI: 10.1186/s12957-024-03516-0] [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: 05/04/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND AIMS Sarcopenia has been associated with poor prognosis in patients with malignant tumors. However, its impact on the outcomes of patients with biliary tract cancer (BTC) undergoing surgical resection remains unclear and warrants further review. This study aims to summarize the available evidence on this issue. METHODS A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for eligible studies up to March 10, 2024. We extracted data on overall survival (OS), recurrence free survival (RFS), and postoperative major complications from the included studies as the outcomes of interest. Following data synthesis and analysis, we assessed the heterogeneity and performed subgroup analyses. Additionally, the potential for publication bias was evaluated. RESULTS A total of 26 studies involving 4292 BTC patients were ultimately retrieved. The findings indicated that sarcopenia was significantly associated with reduced OS in BTC patients after surgery (adjusted HR: 2.03, 95% CI: 1.65-2.48, P < 0.001, I2 = 57.4%). Moreover, sarcopenia may also be linked to poorer RFS (adjusted HR: 2.15, 95% CI: 1.79-2.59, P < 0.001, I2 = 0%) and increased postoperative major complications (OR: 1.22, 95% CI 1.02-1.47, P = 0.033, I2 = 29.2%) as well. Notably, no significant publication bias was detected through funnel plots and Egger's tests. CONCLUSION Sarcopenia is associated with poorer OS in BTC patients following surgery. Additionally, it may serve as a prognostic indicator for poorer RFS and increased postoperative major complications. Further studies are warrant to standardize existing definitions and validate these findings.
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Affiliation(s)
- Jun Ji
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Shizheng Mi
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ziqi Hou
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zhihong Zhang
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Guoteng Qiu
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zhaoxing Jin
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jiwei Huang
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Cheng KYK, Chow SKH, Hung VWY, Tsang ZTL, Yip BHK, Wong RMY, Zhang N, Qin L, Law SW, Cheung WH. Identification of Osteosarcopenia by High-Resolution Peripheral Quantitative Computed Tomography. J Pers Med 2024; 14:935. [PMID: 39338189 PMCID: PMC11433288 DOI: 10.3390/jpm14090935] [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: 07/19/2024] [Revised: 08/21/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024] Open
Abstract
Osteosarcopenia is a prevalent geriatric disease with a significantly increased risk of adverse outcomes than osteoporosis or sarcopenia alone. Identification of older adults with osteosarcopenia using High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) could allow better clinical decision making. This study aimed to explore the feasibility of HR-pQCT to differentiate osteoporosis, sarcopenia, and osteosarcopenia in older adults, with a primary outcome to derive a model to distinguish older adults with osteosarcopenia from those with low bone mineral density only, and to examine important HR-pQCT parameters associated with osteosarcopenia. This was a cross-sectional study involving 628 community-dwelling Chinese adults aged ≥ 40. Subjects were assessed by dual energy X-ray absorptiometry (DXA) for osteopenia/osteoporosis and sarcopenia using the Asian Working Group for Sarcopenia definition; then grouped into healthy, osteopenia/osteoporosis, sarcopenia, and osteosarcopenia groups. A series of regression analyses and other statistical tests were performed to derive the model. HR-pQCT showed the ability to discriminate older adults with osteosarcopenia from those with osteopenia/osteoporosis only. Cross-validation of our derived model correctly classified 77.0% of the cases with good diagnostic power and showed a sensitivity of 76.0% and specificity of 77.6% (Youden index = 0.54; AUC = 0.79, p < 0.001). Analysis showed trabecular volumetric bone density and cortical periosteal perimeter were important and sensitive parameters in discriminating osteosarcopenia from osteopenia/osteoporosis subjects. These findings demonstrated that HR-pQCT is a viable and effective screening method for differentiating osteosarcopenia from low bone mineral density alone without the need to carry out multiple assessments for osteosarcopenia, especially for case-finding purposes. This could facilitate the decision of a follow-up and the management of these frail older adults to ensure they receive timely therapeutic interventions to minimise the associated risks.
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Affiliation(s)
- Keith Yu-Kin Cheng
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Simon Kwoon-Ho Chow
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Vivian Wing-Yin Hung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Zoey Tsz-Lok Tsang
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Benjamin Hon-Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ning Zhang
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ling Qin
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Sheung-Wai Law
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Dos Santos VR, Antunes M, Dos Santos L, Nascimento MA, Pina FLC, Carneiro NH, Trindade MCC, Venturini D, Barbosa DS, Cyrino ES. Effects of Different Resistance Training Frequencies on Body Composition, Muscular Strength, Muscle Quality, and Metabolic Biomarkers in Sarcopenic Older Women. J Strength Cond Res 2024; 38:e521-e528. [PMID: 39178393 DOI: 10.1519/jsc.0000000000004827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2024]
Abstract
ABSTRACT Dos Santos, VR, Antunes, M, dos Santos, L, Nascimento, MA, Pina, FLC, Carneiro, NH, Trindade, MCC, Venturini, D, Barbosa, DS, and Cyrino, ES. Effects of different resistance training frequencies on body composition, muscular strength, muscle quality, and metabolic biomarkers in sarcopenic older women. J Strength Cond Res 38(9): e521-e528, 2024-Resistance training (RT) can ameliorate outcomes related to sarcopenia by promoting beneficial changes in muscular strength, skeletal muscle mass (SMM), and muscle quality. This study compared the effects of 12 weeks of RT performed 2 and 3 sessions a week on body composition, muscular strength, muscle quality, and metabolic biomarkers in sarcopenic older women. Thirty-four sarcopenic older women (>60 years) were randomly assigned to perform a whole-body RT program, either 2 (G2X, n = 18) or 3 (G3X, n = 16) sessions a week during 12 weeks (8 exercises, single set of 10-15 repetitions). Body composition, muscular strength, muscle quality, and metabolic biomarkers were assessed before and after the intervention. Both groups increased (p < 0.05) 1 repetition maximum total muscular strength (G2X = +20.4% and G3X = +21.0%), SMM (G2X = +4.0% and G3X = +7.0%), and improved muscle quality (G2X = +16.7% and G3X = +13.6%), with no differences between groups (p > 0.05). No change over time was found for IGF-1 and testosterone (p > 0.05). Our results suggest that 12 weeks of RT performed at a lower weekly frequency is as effective as a higher frequency in improving muscular strength, SMM, and muscle quality in sarcopenic older women.
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Affiliation(s)
- Vanessa R Dos Santos
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Science, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Melissa Antunes
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Science, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Leandro Dos Santos
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Matheus A Nascimento
- Department of Physical Education, Paraná State University (UNESPAR), Paranavaí, PR, Brazil
| | - Fábio L C Pina
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Nelson H Carneiro
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
| | - Michele C C Trindade
- Department of Physical Education, State University of Maringá, Maringá, PR, Brazil; and
| | - Danielle Venturini
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
- Clinical Analyses Laboratory, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, PR, Brazil
| | - Décio S Barbosa
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
- Clinical Analyses Laboratory, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, PR, Brazil
| | - Edilson S Cyrino
- Metabolism, Nutrition and Exercise Laboratory, Department of Physical Education, Physical Education and Sport Center, State University of Londrina (UEL), Londrina, PR, Brazil
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Sanchez-Garcia E, Cruz-Jentoft AJ, Ravasco P, Suominen M, Pitkälä PK. Nutritional care in older adults: are we doing everything? An expert opinion review. Curr Med Res Opin 2024; 40:1563-1576. [PMID: 39044672 DOI: 10.1080/03007995.2024.2380007] [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: 05/28/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
Malnutrition is a prevalent, yet often underdiagnosed and undertreated, condition in older adults. It is characterized by weight loss and/or reduced muscle mass due to diminished caloric intake, inflammation, and/or disease burden. In return, malnutrition can lead to diminished skeletal muscle functionality and disability, among others. Malnutrition plays a crucial role in the pathogenesis of two prevalent geriatric syndromes, namely sarcopenia and frailty. The complex interplay between malnutrition, sarcopenia, and frailty significantly impacts the older population, leading to increased morbidity, mortality, hospitalization rates, quality-of-life, and healthcare costs. Given the prognostic significance of malnutrition in geriatric care, recent guidelines emphasized the role of nutritional support in vulnerable populations. A group of vulnerable populations to malnutrition, sarcopenia, and frailty are older patients with hip fractures, cancer patients, and those with sarcopenic dysphagia. This article highlights the importance of individualized nutritional assessment and treatment in the management of vulnerable populations such as older patients with hip fractures, cancer, and those suffering from sarcopenic dysphagia. It presents practical protocols and guidelines that can be instrumental in enhancing the nutritional care of these groups, thereby improving their overall health outcomes.
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Affiliation(s)
- Elisabet Sanchez-Garcia
- Consultant in Geriatric Medicine, Mater Private Network, Cork, Ireland
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Paula Ravasco
- Universidade Católica Portuguesa, Faculty of Medicine and Centre for Interdisciplinary Research in Health, Centre for Interdisciplinary Research Egas Moniz (CiiEM), Lisbon, Portugal
| | - Merja Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Prof Kaisu Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
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10
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Pan R, Wang T, Tang R, Qian Z. Association of atherogenic index of plasma and triglyceride glucose-body mass index and sarcopenia in adults from 20 to 59: a cross-sectional study. Front Endocrinol (Lausanne) 2024; 15:1437379. [PMID: 39224122 PMCID: PMC11366597 DOI: 10.3389/fendo.2024.1437379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background The relationship between atherogenic index of plasma (AIP) and triglyceride glucose-body mass index (TyG-BMI) and sarcopenia has not been studied in the United States (US) population. Methods This research included 4,835 people from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. The relationship between sarcopenia and TyG-BMI, as well as the AIP index, was examined through the utilization of restricted cubic spline (RCS) analysis, subgroup analysis, and multivariate logistic regression analysis. Diagnostic value of AIP and TyG-BMI for sarcopenia was compared by receiver operating characteristic (ROC) curves. Results In this research, 428 people with sarcopenia were identified among the 4,835 subjects that were included in the experiment. AIP and sarcopenia were positively associated with an odds ratio (OR) of 1.58 and a 95% confidence interval (CI) of (1.07, 2.34) on fully adjusted multivariate logistic regression analysis. Similarly, TyG-BMI and sarcopenia were positively associated with an OR of 8.83 and a 95% CI of (5.46, 14.26). AIP and sarcopenia had a non-linear positive connection (P-value<0.001, P-Nonlinear=0.010), while TyG-BMI and sarcopenia had a linear positive correlation (P-value<0.001, P-Nonlinear=0.064), according to RCS analysis. Subgroup analyses showed a significant interaction between TyG-BMI and sarcopenia due to gender (P = 0.023). ROC curves showed that TyG-BMI (AUC:0.738, 95% CI: 0.714 - 0.761) was more useful than AIP (AUC:0.648, 95% CI: 0.622 - 0.673) in diagnosing sarcopenia. Conclusion In US adults aged 20-59 years, our study revealed a correlation between elevated AIP and TyG-BMI levels and heightened sarcopenia risk. Moreover, TyG-BMI has better diagnostic validity than AIP.
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Tao J, Shi H, Shen B, Zhang L, Tu Y, Zhang X. The chest CT perspective on sarcopenia: Exploring reference values for muscle mass quantity/quality and its application in old adults. Nutrition 2024; 128:112558. [PMID: 39276682 DOI: 10.1016/j.nut.2024.112558] [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: 03/26/2024] [Revised: 05/12/2024] [Accepted: 08/06/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVE To determine reference values for diagnosing sarcopenia through chest CT scans and evaluate their suitability for use among the Chinese old population. METHODS Chest CT scans were obtained from 500 healthy individuals aged 19-39. Skeletal muscle mass was assessed on chest CT at the level of T4 by the skeletal muscle area (T4SMA), skeletal muscle index (T4SMI), T12 erector spinae muscle area (T12ESMA), and T12 skeletal muscle index (T12SMI), as well as skeletal muscle density (SMD) at T4 and T12 levels. The diagnostic threshold for sarcopenia was defined as a gender-specific value below 2 SD of the mean value in the young group. These cutoff values were then applied to a group of older adults aged 65 and over. RESULTS Diagnostic thresholds for low skeletal muscle in men were 110.05 cm², 36.01 cm²/m², 29.56 cm², and 9.65 cm²/m² for T4SMA, T4SMI, T12ESMA, and T12SMI, respectively. For women, the thresholds were: 69.93 cm², 26.51 cm²/m², 17.84 cm²/m², and 6.87 cm²/m², respectively. Diagnostic thresholds for low SMD were 38.63HU in men, 34.74 HU for women at T4 level. At T12 level, the cutoff values were 40.94 HU for men and 36.63 HU for women. Sarcopenia prevalence in men, defined by T4SMA, T4SMI, T12ESMA, and T12SMI cutoffs, was 35.6%, 18.9%, 36.7%, and 23.7%, respectively. In women, sarcopenia prevalence was 5.1%, 3.2%, 3.2%, and 1.9%, respectively. CONCLUSION This study established reference values for sarcopenia diagnosis through chest CT scans among the Chinese population, highlighting the importance of utilizing chest CT scans for sarcopenia detection and muscle health monitoring in older adults.
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Affiliation(s)
- Jun Tao
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huazheng Shi
- Shanghai Universal Cloud Medical Imaging Diagnostic Center, Shanghai, China
| | - Bixia Shen
- Shanghai Universal Cloud Medical Imaging Diagnostic Center, Shanghai, China
| | - Li Zhang
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Youyi Tu
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Zhang
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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Meng S, He X, Fu X, Zhang X, Tong M, Li W, Zhang W, Shi X, Liu K. The prevalence of sarcopenia and risk factors in the older adult in China: a systematic review and meta-analysis. Front Public Health 2024; 12:1415398. [PMID: 39161853 PMCID: PMC11331796 DOI: 10.3389/fpubh.2024.1415398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024] Open
Abstract
Background Understanding the epidemiological information of a certain disease is the first step in related prevention and control work. This article aims to understand the prevalence and associated risk factors of sarcopenia among the older adult (≥60 years old) in China and to provide an evidence-based basis for early identification, management, and prevention of sarcopenia patients. Methods We searched seven databases: CNKI, Wanfang, VIP, PubMed, Web of Science, Embase, and Cochrane Library databases from the establishment of the database until January 31, 2024. The Quality evaluation criteria of cross-sectional studies recommended by the Agency for Healthcare Research and Quality (AHRQ) were used for literature quality evaluation. Stata 18.0 software was used for statistical analysis. Results We finally included 45 studies, involving a total of 37,571 cases. After statistical analysis, we found that the prevalence of sarcopenia among the older adult in China was 20.7% [95% CI (18.3, 23.0%)]. The results of subgroup analysis suggest that: ① According to gender, the prevalence rate of sarcopenia in women (21.6%) is higher than that in men (19.2%); ② According to age, the prevalence rate of older adult people aged ≥80 (45.4%) was the highest, followed by 70-79 (27.2%) and 60-69 (15.7%). ③ According to region, the prevalence rate of the older adult in the south (21.7%) is higher than that in the north (19.0%); ④ According to the time of publication, the prevalence of sarcopenia among the older adult in China has increased (from 19.2% in 2014-2018 to 21.4% in 2019-2024); ⑤ According to the diagnostic criteria, the detection rate of AWGS (2019) is higher than that of AWGS (2014) (24.5% vs. 19.3%). Finally, aging, low BMI, low leg circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are all risk factors for sarcopenia among the older adult in China. Conclusion The prevalence of sarcopenia in the older adult in China was higher (20.7%), which should be paid attention to by relevant health authorities. In addition, aging, low BMI, low calf circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are risk factors for the development of sarcopenia in the older adult in China. For these high-risk populations, early identification, prevention, and intervention can be carried out to delay the occurrence and progression of sarcopenia.
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Affiliation(s)
- Shilong Meng
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaomin He
- The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xinlei Fu
- The First School of Clinical Medicine, Fujian University of Traditional Chinese Medical, Fuzhou, Fujian, China
| | - Xu Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Minghao Tong
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wei Li
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wei Zhang
- Xianju Branch of the Second Affiliated Hospital, Zhejiang Chinese Medicine University, Taizhou, Zhejiang, China
| | - Xiaolin Shi
- The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Kang Liu
- The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Xianju Branch of the Second Affiliated Hospital, Zhejiang Chinese Medicine University, Taizhou, Zhejiang, China
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Lee DH, Lee HJ, Yang G, Kim DY, Kim JU, Yook TH, Lee JH, Kim HJ. A novel treatment strategy targeting cellular pathways with natural products to alleviate sarcopenia. Phytother Res 2024. [PMID: 39099170 DOI: 10.1002/ptr.8301] [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: 12/26/2023] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 08/06/2024]
Abstract
Sarcopenia is a condition marked by a significant reduction in muscle mass and strength, primarily due to the aging process, which critically impacts muscle protein dynamics, metabolic functions, and overall physical functionality. This condition leads to increased body fat and reduced daily activity, contributing to severe health issues and a lower quality of life among the elderly. Recognized in the ICD-10-CM only in 2016, sarcopenia lacks definitive treatment options despite its growing prevalence and substantial social and economic implications. Given the aging global population, addressing sarcopenia has become increasingly relevant and necessary. The primary causes include aging, cachexia, diabetes, and nutritional deficiencies, leading to imbalances in protein synthesis and degradation, mitochondrial dysfunction, and hormonal changes. Exercise remains the most effective intervention, but it is often impractical for individuals with limited mobility, and pharmacological options such as anabolic steroids and myostatin inhibitors are not FDA-approved and are still under investigation. This review is crucial as it examines the potential of natural products as a novel treatment strategy for sarcopenia, targeting multiple mechanisms involved in its pathogenesis. By exploring natural products' multi-targeted effects, this study aims to provide innovative and practical solutions for sarcopenia management. Therefore, this review indicates significant improvements in muscle mass and function with the use of specific natural compounds, suggesting promising alternatives for those unable to engage in regular physical activity.
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Affiliation(s)
- Da Hee Lee
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Hye Jin Lee
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Gabsik Yang
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Dae Yong Kim
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Jong Uk Kim
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Tae Han Yook
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
| | - Jun Ho Lee
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
- Da Capo Co., Ltd., Jeonju-si, Republic of Korea
| | - Hong Jun Kim
- College of Korean Medicine, Woosuk University, Jeonju-si, Republic of Korea
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Ha YC, Kim S, Yoo JI. Open, Active-Controlled Clinical Study to Evaluate the Correlation between Whole Body DEXA and BIA Muscle Measurements. J Bone Metab 2024; 31:219-227. [PMID: 39307522 PMCID: PMC11416876 DOI: 10.11005/jbm.2024.31.3.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Dual energy X-ray absorptiometry (DXA) is the gold standard for diagnosing sarcopenia. However, comparative studies using bioelectrical impedance analysis (BIA) would be required in the Korean population. This study aimed to evaluate the correlation between total-body bone density measuring devices (Hologic and GE Lunar) and a bioelectrical impedance measurement device (InBody 970) as well as the correlation between upper body muscle mass. METHODS A total of 119 participants were involved in this study, aged 20 to 70 years, with specific body mass index ranges and no severe health conditions used both DXA (or DEXA) and BIA technologies to assess body composition. The participants were scanned using a Hologic QDR-4500W DXA scanner and GE-Lunar Prodigy DXA systems, and the InBody 970 type of multi-frequency BIA machine. Statistical analysis was performed to determine the correlation between the devices, with a coefficient of at least 0.8. RESULTS The muscle mass measurement comparisons between the InBody 970 and Hologic devices demonstrated remarkably high correlation coefficients (exceeding 0.9) across all limbs. Similarly, the muscle mass comparison between the Inbody 970 and GE Lunar devices also revealed substantial correlation coefficients, ranging from 0.83 upwards, across all limbs. CONCLUSIONS Limb muscle mass measurements using Hologic and GE Lunar whole-body DXA and Inbody 970 BIA demonstrated particularly high levels of concordance. In addition, a conversion formula that bridges limb muscle mass measurements from two widely used whole-body DXA machines and a BIA machine will facilitate sarcopenia research and patient management.
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Affiliation(s)
- Yong-Chan Ha
- Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul,
Korea
| | - Shinjune Kim
- Department of Biomedical Research Institute, Inha University Hospital, Inha University School of Medicine, Incheon,
Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon,
Korea
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15
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Álvarez-Bustos A, Carnicero JA, Coelho-Junior HJ, Calvani R, García-García FJ, Marzetti E, Landi F, Rodriguez-Mañas L. Diagnostic and prognostic value of calf circumference for sarcopenia in community-dwelling older adults. J Nutr Health Aging 2024; 28:100290. [PMID: 38908297 DOI: 10.1016/j.jnha.2024.100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND An age-dependent normative values of calf circumference (CC) has been recently proposed as an accessible proxy for muscle mass. However, its usefulness to estimate sarcopenia has not been assessed. The objectives of the present study were to determine if the substitution of the classical way to assess muscle mass by these values have enough diagnostic accuracy and prognostic value among older adults living in the community. METHODS Data from the Toledo Study of Healthy Ageing (TSHA) were used. CC was measured using an anthropometric tape. We used two age-groups CC cut-off points: the TSHA CC median and the one proposed in the Longevity Check-up 7+ (Lookup 7+) project. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH), and FNIH criteria standardized for our population (sFNIH). Frailty (according to the Frailty Phenotype and the Frailty Trait Scale-5) and disability (Katz index) were assessed at baseline and follow-up. Mortality and first hospitalization were also recorded. Logistic (incident frailty and worsening disability) and Cox (mortality and hospitalization) regressions were performed. Diagnostic accuracy was assessed through Kappa index, AUCs, positive and negative predictive values. Predictive ability was assessed through AUCs and integrated AUCs (IAUCs). RESULTS 1531 participants (74.8 ± 5.8 years; 45.6% men) were included in the analysis. Prevalence rates of sarcopenia were 22.7% (sFNIH), 15.0% (FNIH), and 13.9% (EWGSOP2). Using TSHA-based cut-points of CC, the prevalence of sarcopenia was 16.8% (sFNIH), 11.0% (FNIH), and 11.5% (EWGSOP2). According to LC7+-based CC cut-off points, sarcopenia prevalence was 17.6% (sFNIH), 11.9% (FNIH), and 12.4% (EWGSOP2). CC cut-off points showed low-to-moderate agreement (Kappa Index values between 0.49 and 0.69) with appendicular lean mass for the evaluation of sarcopenia. Sarcopenia identified by Lookup 7+ and TSHA CC cut-off points was associated with the adverse events examined, with similar AUCs and IAUCs than original sarcopenia definitions, and were lost after adjustment by baseline frailty, except when the original EWGSOP2 definition was used. CONCLUSIONS Using normalized values of CC as a criteria of muscle mass shows moderate agreement with classical criteria for diagnosing sarcopenia and offer similar predictive value in community-dwelling older adults.
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Affiliation(s)
- Alejandro Álvarez-Bustos
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain
| | - Jose Antonio Carnicero
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain; Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain
| | | | - Riccardo Calvani
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Francisco José García-García
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Department of Geriatrics, Hospital Virgen del Valle, Toledo, Spain
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Leocadio Rodriguez-Mañas
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Department of Geriatrics, Hospital Universitario de Getafe, Madrid, Spain; Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain.
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16
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Pratt J, Motanova E, Pessanha L, Narici M, Boreham C, De Vito G. Plasma C-terminal agrin fragment concentrations across adulthood: Reference values and associations with skeletal muscle health. J Cachexia Sarcopenia Muscle 2024; 15:1501-1510. [PMID: 38845597 PMCID: PMC11294022 DOI: 10.1002/jcsm.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/20/2024] [Accepted: 04/10/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Increasing interest surrounds the utility of blood-based biomarkers for diagnosing sarcopenia. C-terminal agrin fragment (CAF), a marker of neuromuscular junction stability, is amongst the most promising candidates; however, a dearth of reference data impedes the incorporation of its use in public health settings. This study aimed to establish reference values for plasma CAF concentrations across adulthood in a large, well-characterized cohort of healthy adults; and comprehensively examine the association between plasma CAF levels and skeletal muscle health. METHODS One thousand people aged between 18 and 87 years took part in this study (mean age = 50.4 years; 51% females). Body composition and muscle strength were examined using DXA and hand dynamometry. Plasma CAF concentrations were measured, in duplicate, using commercially available ELISA kits. Sarcopenia and individual sarcopenia signatures [low skeletal muscle index (SMI) only/low grip strength only] were classified using the EWGSOP2 algorithm. RESULTS Detailed reference CAF values, according to sex and age, are presented. A significant but modest age-related increase in plasma CAF concentration was observed (P = 0.018). Across adulthood, CAF concentrations were negatively associated with grip strength and SMI (both P < 0.001). In people ≥50 years old, CAF concentrations were 22.6% higher in those with sarcopenia (P < 0.001), 11.3% higher in those with low SMI (P = 0.006) and 9.6% higher in those with low grip strength (P = 0.0034), compared with controls. People in the highest CAF concentration quartile, had 3.25 greater odds for sarcopenia (95% CI = 1.41-7.49, P = 0.005), 2.76 greater odds for low SMI (95% CI = 1.24-5.22, P = 0.012), and 2.56 greater odds for low grip strength (95% CI = 1.07-5.57, P = 0.037), compared with those in the lowest quartile. People with a CAF Z-score ≥2 had 9.52 greater odds for sarcopenia (95% CI = 3.01-30.05, P < 0.001) compared with a Z-score <1. Plasma CAF concentration had an acceptable level of diagnostic accuracy for sarcopenia (AUC = 0.772, 95% CI = 0.733-0.807, P < 0.001). CONCLUSIONS The reference values presented herein may guide the clinical interpretation of circulating CAF and help identify people at risk of poor skeletal muscle outcomes for inclusion in therapeutic interventions. Our findings add clarity to existing data, demonstrating a robust relationship between circulating CAF and skeletal muscle integrity in the largest adult cohort to date, and support the use of CAF as an accessible, cost-effective screening tool for sarcopenia. However, further research into the prognostic utility of plasma CAF, and the establishment of normative data from other populations, are urgently needed if routine CAF screening is to be embedded into public healthcare settings.
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Affiliation(s)
- Jedd Pratt
- Department of Sport and Exercise SciencesManchester Metropolitan University Institute of SportManchesterUK
- Institute for Sport and HealthUniversity College DublinDublinIreland
| | - Evgeniia Motanova
- Department of Biomedical Sciences, CIR‐Myo Myology Centre, Neuromuscular Physiology LaboratoryUniversity of PadovaPaduaItaly
| | - Ludmilla Pessanha
- Conway Institute of Biomolecular and Biomedical ResearchUniversity College DublinDublinIreland
| | - Marco Narici
- Department of Biomedical Sciences, CIR‐Myo Myology Centre, Neuromuscular Physiology LaboratoryUniversity of PadovaPaduaItaly
| | - Colin Boreham
- Institute for Sport and HealthUniversity College DublinDublinIreland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, CIR‐Myo Myology Centre, Neuromuscular Physiology LaboratoryUniversity of PadovaPaduaItaly
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Shi Y, Stanmore E, McGarrigle L, Wang X, Wang X, Li Y, Todd C. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. Maturitas 2024; 186:108027. [PMID: 38820935 DOI: 10.1016/j.maturitas.2024.108027] [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: 02/14/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES There is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. STUDY DESIGN Using guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). MAIN OUTCOME MEASURES This study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. RESULTS The health education included seven videos of 4-6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and "dosage" of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = -5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. CONCLUSIONS The social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Nursing, School of Public Health, Yangzhou University, 225009 Yangzhou, Jiangsu Province, China; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK.
| | - Xiuhua Wang
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China.
| | - Xiaoqing Wang
- Department of Geriatrics, the Second Xiangya Affiliated Hospital, Central South University, 410011 Changsha, Hunan Province, China
| | - Yuhua Li
- Xiangya School of Nursing, Central South University, 410013 Changsha, Hunan Province, China
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M13 9PL Manchester, UK; School of Health Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester, M13 9PL Manchester, UK; Manchester University NHS Foundation Trust, M13 9WL Manchester, UK.
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Wang J, Yang Y, Su Q, Wang J, Zeng H, Chen Y, Zhou J, Wang Y. Association between muscle strength and cardiometabolic multimorbidity risk among middle-aged and older Chinese adults: a nationwide longitudinal cohort study. BMC Public Health 2024; 24:2012. [PMID: 39068419 PMCID: PMC11282630 DOI: 10.1186/s12889-024-19521-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CM) is emerging as a global health challenge. This study investigated the potential impact of muscle strength on the risk of CM in middle-aged and older Chinese adults. METHODS In total, 7610 participants were identified from the China Health and Retirement Longitudinal Study (CHARLS). Muscle strength was measured by absolute, relative grip strength (normalized for body mass index) and chair-rising time which were classified into three categories according to tertiles stratified by gender. Cox proportional hazards models were adopted to evaluate the effect of muscle strength on CM. RESULTS During follow-up, 235(3.76%) participants from none cardiometabolic diseases (CMD), 140 (19.23%) from diabetes, 119 (21.17%) from heart disease, and 22 (30.56%) from stroke progressed to CM. In participants who had low relative grip strength, CM was more likely to occur in individuals with heart disease at baseline (HR: 1.89, 95%CIs: 1.10 to 3.23). Those with high chair-rising time had a higher risk of CM than those with low chair-rising time in the individuals with diabetes (HR: 1.85, 95%CIs:1.20 to 2.86) and with heart disease (HR: 1.67, 95%CIs:1.04 to 2.70). However, we did not observe an association between muscle strength and CM in participants without CMD or with stroke at baseline. CONCLUSIONS In Chinese middle-aged and older adults, low relative grip strength was associated with a higher risk of CM in individuals with heart disease, while high chair-rising time was associated with a higher risk of CM in individuals with diabetes or heart disease.
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Affiliation(s)
- Jingxian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Qing Su
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Juejin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Hao Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Yaqing Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Junxi Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Chashan High Education Zone, Wenzhou, China.
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang, China.
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Wang D, Zeng H, Wu P, Zhou Y, Chen H, Zhao F, Liu S. Path analysis of the awareness status and influencing factors of sarcopenia in older adults in the community: based on structural equation modeling. Front Public Health 2024; 12:1391383. [PMID: 39114524 PMCID: PMC11304347 DOI: 10.3389/fpubh.2024.1391383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Background Sarcopenia is a progressive geriatric syndrome that impacts older adults' quality of life. Insufficient focus has been given to sarcopenia among Chinese residents, resulting in low level of sarcopenia awareness. This study aims to investigate awareness of sarcopenia and its influencing factors and the influencing pathways among older adults in Hangzhou. Methods A stratified random sample of 942 community-dwelling older adults was evaluated using the SARC-CalF screening tool, along with a questionnaire based on health ecology theory to assess awareness of sarcopenia and its influencing factors and the influencing pathways. Descriptive statistics, linear regression analysis, and path analysis were conducted using SPSS 25.0 and Amos 23.0 to analyze the data. Results The mean awareness score for sarcopenia was 60.26 ± 7.31. Self-rated physical health, daily intake of high-quality protein, exercise frequency, smoking status, self-efficacy, religious beliefs, social support, education level, occupation, participation in community free medical examinations, and awareness of nutrition policy were all factors affecting scores for sarcopenia awareness (p < 0.05). Except for negative effects observed in social support, smoking status, and self-rated physical health, all others exhibit positive effects. Conclusion Community healthcare institutions should target populations with low awareness of sarcopenia and focus on these key factors. Diverse health education programs and multi-channel screening activities can promote awareness, guide healthy lifestyles and prevent or delay the onset of sarcopenia in the older.
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Affiliation(s)
| | | | | | | | | | | | - Shucong Liu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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20
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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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Kamińska D, Kamińska O, Sochacka M, Sokół-Szawłowska M. The Role of Selected Speech Signal Characteristics in Discriminating Unipolar and Bipolar Disorders. SENSORS (BASEL, SWITZERLAND) 2024; 24:4721. [PMID: 39066117 PMCID: PMC11281009 DOI: 10.3390/s24144721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/23/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE The objective of this study is to explore and enhance the diagnostic process of unipolar and bipolar disorders. The primary focus is on leveraging automated processes to improve the accuracy and accessibility of diagnosis. The study aims to introduce an audio corpus collected from patients diagnosed with these disorders, annotated using the Clinical Global Impressions Scale (CGI) by psychiatrists. METHODS AND PROCEDURES Traditional diagnostic methods rely on the clinician's expertise and consideration of co-existing mental disorders. However, this study proposes the implementation of automated processes in the diagnosis, providing quantitative measures and enabling prolonged observation of patients. The paper introduces a speech signal pipeline for CGI state classification, with a specific focus on selecting the most discriminative features. Acoustic features such as prosodies, MFCC, and LPC coefficients are examined in the study. The classification process utilizes common machine learning methods. RESULTS The results of the study indicate promising outcomes for the automated diagnosis of bipolar and unipolar disorders using the proposed speech signal pipeline. The audio corpus annotated with CGI by psychiatrists achieved a classification accuracy of 95% for the two-class classification. For the four- and seven-class classifications, the results were 77.3% and 73%, respectively, demonstrating the potential of the developed method in distinguishing different states of the disorders.
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Affiliation(s)
- Dorota Kamińska
- Institute of Mechatronics and Information Systems, Lodz University of Technology, 116 Żeromskiego Street, 90-924 Lodz, Poland
| | - Olga Kamińska
- Systems Research Institute, Polish Academy of Sciences, 01-447 Warsaw, Poland;
| | | | - Marlena Sokół-Szawłowska
- Outpatient Psychiatric Clinic, Institute of Psychiatry and Neurology, 9 Jana III Sobieskiego Street, 02-957 Warsaw, Poland;
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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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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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Grosman Y, Kalichman L. Bidirectional Relationships between Sarcopenia and Pelvic Floor Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:879. [PMID: 39063456 PMCID: PMC11276977 DOI: 10.3390/ijerph21070879] [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: 06/01/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
Sarcopenia and pelvic floor disorders (PFDs) are prevalent and often cooccurring conditions in the aging population. However, their bidirectional relationship and underlying mechanisms remain underexplored. This narrative review aims to elucidate this relationship by exploring potential causative interplays, shared pathophysiological mechanisms, and common risk factors. A comprehensive literature search was conducted to identify relevant studies focusing on epidemiological associations, interaction mechanisms, and implications for patient care. While epidemiological studies demonstrate associations between sarcopenia and PFDs, our findings reveal a cyclical relationship where sarcopenia may exacerbate PFDs through mechanisms such as decreased muscle strength and mobility. Conversely, the presence of PFDs often leads to reduced physical activity due to discomfort and mobility issues, which in turn exacerbate the muscle atrophy associated with sarcopenia. Additionally, shared risk factors such as physical inactivity, nutritional deficiencies, metabolic syndrome, and menopausal hormonal changes likely contribute to the onset and progression of both conditions. These interactions underscore the importance of concurrently integrated care approaches that address both conditions. Effective management requires comprehensive screening, the recognition of contributing factors, and tailored exercise regimens supported by a multidisciplinary approach. Future research should focus on longitudinal studies tracking disease progression and evaluating the efficacy of multidisciplinary care models in optimizing patient outcomes.
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Affiliation(s)
- Yacov Grosman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 84105, Israel
- Department of Physical Therapy, Meuhedet Health Maintenance Organization, Hadera 3824242, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 84105, Israel
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Osman M, Cooper R, Sayer AA, Witham MD. The use of natural language processing for the identification of ageing syndromes including sarcopenia, frailty and falls in electronic healthcare records: a systematic review. Age Ageing 2024; 53:afae135. [PMID: 38970549 PMCID: PMC11227113 DOI: 10.1093/ageing/afae135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Recording and coding of ageing syndromes in hospital records is known to be suboptimal. Natural Language Processing algorithms may be useful to identify diagnoses in electronic healthcare records to improve the recording and coding of these ageing syndromes, but the feasibility and diagnostic accuracy of such algorithms are unclear. METHODS We conducted a systematic review according to a predefined protocol and in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were run from the inception of each database to the end of September 2023 in PubMed, Medline, Embase, CINAHL, ACM digital library, IEEE Xplore and Scopus. Eligible studies were identified via independent review of search results by two coauthors and data extracted from each study to identify the computational method, source of text, testing strategy and performance metrics. Data were synthesised narratively by ageing syndrome and computational method in line with the Studies Without Meta-analysis guidelines. RESULTS From 1030 titles screened, 22 studies were eligible for inclusion. One study focussed on identifying sarcopenia, one frailty, twelve falls, five delirium, five dementia and four incontinence. Sensitivity (57.1%-100%) of algorithms compared with a reference standard was reported in 20 studies, and specificity (84.0%-100%) was reported in only 12 studies. Study design quality was variable with results relevant to diagnostic accuracy not always reported, and few studies undertaking external validation of algorithms. CONCLUSIONS Current evidence suggests that Natural Language Processing algorithms can identify ageing syndromes in electronic health records. However, algorithms require testing in rigorously designed diagnostic accuracy studies with appropriate metrics reported.
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Affiliation(s)
- Mo Osman
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Rachel Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Miles D Witham
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
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Alex Albright J, Testa EJ, Chang K, Scott Paxton E, Daniels AH. Implant-related and medical complications in patients with sarcopenia undergoing total shoulder arthroplasty: A retrospective matched-cohort analysis. Shoulder Elbow 2024; 16:294-302. [PMID: 38818101 PMCID: PMC11135192 DOI: 10.1177/17585732231169500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 06/01/2024]
Abstract
Background In the continually aging United States population, the number of patients with sarcopenia who undergo shoulder arthroplasty may concomitantly increase. This retrospective cohort study aims to evaluate the rates of short-term implant-related and medical complications following shoulder arthroplasty in patients with and without a recent diagnosis of sarcopenia. Methods An exact 1:3 matched analysis of 4177 patients was performed using the PearlDiver database. Multivariable logistic regression was used to compare complications, Kaplan-Meier failure analysis was used to compare the cumulative hospital readmission rates. Two-sample T-testing was used to compare the 90-day cost of care. Results Sarcopenic patients were significantly more likely to experience postoperative shoulder instability (odds ratio (OR) = 2.32, 95% confidence interval (CI), 1.21-4.39) and periprosthetic infection (OR = 3.83, 95% CI, 1.74-8.67) within 1 year of their arthroplasty. Sarcopenic patients were at 25% and 41% greater risk of emergency department presentation and hospital readmission 1-year post-arthroplasty, respectively. Ninty-day total costs were greater among sarcopenics ($16 112.23 vs. 10 679.58, p < 0.001). Conclusion These results are important for orthopaedic surgeons counselling patients with a low muscle mass on the potential for increased complications after undergoing a total shoulder arthroplasty procedure.
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Affiliation(s)
- J Alex Albright
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Edward J Testa
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Kenny Chang
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - E Scott Paxton
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Alan H Daniels
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, RI, USA
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Song Y, Tian Y, Lu X, Chen G, Lv X. Prognostic value of 18F-FDG PET radiomics and sarcopenia in patients with oral squamous cell carcinoma. Med Phys 2024; 51:4907-4921. [PMID: 38252704 DOI: 10.1002/mp.16949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/28/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Oral cancer is one of the most common malignancies in the head and neck region. Approximately 90% of oral cancers are oral squamous cell carcinomas (OSCC). 18F-FDG PET/CT has been used in OSCC patients for its high value in detecting metastatic lymph nodes and distant metastases. PET radiomics and sarcopenia can be measured on the PET and CT components of 18F-FDG PET/CT. PURPOSE This study aimed to investigate the prognostic value of radiomics and sarcopenia measured on the PET and CT components of pre-operation 18F-FDG PET/CT in OSCC. METHODS A total of 116 patients eventually enrolled in our study were randomly divided into two cohorts: training cohort (n = 58) and validation cohort (n = 58). The Cox model combined with the least absolute shrinkage and selection operator (LASSO) algorithm was applied to construct the radiomics score (Rad_score). The third lumber skeletal muscle index (L3 SMI) was calculated to identify sarcopenia. Univariate and multivariate Cox regression analyses were performed to identify the independent prognostic factors. Based on the clinical factors, the clinical model was constructed, and the combined model was developed through the combination of the clinical model and Rad_score. C index, time-dependent C-index curves, receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis were used to evaluate the performance of prediction models. RESULTS Three radiomics features constitute the Rad_score for overall survival (OS) and progression-free survival (PFS), respectively. Multivariate Cox regression analysis revealed that Rad_score was an independent prognostic factor, whereas sarcopenia was not. The combined models showed satisfactory performance in both the training cohort (C-index: OS:0.836, PFS:0.776) and the validation cohort (C-index: OS:0.744, PFS:0.712). The combined models were visualized as nomograms. Nomogram scores can realize the risk stratification of OSCC patients. Lower nomogram score is significantly related to the poorer OS (training cohort: p < 0.0001, validation cohort: p < 0.0001, overall cohort: p < 0.0001) and PFS (training cohort: p < 0.0001, validation cohort: p = 0.00017, overall cohort: p < 0.0001). CONCLUSIONS Rad_score, but not sarcopenia, was an independent prognostic factor for patients with OSCC. The nomograms had a satisfactory performance, which might be helpful for OSCC patients and clinicians in personalized prognostic prediction and treatment decision-making.
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Affiliation(s)
- Yuxing Song
- Department of Oral & Maxillofacial Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Tian
- NanFang PET Center, Southern Medical University NanFang Hospital, Guangzhou, China
| | - Xinyan Lu
- Department of Oral & Maxillofacial Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Gaoxiang Chen
- Department of Oral & Maxillofacial Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaozhi Lv
- Department of Oral & Maxillofacial Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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She Y, He Y, Wu J, Liu N. Association between the sarcopenia-related traits and Parkinson's disease: A bidirectional two-sample Mendelian randomization study. Arch Gerontol Geriatr 2024; 122:105374. [PMID: 38452652 DOI: 10.1016/j.archger.2024.105374] [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: 12/14/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To explore the causal association between sarcopenia-related traits and Parkinson's disease by Mendelian randomization (MR) approach. METHODS A genome-wide association study (GWAS) of sarcopenia-related traits was done at the UK Biobank (UKB). The traits were appendicular lean mass, low hand grip strength (including the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health (FNIH) criteria and usual walking pace. The International Parkinson's Disease Genomics Consortium (IPDGC) gave us GWAS data for Parkinson's disease (PD). We used three different types of MR analyses: including Inverse-variance weighted (IVW), Mendelian randomized Egger regression (MR-Egger), and weighted median methods (both weighted and simple modes). RESULTS The MR analysis showed that low hand grip strength was negatively associated with the risk of developing Parkinson's disease, including EWGSOP criterion (odds ratio (OR) = 0.734; 95% confidence interval (CI) = 0.575-0.937, P = 0.013) and FNIH criterion (OR = 0.619; 95% CI = 0.419-0.914, P = 0.016), and usual walking pace was also a risk factor for Parkinson's disease (OR = 3.307, 95% CI = 1.277-8.565, P = 0.014). CONCLUSIONS In European population, low hand grip strength is negatively associated with the risk of developing Parkinson's disease, and usual walking pace is also a risk factor for Parkinson's disease. Further exploration of the potential genetic mechanisms underlying hand grip strength and Parkinson's disease and the potential relationship between walking pace, balance, and falls in Parkinson's patients may help to reduce the burden of sarcopenia and Parkinson's disease.
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Affiliation(s)
- Yingqi She
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no.447, Coloane, RAEM, 999078, Macau, China
| | - Yaming He
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no.447, Coloane, RAEM, 999078, Macau, China
| | - Jianwei Wu
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no.447, Coloane, RAEM, 999078, Macau, China.
| | - Ning Liu
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no.447, Coloane, RAEM, 999078, Macau, China.
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Yang Y, Sun M, Chen WM, Wu SY, Zhang J. Adverse postoperative outcomes in elderly patients with sarcopenia. BMC Geriatr 2024; 24:561. [PMID: 38937671 PMCID: PMC11212269 DOI: 10.1186/s12877-024-05066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 05/10/2024] [Indexed: 06/29/2024] Open
Abstract
PURPOSE No study has compared 30-day and 90-day adverse postoperative outcomes between old-age patients with and those without sarcopenia. PATIENTS AND METHODS We categorize elderly patients receiving major surgery into two groups according to the presence or absence of preoperative sarcopenia that were matched at a 1:4 ratio through propensity score matching (PSM). We analyzed 30-day or 90-day adverse postoperative outcomes and mortality in patients with and without sarcopenia receiving major surgery. RESULTS Multivariate logistic regression analyses revealed that the patients with preoperative sarcopenia were at significantly higher risk of 30-day postoperative mortality (adjusted odds ratio [aOR]. = 1.25; 95% confidence interval [CI]. = 1.03-1.52) and 30-day major complications such as postoperative pneumonia (aOR = 1.15; 95% CI = 1.00-1.40), postoperative bleeding (aOR = 2.18; 95% CI = 1.04-4.57), septicemia (aOR = 1.31; 95% CI = 1.03-1.66), and overall complications (aOR = 1.13; 95% CI = 1.00-1.46). In addition, surgical patients with sarcopenia were at significantly higher risk of 90-day postoperative mortality (aOR = 1.50; 95% CI = 1.29-1.74) and 90-day major complications such as pneumonia (aOR = 1.27; 95% CI = 1.10-1.47), postoperative bleeding (aOR = 1.90; 95% CI = 1.04-3.48), septicemia (aOR = 1.52; 95% CI = 1.28-1.82), and overall complications (aOR = 1.24; 95% CI = 1.08-1.42). CONCLUSIONS Sarcopenia is an independent risk factor for 30-day and 90-day adverse postoperative outcomes such as pneumonia, postoperative bleeding, and septicemia and increases 30-day and 90-day postoperative mortality among patients receiving major surgery. No study has compared 30-day and 90-day adverse postoperative outcomes between patients with and those without sarcopenia. We conducted a propensity score?matched (PSM) population-based cohort study to investigate the adverse postoperative outcomes and mortality in patients undergoing major elective surgery with preoperative sarcopenia versus those without preoperative sarcopenia. We demonstrated that sarcopenia is an independent risk factor for 30-day and 90-day adverse postoperative outcomes, such as postoperative pneumonia, bleeding, septicemia, and mortality after major surgery. Therefore, surgeons and anesthesiologists should attempt to correct preoperative sarcopenia, swallowing function, and respiratory muscle training before elective surgery to reduce postoperative complications that contribute to the decrease in surgical mortality.
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Affiliation(s)
- Yitian Yang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingyang Sun
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan.
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan.
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Management, College of Management, Fo Guang University, Yilan, Taiwan.
| | - Jiaqiang Zhang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
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Sumbal R, Abbas M, Sheikh SM, Sumbal A. Prevalence and Clinical Impact of Sarcopenia in Patients Undergoing Total Joint Arthroplasty: A Systematic Review and a Meta-Analysis. J Arthroplasty 2024:S0883-5403(24)00621-1. [PMID: 38901711 DOI: 10.1016/j.arth.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sarcopenia is a progressive loss of skeletal muscle mass and function. It is associated with adverse outcomes after several orthopaedic procedures. However, its role in total joint arthroplasty (TJA) is not fully explored. Therefore, we wanted to conduct a systematic review and meta-analysis to answer the following questions: (1) What is the prevalence of sarcopenia in patients undergoing TJA?; (2) What factors are associated with the prevalence of sarcopenia in patients undergoing TJA?; What is the impact of sarcopenia on medical outcomes following TJA?; and (4) What is the impact of sarcopenia on surgical outcomes following TJA? METHODS Electronic databases PubMed, Scopus, Cochrane, and Google Scholar were searched. The data were pooled using the random-effects model and graphically represented by a forest plot. We included a total of 13 studies, evaluating 399,097 patients. RESULTS The pooled prevalence of sarcopenia was 20.1% (95% confidence interval [CI] 13.6 to 28.8%; P < .00001; I2 = 94.7%) in total knee arthroplasty (TKA) and 5.2% (95% CI 0.1 to 69.7%; P = .128; I2 = 99.6%) in total hip arthroplasty (THA). Meta-regression found no links between age, sex, body mass index, diabetes, obesity, arthroplasty type, and sarcopenia prevalence in TJA. Sarcopenia increased risk of blood transfusion (odds ratio [OR] 4.68 [95% CI 3.51 to 6.25]; P < .00001), pneumonia (OR 1.94 [95% CI 1.14 to 3.30]; P = .01), urinary tract infection (UTI) (OR 1.64 [95% CI 1.31 to 2.05]; P < .001), prosthetic fracture (OR 2.12 [95% CI 1.51 to 2.98]; P < .0001), prosthetic dislocation (OR 1.99 [95% CI 1.62 to 2.44]; P < .00001), and mechanical loosening (OR 1.78 [95% CI 1.43 to 2.22]; P < .00001) in TKA. Sarcopenic patients were at an increased risk of UTI (OR 1.79 [95% CI 1.32 to 2.43]; P = .0002) and prosthetic loosening (OR 1.97 [95% CI 1.10 to 3.53]; P = .02) post-THA. CONCLUSIONS Baseline sarcopenia was prevalent in patients undergoing TJA. It was associated with an increased risk of UTI and prosthetic loosening following TKA and THA. Increased risk of blood transfusion, pneumonia, prosthetic fractures, and mechanical loosening following TKA.
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Affiliation(s)
- Ramish Sumbal
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Mudassir Abbas
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Anusha Sumbal
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Rios-Escalante V, Perez-Barba JC, Espinel-Bermudez MC, Zavalza-Gomez AB, Arias-Merino ED, Zavala-Cerna MG, Sanchez-Garcia S, Trujillo X, Nava-Zavala AH. Effects of a Multicomponent Preventive Intervention in Women at Risk of Sarcopenia: A Pilot Study. Healthcare (Basel) 2024; 12:1191. [PMID: 38921304 PMCID: PMC11203817 DOI: 10.3390/healthcare12121191] [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: 02/02/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
Sarcopenia is defined by the presence of decreased skeletal muscle mass, strength, and functionality in older people. Multicomponent interventions represent an alternative to non-pharmacological treatment for preventing disease progression. This study aimed to evaluate the effects of a multicomponent intervention approach in women at risk of sarcopenia. METHODS A quasi-experimental pilot study of 12 weeks was conducted, with 24 sessions of dancing and resistance exercises and 12 sessions of nutritional education. The outcomes were changes in muscle mass, grip strength, gait speed, and body composition. The project was registered on Clinical Trials: NCT06038500 (14 September 2023). RESULTS Twelve women aged 55-75 years participated in this study; after the intervention, changes were found in the following variables: grip strength, from 18.70 (17.98-19.23) at baseline to 21.57 (20.67-23.16) kg (p = 0.002); gait speed, from 0.95 (0.81-1.18) at baseline to 1.34 (1.20-1.47) m/s (p = 0.003); and hip circumference, from 99.75 (94.75-110.37) at baseline to 97.65 (93.92-109.50) cm (p = 0.023). Other measurements that appeared without changes were appendicular skeletal muscle mass, from 21.17 (18.58-22.33) at baseline to 20.77 (18.31-22.39) kg (p = 0.875), and the appendicular skeletal muscle mass index, from 8.64 (8.08-9.35) at baseline to 8.81 (7.91-9.38) kg/m2 (p = 0.875) after the intervention. CONCLUSIONS The three-month multicomponent intervention in women at risk of sarcopenia improved their grip strength and gait speed.
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Affiliation(s)
- Violeta Rios-Escalante
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
- Facultad de Medicina, Universidad de Colima, Colima 28040, Colima, Mexico
| | - Juan Carlos Perez-Barba
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
| | - Maria Claudia Espinel-Bermudez
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
- Facultad de Medicina, Universidad de Colima, Colima 28040, Colima, Mexico
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
- Unidad de Investigacion Biomedica 02, Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico
| | - Ana Bertha Zavalza-Gomez
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
| | - Elva Dolores Arias-Merino
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
| | - Maria G. Zavala-Cerna
- Unidad Academica Ciencias de la Salud, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico;
| | - Sergio Sanchez-Garcia
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Area Envejecimiento, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico 06720, Mexico;
| | - Xochitl Trujillo
- Centro Universitario de Investigaciones Biomedicas, Universidad de Colima, Colima 28040, Colima, Mexico;
| | - Arnulfo Hernan Nava-Zavala
- Unidad de Investigacion Epidemiologica y en Servicios de Salud, Centro Medico Nacional de Occidente Organo de Operación Administrativa Desconcentrada Jalisco, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico
- Programa Internacional de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico
- Departamento de Inmunologia y Reumatologia del Hospital General de Occidente, Secretaria de Salud Jalisco, Guadalajara 45170, Jalisco, Mexico
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Sato R, Vatic M, Peixoto da Fonseca GW, Anker SD, von Haehling S. Biological basis and treatment of frailty and sarcopenia. Cardiovasc Res 2024:cvae073. [PMID: 38828887 DOI: 10.1093/cvr/cvae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 12/20/2022] [Indexed: 06/05/2024] Open
Abstract
In an ageing society, the importance of maintaining healthy life expectancy has been emphasized. As a result of age-related decline in functional reserve, frailty is a state of increased vulnerability and susceptibility to adverse health outcomes with a serious impact on healthy life expectancy. The decline in skeletal muscle mass and function, also known as sarcopenia, is key in the development of physical frailty. Both frailty and sarcopenia are highly prevalent in patients not only with advanced age but also in patients with illnesses that exacerbate their progression like heart failure (HF), cancer, or dementia, with the prevalence of frailty and sarcopenia in HF patients reaching up to 50-75% and 19.5-47.3%, respectively, resulting in 1.5-3 times higher 1-year mortality. The biological mechanisms of frailty and sarcopenia are multifactorial, complex, and not yet fully elucidated, ranging from DNA damage, proteostasis impairment, and epigenetic changes to mitochondrial dysfunction, cellular senescence, and environmental factors, many of which are further linked to cardiac disease. Currently, there is no gold standard for the treatment of frailty and sarcopenia, however, growing evidence supports that a combination of exercise training and nutritional supplement improves skeletal muscle function and frailty, with a variety of other therapies being devised based on the underlying pathophysiology. In this review, we address the involvement of frailty and sarcopenia in cardiac disease and describe the latest insights into their biological mechanisms as well as the potential for intervention through exercise, diet, and specific therapies.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Guilherme Wesley Peixoto da Fonseca
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Stefan D Anker
- Department of Cardiology (CVK) of German Heart Center Charité; German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
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Zhang Y, Guo JY, Wang F, Li CW, Yu K. Start with muscle mass or muscle strength in diagnosis and management of sarcopenia? A systematic review of guidance documents. Asia Pac J Clin Nutr 2024; 33:247-271. [PMID: 38794984 PMCID: PMC11170015 DOI: 10.6133/apjcn.202406_33(2).0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/29/2024] [Accepted: 01/18/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND AND OBJECTIVES Sarcopenia has garnered extensive attention in clinical practice since its high prevalence and significant impact on clinical outcomes. Multiple organizations have published guidance documents on sarcopenia, offering evidence-based recommendations for clinical practice and/or research. We aimed to appraise the methodological quality of the included documents and synthesize available recommendations for the screening, diagnosis, and intervention of sarcopenia. METHODS AND STUDY DESIGN We conducted a search on PubMed, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, guideline database, and guideline organizations and professional societies websites for clinical practices, consensus statements and position papers in terms of sarcopenia, muscle atrophy or muscle loss published before April 17, 2023. The AGREE II instrument was used by three independent reviewers to assess the methodological quality of these documents. RESULTS Thirty-six guidance documents published between 2010 and 2023 were included. Seven documents fulfilled ≥ 50% of all the AGREE II domains. Seven underwent a Delphi process and six graded the strength of the recommendations. The process of screening (n=21), early diagnosis of sarcopenia (n=12), diagnosis of sarcopenia and severe sarcopenia (n=10), and management (n=21) were increasingly recommended. SARC-F (n=14) was the most recommended screening tool, and the assessment of muscle function was considered the first step in diagnosing sarcopenia. The management strategy for both age-related and disease-related sarcopenia mainly focused on exercise and nutrition intervention. CONCLUSIONS The guidance documents have provided referential recommendations that have great guiding significance. But the inconsistency in recommendations and variation in methodological rigour suggests that high-quality evidence is lacking yet.
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Affiliation(s)
- Yu Zhang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia-Yu Guo
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chun-Wei Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Abdulsalam AJ, Kara M, Özçakar L. Comment on: Sarcopenia in long-term survivors of cancer in childhood and adolescence: A cross-sectional study of calf muscle mass by peripheral quantitative computed tomography with an examination of the muscle-bone unit. Pediatr Blood Cancer 2024; 71:e30940. [PMID: 38472739 DOI: 10.1002/pbc.30940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Ahmad J Abdulsalam
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
- Department of Physical Medicine and Rehabilitation, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
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Rolland Y, Fielding R, Landi F, Vellas B. Implementing clinical operationalization of sarcopenia: the contribution of WHO ICOPE program. J Nutr Health Aging 2024; 28:100257. [PMID: 38714090 DOI: 10.1016/j.jnha.2024.100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/09/2024]
Affiliation(s)
- Yves Rolland
- IHU HealthAge, CERPOP UMR 1295, CHU Toulouse, France.
| | - Roger Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, USA
| | - Francesco Landi
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168 Rome, Italy
| | - Bruno Vellas
- IHU HealthAge, CERPOP UMR 1295, CHU Toulouse, France
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Xie WQ, He M, Yu DJ, Li HZ, Jin HF, Ji BZ, Yang G, Chen LL, Rahmati M, Li YS. Correlation study between bone metabolic markers, bone mineral density, and sarcopenia. J Endocrinol Invest 2024; 47:1559-1572. [PMID: 38097848 DOI: 10.1007/s40618-023-02252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To investigate the correlation between bone metabolism markers, bone mineral density (BMD), and sarcopenia. METHODS A total of 331 consecutive patients aged ≥ 60 years who were hospitalized between November 2020 and December 2021 were enrolled. Participants were divided into sarcopenia and non-sarcopenia groups according to the Asian Working Group on Sarcopenia criteria (AWGS, 2019). The clinical data, bone metabolism markers (β-CTX, N-MID, and TP1NP), and BMD were compared between the two groups. RESULTS Age, β-CTX, and N-MID of the sarcopenia group were higher than those of the non-sarcopenia group (P < 0.05), but the BMD T values were lower than those of the non-sarcopenia group (P < 0.05). Binary logistic regression analysis showed that increased femoral neck BMD (FNBMD) was a protective factor for sarcopenia, while increased β-CTX was a risk factor. Pearson/Spearman correlation analysis showed that the diagnostic indices of sarcopenia were positively correlated with FNBMD and negatively correlated with β-CTX and N-MID. Multiple linear regression analysis revealed that BMI and FNBMD significantly positively affected muscle strength and appendicular skeletal muscle mass (ASM). The FNBMD significantly positively affected physical performance, while β-CTX significantly negatively affected muscle strength, ASM, and physical performance. CONCLUSION Increased FNBMD may be a protective factor against sarcopenia, and increased β-CTX may be a risk factor. The FNBMD significantly positively affected the diagnostic indices of sarcopenia, while β-CTX significantly negatively affected them. BMD and bone metabolism marker levels may be considered in early screening for sarcopenia.
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Affiliation(s)
- W Q Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - M He
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - D J Yu
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H Z Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H F Jin
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - B Z Ji
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - G Yang
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - L L Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, 410000, Hunan, China
| | - M Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Y S Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Feng Y, Cheng X, Xu M, Zhao R, Wan Q, Feng W, Gan H. CT-determined low skeletal muscle index predicts poor prognosis in patients with colorectal cancer. Cancer Med 2024; 13:e7328. [PMID: 38924332 PMCID: PMC11196831 DOI: 10.1002/cam4.7328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Sarcopenia is highly prevalent among patients with colorectal cancer (CRC). Computed tomography (CT)-based assessment of low skeletal muscle index (SMI) is widely used for diagnosing sarcopenia. However, there are conflicting findings on the association between low SMI and overall survival (OS) in CRC patients. The objective of this study was to investigate whether CT-determined low SMI can serve as a valuable prognostic factor in CRC. METHODS We collected data from patients with CRC who underwent radical surgery at our institution between June 2020 and November 2021. The SMI at the third lumbar vertebra was calculated using CT scans, and the cutoff values for defining low SMI were determined using receiver operating characteristic curves. Univariate and multivariate analyses were performed to assess the associations between clinical characteristics and postoperative major complications. RESULTS A total of 464 patients were included in the study, 229 patients (46.7%) were classified as having low SMI. Patients with low SMI were older and had a lower body mass index (BMI), a higher neutrophil to lymphocyte ratio (NLR), and higher nutritional risk screening 2002 (NRS2002) scores compared to those with normal SMI. Furthermore, patients with sarcopenia had a higher rate of major complications (10.9% vs. 1.3%; p < 0.001) and longer length of stay (9.09 ± 4.86 days vs. 8.25 ± 3.12 days; p = 0.03). Low SMI and coronary heart disease were identified as independent risk factors for postoperative major complications. Moreover, CRC patients with low SMI had significantly worse OS. Furthermore, the combination of low SMI with older age or TNM stage II + III resulted in the worst OS in each subgroup analysis. CONCLUSIONS CT-determined low SMI is associated with poor prognosis in patients with CRC, especially when combined with older age or advanced TNM stage.
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Affiliation(s)
- Yue Feng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Xiao‐Hong Cheng
- Division of Gastrointestinal Surgery, Department of General Surgery, West China HospitalSichuan UniversityChengduSichuanChina
| | - Mei Xu
- Department of Gastroenterology and Hepatology, West China HospitalSichuan UniversityChengduSichuanChina
| | - Rui Zhao
- Division of Gastrointestinal Surgery, Department of General Surgery, West China HospitalSichuan UniversityChengduSichuanChina
| | - Qian‐Yi Wan
- Division of Gastrointestinal Surgery, Department of General Surgery, West China HospitalSichuan UniversityChengduSichuanChina
| | - Wei‐Hua Feng
- Department of Laboratory Medicine, West China HospitalSichuan UniversityChengduSichuanChina
| | - Hua‐Tian Gan
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
- Laboratory of Inflammatory Bowel Disease, the Center for Inflammatory Bowel Disease, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease‐Related Molecular Network, West China HospitalSichuan UniversityChengduChina
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Jiang M, Hua X, Wu M, Wu J, Xu X, Li J, Meng Q. Longitudinal changes in sarcopenia was associated with survival among cirrhotic patients. Front Nutr 2024; 11:1375994. [PMID: 38873566 PMCID: PMC11169581 DOI: 10.3389/fnut.2024.1375994] [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: 01/24/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background Sarcopenia is common in patients with liver cirrhosis and is an independent predictor of multiple clinical outcomes. Most studies to date have used a static assessment of sarcopenia. However, there is very limited data evaluating the temporal course of muscle area in cirrhosis. To bridge this gap in clinical studies, we performed a longitudinal analysis to evaluate the impact of changes in sarcopenia for cirrhotic patients. Methods Adult patients with clinically diagnosed liver cirrhosis who underwent at least 2 abdominal computed tomography (CT) scans in the hospital were enrolled. The interval between the two abdominal scans was 6 ± 1 months. Patients were categorized into persistent non-sarcopenia, new-onset sarcopenia, sarcopenia to non-sarcopenia, and persistent sarcopenia based on changes in sarcopenia. Kaplan-Meier method and Log-rank tests were used to separately compare unadjusted survival curves by different statuses of sarcopenia. Cox regression analysis was performed to assess the associations between different states of sarcopenia and overall mortality. The association between persistent non-sarcopenia and new-onset sarcopenia was analyzed by multivariate logistic regression analysis. Results A total of 307 patients were included for analysis. At the second assessment, 10.10% (31/307) patients were new-onset sarcopenia, 27.69% (85/307) with persistent sarcopenia status, while 13.03% (40/307) patients with sarcopenia developed non-sarcopenia and 49.19% (151/307) with persistent non-sarcopenia status. The overall survival rate was significantly lower in the persistent sarcopenia and new-onset sarcopenia than in the non-sarcopenia group and sarcopenia to non-sarcopenia group (p < 0.001). Persistent sarcopenia (HR 5.799, 95%CI 1.563-21.521, p = 0.009) and new onset sarcopenia (HR 5.205, 95%CI 1.482-18.282, p = 0.010) were identified as poor prognostic factors for cirrhotic patients. The etiology of cirrhosis and the initial skeletal muscle mass were independent risk factors for new-onset sarcopenia. Conclusion Sarcopenia is a dynamically changing process in patients with cirrhosis. Persistent and new-onset sarcopenia were independently and robustly associated with overall survival.
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Affiliation(s)
- Minjie Jiang
- Department of Medical Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Hepatology, Beijing, China
| | - Xin Hua
- Department of Clinical Nutrition, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Muchen Wu
- Department of Medical Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jing Wu
- Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiaotong Xu
- Department of Medical Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Juan Li
- Department of Medical Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Qinghua Meng
- Department of Medical Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
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Xie S, Wu Q. Association between the systemic immune-inflammation index and sarcopenia: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:314. [PMID: 38802828 PMCID: PMC11131329 DOI: 10.1186/s13018-024-04808-7] [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: 03/29/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Sarcopenia is associated with increased morbidity and mortality. The systemic immune-inflammation index (SII) has been correlated to a variety of disorders. The present study conducted a systematic review and meta-analysis to investigate the relationship between SII and sarcopenia. METHODS A literature search was performed in Web of Science, PubMed, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and VIP Chinese Science and Technology Database, from inception to March 2024. Then, the literature quality was assessed. After the heterogeneity test, a random effects or fixed effects model was applied to establish the forest plot, and investigate the relationship between SII and sarcopenia. Then, the sensitivity analysis and publication bias were examined. RESULTS Nine articles, which included 18,634 adults, were analyzed. Sarcopenic adults had higher SII levels, when compared to non-sarcopenic adults (standardized mean difference [SMD] = 0.66, 95% confidence interval [CI] = 0.22 - 0.19, p = 0.003). The high SII level was associated to the increased risk of sarcopenia (odds ratio = 1.52, 95% CI = 1.09-2.13, p = 0.01). In addition, the subgroup analysis revealed that the SII levels were higher in the sarcopenic group, when compared to the non-sarcopenic group, in elderly adults, as well as in adults with or without gastrointestinal disorders. The analysis was robust with a low risk of publication bias. CONCLUSIONS SII is closely associated to sarcopenia. Sarcopenic adults had elevated SII levels. The high SII level increased the risk of sarcopenia. Large scale multi-center prospective studies are required to validate these study findings.
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Affiliation(s)
- Siye Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Qi Wu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, Zhejiang, 310003, China.
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Boteta-Gomes MI, Aibar-Almazán A, Hita-Contreras F, de Loureiro NEM, Brandão-Loureiro VAF. Cross-Cultural Adaptation and Validation of the Portuguese Version of the SARC-F in Community-Dwelling Older Adults. Diagnostics (Basel) 2024; 14:1096. [PMID: 38893623 PMCID: PMC11172345 DOI: 10.3390/diagnostics14111096] [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: 03/21/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: The goal of this study was to analyze the reliability and validity of the Portuguese version of the SARC-F in older adults. (2) Methods: A total of 100 participants (77.1 ± 7.36 years, 73% women) were included in the study. In a first phase, the Portuguese SARC-F was adapted following the standardized forward-backward translation procedure, and internal consistency as well as inter-rater and test-retest reliability of the Portuguese SARC-F were analyzed. Secondly, clinical validation was evaluated by comparing the SARC-F total score with five operational definitions of sarcopenia and with other sarcopenia-related measurements. Discriminant validity, with respect to low muscle mass and strength and physical function were analyzed. (3) Results: The Portuguese SAR-F showed acceptable internal consistency (Cronbach α = 0.82), excellent inter-rater reliability (total score), and substantial to excellent test-retest reliability (ICC = 0.891 for the total score). Specificity ranged from 72.5% (FNIH) to 73.4 (IGWS), and negative predictive values went from 91.8% (EWGSOP1) to 97.3% (FNIH), but low sensitivity and positive predictive value were observed. The Portuguese SARC-F showed a moderate ability to discriminate people with low muscle strength (AUC = 0.78) and gait speed (AUC = 0.89). (4) Conclusions: The Portuguese SARC-F is a valid and reliable tool for ruling out sarcopenia in community-dwelling older adults and can discriminate between people with low handgrip strength and gait speed.
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Affiliation(s)
- Margarida Isabel Boteta-Gomes
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Nuno Eduardo Marques de Loureiro
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
- ISAMB, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Vânia Azevedo Ferreira Brandão-Loureiro
- Department of Arts, Humanities and Sport, Polytechnic Institute of Beja, 7800-295 Beja, Portugal (N.E.M.d.L.)
- SPRINT—Sport Physical activity and health Research & INnovation CenTter, 7800-295 Beja, Portugal
- ISAMB, University of Lisbon, 1649-028 Lisbon, Portugal
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Li Q, Cheng H, Cen W, Yang T, Tao S. Development and validation of a predictive model for the risk of sarcopenia in the older adults in China. Eur J Med Res 2024; 29:278. [PMID: 38725036 PMCID: PMC11084063 DOI: 10.1186/s40001-024-01873-w] [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: 01/30/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Sarcopenia is a progressive age-related disease that can cause a range of adverse health outcomes in older adults, and older adults with severe sarcopenia are also at increased short-term mortality risk. The aim of this study was to construct and validate a risk prediction model for sarcopenia in Chinese older adults. METHODS This study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), a high-quality micro-level data representative of households and individuals aged 45 years and older adults in China. The study analyzed 65 indicators, including sociodemographic indicators, health-related indicators, and biochemical indicators. RESULTS 3454 older adults enrolled in the CHARLS database in 2015 were included in the final analysis. A total of 997 (28.8%) had phenotypes of sarcopenia. Multivariate logistic regression analysis showed that sex, Body Mass Index (BMI), Mean Systolic Blood Pressure (MSBP), Mean Diastolic Blood Pressure (MDBP) and pain were predictive factors for sarcopenia in older adults. These factors were used to construct a nomogram model, which showed good consistency and accuracy. The AUC value of the prediction model in the training set was 0.77 (95% CI = 0.75-0.79); the AUC value in the validation set was 0.76 (95% CI = 0.73-0.79). Hosmer-Lemeshow test values were P = 0.5041 and P = 0.2668 (both P > 0.05). Calibration curves showed significant agreement between the nomogram model and actual observations. ROC and DCA showed that the nomograms had good predictive properties. CONCLUSIONS The constructed sarcopenia risk prediction model, incorporating factors such as sex, BMI, MSBP, MDBP, and pain, demonstrates promising predictive capabilities. This model offers valuable insights for clinical practitioners, aiding in early screening and targeted interventions for sarcopenia in Chinese older adults.
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Affiliation(s)
- Qiugui Li
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Hongtao Cheng
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Wenjiao Cen
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Tao Yang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shengru Tao
- Department of Healthcare-Associated Infection Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
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Sanchez-Tocino ML, Cigarrán S, Ureña P, González-Casaus ML, Mas-Fontao S, Gracia-Iguacel C, Ortíz A, Gonzalez-Parra E. Definition and evolution of the concept of sarcopenia. Nefrologia 2024; 44:323-330. [PMID: 38945744 DOI: 10.1016/j.nefroe.2023.08.007] [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: 05/24/2022] [Revised: 07/18/2023] [Accepted: 08/06/2023] [Indexed: 07/02/2024] Open
Abstract
Sarcopenia and dynapenia are two terms associated with ageing that respectively define the loss of muscle mass and strength. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) introduced the EWGSOP2 diagnostic algorithm for sarcopenia, which integrates both concepts. It consists of 4 sequential steps: screening for sarcopenia, examination of muscle strength, assessment of muscle mass and physical performance; depending on these last 3 aspects sarcopenia is categorised as probable, confirmed, and severe respectively. In the absence of validation of the EWGSOP2 algorithm in various clinical contexts, its use in haemodialysis poses several limitations: (a) low sensitivity of the screening, (b) the techniques that assess muscle mass are not very accessible, reliable, or safe in routine clinical care, (c) the sequential use of the magnitudes that assess dynapenia and muscle mass do not seem to adequately reflect the muscular pathology of the elderly person on dialysis. We reflect on the definition of sarcopenia and the use of more precise terms such as "myopenia" (replacing the classic concept of sarcopenia to designate loss of muscle mass), dynapenia and kratopenia. Prospective evaluation of EWGSOP2 and its comparison with alternatives (i.e. assessment of kratopenia and dynapenia only; steps 2 and 4) is proposed in terms of its applicability in clinical routine, resource consumption, identification of at-risk individuals and impact on events.
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Affiliation(s)
| | - Secundino Cigarrán
- Servicio de Nefrología, Unidad ERCA, Hospital Público da Mariña, Burela, Lugo, Spain
| | - Pablo Ureña
- Departamento de Diálisis, AURA Nord Saint Ouen, París, France; Departamento de Fisiología Renal, Necker Hospital, Universidad de París Descartes, París, France
| | | | - Sebastian Mas-Fontao
- Laboratorio de patología renal y diabetes, IIS-Fundación Jiménez Díaz/CIBERDEM, Madrid, Spain
| | | | - Alberto Ortíz
- Servicio de Nefrología e Hipertensión, Fundación Jiménez Díaz, Madrid, Spain
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Kim S, Ha YC, Kim DY, Yoo JI. Recent Update on the Prevalence of Sarcopenia in Koreans: Findings from the Korea National Health and Nutrition Examination Survey. J Bone Metab 2024; 31:150-161. [PMID: 38886972 PMCID: PMC11184149 DOI: 10.11005/jbm.2024.31.2.150] [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: 02/22/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND As recognized by the World Health Organization in 2016 with its inclusion in the International Classification of Diseases, Tenth Revision as M62.84, and by South Korea in 2021 as M62.5, the diagnostic guidelines for sarcopenia vary globally. Despite its prevalence in older populations, data on sarcopenia in Koreans aged 60 and above is scarce, highlighting the need for research on its prevalence in this demographic. METHODS Utilizing the 2022 Korea National Health and Nutrition Examination Survey dataset, sarcopenia was assessed among 1,946 individuals aged 60 or older according to the Asian Working Group for Sarcopenia 2019 criteria, incorporating grip strength and bioelectrical impedance analysis measurements. Statistical analyses were performed to differentiate categorical and continuous variables using logistic regression and Student's t-tests, respectively. RESULTS The prevalence of sarcopenia was found to increase with age, with the highest prevalence observed in the oldest age group (80 years and older). The overall prevalence of sarcopenia in our study population was 6.8%. Among men, the prevalence of sarcopenia was 5.5% in the 60 or older age group, 9.6% in the 70 or older age group, and 21.5% in the 80 or older age group. Among women, the prevalence of sarcopenia was 7.9%, 10.5%, and 25.9%, respectively. CONCLUSIONS This study highlights the significant burden of sarcopenia in elderly Koreans, particularly among the oldest individuals. These findings call for targeted interventions to manage and prevent sarcopenia, along with further research on its risk factors, consequences, and effective mitigation strategies.
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Affiliation(s)
- Shinjune Kim
- Department of Biomedical Research Institute, Inha University Hospital, Incheon,
Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul,
Korea
| | - Deog-Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul,
Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon,
Korea
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Gay-As MU, Lee SC, Lai FC. Sarcopenia Among Older People in the Philippines: A Scoping Review. Creat Nurs 2024; 30:133-144. [PMID: 38533549 DOI: 10.1177/10784535241239684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Aims: This review aimed to identify and map the evidence about sarcopenia among older Filipinos. Methods: Studies about sarcopenia among Filipinos aged 60 and above were included. All studies regardless of type, setting, language, and timeframe were reviewed. The Cochrane Library, Cumulative Index of Nursing and Allied Health, Embase, PubMed, and Health Research and Development Information Network were searched. The study was conducted per an a priori protocol and utilized the Joanna Briggs Institute guidance for scoping reviews. Results: From the 87 records identified, 20 studies published from 2013 to 2023 were eligible (≥ 5424 participants). The studies were varied; 11 cross-sectional, 2 conference lectures, 2 consensus reports, 1 meta-analysis, cohort study, case series, posthoc analysis, and continuing education. As to setting, 11 studies were conducted in the hospital and 4 in the community. On the level of prevention, 5 studies addressed the primary level, 10 studies secondary, and 2 studies both tertiary and secondary. The studies focused on: sarcopenia in a specific group (13 studies), consensus (4 studies), and education (3 studies). Conclusions: Sarcopenia studies among older Filipinos were limited. Most were hospital-based and involved patients with comorbidities. Some studies used sarcopenia assessment guidelines with Filipino normative references. Sarcopenia impacts the overall well-being of older Filipinos; hence more studies and health promotion programs are necessary.
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Affiliation(s)
- Mark U Gay-As
- School of Nursing, Taipei Medical University, Taipei City
- College of Nursing, Benguet State University in La Trinidad, Benguet, Philippines
| | - Shu-Chun Lee
- School of Gerontology and Long-term Care, Taipei Medical University, Taipei City
| | - Fu-Chih Lai
- School of Nursing, Taipei Medical University, Taipei City
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Zhang Y, Liu K, Zhan Y, Zhao Y, Chai Y, Ning J, Pan H, Kong L, Yuan W. Impact of Chinese herbal medicine on sarcopenia in enhancing muscle mass, strength, and function: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2024; 38:2303-2322. [PMID: 38419525 DOI: 10.1002/ptr.8154] [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: 04/07/2023] [Revised: 12/31/2023] [Accepted: 01/28/2024] [Indexed: 03/02/2024]
Abstract
Sarcopenia has become important to the public health with the increase in the aging population in society. However, the therapeutic effects of conventional approaches, including pharmacotherapy, exercise, and nutritional intervention, are far from satisfactory. Chinese herbal medicine is a new treatment format with interesting possibilities in sarcopenia has been widely practiced. The study aims to explore the effectiveness of Chinese herbal medicine in sarcopenia. We comprehensively searched the following electronic databases: Medline, EMBASE, APA PsycInfo, Cochrane Library, Web of Science, PubMed, and Chinese database from the establishment of the database to December 2022 (no language restrictions). Randomized controlled clinical studies on the use of Chinese herbal medicine in sarcopenia were selected in compliance with PRISMA guidelines. Review Manager and Stata were used for statistical analysis and the mean difference and standardized mean difference were adopted. Of 277 identified studies, 17 were eligible and included in our analysis (N = 1440 participants). The results showed that Chinese herbal medicine can improve total efficiency (RR = 1.29, 95% CI [1.21, 1.36], p < 0.00001) in sarcopenia and enhance muscle mass (SMD = 1.02, 95% CI [0.55, 1.50], p < 0.0001), and muscle strength measured by grip strength (SMD = 0.66, 95% CI [0.36, 0.96], p < 0.0001), measured by 60°/s knee extension peak TQ (MD = 5.63, 95% CI [-0.30, 11.57], p = 0.06) and muscle function measured by 6-meter walking speed (SMD = 1.34, 95% CI [0.60, 2.08], p = 0.0004), measured by the short physical performance battery of 1.50%, 95% CI (1.05, 1.95), measured by the EuroQoL 5-dimension of (SMD = 0.27, 95% CI [-0.10, 0.65], p = 0.16), suggesting that Chinese herbal medicine alone or combined with conventional treatment has ameliorating effect on sarcopenia. Chinese herbal medicine is a potential therapeutic strategy in sarcopenia. The funnel plot and Egger's test indicated publication bias. To confirm our conclusions, further high-quality studies should be conducted.
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Affiliation(s)
- Yujie Zhang
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kaoqiang Liu
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunfan Zhan
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ye Zhao
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongli Chai
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiawei Ning
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Pan
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei'an Yuan
- Clinical Research Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Raghavan P. Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke. Phys Med Rehabil Clin N Am 2024; 35:235-257. [PMID: 38514216 DOI: 10.1016/j.pmr.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Stroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early closure of the sensitive period and downstream changes in muscles, such as sarcopenia, muscle stiffness, and reduced cardiovascular capacity, and blood flow that impede recovery.
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Affiliation(s)
- Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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Rondanelli M, Gasparri C, Cavioni A, Sivieri C, Barrile GC, Mansueto F, Perna S. A Patented Dietary Supplement (Hydroxy-Methyl-Butyrate, Carnosine, Magnesium, Butyrate, Lactoferrin) Is a Promising Therapeutic Target for Age-Related Sarcopenia through the Regulation of Gut Permeability: A Randomized Controlled Trial. Nutrients 2024; 16:1369. [PMID: 38732615 PMCID: PMC11085744 DOI: 10.3390/nu16091369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Adequate diet, physical activity, and dietary supplementation with muscle-targeted food for special medical purposes (FSMP) or dietary supplement (DS) are currently considered fundamental pillars in sarcopenia treatment. The aim of this study is to evaluate the effectiveness of a DS (containing hydroxy-methyl-butyrate, carnosine, and magnesium, for its action on muscle function and protein synthesis and butyrate and lactoferrin for their contribution to the regulation of gut permeability and antioxidant/anti-inflammation activity) on muscle mass (assessed by dual X-ray absorptiometry (DXA)), muscle function (by handgrip test, chair test, short physical performance battery (SPPB) test, and walking speed test), inflammation (tumor necrosis factor-alpha (TNF-a), C-reactive protein (CRP), and visceral adipose tissue (VAT)) and gut axis (by zonulin). A total of 59 participants (age 79.7 ± 4.8 years, body mass index 20.99 ± 2.12 kg/m2) were enrolled and randomly assigned to intervention (n = 30) or placebo (n = 28). The skeletal muscle index (SMI) significantly improved in the supplemented group compared to the placebo one, +1.02 (CI 95%: -0.77; 1.26), p = 0.001; a significant reduction in VAT was observed in the intervention group, -70.91 g (-13.13; -4.70), p = 0.036. Regarding muscle function, all the tests significantly improved (p = 0.001) in the supplemented group compared to the placebo one. CRP, zonulin, and TNF-alpha significantly decreased (p = 0.001) in intervention, compared to placebo, -0.74 mg/dL (CI 95%: -1.30; -0.18), -0.30 ng/mL (CI 95%: -0.37; -0.23), -6.45 pg/mL (CI 95%: -8.71; -4.18), respectively. This DS improves muscle mass and function, and the gut muscle has emerged as a new intervention target for sarcopenia.
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Affiliation(s)
- Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy; (A.C.); (C.S.); (G.C.B.); (F.M.)
| | - Alessandro Cavioni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy; (A.C.); (C.S.); (G.C.B.); (F.M.)
| | - Claudia Sivieri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy; (A.C.); (C.S.); (G.C.B.); (F.M.)
| | - Gaetan Claude Barrile
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy; (A.C.); (C.S.); (G.C.B.); (F.M.)
| | - Francesca Mansueto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy; (A.C.); (C.S.); (G.C.B.); (F.M.)
| | - Simone Perna
- Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20019 Milano, Italy;
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Lei Y, Gan M, Qiu Y, Chen Q, Wang X, Liao T, Zhao M, Chen L, Zhang S, Zhao Y, Niu L, Wang Y, Zhu L, Shen L. The role of mitochondrial dynamics and mitophagy in skeletal muscle atrophy: from molecular mechanisms to therapeutic insights. Cell Mol Biol Lett 2024; 29:59. [PMID: 38654156 PMCID: PMC11036639 DOI: 10.1186/s11658-024-00572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024] Open
Abstract
Skeletal muscle is the largest metabolic organ of the human body. Maintaining the best quality control and functional integrity of mitochondria is essential for the health of skeletal muscle. However, mitochondrial dysfunction characterized by mitochondrial dynamic imbalance and mitophagy disruption can lead to varying degrees of muscle atrophy, but the underlying mechanism of action is still unclear. Although mitochondrial dynamics and mitophagy are two different mitochondrial quality control mechanisms, a large amount of evidence has indicated that they are interrelated and mutually regulated. The former maintains the balance of the mitochondrial network, eliminates damaged or aged mitochondria, and enables cells to survive normally. The latter degrades damaged or aged mitochondria through the lysosomal pathway, ensuring cellular functional health and metabolic homeostasis. Skeletal muscle atrophy is considered an urgent global health issue. Understanding and gaining knowledge about muscle atrophy caused by mitochondrial dysfunction, particularly focusing on mitochondrial dynamics and mitochondrial autophagy, can greatly contribute to the prevention and treatment of muscle atrophy. In this review, we critically summarize the recent research progress on mitochondrial dynamics and mitophagy in skeletal muscle atrophy, and expound on the intrinsic molecular mechanism of skeletal muscle atrophy caused by mitochondrial dynamics and mitophagy. Importantly, we emphasize the potential of targeting mitochondrial dynamics and mitophagy as therapeutic strategies for the prevention and treatment of muscle atrophy, including pharmacological treatment and exercise therapy, and summarize effective methods for the treatment of skeletal muscle atrophy.
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Affiliation(s)
- Yuhang Lei
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Mailin Gan
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Yanhao Qiu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Qiuyang Chen
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Xingyu Wang
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Tianci Liao
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Mengying Zhao
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Lei Chen
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Shunhua Zhang
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Ye Zhao
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Lili Niu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Yan Wang
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China
| | - Li Zhu
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China.
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China.
| | - Linyuan Shen
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, 611130, China.
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, College of Animal and Technology, Sichuan Agricultural University, Chengdu, 611130, China.
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Lu Y, Chen T, Hao N, Van Rechem C, Chen J, Fu T. Uncertainty Quantification and Interpretability for Clinical Trial Approval Prediction. HEALTH DATA SCIENCE 2024; 4:0126. [PMID: 38645573 PMCID: PMC11031120 DOI: 10.34133/hds.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/17/2024] [Indexed: 04/23/2024]
Abstract
Background: Clinical trial is a crucial step in the development of a new therapy (e.g., medication) and is remarkably expensive and time-consuming. Forecasting the approval of clinical trials accurately would enable us to circumvent trials destined to fail, thereby allowing us to allocate more resources to therapies with better chances. However, existing approval prediction algorithms did not quantify the uncertainty and provide interpretability, limiting their usage in real-world clinical trial management. Methods: This paper quantifies uncertainty and improves interpretability in clinical trial approval predictions. We devised a selective classification approach and integrated it with the Hierarchical Interaction Network, the state-of-the-art clinical trial prediction model. Selective classification, encompassing a spectrum of methods for uncertainty quantification, empowers the model to withhold decision-making in the face of samples marked by ambiguity or low confidence. This approach not only amplifies the accuracy of predictions for the instances it chooses to classify but also notably enhances the model's interpretability. Results: Comprehensive experiments demonstrate that incorporating uncertainty markedly enhances the model's performance. Specifically, the proposed method achieved 32.37%, 21.43%, and 13.27% relative improvement on area under the precision-recall curve over the base model (Hierarchical Interaction Network) in phase I, II, and III trial approval predictions, respectively. For phase III trials, our method reaches 0.9022 area under the precision-recall curve scores. In addition, we show a case study of interpretability that helps domain experts to understand model's outcome. The code is publicly available at https://github.com/Vincent-1125/Uncertainty-Quantification-on-Clinical-Trial-Outcome-Prediction. Conclusion: Our approach not only measures model uncertainty but also greatly improves interpretability and performance for clinical trial approval prediction.
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Affiliation(s)
- Yingzhou Lu
- School of Medicine,
Stanford University, Stanford, CA, USA
| | - Tianyi Chen
- Computer Science Department,
Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Nan Hao
- Stony Brook University Hospital, Stony Brook, NY, USA
| | | | - Jintai Chen
- Computer Science Department,
University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Tianfan Fu
- School of Medicine,
Stanford University, Stanford, CA, USA
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50
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Flores-Flores O, Zevallos-Morales A, Pollard SL, Checkley W, Siddharthan T, Hurst JR, Bernabé-Ortiz A, Runzer-Colmenares FM, Witham MD, Parodi JF. Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study. PLoS One 2024; 19:e0300224. [PMID: 38593158 PMCID: PMC11003669 DOI: 10.1371/journal.pone.0300224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru. METHODS This cross-sectional study was conducted between 2018 and 2020. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS2) guidelines. We measured muscle strength by maximum handgrip strength and muscle mass using bioelectrical impedance analyzer. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia. RESULTS The study participants had a mean age of 66.2 years (SD 7.1), age range between 60 to 92 years old, of which 621 (53.9%) were men. Among the sample, 41.7% were classified as obese (BMI ≥30.0 kg/m²). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI: 25.2-30.4) using the AWGS2 criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS2 criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3). CONCLUSION Our findings reveal substantial variation in the prevalence of sarcopenia and SO, underscoring the necessity for context-specific cut-off values. Although the prevalence of SO was relatively low, this result may be underestimated. Furthermore, the consistently high proportion of probable sarcopenia and sarcopenia point to a substantial public health burden.
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Affiliation(s)
- Oscar Flores-Flores
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru
- Asociación Benéfica PRISMA, Lima, Peru
| | - Alejandro Zevallos-Morales
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru
- Asociación Benéfica PRISMA, Lima, Peru
| | - Suzanne L. Pollard
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Trishul Siddharthan
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Division of Pulmonary and Critical Care, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - John R. Hurst
- UCL Respiratory, University College London, London, United Kingdom
| | | | - Fernando M. Runzer-Colmenares
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Lima, Peru
| | - Miles D. Witham
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jose F. Parodi
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Lima, Peru
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