1
|
Qiu W, Cai A, Li L, Feng Y. Trend in prevalence, associated risk factors, and longitudinal outcomes of sarcopenia in China: A national cohort study. J Intern Med 2024; 296:156-167. [PMID: 38801732 DOI: 10.1111/joim.13808] [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] [Indexed: 05/29/2024]
Abstract
AIMS To estimate the contemporary trend in the prevalence of sarcopenia and evaluate its risk factors and the longitudinal associations with multiple chronic conditions and mortality among Chinese middle-aged and older adults. METHODS This was a nationwide, prospective cohort study using data from the China Health and Retirement Longitudinal Study. The definition of sarcopenia was based on the Asian Working Group for Sarcopenia 2019 algorithm. In the cross-sectional analysis, we estimated the trend in the weighted prevalence of sarcopenia from 2011 to 2015 and examined the associated risk factors for sarcopenia severity in 2011. In the longitudinal analysis, we assessed the longitudinal associations between sarcopenia and 14 chronic conditions and mortality during a 9-year follow-up. RESULTS The weighted prevalence of sarcopenia remained consistently high in the overall population from 2011 (15.9%, 95% confidence intervals [CI]: 15.1, 16.6) to 2015 (15.0%, 95% CI: 14.3, 15.6; p for trend = 0.075). A range of risk factors were independently associated with the severity of sarcopenia, including older age, female sex, lower socioeconomic status, smoking status, malnutrition, and several chronic conditions. Possible sarcopenic and sarcopenic individuals had higher odds of several chronic conditions (i.e., heart disease, chronic lung disease, and memory-related disease) and increased risks of mortality (possible sarcopenia: odds ratios (OR): 1.66, 95% CI: 1.37, 2.00; sarcopenia: OR: 1.69, 95% CI: 1.36, 2.11) in 9 years of follow-up. CONCLUSIONS The prevalence of sarcopenia remained consistently high in the investigated population. Various risk factors were significantly associated with a higher prevalence of sarcopenia. Sarcopenic individuals had higher odds of several chronic conditions and increased risks of mortality, highlighting that the urgent need for dedicated efforts to improve the management of sarcopenic patients.
Collapse
Affiliation(s)
- Weida Qiu
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Anping Cai
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Liwen Li
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yingqing Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| |
Collapse
|
2
|
Zhu F, Guo J, Zheng W. Associations between sarcopenia and depression in middle-aged and older adults: the moderating effect of smoking. Sci Rep 2024; 14:15187. [PMID: 38956420 PMCID: PMC11219743 DOI: 10.1038/s41598-024-65343-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
The aim of this study were to estimate associations of sarcopenic status with depressive symptoms. We used mixed-effects linear model to estimate longitudinal association between sarcopenic status and rate of change in 10-item Center for Epidemiologic Studies Depression (CES-D) scores, and used Cox regression model to estimate the association between sarcopenic status and incident depression (CES-D ≥ 10). Stratification analyses were performed when the interactions between sarcopenic status and covariates were significant. A total of 6522 participants were ultimately included. After adjusting for covariates, participants with possible sarcopenia (β = 0.117; 95% CI 0.067 to 0.166; P < 0.001) and sarcopenia (β: 0.093; 95% CI 0.027-0.159; P < 0.001) had a faster increase in CES-D scores compared with normal individuals. Interactions between smoking and sarcopenic status were significant (Pinteraction < 0.05). We found significantly positive associations of sarcopenic status with CES-D scores in nonsmokers, but not in current and past smokers. Besides, compared with normal participants, those with possible sarcopenia (HR 1.15; 95% CI 1.05 to 1.27) and sarcopenia (HR 1.28; 95% CI 1.12 to 1.46) (Ptrend < 0.001) had elevated risks of incident depression. Sarcopenia is associated with a faster increase in CES-D scores and increased risks of depression among Chinese middle-aged and older adults. Stronger associations between sarcopenia and trajectory of CES-D scores were found in nonsmokers than in smokers.
Collapse
Affiliation(s)
- Feiyun Zhu
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China
| | - Jing Guo
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China.
| |
Collapse
|
3
|
Sato K, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Uchida S, Ueno K, Yamashita M, Noda T, Ogura K, Miki T, Hotta K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure. J Cardiol 2024; 84:59-64. [PMID: 38135146 DOI: 10.1016/j.jjcc.2023.12.003] [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: 09/11/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Diagnosing sarcopenia in heart failure (HF) patients is important, but how to assess skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients. METHODS We included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males). Sarcopenia was diagnosed using grip strength, usual gait speed, and skeletal muscle mass according to international criteria. We used mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MAMC), calf circumference (CC), and skeletal muscle mass index (SMI) assessed by bioelectrical impedance analysis to assess skeletal muscle mass and defined sarcopenia in each of these measurements. Prognostic outcomes were composite events (all-cause death and HF rehospitalization) and cardiovascular disease (CVD) events (CVD death and CVD rehospitalization). Quality of life (QOL) was assessed using the 36-item Short-Form Health Survey physical functioning (SF-36PF) score. RESULTS The sarcopenia defined by MUAC [hazard ratio (HR): 2.50; 95 % confidence interval (95 % CI): 1.64-3.81; p < 0.001] or MAMC (HR: 1.98; 95 % CI: 1.35-2.92; p = 0.001) were associated with higher composite event rates than the non-sarcopenia. The sarcopenia defined by MUAC (HR: 1.88; 95 % CI: 1.25-2.83; p = 0.002) or MAMC (HR: 1.70; 95 % CI: 1.16-2.49; p = 0.007) were associated with higher CVD event rates than the non-sarcopenia. The sarcopenia defined by CC or SMI were not associated with prognoses. The sarcopenia defined by MUAC, MAMC, or CC were associated with low SF-36PF scores (all p < 0.05). CONCLUSIONS These results suggest that a diagnosis of sarcopenia based on MUAC or MAMC rather than CC or SMI reflects prognosis and QOL in older HF patients.
Collapse
Affiliation(s)
- Kaoru Sato
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - Shota Uchida
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kensuke Ueno
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Division of Research, ARCE Inc., Sagamihara, Kanagawa, Japan
| | - Takumi Noda
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Ken Ogura
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Takashi Miki
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Kazuki Hotta
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| |
Collapse
|
4
|
Zeng N, Li C, Mei H, Wu S, Liu C, Wang X, Shi J, Lu L, Bao Y. Bidirectional Association between Sarcopenia and Depressive Symptoms among Chinese Middle- and Older-Aged Adults: Longitudinal Observational Study. Brain Sci 2024; 14:593. [PMID: 38928593 PMCID: PMC11201564 DOI: 10.3390/brainsci14060593] [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: 04/10/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The study aimed to examine the bidirectional relationship between sarcopenia and depressive symptoms in a national, community-based cohort study, despite the unclear temporal sequence demonstrated previously. METHODS Data were derived from four waves (2011 baseline and 2013, 2015, and 2018 follow-ups) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants aged 45 years or older who had baseline data on both sarcopenia status and depressive symptoms in 2011 were included in the study. For the two cohort analyses, a total of 8092 adults without depressive symptoms and 11,292 participants without sarcopenia in 2011 were included. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Depressive symptoms were defined as a score of 20 or higher on the 10-item Center for Epidemiologic Studies Depressive Scale (CES-D-10). Cox proportional hazard regression models were conducted to examine the risk of depressive symptoms and sarcopenia risk, while cross-lagged panel models were used to examine the temporal sequence between depressive symptoms and sarcopenia over time. RESULTS During a total of 48,305.1 person-years follow-up, 1262 cases of incident depressive symptoms were identified. Sarcopenia exhibited a dose-response relationship with a higher risk of depressive symptoms (HR = 1.7, 95%CI: 1.2-2.3 for sarcopenia, and HR = 1.5, 95%CI: 1.2-1.8 for possible sarcopenia, p trend < 0.001). In the second cohort analysis, 240 incident sarcopenia cases were identified over 39,621.1 person-years. Depressive symptoms (HR = 1.5, 95%CI: 1.2-2.0) are significantly associated with a higher risk of developing sarcopenia after multivariable adjustment (p < 0.001, Cross-lagged panel analyses demonstrated that depressive symptoms were associated with subsequent sarcopenia (β = 0.003, p < 0.001). Simultaneously, baseline sarcopenia was also associated with subsequent depressive symptoms (β = 0.428, p < 0.001). CONCLUSION This study identified a bidirectional relationship between depressive symptoms and sarcopenia. It seems more probable that baseline sarcopenia is associated with subsequent depressive symptoms in a stronger pattern than the reverse pathway. The interlinkage indicated that maintaining normal muscle mass and strength may serve as a crucial intervention strategy for alleviating mood disorders.
Collapse
Affiliation(s)
- Na Zeng
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Chao Li
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Huan Mei
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Shuilin Wu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Chang Liu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Xiaokun Wang
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
- National Clinical Research Center for Mental Disorders, Key of Mental Health, Ministry of Health (Peking University), Peking University Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Yanping Bao
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| |
Collapse
|
5
|
Iversen MKF, Buhl A, Schnieber A. Nutritional risk predicts readmission within 30 and 180 days after discharge among older adult patients across a broad spectrum of diagnoses. Clin Nutr ESPEN 2024; 61:288-294. [PMID: 38777446 DOI: 10.1016/j.clnesp.2024.03.027] [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: 10/29/2023] [Revised: 03/08/2024] [Accepted: 03/25/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND AND AIMS Hospital readmissions can have negative consequences for older adult patients, their relatives, the hospital, and society. Previous studies indicate that older adult patients who are at nutritional risk during hospital admission are at higher risk of readmission. There is a lack of studies investigating this relationship across different older adult patient groups while using recommended instruments and adjusting for relevant confounders. Thus, the aim of the present study was to investigate whether nutritional status according to the Nutrition Risk Screening 2002 during hospitalization predicted readmission among older adult patients within 30 and 180 days across a broad spectrum of wards and diagnoses when adjusting for age, sex, length-of-stay, diagnosis, and discharge destination. MATERIALS AND METHODS The present study is a retrospective cohort study based on registry data and included 21,807 older adult patients (≥65 years) hospitalized during a 5-year period. In order to investigate the relationship between nutritional risk and readmission, hierarchical logistic regression analyses with readmission within 30 days (n = 8371) and 180 days (n = 7981) as the dependent variable were performed. RESULTS Older adult patients at nutritional risk during the index admission were 1.44 times more likely to be readmitted within 30 days after discharge (P < 0.001), and 1.47 times more likely to be readmitted within 180 days after discharge (P < 0.001), compared to older adult patients who were not at nutritional risk during index admission when adjusting for age, sex, discharge destination, diagnosis group, and length-of-stay. CONCLUSIONS Our results highlight the importance of focusing on nutritional status in older adults as a factor in the prevention of readmissions, including ensuring that practices, resources, and guidelines support appropriate screening procedures. Because nutritional risk predicts readmission both in a 30-days and 180-days perspective, the results point to the importance of ensuring follow-up on the screening result, both in the hospital context and after discharge.
Collapse
Affiliation(s)
- Mette Kathrine Friis Iversen
- VIA University College, Department of Nutrition and Health, Hedeager 2, Aarhus N 8200, Denmark; VIA University College, Research Centre for Health and Welfare Technology, Hedeager 2, Aarhus N 8200, Denmark.
| | - Annette Buhl
- VIA University College, Department of Nutrition and Health, Hedeager 2, Aarhus N 8200, Denmark; VIA University College, Research Centre for Health and Welfare Technology, Hedeager 2, Aarhus N 8200, Denmark.
| | - Anette Schnieber
- VIA University College, Department of Nutrition and Health, Hedeager 2, Aarhus N 8200, Denmark; VIA University College, Research Centre for Health and Welfare Technology, Hedeager 2, Aarhus N 8200, Denmark.
| |
Collapse
|
6
|
Hu Z, Tang L, Zhan Y. Cognition as mediator of pulmonary function and risk of sarcopenia among older adults. BMC Public Health 2024; 24:1347. [PMID: 38762539 PMCID: PMC11102626 DOI: 10.1186/s12889-024-18848-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The relationship between lung function and sarcopenia remains ambiguous. The primary aim of this study was to investigate the potential association between lung function and sarcopenia in the older adults, as well as to examine the mediating role of cognitive function in this relationship. METHODS The participants were selected from a nationally representative population-based cohort in China. The peak expiratory flow (PEF) measurement was used to evaluate the lung function in older persons. The sarcopenia was diagnosed using the guidelines of the Asian Working Group for Sarcopenia (AWGS) in 2019. The Cox proportional hazard model was utilized to perform primary analyses of the relationship between PEF and sarcopenia. The mediating effect of cognitive function was evaluated using the counterfactual mediation method. RESULTS This cohort study included 4,011 older adults (average age, 66.6 years; 53.3% males). During a follow-up period of 3.86 years, 349 individuals were diagnosed with sarcopenia. After adjusting for potential confounders, each one-standard-deviation increase in PEF was associated with a 28% reduction in the risk of sarcopenia (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.63, 0.80). There was a significant mediation of cognition for the association between PEF and incident sarcopenia, and the proportion mediated was 12.2% (95% CI: 4.5%, 23.1%). CONCLUSIONS Older adults with impaired lung function are more likely to develop sarcopenia. Nevertheless, cognition can explain only a small portion of this association. Thus, other potential pathways between lung function and sarcopenia must be elucidated.
Collapse
Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
| | - Lu Tang
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Liu L, Zhang Y, Shi Y, Wu L, Meng L, Zhao T. The bidirectional relationship between sarcopenia and disability in China: a longitudinal study from CHARLS. Front Public Health 2024; 12:1309673. [PMID: 38774050 PMCID: PMC11106476 DOI: 10.3389/fpubh.2024.1309673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Objectives Sarcopenia and disability represent significant concerns impacting the health of older people. This study aimed to explore the bidirectional relationship between sarcopenia and disability in Chinese older people. Methods This study recruited older people ≥60 years old from the China Health and Retirement Longitudinal Study. In phase I, the study analyzed the relation between disability and subsequent sarcopenia using multinomial logistic regression models. Conversely, in phase II, the study assessed whether sarcopenia was associated with future disability using binary logistic regression models. Results In phase I, 65 (16.80%) new cases of possible sarcopenia, 18 (4.65%) cases of sarcopenia, and 9 (2.33%) cases of severe sarcopenia were observed in the disabled older people and 282 (10.96%) new cases of possible sarcopenia, 97 (3.77%) cases of sarcopenia, 35 (1.36%) cases of severe sarcopenia were observed in the older people without disability. The OR (95% CI) for sarcopenia in older disabled individuals compared to those without disability was 1.61 (1.25-2.07). Adjusting for all covariates in 2011, the OR (95% CI) value for disabled individuals vs. those without disability was 1.35 (1.02-1.79). Subgroup analyses showed that disabled participants aged < 80 years were more likely to have sarcopenia (OR = 1.42, 95% CI: 1.07-1.89), and the risk of sarcopenia did not differ significantly between sex subgroups. In phase II, 114 cases (33.83%) in the possible sarcopenia patients, 85 cases (28.91%) in the sarcopenia patients, 23 cases (35.94%) in the severe sarcopenia patients, and 501 cases (16.10%) in the individuals without sarcopenia showed symptoms of disability. The OR (95% CI) for disability was 2.66 (2.08-3.40) in the possible sarcopenia patients, 2.12 (1.62-2.77) in the sarcopenia patients, and 2.92 (1.74-4.91) in the severe sarcopenia patients compared with the no sarcopenia patients. After adjusting for all covariates in 2011, the OR (95% CI) values were 2.21 (1.70-2.85) in the possible sarcopenia patients, 1.58 (1.14-2.19) in the sarcopenia patients, and 1.99 (1.14-3.49) in the severe sarcopenia patients, as compared to the older people without sarcopenia. Subgroup analyses showed that compared with men, women with possible sarcopenia had a higher risk of disability (OR = 2.80, 95% CI: 1.98-3.97). In addition, participants aged < 80 years with sarcopenia or severe sarcopenia s were more likely to have disability (OR = 2.13, 95% CI: 1.52-2.98; OR = 2.98, 95% CI: 1.60-5.54). Conclusion The occurrence of disability increase the risk of sarcopenia in the older people, and baseline sarcopenia predicts the future disability in older people.
Collapse
Affiliation(s)
| | - Yan Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Shi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | | | | | | |
Collapse
|
9
|
Zhou S, Li L, Li S, Si H, Wu L, Shen B. The Negative Impacts of Sarcopenia on Primary Total Knee Arthroplasty under the Enhanced Recovery after Surgery Protocol. Orthop Surg 2024; 16:1160-1167. [PMID: 38556481 PMCID: PMC11062878 DOI: 10.1111/os.14053] [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: 10/03/2023] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Sarcopenia, as an emerging public health concern, has been associated with postoperative adverse outcomes in various surgical procedures. However, the evidence regarding the impacts of sarcopenia on total knee arthroplasty (TKA) remained limited. This study aimed to assess the impacts of sarcopenia on primary TKA based on the enhanced recovery after surgery (ERAS) protocol. METHODS This retrospective study included 291 patients who received unilateral TKA from October 2017 to May 2018 in our institution. Sarcopenia was diagnosed based on the algorithm of Asian Working Group for Sarcopenia 2019. The handgrip strength was measured using a handheld dynamometer and the muscle mass was estimated by a previously validated anthropometric equation. Patients were classified into sarcopenia group and non-sarcopenia group. The outcomes included complications, postoperative length of stay (LOS), total hospitalization cost, operative time, total estimated blood loss, blood transfusion rate, and the 12-item forgotten joint score (FJS-12) at the follow-up. The propensity score matching (PSM) was used to adjust confounding factors. We compared continuous variables using Student's t-test and the Wilcoxon Mann-Whitney U test for normal and non-normal distributions, respectively, and categorical variables with chi-square tests. RESULTS Of the 291 patients, 58 (19.9%) patients were identified as having sarcopenia. After PSM, each group matched 42 patients. All matched patients were followed-up at least 5 years. Patients with sarcopenia had higher rates of surgical complications compared to the non-sarcopenia group (p = 0.019), and no significant difference was observed in 30-day readmission, and periprosthetic joint infection. The sarcopenia group had significantly longer LOS (p = 0.038), higher total hospitalization (p = 0.015) than the non-sarcopenia group. For the FJS-12 scores at follow-up, patients with sarcopenia had significantly higher scores than the non-sarcopenia group (p = 0.024). CONCLUSION Our findings indicated sarcopenia may be a risk factor for postoperative complications, prolonged LOS, increased hospitalization cost and reduced patient satisfaction.
Collapse
Affiliation(s)
- Shengliang Zhou
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Lan Li
- Department of Endocrinology and Metabolism and Key Lab of Transplant Engineering and Immunology, NHFPC, West China HospitalSichuan UniversityChengduChina
| | - Shuai Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Haibo Si
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Limin Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Bin Shen
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| |
Collapse
|
10
|
Liu Q, Wang B, Huang Y, Bian Y, Li Y, Zhou W, Yu J, Chen H, Wang C. Joint trajectories of loneliness, social isolation and sarcopenia and associations with adverse outcomes: A prospective cohort study. Geriatr Nurs 2024; 57:132-139. [PMID: 38642489 DOI: 10.1016/j.gerinurse.2024.04.013] [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: 01/06/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
This study aimed to examine joint trajectories of loneliness, social isolation and sarcopenia and their associations with adverse outcomes. A total of 4701 participants aged ≥60 years who had a baseline and at least one follow-up assessment of loneliness, social isolation and sarcopenia across 2011, 2013 and 2015 waves in China Health and Retirement Longitudinal Study. Adverse outcomes were obtained in 2018 wave. Joint trajectories were fit using the parallel process latent class growth analysis, and their associations with adverse outcomes were evaluated using modified Poisson regression. Joint trajectory patterns for social relationship and sarcopenia did not vary by the assessment for sarcopenia, but did vary by the assessment for social relationship. Older adults exhibit distinct joint trajectories and those with persistent combination of loneliness or social isolation and sarcopenia experience greatest risk of adverse outcomes. These findings implicate integration of health care and social care for community-dwelling older adults.
Collapse
Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Binlin Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yuli Huang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Wendie Zhou
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Hejing Chen
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| |
Collapse
|
11
|
He L, Shi K, Chen X, Gao M, Han Y, Fang Y. Blood Profiles of Community-Dwelling People with Sarcopenia: Analysis Based on the China Health and Retirement Longitudinal Study. Gerontology 2024; 70:561-571. [PMID: 38657571 DOI: 10.1159/000537936] [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: 05/07/2023] [Accepted: 02/15/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Routine blood factors can be economical and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China. METHODS A total of 1,307 participants and 17 routine blood indices were selected from two waves (year 2011 and year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The diagnosis of sarcopenia was based on the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019). Generalized mixed-effects models were performed for association analyses. A logistic regression (LR) model was conducted to examine the predictive power of identifying significant blood factors for sarcopenia. RESULTS A higher sarcopenia risk was cross-sectionally associated with elevated blood concentrations of high-sensitivity C-reactive protein (hsCRP) (OR = 1.030, 95% CI [1.007, 1.053]), glycated hemoglobin (HbA1c) (OR = 1.407, 95% CI [1.126, 1.758]) and blood urea nitrogen (BUN) (OR = 1.044, 95% CI [1.002, 1.089]), and a decreased level of glucose (OR = 0.988, 95% CI [0.979, 0.997]). A higher baseline hsCRP value (OR = 1.034, 95% CI [1.029, 1.039]) and a greater over time change in hsCRP within 4 years (OR = 1.034, 95% CI [1.029, 1.039]) were associated with a higher sarcopenia risk. A higher BUN baseline value was related to a decreased sarcopenia risk over time (OR = 0.981, 95% CI [0.976, 0.986]), while a greater over time changes in BUN (OR = 1.034, 95% CI [1.029, 1.040]) and a smaller over time change in glucose (OR = 0.992, 95% CI [0.984, 0.999]) within 4 years were also related to a higher sarcopenia risk. LR based on significant blood factors (i.e., hsCRP, HbA1c, BUN, and glucose), and sarcopenia status in year 2015 yielded an area under the curve of 0.859 (95% CI: 0.836-0.882). CONCLUSION Routine blood factors involved in inflammation, protein metabolism, and glucose metabolism are significantly associated with sarcopenia. In clinical practice, plasma hsCRP, BUN, blood sugar levels, sex, age, marital status, height, and weight might be helpful for sarcopenia evaluation and monitoring.
Collapse
Affiliation(s)
- Lingxiao He
- School of Public Health, Xiamen University, Xiamen, China
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Kewei Shi
- School of Public Health, Xiamen University, Xiamen, China,
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China,
| | - Xiaodong Chen
- School of Public Health, Xiamen University, Xiamen, China
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Mingyue Gao
- School of Public Health, Xiamen University, Xiamen, China
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Yaofeng Han
- School of Public Health, Xiamen University, Xiamen, China
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, China
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| |
Collapse
|
12
|
Peng X, Zhou R, Liu C, Chen X, Zhu T, Chen G. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study. Open Med (Wars) 2024; 19:20240938. [PMID: 38584821 PMCID: PMC10998674 DOI: 10.1515/med-2024-0938] [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: 11/22/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Aim Abnormalities in sleep patterns are a common health problem for the older adults. The relationship between sarcopenia and sleep duration in older people is controversial. This research is to examine the association between sleep duration and sarcopenia. Methods We drew 21,095 adults from the China Health and Retirement Longitudinal Survey (CHARLS). Not only we explore the relationship between sleep duration and sarcopenia, but also compare sleep duration to three sarcopenia subcomponents. Moreover, the sensitivity analysis was conducted by the gender and residence area to ascertain the discrepancy, separately. Finally, using restricted cubic spline to find the non-linear association between them. Results Among 7,342 community older adults engaged by CHARLS in 2015, the incidence of possible sarcopenia and sarcopenia was 23.14 and 11.30%, separately. Sleep duration (≤6 h) [OR(95%CI) = 1.30(1.03-1.65), p < 0.05] and (≥8 h) [OR(95%CI) = 1.33(1.05-1.69), p < 0.05] were significantly linked with possible sarcopenia, while long sleep duration (≥8 h) [OR(95%CI) = 1.41(1.01-2.02), p < 0.05] was correlated strongly with sarcopenia. A non-linear relationship (U-shaped) between sarcopenia risk and sleep duration was found (p for non-linear = 0.009). Conclusions Our findings highlight the importance of sleep duration in the onset of sarcopenia and might assist older persons to maintain good sleeping habits.
Collapse
Affiliation(s)
- Xilin Peng
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Ruihao Zhou
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Congqi Liu
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Xudong Chen
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Zhu
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Wuhou District, Chengdu, Sichuan 610041, China
| | - Guo Chen
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Wuhou District, Chengdu, Sichuan 610041, China
| |
Collapse
|
13
|
Chen C, Ou Y, Cai A, Huang Y, Feng Y, Nie Z. Household use of solid fuel and sarcopenia among middle-aged and older adults: The China Health and Retirement Longitudinal Study. Maturitas 2024; 182:107925. [PMID: 38325137 DOI: 10.1016/j.maturitas.2024.107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/25/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Few studies have examined the effects of air pollution on the risk of sarcopenia, especially pollution in indoor settings. We explored the cross-sectional and longitudinal associations of household use of solid fuel for cooking and heating, separately and simultaneously, with risk of sarcopenia. METHODS Cross-sectional and follow-up data from the China Health and Retirement Longitudinal Study were used. Multivariable-adjusted generalized linear models and Cox proportional hazards regression models were performed to estimate the odds ratio and hazard ratio for sarcopenia, respectively. RESULTS 11,494 (median age: 57.0 years; 47.4 % males) and 7483 (median age: 57.0 years; 46.9 % males) participants were included in the cross-sectional and longitudinal study, respectively. After fully adjusting for covariates, including outdoor concentration of particulate matter (PM2.5), both the use of solid fuels for cooking and use for heating were positively associated with incident sarcopenia in the longitudinal analyses, with hazard ratios (95 % confidence interval) of 1.56 (1.28-1.89) and 1.26 (1.04-1.52), respectively. Moreover, significant multiplicative and/or additive interactions were observed between age, smoking and cooking with solid fuel and risk of sarcopenia (all P for interaction <0.05). Similar results were found in the cross-sectional analyses. CONCLUSIONS Household use of solid fuel was significantly associated with a higher risk of sarcopenia, while ageing and smoking had synergetic effects with burning solid fuels on the risk of sarcopenia. Our results highlight the importance of taking multi-pronged measures with respect to both air pollution and healthy lifestyle to prevent sarcopenia and promote healthy ageing.
Collapse
Affiliation(s)
- Chaolei Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yanqiu Ou
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Anping Cai
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yuqing Huang
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yingqing Feng
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Zhiqiang Nie
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Global Health Research Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| |
Collapse
|
14
|
Lu CF, Liu WS, Cang XM, Sun X, Wang XQ, Wang CH, Xu F. The bidirectional associations between sarcopenia-related traits and cognitive performance. Sci Rep 2024; 14:7591. [PMID: 38555389 PMCID: PMC10981681 DOI: 10.1038/s41598-024-58416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
While many studies have sought to explore the degree to which sarcopenia-related traits are associated with cognitive performance, these studies have yielded contradictory results without any clear indication of the causality of such relationships. In efforts to better understand associations between sarcopenia-related traits and cognitive ability, a series of multivariate linear regression assessments were carried out upon datasets derived through the National Health and Nutrition Examination Survey (NHANES). Of these, cognitive performance was assessed by the Digit Symbol Substitution Test (DDST), the Consortium to Establish a Registry for Alzheimer's Disease Immediate Recall Test (CERAD-IR), Delayed Recall Test (CERAD-DR) and Animal Fluency Test (AFT). Causal relationships between the two were further inferred via a two-sample Mendelian randomization (MR) analysis approach. Sarcopenia-related traits considered in these assessments included walking speed, appendicular skeletal muscle mass (ASM), and hand grip strength (HGS). Walking speed, ASM, and HGS were all significantly independently related to cognitive scores following adjustment for covariates. MR assessments also identified that each 1-SD higher walking speed and appendicular lean mass were causally and respectively associated with a 0.34 [standard error (SE) = 0.09; p < 0.001)] standardized score higher and a 0.07 (SE = 0.01; p < 0.001) standardized score higher cognitive score, whereas a higher hand grip strength was positively associated with a better cognitive performance. Reverse MR assessments also yielded similar findings. These data suggest that lower walking speed, muscle strength, and muscle mass were all closely related to lower cognitive performance irrespective of gender, and that there may be a mutually reinforcing relationship among these variables.
Collapse
Grants
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- HS2020005, JC202111 Science and Technology Support Program of Nantong
- HS2020005, JC202111 Science and Technology Support Program of Nantong
- MS22022001 Social and People's Livelihood Project of Nantong
- 2022LZ005 Clinical Research Program of Nantong University
- Social and People’s Livelihood Project of Nantong
Collapse
Affiliation(s)
- Chun-Feng Lu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Wang-Shu Liu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xiao-Min Cang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xin Sun
- Department of Anesthesiology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xue-Qin Wang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
| | - Chun-Hua Wang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
| | - Feng Xu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
| |
Collapse
|
15
|
Zhang Z. Association between sarcopenia and hearing impairment in middle-aged and elderly people in China: a prospective cohort study. Sci Rep 2024; 14:6061. [PMID: 38480872 PMCID: PMC10937624 DOI: 10.1038/s41598-024-56850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/12/2024] [Indexed: 03/17/2024] Open
Abstract
This study used longitudinal data from CHARLS 2011-2018 for cross-sectional and longitudinal analyses to investigate the relationship between sarcopenia and hearing impairment in middle-aged and elderly adults in China. The study selected 9723 participants aged 45 years and older from CHARLS 2011 and followed up in 2015 and 2018. Binary logistic regression and cox proportional risk regression models were used for testing. The results of the study showed that in the cross-sectional analysis, probable sarcopenia was significantly associated with hearing impairment compared with the group without sarcopenia [OR (95% CI) 0.342 (1.187, 1.669), p < 0.001], but sarcopenia was not significantly associated with hearing impairment. In the longitudinal analysis, middle-aged and elderly adults with sarcopenia [HR (95% CI) 0.354 (1.043, 1.945), p < 0.01] were more likely to have hearing impairment than those with probable sarcopenia and without sarcopenia. Probable sarcopenia was strongly associated with hearing impairment in middle-aged and elderly adults, whereas sarcopenia was a strong predictor of hearing impairment over the next 7 years. The results of this study emphasize the urgent need for measures to address sarcopenia in order to prevent and delay the decline in hearing function.
Collapse
Affiliation(s)
- Zeqi Zhang
- Management School, University of Liverpool, Liverpool, L69 3BX, UK.
| |
Collapse
|
16
|
Huang R, Li Y, Ma C, Ren R, Yuan X, Peng Y, Wang D. Adverse childhood experiences, sarcopenia, and social participation in older adults: a cohort study. BMC Public Health 2024; 24:711. [PMID: 38443827 PMCID: PMC10916056 DOI: 10.1186/s12889-024-18138-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES To examine the relationships between adverse childhood experiences (ACEs) and developing sarcopenia in older adults and the modifying effects of active social participation. METHODS This prospective cohort study used survey data from the China Health and Retirement Longitudinal Study, including baseline surveys from 2011, follow-up data from 2013, follow-up data from 2015, and information on ACEs from the 2014 Life History Survey. Information concerning 10 ACEs, including five threat-related ACEs and five deprivation-related ACEs before 17 years of age was obtained by questionnaires through face-to-face interviews. Sarcopenia status was assessed according to the Asian Working Group for Sarcopenia 2019 algorithm, consisted of low muscle mass, and low muscle strength, or poor physical performance. The relationship between ACEs, social participation, and sarcopenia was evaluated using Cox proportional hazard regression models. RESULTS The study population comprised 6859 older adults in main analyses. Having experienced ≥ 3 ACEs led to an increased 31% risk of developing sarcopenia (hazard ratio [HR]:1.31, 95% confidence interval [CI]:1.10-1.56). Participants having experienced ≥ 2 threat-related ACEs (HR:1.22, 95%CI:1.04-1.43) or deprivation-related ACEs (HR:1.22, 95%CI:1.02-1.46) had a 22% higher risk of developing sarcopenia. Active social participation significantly modified the association between ACEs (p < 0.05), especially threat-related ACEs (p < 0.05), and sarcopenia. CONCLUSIONS ACEs were associated with the development of sarcopenia; however, social participation had a modifying effect. These findings provide insights for early identification of vulnerable groups, advance intervention timing, and highlight the benefits of promoting active social participation among individuals with sarcopenia who have experienced ACEs.
Collapse
Affiliation(s)
- Runnian Huang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Yi Li
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Chunhua Ma
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Rui Ren
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Xiaoyue Yuan
- Department of Health Statistics, School of Public Health, China Medical University, 110122, Shenyang, Liaoning, China
| | - Yang Peng
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China.
| | - Difei Wang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, 110004, Shenyang, Liaoning, China.
| |
Collapse
|
17
|
Ramoo K, Hairi NN, Yahya A, Choo WY, Hairi FM, Ismail N, Peramalah D, Kandiben S, Ali ZM, Ahmad N, Abdul Razak I, Bulgiba A. Sarcopenia and All-Cause Mortality Risk in Community-Dwelling Rural Malaysian Older Adults. Asia Pac J Public Health 2024; 36:225-231. [PMID: 38482589 DOI: 10.1177/10105395241237811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
Collapse
Affiliation(s)
- Karthikeyanathan Ramoo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Public Health, Universitas Airlangga, Surabaya City, Indonesia
| | - Abqariyah Yahya
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Devi Peramalah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shathanapriya Kandiben
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - NurSakinah Ahmad
- Mental Health, Injury Prevention, Violence and Substance Abuse Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Awang Bulgiba
- Academy of Sciences Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
18
|
Wu W, Guo Z, Gu Z, Mao Y, She C, Gu J, Lv B, Xu W, Li L. GLIM criteria represent a more suitable tool to evaluate the nutritional status and predict postoperative motor functional recovery of older patients with hip fracture: A retrospective study. Medicine (Baltimore) 2024; 103:e37128. [PMID: 38335434 PMCID: PMC10860930 DOI: 10.1097/md.0000000000037128] [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: 09/28/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
Early recognition of malnutrition is essential to improve the prognosis of older patients with hip fracture. The Nutritional Risk Screening 2002 (NRS-2002), the Short-Form Mini Nutritional Assessment (MNA-SF) and the Global Leadership Initiative on Malnutrition (GLIM) are widely used in malnutrition diagnosis. However, criteria for predicting postoperative hip joint motor function in older patients with hip fractures are still necessary. The objective of this study was to select the most appropriate criteria from the NRS-2002, the MNA-SF and the GLIM in predicting the postoperative hip joint motor function recovery 1 year after surgery. This retrospective observational study included 161 patients aged ≥ 65 years with hip fractures. The nutritional status of patients was determined by the NRS-2002, MNA-SF and GLIM. The Harris hip joint score (HHS), the primary outcome of this study, was used to evaluate hip joint motor function. HHS was classified as excellent (HHS > 75) or non-excellent outcomes (HHS ≤ 75). Logistic regression models for hip joint motor function recovery were constructed. Both the receiver operating characteristic curve and the decision curve analysis were used to select the most predictive criteria. The overall mean age of the 161 patients was 77.90 ± 8.17. As a result, NRS-2002 (OR:0.06, 95%CI [0.01, 0.17]), MNA-SF (OR:0.05, 95%CI [0.00, 0.23]) and GLIM (OR of moderate: 0.03, 95%CI [0.01, 0.11]; OR of severe: 0.02 [0.00, 0.07]) were predictive for recovery of hip joint motor function. Additionally, both the area under curve of the receiver operating characteristic curve (NRS-2002: 81.2 [73.8, 88.6], MNA-SF: 76.3 [68.5, 84.2], GLIM: 86.2 [79.6,92.8]) and the decision curve analysis showed the GLIM was better than others. Compared with NRS-2002 and MNA-SF, GLIM was a more suitable nutritional assessment criteria to predict the postoperative recovery of hip joint motor function for older patients with hip fracture 1 year after surgery.
Collapse
Affiliation(s)
- Weicheng Wu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhening Guo
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zenghui Gu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongtao Mao
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chang She
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Gu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Lv
- Department of Pharmacy, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Xu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Liubing Li
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| |
Collapse
|
19
|
Liu T, Wu Y, Cao X, Yang K, Tong Y, Zhang F, Wang C, Cui R, Ren J, Li Q, Wang H, Liu C, Zhang J. Association between sarcopenia and new-onset chronic kidney disease among middle-aged and elder adults: findings from the China Health and Retirement Longitudinal Study. BMC Geriatr 2024; 24:134. [PMID: 38321394 PMCID: PMC10848350 DOI: 10.1186/s12877-024-04691-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Sarcopenia is a senile syndrome of age-related muscle loss. It is thought to affect the development of chronic kidney disease and has a serious impact on the quality of life of the elder adults. Little is known about the association between sarcopenia and new-onset chronic kidney disease in middle-aged and elder adults. Using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted a longitudinal analysis to investigate the association between sarcopenia status and new-onset chronic kidney disease in middle-aged and elder adults in China. METHODS The study population consisted of 3676 participants aged 45 or older selected from 2011 CHARLS database who had no history of chronic kidney disease at the baseline and completed the follow-up in 2015. A multivariate cox regression model was employed to examine the association between sarcopenia and the incidence of new-onset chronic kidney disease. RESULTS Followed up for 4 years, a total of 873 (22.5%) new cases of chronic kidney disease occurred. Among them, participants diagnosed with sarcopenia (HR1.45; 95% CI 1.15-1.83) were more likely to develop new-onset chronic kidney disease than those without sarcopenia. Similarly, patients with sarcopenia were more likely to develop new-onset chronic kidney disease than those with possible sarcopenia (HR 1.27; 95%CI 1.00-1.60). Subgroup analysis revealed that elder adults aged between 60 and 75 years old (HR 1.666; 95%CI 1.20-22.28), with hypertension (HR 1.57; 95%CI 1.02-2.40), people with sarcopenia had a significantly higher risk of developing new-onset chronic kidney disease than those without sarcopenia (all P < 0.05). CONCLUSION Middle-aged and elder adults diagnosed with sarcopenia have a higher risk of developing new-onset chronic kidney disease.
Collapse
Affiliation(s)
- Tong Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yang Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xirong Cao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kun Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yingmu Tong
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fengping Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Cong Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruixia Cui
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jie Ren
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qinglin Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hai Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chang Liu
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, Xi'an, China.
| | - Jingyao Zhang
- Department of SICU, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| |
Collapse
|
20
|
He YY, Jin ML, Chang J, Wang XJ. Associations of sarcopenia with peak expiratory flow among community-dwelling elderly population: based on the China Health and Retirement Longitudinal Study (CHARLS). Eur Geriatr Med 2024; 15:95-104. [PMID: 37466901 PMCID: PMC10876815 DOI: 10.1007/s41999-023-00838-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To cross-sectionally and longitudinally investigate the correlations of sarcopenia and its components with peak expiratory flow (PEF) among Chinese community-dwelling elderly people. METHODS The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4053 participants aged ≥ 60 years were enrolled from CHARLS 2011, and 2810 were followed up until 2015. Participants were classified into no-sarcopenia, non-severe sarcopenia, and severe sarcopenia groups based on skeletal muscle mass index (SMI), hand grip strength (HGS), and physical performance [gait speed, five-repetition chair stand test (5CST) and short physical performance battery (SPPB)]. Multivariate linear and logistic regression analyses were used to evaluate the associations of sarcopenia and its components with PEF cross-sectionally and longitudinally. RESULTS In the cross-sectional analysis, the prevalence of non-severe sarcopenia was 14.6% and severe sarcopenia was 4.9%. The results of linear regression analysis revealed that sarcopenia and its components were all correlated with PEF and PEF%pred. In the longitudinal analysis, compared with non-sarcopenia, subjects with severe sarcopenia were associated with a higher risk of PEF (OR = 2.05, 95%CI = 1.30-3.26) and PEF%pred (OR = 1.83, 95%CI = 1.17-2.86) decline. The changes in physical performance were correlated with changes in PEF and PEF%pred. No associations were observed between changes in SMI and PEF as well as PEF%pred. CONCLUSIONS We demonstrated the associations of baseline sarcopenia status with PEF and longitudinal PEF decline. Also, the changes in physical performance were associated with changes in PEF during a 4-year follow-up. It indicates that improving sarcopenia, especially physical performance may increase PEF.
Collapse
Affiliation(s)
- Yun-Yun He
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Mei-Ling Jin
- Department of Nephrology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jing Chang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiao-Juan Wang
- Department of General Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China.
| |
Collapse
|
21
|
Zhou W, Tong J, Wen Z, Mao M, Wei Y, Li X, Zhou M, Wan H. Prevalence and factors associated with dynapenia among middle-aged and elderly people in rural southern China. Prev Med Rep 2024; 38:102630. [PMID: 38375165 PMCID: PMC10874841 DOI: 10.1016/j.pmedr.2024.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 12/09/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
To estimate the prevalence of dynapenia and examine potential risk factors for dynapenia using a sample of rural middle-aged and elderly Chinese. A cross-sectional study of 253 Chinese adults aged 50 years and older was conducted from June to August in 2022 in Nanjing. A questionnaire was used to collect data on all socioeconomic variables. Body weight, height, body fat percentage, grip strength, waist circumference, calf circumference, and gait speed were measured. The prevalence of dynapenia was 69.6 %, 62.3 % in men and 72.7 % in women respectively. Binary logistic regressions indicated significant associations between dynapenia and age (odds ratio [OR] = 2.59; 95 % confidence interval [CI] 1.63, 4.12; p < 0.001), educational level (OR = 0.55; 95 % CI 0.38, 0.80; p = 0.002). Dynapenia was prevalent among rural middle-aged and elderly people in southern China. Age and lower education level were both associated with dynapenia. Nutrition and physical activity should be strongly recommended as important strategies to maintain and improve muscle strength.
Collapse
Affiliation(s)
- Wanqing Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Jiali Tong
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Zhiyu Wen
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Mao Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Yimin Wei
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Xiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Ming Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Hua Wan
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, 108 Longmian Avenue, Jiangning District, Nanjing 211166, China
| |
Collapse
|
22
|
Shi W, Li Y, Zhao JV. Long-term exposure to ambient air pollution with sarcopenia among middle-aged and older adults in China. J Nutr Health Aging 2024; 28:100029. [PMID: 38388113 DOI: 10.1016/j.jnha.2023.100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/19/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Few studies have examined the role of outdoor air pollution exposure in sarcopenia in Asia. We aimed to investigate the association of outdoor air pollutants exposure with sarcopenia among Chinese adults. METHODS This nationally population-representative study used data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, 11,700 participants at least 45 years old from 125 Chinese cities were included. Sarcopenia status was identified according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Ambient annual average air pollutants including fine particulate matter (PM2.5), inhalable particles (PM10), coarse particulate matter (PMcoarse), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) were estimated by satellite models and ground-based measurements. Multinomial logistic regression models were performed to examine the associations of air pollutants exposure with different status of sarcopenia (including possible sarcopenia and sarcopenia). Stratified analyses were utilized to assess the effect modifiers. RESULTS Among the 11,700 participants (52.6% women), the average age was 61.0 years. Each 10 μg/m3 increment of annual PMcoarse was associated with a higher risk of possible sarcopenia (odds ratio (OR) = 1.08, 95% confidence interval (CI) 1.04-1.11). Stratified analyses showed a positive risk of possible sarcopenia in women after exposure to PM10, PMcoarse, and NO2. Ambient NO2 exposure was positively associated with sarcopenia (OR = 1.13, 95% CI 1.04-1.22) in those aged 65 years and older. However, we have not observed differences by sex, age, residence, smoking, and drinking. Robustness results were found for PMcoarse in the sensitivity analyses. CONCLUSION This nationwide study suggested that long-term exposure to outdoor air pollution, especially for PMcoarse, was associated with the risk of sarcopenia among Chinese adults. Our findings provide epidemiological implications for protecting healthy ageing by improving air quality.
Collapse
Affiliation(s)
- Wenming Shi
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 999077, Hong Kong SAR, China
| | - Yongzhen Li
- Clinical Nutrition Department, Starkids Children's Hospital, Shanghai, New Hong Qiao Campus for Children's Hospital of Fudan University, Shanghai, 201106, China
| | - Jie V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 999077, Hong Kong SAR, China.
| |
Collapse
|
23
|
Okamura M, Kataoka Y, Taito S, Fujiwara T, Ide A, Oritsu H, Shimizu M, Shimizu Y, Someya R, Konishi M. Early mobilization for acute heart failure: A scoping and a systematic review. J Cardiol 2024; 83:91-99. [PMID: 37797714 DOI: 10.1016/j.jjcc.2023.09.009] [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: 06/07/2023] [Revised: 08/26/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023]
Abstract
Early mobilization of hospitalized patients is beneficial under certain circumstances. This has been applied in clinical practice for patients with acute heart failure (HF). However, its current definition, effectiveness, and safety are not well established. This review aimed to clarify the current definition of "early mobilization," and summarize its effectiveness and safety in acute HF. We conducted a scoping review to define early mobilization (Part 1) and a systematic review and meta-analysis (Part 2) to evaluate its effectiveness and safety. For Part 1, we searched MEDLINE (Ovid), and for Part 2, we searched the Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), Embase (ProQuest Dialog), CINAHL, and PEDro. We included 12 studies in Part 1 and defined early mobilization as protocol-based interventions or walking within 3 days of admission. Based on this definition, two observational studies were included in Part 2, with no randomized controlled trials. Early mobilization may result in a large reduction in the readmission rate compared with that of the control (two studies, 283 participants: odds ratio 0.25, 95 % confidence interval 0.14 to 0.42; I2 = 0 %; low certainty evidence). We could not define frequency, intensity, or quantity because many of the included studies did not describe them. In conclusions, our review suggests that early mobilization, defined as protocol-based interventions or walking within 3 days of admission, may be associated with a low readmission rate in patients with acute HF. Future studies are essential, to investigate the causal relationship between early mobilization and possible outcomes.
Collapse
Affiliation(s)
- Masatsugu Okamura
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Rehabilitation Medicine, School of Medicine, Yokohama City University, Yokohama, Japan; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yuki Kataoka
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan; Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Shunsuke Taito
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan; Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Takashi Fujiwara
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan; Kurashiki Clinical Research Institute, Kurashiki, Japan
| | - Atsushi Ide
- Department of Rehabilitation, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hideyuki Oritsu
- Department of Rehabilitation, Yokohama City University Hospital, Yokohama, Japan
| | - Masashi Shimizu
- Department of Rehabilitation, Osaka Metropolitan University Hospital, Osaka, Japan
| | - Yoshitaka Shimizu
- Department of Rehabilitation, Yokohama City University Medical Center, Yokohama, Japan
| | - Ryoko Someya
- Department of Rehabilitation, Yokohama City University Medical Center, Yokohama, Japan
| | - Masaaki Konishi
- Department of Cardiology, School of Medicine, Yokohama City University, Yokohama, Japan.
| |
Collapse
|
24
|
Sato S, Sezaki R, Shinohara H. Significance of preoperative evaluation of modified advanced lung cancer inflammation index for patients with resectable non-small cell lung cancer. Gen Thorac Cardiovasc Surg 2024:10.1007/s11748-023-02003-9. [PMID: 38246904 DOI: 10.1007/s11748-023-02003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/17/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES Body composition and systemic inflammation/nutrition have been identified as important clinical factors in cancer patients. The modified advanced lung cancer inflammation index (mALI), which combines body composition and systemic inflammation/nutrition, is defined as appendicular skeletal muscle index × serum albumin/neutrophil-lymphocyte ratio. This retrospective study aimed to investigate associations between preoperative mALI and surgical outcomes in non-small cell lung cancer (NSCLC) patients. METHODS We examined 665 patients with resectable stage I-III NSCLC who underwent pulmonary resection. Patients were divided into low-mALI (n = 168) and high-mALI (n = 497) based on the lower quartile. Kaplan-Meier curves and Cox regression analysis were used to assess the prognostic value of mALI. We then performed 1:1 propensity score matching (PSM) for high- and low-mALI to further investigate impacts on survival. RESULTS Overall survival (OS) and recurrence-free survival (RFS) were both significantly poorer in the low-mALI group than in the high-mALI group (58.2% vs. 79.6%, P < 0.001; 48.8% vs. 66.7%, P < 0.001, respectively). Multivariate analysis revealed low-mALI as an independent predictor of OS (hazard ratio [HR], 2.116; 95% confidence interval (CI) 1.458-3.070; P < 0.001) and RFS (HR, 1.634; 95% CI 1.210-2.207; P = 0.001). After PSM, low-mALI remained as an independent predictor of OS (HR, 2.446; 95% CI 1.263-4.738; P = 0.008) and RFS (HR 1.835; 95% CI 1.074-3.137; P = 0.026). CONCLUSION Preoperative mALI appears to offer an independent predictor of poor surgical outcomes as a simple, routinely available, and inexpensive biomarker in patients with resectable NSCLC.
Collapse
Affiliation(s)
- Seijiro Sato
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.
| | - Ryo Sezaki
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
| | - Hirohiko Shinohara
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
| |
Collapse
|
25
|
Pham LAT, Nguyen BT, Huynh DT, Nguyen BMLT, Tran PAN, Van Vo T, Bui HHT, Thai TT. Community-based prevalence and associated factors of sarcopenia in the Vietnamese elderly. Sci Rep 2024; 14:17. [PMID: 38168916 PMCID: PMC10761948 DOI: 10.1038/s41598-023-50979-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
Sarcopenia, a condition characterized by muscle mass decline, is one of the leading health problems in the elderly. This study determined the rate of sarcopenia according to criteria by Asian Working Group for Sarcopenia (AWGS) and related factors in elderly people. A community-based cross-sectional study was conducted in 632 people aged 60 years or over in Ho Chi Minh City. Data were collected through a predefined questionnaire and direct measurement. Sarcopenia was identified based on the Inbody 770 machine and AWGS criteria. The prevalence of sarcopenia was 32.0%. Participants with advanced age, low education, unemployment, low level of family economics and frailty were more likely to have sarcopenia. Among these, frailty had the highest impact on sarcopenia, with significantly higher odds of having sarcopenia found in participants with pre-frailty (OR = 4.80, 95% CI 2.75-8.38, p < 0.001) and frailty (OR = 21.16, 95% CI 8.96-49.97, p < 0.001). In contrast, BMI was inversely associated with sarcopenia. Sarcopenia is prevalent in the Vietnamese elderly. Apart from social demographic characteristics including age, education, employment and family economic status, frailty appeared to be an important risk factor. Early screening, referral, and treatment of sarcopenia among the elderly having a high risk of sarcopenia are recommended.
Collapse
Affiliation(s)
- Lan-Anh Thi Pham
- Department of Nutrition and Food, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Binh Thanh Nguyen
- Department of Medicine and Pharmacy, Tra Vinh University, 126 Nguyen Thien Thanh Street, Ward 5, Tra Vinh City, Tra Vinh Province, Vietnam.
| | - Dao Tieu Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Binh-Minh Le Thi Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Phuong-Anh Nhat Tran
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
- Laboratory Department, University Medical Center Ho Chi Minh City, 215 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Tam Van Vo
- Department of Nutrition and Food, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Hy-Han Thi Bui
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| | - Truc Thanh Thai
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam
| |
Collapse
|
26
|
Deng M, Lu Y, Li X, Zhou X, Hou G. Association between sarcopenia and multimorbidity among middle-aged and older adults in China: Findings from the China Health and Retirement Longitudinal Study. Exp Gerontol 2024; 185:112348. [PMID: 38128847 DOI: 10.1016/j.exger.2023.112348] [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: 10/02/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Little is known about the association between sarcopenia and multimorbidity among middle-aged and older adults. This study investigated whether sarcopenia is associated with multimorbidity in middle-aged and older Chinese individuals. MATERIALS AND METHODS A total of 12,760 participants from China Health and Retirement Longitudinal Study (CHARLS) 2015, with data on 14 specified chronic diseases and sarcopenia status were included in the cross-sectional analysis. A total of 7345 participants without multimorbidity from the CHARLS 2015 were included and followed up in 2018 in the longitudinal analysis. Logistic regression models were used in a cross-sectional investigation to assess the association between sarcopenia status and multimorbidity. In a longitudinal analysis, the relationships between sarcopenia status and multimorbidity were investigated using Cox proportional hazards models. RESULTS Multimorbidity was prevalent in the no sarcopenia, possible sarcopenia, and sarcopenia groups at 38.8 % (3765/9713), 56.6 % (1199/2118), and 48.5 % (451/929), respectively. Multivariable regression revealed that both possible sarcopenia (β = 0.088, P<0.001) and sarcopenia (β = 0.028, P = 0.009), contributed to the number of chronic diseases. Logistic regression revealed that possible sarcopenia (OR: 1.56, 95 % CI: 1.39-1.76) was associated with multimorbidity. In the longitudinal analysis, participants in the possible sarcopenia group (HR: 1.19, 95 % CI:1.03-1.38) were more prone to experience new onset multimorbidity than did participants in the no sarcopenia group. CONCLUSIONS Possible sarcopenia is associated with the development of multimorbidity in middle-aged and older Chinese populations. Health screening of populations with possible sarcopenia can facilitate early detection of multimorbidity.
Collapse
Affiliation(s)
- Mingming Deng
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, PR China
| | - Ye Lu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xuelian Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoming Zhou
- Respiratory Department, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Hou
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, PR China.
| |
Collapse
|
27
|
Liu YH, Ma LL, Hu LK, Cui L, Li YL, Chen N, Yang K, Zhang Y, Yan YX. The joint effects of sarcopenia and cardiometabolic risk factors on declined cognitive function: Evidence from a 7-year cohort study. J Affect Disord 2024; 344:644-652. [PMID: 37852588 DOI: 10.1016/j.jad.2023.10.056] [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: 04/19/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Sarcopenia and cardiometabolic risk factors are very common in the middle-aged and older population. This study aimed to explore the joint effect of sarcopenia and cardiometabolic risk factors on cognitive performance and cognitive decline. METHODS The definition of sarcopenia status was referenced in the AWGS 2019 algorithm. Linear regression models were used to explore the association of sarcopenia status with cognitive performance at baseline. Mixed effect models and multinomial logistic regression models were used to evaluate the long-term effect of sarcopenia status. The additive interaction between the effects of sarcopenia and cardiometabolic risk factors on cognitive performance was also evaluated. RESULTS In the cross-sectional analysis, sarcopenia and possible sarcopenia were associated with worse cognitive performance. In the longitudinal analysis, the participant with sarcopenia had a 0.34 [95 % CI (-0.43, -0.24)] lower global cognition score, and those with possible sarcopenia had a 0.20 [95 % CI (-0.27, -0.14)] lower global cognition score, compared with participants with no-sarcopenia. Sarcopenia and possible sarcopenia were identified as significant risk factors for cognitive decline. Sarcopenia combined with hypertension, type 2 diabetes, dyslipidemia, or abdominal obesity was associated with worse cognitive function. LIMITATIONS The assessment of cognitive function was not diagnosed accurately. CONCLUSIONS Sarcopenia and possible sarcopenia had adverse effects on cognitive performance and cognitive decline, sarcopenia combined with cardiometabolic risk factors can significantly enhance these effects. Therefore, the prevention of sarcopenia in the older population is crucial.
Collapse
Affiliation(s)
- Yu-Hong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China; Nanchang Center for Disease Control and Prevention, Nanchang 330038, China
| | - Lin-Lin Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Li-Kun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Lu Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yan-Ling Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Kun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| |
Collapse
|
28
|
Alhmly HF, Fielding RA. A Critical Review of Current Worldwide Definitions of Sarcopenia. Calcif Tissue Int 2024; 114:74-81. [PMID: 38043100 DOI: 10.1007/s00223-023-01163-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023]
Abstract
With the increasing number of elderly individuals worldwide, the prevalence of age-related loss of muscle mass, referred to as sarcopenia, is expected to increase. Sarcopenia is a relatively new recognized syndrome, which is thought to affect 13% individuals worldwide, and the significant efforts made by different groups have advanced our understanding of the diagnosis, treatment, and natural history of this condition. However, the challenge is now to standardize its measurement and diagnosis to facilitate research in this area and a greater understanding of this condition and its management between clinicians and researchers. The Global Leadership Initiative on Sarcopenia (GLIS) is at the forefront of an international effort to produce standardized definition of sarcopenia. Setting a definition for sarcopenia entails several considerations and trade-offs. In this critical review, we have addressed key challenges driving the process of standardizing the definition, while delving into future avenues in sarcopenia research. Establishing a clear consensus on the working definition of sarcopenia is essential not only for advancing research in this field but also for assessing the prognostic implications of diagnosing sarcopenia and determining the most suitable treatment for affected patients.
Collapse
Affiliation(s)
- Haya F Alhmly
- Jean Mayer USDA Human Nutrition Research Center on Aging, The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA.
- Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| |
Collapse
|
29
|
López Jiménez E, Neira Álvarez M, Menéndez Colino R, Checa López M, Grau Jiménez C, Pérez Rodríguez P, Vasquez Brolen B, Arias Muñana E, Ramírez Martín R, Alonso Bouzón C, Amor Andrés MS, Bermejo Boixareu C, Brañas F, Alcantud Ibáñez M, Alcantud Córcoles R, Cortés Zamora EB, Gómez Jiménez E, Romero Rizos L, Avendaño Céspedes A, Hernández Socorro CR, Abizanda P. Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study. J Nutr Health Aging 2024; 28:100010. [PMID: 38267149 DOI: 10.1016/j.jnha.2023.100010] [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: 10/28/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES The main objective was to analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs). DESIGN Prospective multicentric observational cohort study. SETTING Seven AGUs from University Hospitals in Spain. PARTICIPANTS Hospitalized adults ≥ 70 years old, able to ambulate and without severe dementia. MEASUREMENTS Ultrasound measurements of QRF were acquired at 2/3 distal between anterior-superior iliac spine and patella in both legs by trained Geriatricians. Ultrasound Chison model ECO2 was used. QRF area, thickness, edema, echogenicity, and fasciculations were measured. RESULTS From the complete sample (n = 143), in 45 (31.5%) participants, ultrasound images were classified as non-valid by an expert radiologist. Mean age was 87.8 (SD 5.4). Mean hospital stay 7.6 days (SD 4.3). From those with valid images, 36 (49.3%), 2 (2.7%), and 35 (47.9%) presented a decrease, equal values, or an increase in QRF area from baseline to discharge, respectively, and 37 (50.0%), 2 (2.7%), and 35 (47.3%) presented a decrease, equal values, or an increase in QRF thickness, respectively. 26 (35.6%) presented a decrease in more than 0.2 cm2 of QRF area, and 23 (31.1%) a decrease in more than 0.1 cm of QRF thickness. Only 4 (5.4%) patients presented new edema, while 13 (17.6%) worsened echogenicity. CONCLUSION One third of older adults develop significant muscle loss during a hospitalization for acute medical diseases. TRIAL REGISTRATION NUMBER NCT05113758.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Fátima Brañas
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Rubén Alcantud Córcoles
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa Belén Cortés Zamora
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Gómez Jiménez
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Luis Romero Rizos
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain
| | - Almudena Avendaño Céspedes
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | - Pedro Abizanda
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain.
| |
Collapse
|
30
|
Zhang J, Jia X, Li Y, Li H, Yang Q. The longitudinal bidirectional association between sarcopenia and cognitive function in community-dwelling older adults: Findings from the China Health and Retirement Longitudinal Study. J Glob Health 2023; 13:04182. [PMID: 38148730 PMCID: PMC10751559 DOI: 10.7189/jogh.13.04182] [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: 12/28/2023] Open
Abstract
Background Although an association between sarcopenia and cognitive function has been demonstrated, the directional association remains unclear. The present study aimed to evaluate the longitudinal reciprocal relationship and identify the possible temporal sequence between sarcopenia and cognitive function in older Chinese adults. Methods Data were collected from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey in 2011 and the follow-up survey in 2015. Cognitive function was measured by episodic memory and executive function. Sarcopenia status (non-sarcopenia, possible sarcopenia and sarcopenia) was defined based on the Asian Working Group for Sarcopenia 2019 criteria. Linear regression analysis and ordinal logistic regression analysis were employed to investigate the relationship between baseline sarcopenia status and follow-up cognition, as well as the association of baseline cognition with follow-up sarcopenia status, respectively. A cross-lagged panel analysis was performed to simultaneously evaluate the bidirectional association and the strength of the temporal relationship. Results Of 2689 participants, the median age was 65.0 years and 1249 (46.5%) were female. After adjusting for potential confounders and baseline measurements, baseline sarcopenia status was dose-dependently associated with subsequent cognitive scores (β = -0.45; P for trend = 0.001), and baseline cognitive scores (in tertiles) were also dose-dependently associated with subsequent sarcopenia status (odds ratio (OR) = 0.86; P for trend = 0.017). The cross-lagged panel analysis indicated that the standardised effect size of sarcopenia status on cognitive function (β = -0.09; P < 0.001) is larger relative to the effect of cognitive function on sarcopenia status (β = -0.05; P = 0.019). Conclusions There is a longitudinal, bidirectional relationship between sarcopenia status and cognitive function in older Chinese adults. Sarcopenia is likely the driving force in these dynamic associations. These findings imply that interventions in either sarcopenia or cognitive decline may have the ability to generate reciprocal benefits over time. More research is warranted to confirm these findings and to further elucidate underlying causal pathways.
Collapse
Affiliation(s)
- Jiajia Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiuqin Jia
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yingying Li
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Haibin Li
- Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China
- Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
| |
Collapse
|
31
|
Liu Q, Wang L, Ma Y, Geng Y. Association between dietary knowledge and muscle mass in Chinese older adults: a cross-sectional and longitudinal study. BMJ Open 2023; 13:e075964. [PMID: 38056943 PMCID: PMC10711816 DOI: 10.1136/bmjopen-2023-075964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES This study aims to explore the possible association between dietary knowledge and muscle mass in a Chinese population aged 60 years and above. DESIGN Cross-sectional and longitudinal studies. SETTING Data from the 2006 and 2011 China Health and Nutrition Survey (CHNS) were used for this study. PARTICIPANTS A total of 1487 Chinese participants (44.38% males) aged 60 and above in the 2006 survey were included in the cross-sectional study. From the same study population, a total of 1023 participants (46.82% males) with normal muscle mass on the interview date of 2006 were included in the longitudinal study. OUTCOME MEASURES Dietary knowledge was accessed by a validated CHNS questionnaire. Appendicular skeletal muscle mass was calculated using a validated anthropometric equation derived from a representative Chinese population. Based on the 2021 Chinese consensus on sarcopenia, the appendicular skeletal muscle mass was categorised as 'normal' or 'low' using sex-specific cut-off values. RESULTS The prevalence of low muscle mass in the study population was 31.20%, with a higher prevalence in females (34.22%). People with low muscle mass have a significantly lower dietary knowledge score (mean difference: -1.74, 95% CI -2.20 to -1.29). In the cross-sectional analysis, one score higher in dietary knowledge score was associated with a 4% lower odds of low muscle mass (OR=0.96, 95% CI 0.93 to 0.99). Compared with people in the lowest quartile of dietary knowledge, people in the highest quartile have a 44% lower odds of low muscle mass (OR=0.56, 95% CI 0.35 to 0.91). In the longitudinal analysis, no significant association was found between dietary knowledge and low muscle mass, yet the upper 95% CI was close to one (HR=0.97, 95% CI 0.93 to 1.01). CONCLUSIONS Sufficient dietary knowledge may play a protective role in maintaining normal muscle mass in Chinese adults aged 60 or above.
Collapse
Affiliation(s)
- Qiaoling Liu
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Luonan Wang
- Faculty of Business, Economics and Law, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Yuge Ma
- The First School of Clinical Medicine, Hainan Medical University, Haikou, Hainan, China
| | - Yunjie Geng
- Research Institute of Statistical Sciences, National Bureau of Statistics of China, Beijing, China
| |
Collapse
|
32
|
Hayashi T, Kataoka Y. Association Between Sarcopenic Complications and Readmission in a Kaifukuki Rehabilitation Ward: A Retrospective Cohort Study. Cureus 2023; 15:e50067. [PMID: 38186508 PMCID: PMC10769531 DOI: 10.7759/cureus.50067] [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] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives This study investigated the association between sarcopenia and readmission to the Kaifukuki Rehabilitation Ward. Methods We conducted a retrospective observational study in a Kaifukuki Rehabilitation Ward in Japan. Muscle mass was evaluated using a body composition analyzer (InBody, Tokyo, Japan). Grip strength was measured using a grip dynamometer, and walking speed was measured using a 10-meter walk test. Sarcopenia was characterized based on the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. The presence or absence of readmission was calculated from the medical charts. This study used Rstudio for statistical analysis (Posit, Boston, USA). To examine the effect of sarcopenia on readmissions, we used the Kaplan-Meier method to estimate readmissions. Differences between curves were assessed using the log-rank test. Results A total of 131 patients were selected during the target period (March 1, 2020, to August 31, 2021). Of these, 12 (9%) were readmitted during the study period. The median patient age was 83 years. The study population consisted of 53 males (40%) and 78 females (60%). Sixty (50%) patients in the no-readmission group and seven (58%) patients in the readmission group had sarcopenia. For readmission, the presence of sarcopenia yielded an unadjusted hazard ratio of 1.37 (95% confidence interval: 0.41 to 4.56) and an adjusted hazard ratio of 1.74 (95% confidence interval: 0.52 to 5.83). Conclusions Sarcopenia may be a prognostic factor for readmission in Kaifukuki Rehabilitation Wards. Therefore, further evaluation is necessary.
Collapse
Affiliation(s)
- Tomoki Hayashi
- Department of Rehabilitation, Kyoto Min-iren Asukai Hospital, Kyoto, JPN
| | - Yuki Kataoka
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, JPN
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, JPN
- Department of Systematic Reviewers, Scientific Research WorkS Peer Support Group, Kyoto, JPN
- Department of Internal Medicine, Kyoto Min-iren Asukai Hospital, Kyoto, JPN
- Department of Systematic Reviewers, Kyoto Min-iren Asukai Hospital, Kyoto, JPN
| |
Collapse
|
33
|
Sato Y, Yoshimura Y, Abe T, Nagano F, Matsumoto A. Hospital-associated sarcopenia and the preventive effect of high energy intake along with intensive rehabilitation in patients with acute stroke. Nutrition 2023; 116:112181. [PMID: 37678013 DOI: 10.1016/j.nut.2023.112181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Hospital-associated sarcopenia is prevalent and associated with poor outcomes in acutely admitted patients. Prevention of developing sarcopenia during hospitalization is an important factor in stroke management. Therefore, this study aimed to investigate whether energy intake and rehabilitation duration contribute to the prevention of hospital-associated sarcopenia in patients with acute stroke. METHODS Patients with acute stroke were included in this study. Energy intake during the first week of hospitalization was classified as "high" or "low" based on the reported cutoff value. Rehabilitation time during hospitalization was classified as "intense" or "mild" based on the median. The four groups were compared based on the combinations of high or low energy intake and intense or mild rehabilitation. The primary outcome was the development of sarcopenia during hospitalization. The secondary outcome was the Functional Independence Measure motor item gain during hospitalization. Multivariate analysis was performed with the primary or secondary outcome as the dependent variable and the effect of each group on the outcome was examined. RESULTS A total of 112 participants (mean age = 70.6 y; 63 men) were included in the study. Multivariate analysis found that high × intense (odds ratio = 0.113; P = 0.041) was independently associated with the development of sarcopenia during hospitalization (i.e., hospital-related sarcopenia). High × intense (β = 0.395; P < 0.001) was independently associated with the gain of Functional Independence Measure motor items. CONCLUSIONS In patients with acute stroke, the combination of high energy intake and adequate rehabilitation time is associated with prevention of hospital-associated sarcopenia.
Collapse
Affiliation(s)
- Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| |
Collapse
|
34
|
Shi W, Zhang T, Yu Y, Luo L. Association of indoor solid fuel use and long-term exposure to ambient PM 2.5 with sarcopenia in China: A nationwide cohort study. CHEMOSPHERE 2023; 344:140356. [PMID: 37802484 DOI: 10.1016/j.chemosphere.2023.140356] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Little is known about the association between air pollution exposure and sarcopenia in Asia. We aimed to investigate the associations of indoor solid fuel use and long-term exposure to ambient fine particulate matter (PM2.5) with sarcopenia in China. METHODS Using a nationally population-representative study, 12,723 participants aged at least 45 years across 125 cities from the China Health and Retirement Longitudinal Study were enrolled in 2011, and further 3110 participants were followed up until 2013. Sarcopenia status was classified according to the Asian Working Group for Sarcopenia 2019 criteria. Household fuel types used for heating and cooking were assessed using a standard questionnaire. Ambient annual PM2.5 was estimated using satellite-based spatiotemporal models. Multinomial logistic regression as well as the multiplicative interaction and additive interaction analysis were used to explore the associations of indoor solid fuel and ambient PM2.5 with different status of sarcopenia. RESULTS Of the 12,723 participants, 6071 (47.7%) were men. In the cross-sectional analyses, compared with clean fuel, using solid fuel for heating and cooking, separately or simultaneously, was significantly associated with a higher risk of both possible sarcopenia and sarcopenia. Each 10 μg/m3 increment of PM2.5 was positively related to possible sarcopenia (adjusted odds ratio, [aOR] 1.04, 1.02-1.07) and sarcopenia (1.06, 1.01-1.12). We found a significant interaction between solid fuel use for heating and ambient PM2.5 exposure with possible sarcopenia. During a two-year follow-up, solid fuel use was associated with incident possible sarcopenia (aOR 1.59, 1.17-2.15). These associations did not differ by sex and age, while participants living in a house with poor cleanliness might have a higher risk of sarcopenia. CONCLUSIONS Indoor solid fuel use and long-term exposure to ambient PM2.5 were associated with a higher risk of sarcopenia among Chinese adults. These findings provide implications for promoting healthy aging by reducing air pollution.
Collapse
Affiliation(s)
- Wenming Shi
- School of Public Health, Fudan University, Shanghai, 200032, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 999077, Hong Kong, China.
| | - Tiantian Zhang
- School of Social Development and Public Policy, Fudan University, Shanghai, 200433, China; Fudan University Center for Population and Development Policy Studies, Fudan University, Shanghai, 200433, China; Fudan Institute on Ageing, Fudan University, Shanghai, 200433, China
| | - Yongsheng Yu
- Chongqing Institute of Green and Intelligent Technology, Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai, 200032, China; Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
35
|
Wang M, Hu L, Peng H, Yao J, Zhang X, Zhang Z. The longitudinal association between indoor air pollution and sarcopenia in China: the mediating role of depression. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:115506-115516. [PMID: 37884706 DOI: 10.1007/s11356-023-30379-x] [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: 06/29/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023]
Abstract
Several studies showed that indoor air pollution may pose significant risks to public health, causing illnesses such as pulmonary and cardiovascular disorders. It is known very little of the association between air pollution and sarcopenia in older Chinese adults. We conducted a cohort study to examine the detrimental health effects of indoor solid fuel use for heating and cooking on sarcopenia and further explore the mediating role of depression and C-reaction protein (CRP). The sample of the study consists of 2088 participants from the CHARLS 2011-2015. Sarcopenia status was assessed according to the AWGS 2019 criteria. Participants were asked specific questions about the source of their primary heating and cooking fuels, which served as the basis for defining solid fuel use. Multivariate logistic regressions were constructed to explore the relationship between indoor solid fuel use and sarcopenia or possible sarcopenia. Serial mediation analyses were applied to explore the potential mediating role of depression and CRP in the relationship. Among all participants, 224 and 61 had possible sarcopenia or sarcopenia. Compared to individuals who used clean fuel for heating and cooking, participants who utilized indoor solid fuel for heating exhibited a higher risk of possible sarcopenia or sarcopenia, with OR (and 95% CI) of 1.48 (1.04, 2.11) and 8.42 (2.01, 35.32). The risk of possible sarcopenia demonstrates a gradual increase in correlation with the duration of solid fuel usage for heating (P for trend <0.01). Approximately 16.27% of the relationship between indoor solid fuel use and possible sarcopenia is mediated by depression. Our stratified analysis indicates that participants residing in a city/town are associated with higher odds of possible sarcopenia. Additionally, our sensitivity analysis demonstrates that our estimates are generally robust and consistent. Indoor heating using solid fuels is associated with a higher risk of sarcopenia, while prolonged exposure to household air pollution is found to be positively correlated with this increased risk. Furthermore, depression plays a mediating role in this relationship.
Collapse
Affiliation(s)
- Miyuan Wang
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029, China
- Department of Orthopedics, HuangGang Hospital of TCM Affiliated to Hubei University of Chinese Medicine, HuangGang, 438000, Hubei, China
| | - Lin Hu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan Province, China
| | - Hongye Peng
- Department of Infection, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Junjie Yao
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Xinyi Zhang
- College of Traditional Chinese Medicine, Tianjin University of Chinese Medicine, Tianjin, 301617, China
| | - Zheng Zhang
- Department of Orthopedics, HuangGang Hospital of TCM Affiliated to Hubei University of Chinese Medicine, HuangGang, 438000, Hubei, China.
- Basic Medicine College, Hubei University of Chinese Medicine, Wuhan, 430065, Hubei, China.
| |
Collapse
|
36
|
Cavalheiro A, Afonso S, Silva M, Ramalhão N, Machado J, Magalhães S. Evaluation of Probable Sarcopenia's Prevalence in Hospitalized Geriatric Patients Using Ishii's Score. Cureus 2023; 15:e49158. [PMID: 38130551 PMCID: PMC10733612 DOI: 10.7759/cureus.49158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sarcopenia is defined as a progressive loss of skeletal muscle mass and strength related to age and comorbidities. Worldwide sarcopenia's prevalence varies between 10-40%, being associated with functional impairment, lower quality of life, and higher mortality. Sarcopenia can be estimated based on age, calf circumference, and handgrip strength (Ishii's formula). Early diagnosis is essential because treatment with nutritional support and rehabilitation programs can prevent complications. The aim of the study was to assess the prevalence of probable sarcopenia in hospitalized patients using Ishii's score and possible associated risk factors. METHODS We developed an observational prospective study in a medicine inpatient ward of a Central Hospital. We applied Ishii's formula to the patients admitted to the medical ward in December 2021 and January 2022. Patients should be aged 60 or above and able to collaborate with the tests. One year later, we analyzed re-hospitalization and mortality rates. Patients with edema of the lower limbs, who were not able to follow instructions, and who were admitted exclusively for symptomatic treatment were excluded. RESULTS Our final sample was 49 patients (55% males, mean age 78 ± 8.88 years). Only one patient had a previous diagnosis of sarcopenia. Estimated sarcopenia´s prevalence was 73.5% N=36), higher in men and people with three or more comorbidities. In the sarcopenic group, 77% had some degree of functional dependency and positive markers for malnutrition. After one year of follow-up, we found a higher mortality rate in the sarcopenic group (44.4% against 7.6%) and a higher number of re-hospitalizations (1.03 hospitalizations per patient, against 0.31). CONCLUSIONS Our data showed that the prevalence of probable sarcopenia is high, but this pathology is still underdiagnosed. Traditional diagnosis is complex in some hospital settings and a simple tool such as Ishii's score can help to improve diagnostic rates. We suggest screening all patients at admission to provide early rehabilitation and nutritional support.
Collapse
Affiliation(s)
- Ana Cavalheiro
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Sara Afonso
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Marta Silva
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Nuno Ramalhão
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - João Machado
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Sandra Magalhães
- Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT
| |
Collapse
|
37
|
Han L, Jiang M, Ren X, Zheng X. Association Between Changes in Depressive Symptoms and Sarcopenia: Findings From a Nationwide Cohort Study. J Am Med Dir Assoc 2023; 24:1669-1676.e2. [PMID: 37516438 DOI: 10.1016/j.jamda.2023.06.019] [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: 02/15/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the association between changes in depressive symptoms and sarcopenia by repeated measures of depressive symptoms at a follow-up visit every 2 years. DESIGN Cross-sectional design and longitudinal design. SETTING AND PARTICIPANTS We conducted a cross-sectional and longitudinal study using data from the China Health and Retirement Longitudinal Study, which is a representative national survey. A total of 12,287 participants were included in Wave 1 (2011-2012) for the cross-sectional analysis, followed by a total of 5285 participants in Wave 2 (2013-2014) and Wave 3 (2015-2016) for the longitudinal analysis based on the cross-sectional analysis. METHODS Depressive symptoms were measured by the 10-item Center for the Epidemiological Studies of Depression Short Form. Sarcopenia was defined according to the Asian Sarcopenia Working Group criteria (AWGS 2019). Changes in depressive symptoms in Wave 1 and Wave 2 were used as exposure, and sarcopenia in Wave 3 was used as outcome. Cox proportional hazards regression model was used to test the relationship between changes in depressive symptoms and sarcopenia. RESULTS In cross-sectional analysis, depression was significantly associated with sarcopenia (odds ratio, 1.27; 95% CI, 1.10-1.48). In subsequent longitudinal analyses, a total of 174 sarcopenia events occurred, and those with increased depressive symptoms and persistent depressive symptoms were at higher risk for sarcopenia than those without depressive symptoms, with multivariable-adjusted hazard ratios of 1.65 (95% CI, 1.00-2.73) and 1.68 (95% CI, 1.06-2.68), respectively. CONCLUSIONS AND IMPLICATIONS People with increased depressive symptoms and persistent depressive symptoms may have a higher risk of developing sarcopenia over time. In the future, more research is needed to confirm the mechanism by which long-term changes in depression contribute to the risk of sarcopenia, and to propose preventive measures accordingly.
Collapse
Affiliation(s)
- Longyang Han
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Minglan Jiang
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Xiao Ren
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
| |
Collapse
|
38
|
Zhong Q, Jiang L, An K, Zhang L, Li S, An Z. Depression and risk of sarcopenia: a national cohort and Mendelian randomization study. Front Psychiatry 2023; 14:1263553. [PMID: 37920543 PMCID: PMC10618558 DOI: 10.3389/fpsyt.2023.1263553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/29/2023] [Indexed: 11/04/2023] Open
Abstract
Background Depression and the increased risk of sarcopenia are prevalent among the elderly population. However, the causal associations between these factors remain unclear. To investigate the potential association between depression and the risk of sarcopenia in older adults, this study was performed. Methods In the baseline survey, a total of 14,258 individuals aged 40 and above from the China Health and Retirement Longitudinal Study (2015) participated. We initially described the baseline prevalence of the disease. Then, logistic regression and restricted cubic spline (RCS) regression were conducted to assess the relationship between depression and sarcopenia. Subgroup analysis was performed to validate the robustness of the findings. Additionally, we conducted Mendelian randomization analysis using the inverse variance weighting estimator to assess the causal relationship between depression and sarcopenia. Furthermore, we adopted six methods, including MR-Egger, simple median, weighted median, maximum likelihood, robust adjusted profile score (RAPS), and MR Pleiotropy Residual Sum and Outlier (MR-PRESSO), for sensitivity analyses. Results Depression patients exhibited higher risks of sarcopenia in all five models adjusting for different covariates (P < 0.05). The RCS analysis demonstrated a linear relationship between depression and sarcopenia (P < 0.05). In the subgroup analysis, increased risk was observed among participants aged 60-70, married or cohabiting individuals, non-smokers, non-drinkers, those with less than 8 h of sleep, BMI below 24, and individuals with hypertension (all P < 0.05). Mendelian randomization results revealed that genetically proxied depression led to a reduction in appendicular skeletal muscle mass (all P < 0.05). Conclusion Our study provides observational and causal evidences that depression can lead to sarcopenia. This finding emphasizes the importance of timely identification and management of depression, as well as implementing targeted educational programs as part of comprehensive strategies to prevent sarcopenia.
Collapse
Affiliation(s)
- Qian Zhong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lisha Jiang
- Day Surgery Center of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kang An
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shuangqing Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmei An
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
39
|
Sunayama T, Fujimoto Y, Matsue Y, Dotare T, Daichi M, Yatsu S, Ishiwata S, Nakamura Y, Akama Y, Tsujimura Y, Suda S, Kato T, Hiki M, Kasai T, Minamino T. Prognostic value of estimating appendicular muscle mass in heart failure using creatinine/cystatin C. Nutr Metab Cardiovasc Dis 2023; 33:1733-1739. [PMID: 37407312 DOI: 10.1016/j.numecd.2023.05.031] [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: 11/28/2022] [Revised: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND AND AIMS Heart failure with concomitant sarcopenia has a poor prognosis; therefore, simple methods for evaluating the appendicular skeletal muscle mass index (ASMI) are required. Recently, a model incorporating anthropometric data and the sarcopenia index (i.e., serum creatinine-to-cystatin C ratio [Cre/CysC]), was developed to estimate the ASMI. We hypothesized that this model was superior to the traditional model, which uses only anthropometric data to predict prognosis. This retrospective cohort study compared the prognostic value of low ASMI as defined by the biomarker and anthropometric models in patients with heart failure. METHODS AND RESULTS Among 847 patients, we estimated ASMI using an anthropometric model (incorporating age, body weight, and height) in 791 patients and a biomarker model (incorporating age, body weight, hemoglobin, and Cre/CysC) in 562 patients. The primary outcome was all-cause mortality. Overall, 53.4% and 39.1% of patients were diagnosed with low ASMI (using the Asian Working Group for Sarcopenia cut-off) by the anthropometric and biomarker models, respectively. The two models showed a poor agreement in the diagnosis of low ASMI (kappa: 0.57, 95% confidence interval: 0.50-0.63). Kaplan-Meier curves showed that a low ASMI was significantly associated with all-cause death in both models. However, this association was retained after adjustment for other covariates in the biomarker model (hazard ratio: 2.32, p = 0.001) but not in the anthropometric model (hazard ratio: 0.79, p = 0.360). CONCLUSION Among patients hospitalized with heart failure, a low ASMI estimated using the biomarker model, and not the anthropometric model, was significantly associated with all-cause mortality.
Collapse
Affiliation(s)
- Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yudai Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maeda Daichi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shoichiro Yatsu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Sayaki Ishiwata
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Nakamura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuka Akama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichiro Tsujimura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shoko Suda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takao Kato
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
| |
Collapse
|
40
|
Wang H, Qiu H, Gu X, Zhang Y, Wang S. The association between sarcopenia and incident chronic lung disease in the general population: A longitudinal study based on CHARLS data. Exp Gerontol 2023; 180:112257. [PMID: 37467900 DOI: 10.1016/j.exger.2023.112257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Data regarding the association of sarcopenia with chronic lung disease (CLD) has led to inconclusive results. The main goal of this research was to investigate the association between sarcopenia and CLD in middle-aged and elderly individuals in China. METHODS The study sample consisted of 11,077 individuals without CLD at baseline chosen from the China Health and Retirement Longitudinal Study (CHARLS) data from 2015, followed up until 2018. Sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia (AWGS 2019) in 2019. Individuals were categorized into no-sarcopenia, possible-sarcopenia, and sarcopenia groups. The outcome of the study was considered to be incident CLD, which included chronic bronchitis, emphysema, pulmonary heart disease, and asthma. The association between sarcopenia and the risk of CLD was also examined by employing weighted Cox proportional hazard regression models. RESULTS A total of 356 (3.20 %) participants developed CLD during the 3.6-year follow-up period. The cumulative incidence of CLD in the no-sarcopenia, possible-sarcopenia, and sarcopenia groups was 2.80 % (230/8222), 4.37 % (55/1260), and 4.45 % (71/1595), respectively. Individuals with possible sarcopenia {hazard ratio [HR] [95 % confidence interval (CI)]: 1.48 [1.04-2.09]} and sarcopenia [HR (95 % CI): 1.68 (1.12-2.51)] demonstrated a considerably high risk of developing CLD compared to individuals in the no-sarcopenia group. Moreover, individuals diagnosed with sarcopenia, as per the criteria established by the European Working Group on Sarcopenia in Older People (EWGSOP) 2018, were at considerably high risk for developing CLD compared to those in the no-sarcopenia group. CONCLUSION This research involving adult Chinese individuals demonstrated a significant association between, possible sarcopenia and sarcopenia with an elevated risk of incident CLD, thereby emphasizing the importance of monitoring respiratory health in this population. KEY POINTS Question: Whether muscle mass and sarcopenia are associated with the development of chronic lung disease (CLD) in Asian middle-aged and elderly individuals. FINDINGS This longitudinal study encompassing 11,077 adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) data with 3.6 years of follow-up revealed a positive association between sarcopenia at baseline and incidence of CLD. Meaning: The findings suggest that possible sarcopenia and sarcopenia are linked to the development of CLD. Consequently, middle-aged and elderly individuals with possible sarcopenia and sarcopenia can be considered vulnerable regarding the primary prevention strategies for CLD.
Collapse
Affiliation(s)
- Hongxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Hongbin Qiu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Xia Gu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China.
| | - Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
| |
Collapse
|
41
|
Bae JH, Seo JW, Kim DY. Deep-learning model for predicting physical fitness in possible sarcopenia: analysis of the Korean physical fitness award from 2010 to 2023. Front Public Health 2023; 11:1241388. [PMID: 37614451 PMCID: PMC10443707 DOI: 10.3389/fpubh.2023.1241388] [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: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Physical fitness is regarded as a significant indicator of sarcopenia. This study aimed to develop and evaluate a deep-learning model for predicting the decline in physical fitness due to sarcopenia in individuals with potential sarcopenia. Methods This study used the 2010-2023 Korean National Physical Fitness Award data. The data comprised exercise- and health-related measurements in Koreans aged >65 years and included body composition and physical fitness variables. Appendicular muscle mass (ASM) was calculated as ASM/height2 to define normal and possible sarcopenia. The deep-learning model was created with EarlyStopping and ModelCheckpoint to prevent overfitting and was evaluated using stratified k-fold cross-validation (k = 5). The model was trained and tested using training data and validation data from each fold. The model's performance was assessed using a confusion matrix, receiver operating characteristic curve, and area under the curve. The average performance metrics obtained from each cross-validation were determined. For the analysis of feature importance, SHAP, permutation feature importance, and LIME were employed as model-agnostic explanation methods. Results The deep-learning model proved effective in distinguishing from sarcopenia, with an accuracy of 87.55%, precision of 85.57%, recall of 90.34%, and F1 score of 87.89%. Waist circumference (WC, cm), absolute grip strength (kg), and body fat (BF, %) had an influence on the model output. SHAP, LIME, and permutation feature importance analyses revealed that WC and absolute grip strength were the most important variables. WC, figure-of-8 walk, BF, timed up-and-go, and sit-and-reach emerged as key factors for predicting possible sarcopenia. Conclusion The deep-learning model showed high accuracy and recall with respect to possible sarcopenia prediction. Considering the need for the development of a more detailed and accurate sarcopenia prediction model, the study findings hold promise for enhancing sarcopenia prediction using deep learning.
Collapse
Affiliation(s)
- Jun-Hyun Bae
- Able-Art Sport, Department of Theory, Hyupsung University, Hwaseong, Gyeonggi-do, Republic of Korea
| | - Ji-won Seo
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Dae Young Kim
- Senior Exercise Rehabilitation Laboratory, Department of Gerokinesiology, Kyungil University, Gyeongsan, Gyeongsangbuk-do, Republic of Korea
| |
Collapse
|
42
|
Zhou S, Wu L, Si H, Shen B. Longitudinal Association between Uric Acid and Incident Sarcopenia. Nutrients 2023; 15:3097. [PMID: 37513515 PMCID: PMC10384494 DOI: 10.3390/nu15143097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Sarcopenia has emerged as a significant public health concern. Uric acid (UA), as a metabolite with excellent antioxidant capacity, has been found to be associated with sarcopenia. However, the casual effects of UA on incident sarcopenia still remain unclear. Our study aimed to explore the longitudinal association between UA and incident sarcopenia among middle-aged and older adults. METHOD A total of 5086 participants aged ≥45 years old without sarcopenia at baseline were included from the China Health and Retirement Longitudinal Study (CHARLS). Due to the sex differences, the UA levels were analyzed by categorizing into sex-specific quartiles or by using UA levels as a continuous variable (per 1 mg/dL). The longitudinal association between UA and incident sarcopenia was evaluated using Cox proportional hazards regression models. RESULTS During the 4-year follow-up period, 552 (10.85%) participants with incident sarcopenia were identified, of which 370 cases were males and 182 cases were females. Compared to the first quartile (Q1) UA levels, the Q3 and Q4 UA levels were significantly associated with lower risk of incident sarcopenia in males (Q3: adjusted hazard ratio (HR), 0.72; 95% CI (confidence interval), 0.54-0.97; Q4: HR, 0.57; 95% CI, 0.41-0.80). When UA was as a continuous variable (per 1 mg/dL), the association in males remained significant (HR: 0.87; 95% CI: 0.79-0.97). No significant association was observed in females. CONCLUSION Our findings indicated that UA was negatively associated with incident sarcopenia in males but not in females among middle-aged and older Chinese.
Collapse
Affiliation(s)
- Shengliang Zhou
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Limin Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haibo Si
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bin Shen
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
43
|
Luo S, Chen X, Hou L, Yue J, Liu X, Xia X, Cao L, Dong B. Cut-off points of the Ishii test to diagnosing severe sarcopenia among multi-ethnic middle-aged to older adults: results from the West China Health and Aging Trend study. Front Med (Lausanne) 2023; 10:1176128. [PMID: 37425295 PMCID: PMC10323675 DOI: 10.3389/fmed.2023.1176128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Objective This study was designed to establish the cut-off value and diagnostic utility of the Ishii test, which gauges the odds of severe sarcopenia based on the results of an equation based upon age, grip strength, and calf circumference among middle-aged and older adults in Western China. Methods This study incorporated adults ≥ 50 years of age from the West China Health and Aging Trend (WCHAT) study. Severe sarcopenia was defined as per the Asian Working Group for Sarcopenia: 2019 Consensus (AWGS2019) recommendations, with the odds of severe sarcopenia being estimated with the Ishii test score chart. The diagnostic utility of the Ishii test in this patient cohort was assessed by analyzing its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve (AUC). Results In total, 4,177 individuals ≥ 50 years of age were included in this study including 2668 females (63.9%) and 1,509 males (36.1%). These included 568 (13.6%) participants affected by severe sarcopenia, of whom 237 were male (15.7%) and 331 were female (12.4%). Optimal Ishii test cut-off values established based on Youden's index were ≥ 114 for males and ≥ 120 for females when using the AWGS2019 reference standard. The sensitivity/specificity/PPV/NPV of the Ishii test when screening for severe sarcopenia were 89.45%/77.15%/0.42/0.98 in males and 90.03%/77.05%/0.36/0.98 in females. The AUC values for the Ishii test in males and females were 0.899 (95% CI, 0.883-0.916) and 0.905 (95% CI, 0.892-0.917), respectively. Conclusion These data indicate that the Ishii test offers value as a candidate diagnostic test that can be used to screen for severe sarcopenia, with recommended diagnostic cut-off values of ≥ 114 for males and ≥ 120 for females.
Collapse
Affiliation(s)
- Shuyue Luo
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyan Chen
- Zigong Psychiatric Research Center, Zigong Affiliated Hospital of Southwest Medical University, Zigong, China
| | - Lisha Hou
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Li Cao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
44
|
Zhang F, Li T, Chen B, Li N, Zhang X, Zhu S, Zhao G, Zhang X, Ma T, Zhou F, Liu H, Zhu W. Air pollution weaken your muscle? Evidence from a cross-sectional study on sarcopenia in central China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 258:114962. [PMID: 37121078 DOI: 10.1016/j.ecoenv.2023.114962] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND As the world experiences a demographic shift towards aging populations, there will be a significant surge in the number of sarcopenia patients, along with an unprecedented expansion in the associated economic burden. The multitudinous risk factors for sarcopenia have been reported, but evidence for air pollution remains rare. METHODS This cross-sectional study employed multi-stage random sampling to select 1592 participants over 40 years of age from Hubei Province. Daily mean concentrations of air pollutants were collected ChinaHighAirPollutants dataset. Unconditional logistic regression models were utilized to investigate the associations between air pollution and sarcopenia. RESULTS For each 1 μg/m3 increase in PM2.5, PM10, SO2 and O3, there were corresponding elevations of 11.1% [95% confidence interval (CI): 4.9, 17.7], 4.3% (95% CI: 1.4, 7.2), 22.6% (95% CI: 7.2, 40.1) and 9.3% (95% CI: 0.7, 18.7) in the risk of sarcopenia, respectively. The associations of PM2.5/PM10/O3-sarcopenia were more pronounced in females, with corresponding odds ratios (ORs) and 95% CIs of 1.179 (1.062, 1.310), 1.079 (1.027, 1.135) and 1.180 (1.026, 1.358), separately. Additionally, individuals residing in rural areas were more susceptible to the effects of PM2.5 and PM10. Current/ever smokers or drinkers were also at higher risk of developing sarcopenia caused by PM2.5, PM10 and O3 exposure. Mixture analyses show a surge of 48.4% (95% CI: 3.6%, 112.5%) in the likelihood of suffering from sarcopenia, and the joint impacts of the air pollution were mainly driven by PM2.5. CONCLUSIONS Our results produced evidence for a relationship between air pollution exposure and the increased prevalence of sarcopenia in China. Public health and relevant departments should make efforts to prevent sarcopenia, particularly in China experiencing rapid demographic aging.
Collapse
Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Bingbing Chen
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Nuoya Li
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | | | - Fang Zhou
- Institute of Chronic Disease Prevention and Cure, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Hao Liu
- Institute of Chronic Disease Prevention and Cure, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
| |
Collapse
|
45
|
Zhang B, Huang L, Zhu X, Ran L, Zhao H, Zhu Z, Wang Y. Impact of household solid fuel use on sarcopenia in China: A nationwide analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 877:162814. [PMID: 36933714 DOI: 10.1016/j.scitotenv.2023.162814] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Household air pollution from solid fuel combustion is a leading cause of age-related diseases worldwide. However, little is known about the association between indoor solid fuel use and sarcopenia, especially in developing countries. METHODS A total of 10,261 and 5129 participants from the China Health and Retirement Longitudinal Study were enrolled in the cross-sectional and follow-up analysis, respectively. The effects of household solid fuel use (for cooking and heating) on sarcopenia were evaluated using generalized linear models in the cross-sectional analysis and Cox proportional hazards regression models in the longitudinal analysis. RESULTS The prevalence of sarcopenia in the total population, clean cooking fuel users, and solid cooking fuel users were 13.6 % (1396/10,261), 9.1 % (374/4114), and 16.6 % (1022/6147), respectively. A similar pattern was observed for heating fuel users, with a higher prevalence of sarcopenia among solid fuel users (15.5 %) than among clean fuel users (10.7 %). In the cross-sectional analysis, solid fuel use for cooking/heating, separately or simultaneously, was positively associated with an elevated risk of sarcopenia after adjusting for potential confounders. During the four-years follow-up period, 330 participants (6.4 %) with sarcopenia were identified. The multivariate-adjusted hazard ratio (HR) (95 % confidence interval [95 % CI]) for solid cooking fuel users and solid heating fuel users was 1.86(95 % CI:1.43-2.41) and 1.32(95 % CI:1.05-1.66), respectively. Moreover, compared with persistent clean fuel users, participants who switched from clean to solid fuel for heating appeared to have an increased risk of sarcopenia (HR:1.58; 95 % CI:1.08-2.31). CONCLUSIONS Our findings show that household solid fuel use is a risk factor for sarcopenia development among middle-aged and older Chinese adults. The transition from solid to clean fuel use may help reduce the burden of sarcopenia in developing countries.
Collapse
Affiliation(s)
- Bing Zhang
- Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China.
| | - Liping Huang
- Department of Medical Records, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Xiaoyan Zhu
- Suzhou Center for Disease Prevention and Control, Suzhou 215004, China
| | - Longmei Ran
- Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China
| | - Hang Zhao
- Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China
| | - Zhigang Zhu
- Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China
| | - Yuqing Wang
- Department of Geriatrics, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China.
| |
Collapse
|
46
|
Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, Triantafyllidis KK, Kechagias KS, Dionyssiotis Y, Cesari M, Ibrahim K, Scott D, Barbagallo M, Veronese N. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:671-683. [PMID: 36781175 PMCID: PMC10067503 DOI: 10.1002/jcsm.13190] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.
Collapse
Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Society of Meta‐research and Biomedical InnovationLondonUK
| | - Panagiotis Giannos
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Jean Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and AgingLiègeBelgium
- Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and AgeingUniversity of LiègeLiègeBelgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and PaediatricsGhent UniversityGhentBelgium
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCAAnconaItaly
| | - Konstantinos K. Triantafyllidis
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Nutrition and DieteticsHomerton University Hospital Foundation TrustLondonUK
| | - Konstantinos S. Kechagias
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Metabolism, Digestion and Reproduction, Faculty of MedicineImperial College LondonLondonUK
| | - Yannis Dionyssiotis
- Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital PatrasUniversity of PatrasPatrasGreece
| | - Matteo Cesari
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Geriatric UnitIRCCS Istituti Clinici Scientifici MaugeriMilanItaly
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University Hospital SouthamptonUniversity of SouthamptonSouthamptonUK
- Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR)University of SouthamptonSouthamptonUK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Mario Barbagallo
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Nicola Veronese
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | | |
Collapse
|
47
|
Liu Q, You J, Zhong M, Wu Z, Geng Y, Huang C. Hemoglobin level is negatively associated with sarcopenia and its components in Chinese aged 60 and above. Front Public Health 2023; 11:1081843. [PMID: 36992883 PMCID: PMC10040688 DOI: 10.3389/fpubh.2023.1081843] [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: 11/01/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction Sarcopenia and low hemoglobin level are common in older adults. Few studies have evaluated the association between hemoglobin level and sarcopenia and with inconsistent findings. The multifaceted effects of sarcopenia on the human body and the high prevalence of anemia in the Chinese population make it necessary to explore the association between the two. Methods Using the China Health and Retirement Longitudinal Study (CHARLS), we explored the association between hemoglobin with sarcopenia and its components in the Chinese population aged 60 and above. Multivariate logistic and Cox proportional hazards models were constructed to examine the association of hemoglobin level with sarcopenia and sarcopenia components in individuals aged 60 years or above. The subgroup analysis covered residence, body mass index level, drinking status, and smoking status were conducted. The possible difference of associations between sexes was also explored. Results With a total of 3,055 people, the hemoglobin concentration in people without sarcopenia, possible sarcopenia, and sarcopenia are 14.34 ± 2.22, 14.64 ± 2.27, and 13.58 ± 2.02 g/dl, respectively. Cross-sectional analysis showed strong evidence that hemoglobin was negatively associated with sarcopenia [Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI): 0.90-0.99] and low height-adjusted appendicular skeletal muscle mass (OR = 0.91, 95% CI: 0.86-0.97). On average, a per 1 g/dl higher hemoglobin level was associated with 5% lower odds of sarcopenia (OR = 0.95, 95% CI: 0.90-0.98). The cohort study of 1,022 people demonstrated a statistically significant negative association of hemoglobin level with low physical performance [Hazard Ratio (HR) = 0.92, 95% CI: 0.85-0.99], merely with sarcopenia (HR = 0.92, 95% CI: 0.84-1.00) and skeletal muscle mass (HR = 0.95, 95% CI: 0.80-1.00). Sex-specific analysis suggested hemoglobin's association with sarcopenia, muscle mass, and physical performance in all sexes, with weaker magnitudes in females. Hemoglobin in urban residents and people with high body mass index (BMI) has a larger magnitude of the negative association with sarcopenia. Discussion Hemoglobin level associates with sarcopenia, muscle mass, and physical performance in the Chinese population aged 60 and above, with sex-specific, residence-specific, and BMI-specific effects.
Collapse
Affiliation(s)
- Qiaoling Liu
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Jiuhong You
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Zhong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhigang Wu
- Department of Chemistry, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yunjie Geng
- Research Institute of Statistical Sciences, National Bureau of Statistics, Beijing, China
| | - Cheng Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
48
|
Xie HL, Ruan GT, Wei L, Zhang Q, Ge YZ, Song MM, Zhang X, Lin SQ, Liu XY, Zhang XW, Li XR, Zhang KP, Hu CL, Yang M, Tang M, Song CH, Cong MH, Weng M, Li ZN, Li W, Wang KH, Shi HP. The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia. J Cachexia Sarcopenia Muscle 2023; 14:879-890. [PMID: 36872512 PMCID: PMC10067477 DOI: 10.1002/jcsm.13205] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/17/2022] [Accepted: 02/06/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Changes in body composition and systemic inflammation are important characteristics of cancer cachexia. This multi-centre retrospective study aimed to explore the prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia. METHODS The modified advanced lung cancer inflammation index (mALI), which combines body composition and systemic inflammation, was defined as appendicular skeletal muscle index (ASMI) × serum albumin/neutrophil-lymphocyte ratio. The ASMI was estimated according to a previously validated anthropometric equation. Restricted cubic splines were used to evaluate the relationship between mALI and all-cause mortality in patients with cancer cachexia. Kaplan-Meier analysis and Cox proportional hazard regression analysis were used to evaluate the prognostic value of mALI in cancer cachexia. A receiver operator characteristic curve was used to compare the effectiveness of mALI and nutritional inflammatory indicators in predicting all-cause mortality in patients with cancer cachexia. RESULTS A total of 2438 patients with cancer cachexia were enrolled, including 1431 males and 1007 females. The sex-specific optimal cut-off values of mALI for males and females were 7.12 and 6.52, respectively. There was a non-linear relationship between mALI and all-cause mortality in patients with cancer cachexia. Low mALI was significantly associated with poor nutritional status, high tumour burden, and high inflammation. Patients with low mALI had significantly lower overall survival (OS) than those with high mALI (39.5% vs. 65.5%, P < 0.001). In the male population, OS was significantly lower in the low mALI group than in the high group (34.3% vs. 59.2%, P < 0.001). Similar results were also observed in the female population (46.3% vs. 75.0%, P < 0.001). mALI was an independent prognostic factor for patients with cancer cachexia (hazard ratio [HR] = 0.974, 95% confidence interval [CI] = 0.959-0.990, P = 0.001). For every standard deviation [SD] increase in mALI, the risk of poor prognosis for patients with cancer cachexia was reduced by 2.9% (HR = 0.971, 95%CI = 0.943-0.964, P < 0.001) in males and 8.9% (HR = 0.911, 95%CI = 0.893-0.930, P < 0.001) in females. mALI is an effective complement to the traditional Tumour, Lymph Nodes, Metastasis (TNM) staging system for prognosis evaluation and a promising nutritional inflammatory indicator with a better prognostic effect than the most commonly used clinical nutritional inflammatory indicators. CONCLUSIONS Low mALI is associated with poor survival in both male and female patients with cancer cachexia and is a practical and valuable prognostic assessment tool.
Collapse
Affiliation(s)
- Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Lishuang Wei
- Department of Geriatric Respiratory Disease Ward, the First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Shi-Qi Lin
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiao-Yue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiao-Wei Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiang-Rui Li
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Kang-Ping Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Chun-Lei Hu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Ming Yang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Meng Tang
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Chun-Hua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhenzhou, China
| | - Ming-Hua Cong
- General Department, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Weng
- Department of Clinical Nutrition, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zeng-Ning Li
- Department of Clinical Nutrition, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Kun-Hua Wang
- Department of Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| |
Collapse
|
49
|
Luo S, Chen X, Hou L, Yue J, Liu X, Xia X, Dong B, Cao L. The accuracy of body mass index and calf circumference values when assessing sarcopenia in a multi-ethnic cohort of middle-aged and older adults: West China health and aging trend study results. Heliyon 2023; 9:e15027. [PMID: 37151646 PMCID: PMC10161364 DOI: 10.1016/j.heliyon.2023.e15027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Objective This analysis was designed to explore the utility of body mass index (BMI) and calf circumference (CC) values in the diagnosis of sarcopenia. Methods A cross-sectional analysis of community-dwelling adults ≥50 years old was conducted. An InBody 770 bioimpedance analysis (BIA) device was used for measuring muscle mass, a grip-strength dynamometer was used to assess muscle strength, and a 4 m gait speed (GS) analysis was used to gauge physical function. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to define sarcopenia. The cut-off values for BMI and CC were based on the computed Younden's index values and AWGS 2019 criteria, respectively. The area under the ROC curves (AUC), specificity, sensitivity, and positive and negative predictive values (PPV and NPV) were calculated to establish the value of BMI and CC for the diagnosis of sarcopenia. Results In total, the data of 4177 participants ≥50 years of age were analyzed. These included 2668 (63.9%) females and 1509 (36.1%) males. Of these participants, 946 (22.6%) met the criteria for sarcopenia, including 408 (27%) males and 538 (20.2%) females. The sensitivity, specificity, and NPVs obtained when using BMI and CC values to predict sarcopenia were as follows: 84.03%/65.51%/0.90 and 74.76%/83.51%/0.87, respectively, in males; 87.36%/64.12%/0.94 and 78.25%/82.09%/0.93, in females. The respective AUC values for BMI and CC in males were 0.83 (0.80-0.85) and 0.85 (0.83-0.88), while in females they were 0.85 (0.83-0.87) and 0.88 (0.87-0.90). Conclusions These data suggest that BMI and CC can both serve as accurate predictors of sarcopenic incidence in a multi-ethnic population ≥50 years of age. The specificity values for BMI were relatively low in both males and females, however, underscoring the relative advantages of measuring CC when assessing individual sarcopenia risk.
Collapse
|
50
|
Xie H, Wei L, Gao S, Liu M, Liang Y, Yuan G, Wang Q, Xu Y, Tang S, Gan J. Prognostic significance of sarcopenia diagnosed based on the anthropometric equation for progression-free survival and overall survival in patients with colorectal cancer. Front Nutr 2023; 10:1076589. [PMID: 36819674 PMCID: PMC9928878 DOI: 10.3389/fnut.2023.1076589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023] Open
Abstract
Background The purpose of this study was to investigate the prognostic significance of sarcopenia diagnosed based on anthropometric equations for progression-free survival (PFS) and overall survival (OS) in patients with colorectal cancer (CRC). Methods A total of 1,441 CRC patients who underwent surgical treatment between January 2012 and December 2016 were enrolled in this study. Sarcopenia was diagnosed according to validated anthropometric equations. The Kaplan-Meier method with the log-rank test was used to estimate the survival curve. Cox proportional hazards regression models with forward selection were used to evaluate risk factors affecting the prognosis of CRC patients. R package "survival" was used to build the prognostic nomograms to predict 1-5 years of PFS and OS in CRC patients. The concordance index (C-index) and calibration curve were used to evaluate the prognostic accuracy of the prognostic nomogram. Results Two hundred and seventy-one patients (18.8%) were diagnosed with sarcopenia. Sarcopenia was significantly associated with advanced age, large tumor size, and high mortality. Compared with the non-sarcopenia patients, the PFS of sarcopenia patients was worse (5-year PFS, 48.34 vs. 58.80%, p = 0.003). Multivariate survival analysis showed that patients with sarcopenia had a higher risk (23.9%) of adverse PFS (HR, 1.239; 95%CI: 1.019-1.505, p = 0.031) than patients without sarcopenia. The OS of patients with sarcopenia was significantly worse than that of patients without sarcopenia (5-year OS: 50.92 vs. 61.62%, p = 0.001). In CRC patients, sarcopenia was independently associated with poor OS (HR: 1.273, 95%CI: 1.042-1.556, p < 0.001). Moreover, sarcopenia effectively differentiated the OS of CRC patients in the normal carcinoembryonic antigen (CEA) subgroup but not in the high CEA subgroup. Notably, sarcopenia can provide effective prognostic stratification in CRC patients at different pathological stages. Nomograms that integrated prognostic features were built to predict the risk of adverse outcomes in CRC patients. The C-index and calibration curves showed that these nomograms had good prediction accuracy. Internal validation confirmed that our nomogram has wide application potential. Conclusion Sarcopenia diagnosed based on anthropometric equations is an independent risk factor for PFS and OS in CRC patients.
Collapse
Affiliation(s)
- Hailun Xie
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Lishuang Wei
- Department of Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Shunhui Gao
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Mingxiang Liu
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanren Liang
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Guanghui Yuan
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Qiwen Wang
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Yansong Xu
- Department of Emergency Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Shuangyi Tang
- Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,*Correspondence: Jialiang Gan ✉
| | - Jialiang Gan
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China,Shuangyi Tang ✉
| |
Collapse
|