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Theodorou SJ, Theodorou DJ, Kigka V, Gkiatas I, Fotopoulos A. DXA-based appendicular composition measures in healthy aging Caucasian Greek women: a cross-sectional study. Rheumatol Int 2024; 44:1715-1723. [PMID: 38860993 DOI: 10.1007/s00296-024-05622-4] [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: 02/11/2024] [Accepted: 05/26/2024] [Indexed: 06/12/2024]
Abstract
As the global population of older persons increases, age-related medical conditions will have a greater impact on public health. DXA-derived bone and soft tissue metrics are associated with adverse clinical events in aging persons. This study aims to investigate the regional body composition of the appendices by whole-body DXA scans, and the age-related relationships between measures of bone and soft tissue in healthy Caucasian females of a Greek origin residing in the Mediterranean area. Body composition of the legs and the arms was analyzed, and lean mass (LM) and fat mass (FM) metrics were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the legs and arms was achieved between ages 20-30 and 41-50 years, respectively. The overall BMD reduction with age was for the legs 43% and the arms 32.2% (p < 0.001). Peak %LM of the legs and the arms was achieved between ages 20-30. The overall reduction of %LM with age was for the legs 22.5% (p < 0.001) and arms 6.6% (p < 0.05). Peak %FM of the legs and arms was attained between ages 31-40 and 61-70, respectively. The overall %FM reduction with age was for the legs and arms 7.5% and 1.9% (p > 0.05). In appendicular sites, Greek women reach peak values of bone mass in the legs first, in early adulthood. Bone loss predominates in the legs as women age. Also, with advancing age Greek women show preferential significant decreases of %LM and %FM in the legs as opposed to the arms. Although variation in appendicular bone and soft tissue metrics is present, the implications of variable biological crosstalks among the tissue components as women age may ultimately lay the foundation for future clinical trials aimed at healthy aging.
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Affiliation(s)
| | - Daphne J Theodorou
- Department of Radiology, General Hospital of Ioannina and National Healthcare System, Ioannina, Greece
| | - Vassiliki Kigka
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Ioannis Gkiatas
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Andreas Fotopoulos
- Department of Nuclear Medicine, University of Ioannina, Ioannina, Greece
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Ma Y, Liu B, Yin F, Liu J, Wang X, Fan D, Sun L, Lu L. Vitamin D level as a predictor of dysmobility syndrome with type 2 diabetes. Sci Rep 2024; 14:19792. [PMID: 39187642 PMCID: PMC11347565 DOI: 10.1038/s41598-024-70400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 08/16/2024] [Indexed: 08/28/2024] Open
Abstract
Dysmobility Syndrome (DMS), is a combination, that is analogous to the approach taken with metabolic syndrome, The diagnosis of DMS is complex. So this study aimed to explore the relationship between 25-(OH) Vit D with Dysmobility Syndrome (DMS)in type 2 diabetes mellitus(T2DM) patients. This is a cross-sectional study, including 330 patients (67.0 ± 8.8 years old) with T2DM who were admitted to the Qinhuangdao First Hospital from October 2020 to February 2022. Selected independent variables include grip strength, six-meter gait speed, level of 25-(OH) vitamin D, and bone mineral density (BMD) measured by Dual-energy X-ray (DXA). DMS includes six conditions: osteoporosis, low muscle mass, low muscle strength, slow gait speed, occurrences of falls in the past year ≥ 1, and obesity, having three or more of these conditions were diagnosed with DMS. Patients were classified based on DMS. The detection rate of DMS in patients with T2DM was 25.5%. The proportion of vitamin deficiency is 67.9% in patients with T2DM. The 25-(OH) Vit D deficiency was defined based on the 25th percentile into two groups; < 36.2 nmol/L. The vitamin D levels in Group DMS were significantly lower than that in Group Non-DMS (41.74 ± 14.60 vs. 47.19 ± 13.01, P < 0.05). After adjusting confounder factors including sex, age, vitamin D levels, HbA1c, ALB, HDLC, eGFR, diabetes microvascular complications and macrovascular, there was an independent association between risk of DMS and age (OR value = 1.160, 95% CI 1.091-1.234, P = 0.000), HbA1c(OR value = 1.262, 95% CI 1.046-1.532, P = 0.015), and vitamin D deficiency (< 36.2 nmol/L) (OR value = 2.990, 95% CI 1.284-6.964, P = 0.011). Our findings suggest that low levels of vitamin D are a predictor of DMS in middle-aged and elderly patients with poor control of type 2 diabetes.
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Affiliation(s)
- Yongfang Ma
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Bowei Liu
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China.
| | - Fuzai Yin
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Junru Liu
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Xing Wang
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Dongmei Fan
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Lina Sun
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
| | - Lanyu Lu
- The First Hospital of Qinhuangdao, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, People's Republic of China
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Wang S, Zhang X, Qu B, Yang K, Hu Y, Liu H, Hong J, Niu H, Yang H. A Novel MRI-Based Paravertebral Muscle Quality (PVMQ) Score for Evaluating Muscle Quality and Bone Quality: A Comparative Study with the VBQ Score. Clin Interv Aging 2024; 19:1203-1215. [PMID: 38974509 PMCID: PMC11227326 DOI: 10.2147/cia.s464187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/15/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose This study aims to develop a novel MRI-based paravertebral muscle quality (PVMQ) score for assessing muscle quality and to investigate its correlation with the degree of fat infiltration (DFF) and the vertebral bone quality (VBQ) score of paravertebral muscles. Additionally, the study compares the effectiveness of the PVMQ score and the VBQ score in assessing muscle quality and bone quality. Methods PVMQ scores were derived from the ratio of paravertebral muscle signal intensity (SI) to L3 cerebrospinal fluid SI on T2-weighted MRI. Image J software assessed paravertebral muscle cross-sectional area (CSA) and DFF. Spearman rank correlation analyses explored associations between PVMQ, VBQ scores, DFF, and T-scores in both genders. Receiver operating characteristic (ROC) curves compared PVMQ and VBQ scores' effectiveness in distinguishing osteopenia/osteoporosis and high paraspinal muscle DFF. Results In this study of 144 patients (94 females), PVMQ scores were significantly higher in osteoporosis and osteopenia groups compared to normals, with variations observed between genders (P < 0.05). PVMQ showed stronger positive correlation with VBQ scores and DFF in females than males (0.584 vs 0.445, 0.579 vs 0.528; P < 0.01). ROC analysis favored PVMQ over VBQ for low muscle mass in both genders (AUC = 0.767 vs 0.718, 0.793 vs 0.718). VBQ was better for bone mass in males (0.737/0.865 vs 0.691/0.858), whereas PVMQ excelled for females (0.808/0.764 vs 0.721/0.718). Conclusion The novel PVMQ score provides a reliable assessment of paravertebral muscle quality and shows a strong correlation with VBQ scores and DFF, particularly in females. It outperforms VBQ scores in evaluating muscle mass and offers valuable insights for assessing bone mass in females. These findings underscore the potential of the PVMQ score as a dual-purpose tool for evaluating both muscle and bone health, informing future research and clinical practice.
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Affiliation(s)
- Song Wang
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Xiang Zhang
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Bo Qu
- Department of Orthopaedics, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Kunhai Yang
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Yongrong Hu
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Hao Liu
- Department of Orthopaedics, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Juntao Hong
- Department of Orthopaedics, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Hao Niu
- Computer Science of Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Hongsheng Yang
- Department of Orthopaedics, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
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Sun W, Wang P, Zhao Y. The characteristics of the body mass frequency index in dysmobility syndrome: A pilot study. Exp Gerontol 2024; 191:112414. [PMID: 38570056 DOI: 10.1016/j.exger.2024.112414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND With the advancement of global aging, there has been an increase in patients with dysmobility syndrome (DS), often accompanied by osteoporosis, sarcopenia, and sarcopenic obesity. The objective of this study was to evaluate the application value of the body mass frequency index (BMFI) in older patients with DS by comprehensively analyzing the differences in BMFI between community-dwelling older subjects using medical and engineering methods. METHODS A cross-sectional study was conducted to recruit community-dwelling older subjects aged 60-90 years. Various assessments and measurements were performed, including basic information collection, gait analysis, bone mineral density (BMD) and body composition measurement, fall and fracture risk et al. Gait analysis and body mass index (BMI) are in the established model to calculate BMFI. Analysis of BMFI was performed in community-dwelling older subjects, and the specificity and threshold of BMFI in predicting dysmobility syndrome (DS) were further analyzed. RESULTS Significant differences in BMFI were observed between older adults with DS and those without DS. BMFI in older people was associated with bone quality, fracture risk, body fat percentage, appendicular skeletal muscle mass index (ASMI), grip strength, and speed. The odds ratio (OR) and 95 % confidence interval (CI) for BMFI in the non-DS and DS groups were 0.823 (0.743-0.901), respectively. Receiver operating characteristic (ROC) analysis demonstrated that BMFI had predictive value in distinguishing non-DS from DS (AUC = 0.669) (P < 0.05). The optimal threshold for predicting non-DS and DS was found to be 16.04 (sensitivities = 0.483, specificities = 0.774). CONCLUSION The measurement of BMFI has demonstrated disparities in musculoskeletal status among older adults with and without DS. Notably, BMFI exhibits a unique predictive capacity for DS among the elderly population.
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Affiliation(s)
- Wen Sun
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Department of Traditional Chinese Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai 200434, China.
| | - Peige Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Yongfang Zhao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
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Geng Z, Wang P, Yang G, Li Y, Zhao Y. Circulating Hsa-miR499a-5p as markers in dysmobility syndrome patients: a new index for diagnosing dysmobility syndrome based on osteoporosis and predicting fracture risk. Postgrad Med J 2024; 100:297-304. [PMID: 38263934 DOI: 10.1093/postmj/qgae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 11/25/2024] [Accepted: 12/25/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Dysmobility syndrome based on osteoporosis (ODS) is a disease characterized by low bone mass and low muscle mass. Its features are high fracture and high fall risk. Falls and fractures are the most important factors affecting the quality of life and lifespan of ODS. However, there is no serum marker for the evaluation of ODS patients.Our previous studies have shown that the expression of circulating miRNA is stable and is a good marker for disease diagnosis. Therefore, this study aims to explore potential serum markers of ODS. METHODS A total of 78 subjects were included in this study. The data including appendicular skeletal muscle mass index, bone mineral density, bone metabolism markers, and other relevant information were collected for analysis. Real-time quantitative polymerase chain reaction was used to detect 19 miRNAs associated with muscle mass reduction. The correlation of quantitative data was analyzed by Pearson. The receiver operating characteristic curve was used to evaluate the performance of miRNA as a biomarker. RESULTS In this study, we found that the muscle mass and strength of patients with ODS are significantly reduced and are negatively correlated with the risk of fracture. The hsa-miR-499a-5p is specifically downregulated in ODS, and is positively correlated with muscle mass and strength, and negatively correlated with the risk of fracture. Compared with muscle mass and strength, hsa-miR-499a-5p has better sensitivity and specificity as a diagnostic marker. CONCLUSION hsa-miR-499a-5p is a potential serum biomarker for assessing muscle function and predicting fall or fracture risk in the ODS population.
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Affiliation(s)
- Zixiang Geng
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine , Shanghai 201203, China
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Peige Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine , Shanghai 201203, China
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Guangyue Yang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine , Shanghai 201203, China
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yifei Li
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yongfang Zhao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine , Shanghai 201203, China
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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Weiwei, Wang S, Hou D, Zhan L. Methods and research progress in the construction of animal models of osteosarcopenia: a scoping review. Front Endocrinol (Lausanne) 2023; 14:1228937. [PMID: 37964970 PMCID: PMC10641866 DOI: 10.3389/fendo.2023.1228937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background Osteosarcopenia(OS) is a significant health concern resulting from the ageing process. Currently, as the population grows older, the prevalence of OS, a disease that entails the synchronous degeneration of muscles and bones, is mounting. This poses a serious threat to the health of the elderly while placing an enormous burden on social care. In order to comprehend the pathological mechanism of OS and develop clinical drugs, it is pertinent to construct an efficient animal model of OS. To investigate the modeling techniques of diverse experimental models of OS and elucidate their respective benefits and drawbacks, with the purpose of furnishing a theoretical foundation to advance experimental research on OS. Methods We searched PubMed, Embase database, China Knowledge Network, Wanfang data platform and Vipshop journal platform databases from 2000 through to September 1, 2023. We included animal studies on sarcopenia or osteoporosis or osteosarcopenia or sarcopenia-osteoporosis, modeling methods for osteosarcopenia. Two independently screened study abstracts and full reports and complete data extraction. Results Eventually, Of 112, 106 citations screened. 4938 underwent full-text review and 38 met the inclusion criteria. we reviewed and analyzed the literature and categorized the animal models of OS into the following five categories: Aging OS models; Hormonal deficiency model of OS;Chemical injection to induce OS;Disuse OS models and Genetic engineering OS models. Conclusion This review outlines animal modeling approaches for OS, providing a comprehensive summary of their advantages and disadvantages. The different models were evaluated and selected based on their respective strengths and weaknesses to enable higher quality research outcomes in various research directions. The most widely used and established approach is considered to be the ageing and chemical injection OS model, which has the advantages of excellent reproducibility and low cost. The translational potential of this article To gain a profound comprehension of the pathological mechanism of OS and to devise efficacious clinical treatments, it is imperative to establish a viable laboratory animal model of OS. This article surveys various modeling techniques assessing their benefits, drawbacks and areas of applicability while predominantly employing mice as the primary model animal. Additionally, the evaluation indicators of OS models are briefly described.
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Affiliation(s)
- Weiwei
- The Second Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Shixuan Wang
- The Second Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Decai Hou
- Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Libin Zhan
- Liaoning University of Traditional Chinese Medicine, Experimental Platform, Shenyang, China
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Khaleghi MM, Emamat H, Marzban M, Farhadi A, Jamshidi A, Ghasemi N, Falahatzadeh A, Jalaliyan Z, Malekizadeh H, Nabipour I, Larijani B. The association of body composition and fat distribution with dysmobility syndrome in community-dwelling older adults: Bushehr Elderly Health (BEH) program. BMC Musculoskelet Disord 2023; 24:809. [PMID: 37828473 PMCID: PMC10568758 DOI: 10.1186/s12891-023-06934-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Dysmobility Syndrome (DS) is characterized as an accumulation of clinical risk factors for functional disability, such as osteoporosis, sarcopenia, and obesity. Neurological disorders that affect the motor and sensory systems can also contribute to the condition, resulting in gait and muscle strength disturbances, as well as a history of falls and fractures. The study aimed to determine the association between fat distribution in different body areas and the odds of older adults developing DS, as there is still uncertainty about the accumulation of fat in which area is most closely linked to the condition. METHODS This cross-sectional study was conducted according to the data from the second phase of the Bushehr Elderly Health Cohort (BEH). Dysmobility Syndrome was defined based on the co-occurrence of at least three outcomes of its criteria. Body composition was measured using dual-energy X-ray absorptiometry (DXA) and anthropometric studies. For evaluating the relationship, multivariate logistic regression and adjusted univariate linear regression were used. RESULTS Of 2,359 who were recruited in the study, 1,277 participants (54.13%) had DS. According to the final logistic regression model in the limb region, FM and FM to FFM ratios were significantly associated with DS [OR (95%CI) = 1.04 (1.02 to 1.05), and 3.42 (1.95 to 5.99), respectively]. Also, In the trunk region, the FM and FM to FFM ratio were significantly related to the odds of DS, although this relationship was weaker than in the limbs region [OR (95%CI) = 1.02 (1.00 to 1.03), and 2.45 (1.36 to 4.39), respectively]. CONCLUSION Our findings indicate that a higher regional and whole-body amount of fat mass rather than fat-free mass is closely linked to an increased risk of DS, particularly in the elderly population. Notably, higher fat mass in the limbs (especially in the legs) is associated with greater odds of DS, while a higher android-to-gynoid fat mass ratio is associated with lower DS risk. Screening fat mass distribution in older individuals can be a valuable strategy for promptly diagnosing DS, implementing interventions to prevent disabilities, and improving their quality of life.
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Affiliation(s)
| | - Hadi Emamat
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Nutritional Sciences, School of Health, Bushehr University of Medical Science, Bushehr, Iran
| | - Maryam Marzban
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Ali Jamshidi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Nutritional Sciences, School of Health, Bushehr University of Medical Science, Bushehr, Iran
| | - Negin Ghasemi
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Azar Falahatzadeh
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Hasan Malekizadeh
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Gielen E, Dupont J, Dejaeger M, Laurent MR. Sarcopenia, osteoporosis and frailty. Metabolism 2023; 145:155638. [PMID: 37348597 DOI: 10.1016/j.metabol.2023.155638] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/21/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
Muscles and bones are intricately connected tissues displaying marked co-variation during development, growth, aging, and in many diseases. While the diagnosis and treatment of osteoporosis are well established in clinical practice, sarcopenia has only been classified internationally as a disease in 2016. Both conditions are associated with an increased risk of adverse health outcomes such as fractures, dysmobility and mortality. Rather than focusing on one dimension of bone or muscle mass or weakness, the concept of musculoskeletal frailty captures the overall loss of physiological reserves in the locomotor system with age. The term osteosarcopenia in particular refers to the double jeopardy of osteoporosis and sarcopenia. Muscle-bone interactions at the biomechanical, cellular, paracrine, endocrine, neuronal or nutritional level may contribute to the pathophysiology of osteosarcopenia. The paradigm wherein muscle force controls bone strength is increasingly facing competition from a model centering on the exchange of myokines, osteokines and adipokines. The most promising results have been obtained in preclinical models where common drug targets have been identified to treat these conditions simultaneously. In this narrative review, we critically summarize the current understanding of the definitions, epidemiology, pathophysiology, and treatment of osteosarcopenia as part of an integrative approach to musculoskeletal frailty.
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Affiliation(s)
- Evelien Gielen
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Jolan Dupont
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Marian Dejaeger
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Michaël R Laurent
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; Geriatrics Department, Imelda Hospital, Bonheiden, Belgium.
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Abshirini M, Coad J, Wolber FM, von Hurst P, Miller MR, Tian HS, Kruger MC. Effect of green-lipped mussel ( Perna canaliculus) supplementation on faecal microbiota, body composition and iron status markers in overweight and obese postmenopausal women: a randomised, double-blind, placebo-controlled trial. J Nutr Sci 2023; 12:e58. [PMID: 37252684 PMCID: PMC10214140 DOI: 10.1017/jns.2023.41] [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: 03/03/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 05/31/2023] Open
Abstract
The present study aimed to determine the effect of whole meat GSM powder on gut microbiota abundance, body composition and iron status markers in healthy overweight or obese postmenopausal women. This was a 3-months trial involving forty-nine healthy postmenopausal women with body mass index (BMI) between 25 and 35 kg/m2 who were randomly assigned to receive 3 g/d of either GSM powder (n 25) or placebo (n 24). The gut microbe abundance, serum iron status markers and body composition were measured at the baseline and the end of the study. The between-group comparison at the baseline showed a lower abundance of Bacteroides and Clostridium XIVa in the GSM group compared with the placebo (P = 0⋅04). At the baseline, the body fat (BF)% and gynoid fat% were higher in the GSM group compared with the placebo (P < 0⋅05). No significant changes were found in any of the outcome measures, except for ferritin levels that showed a significant reduction over time (time effect P = 0⋅01). Some trend was observed in bacteria including Bacteroides and Bifidobacterium which tended to increase in the GSM group while their abundance decreased or remained at their baseline level in the control group. Supplementation with GSM powder did not result in any significant changes in gut microbe abundance, body composition and iron markers compared with placebo. However, some commensal bacteria such as Bacteroides and Bifidobacteria tended to increase following supplementation with GSM powder. Overall, these findings can expand the knowledge surrounding the effects of whole GSM powder on these outcome measures in healthy postmenopausal women.
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Affiliation(s)
- Maryam Abshirini
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Jane Coad
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand
| | - Frances M. Wolber
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand
- Centre for Metabolic Health Research, Massey University, Palmerston North, New Zealand
| | - Pamela von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | | | - Hong Sabrina Tian
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand
- Sanford Ltd., Auckland, New Zealand
| | - Marlena C. Kruger
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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Tu Y, Tang G, Li L, Ji R, Tang R, Wang S, Zhu J. A preliminary study on degenerate characteristics of lumbar and abdominal muscles in middle-aged and elderly people with varying bone mass. BMC Musculoskelet Disord 2023; 24:136. [PMID: 36810003 PMCID: PMC9942411 DOI: 10.1186/s12891-023-06229-9] [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: 10/23/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND With the wide application of QCT in the clinical assessment of osteoporosis and sarcopenia, the characteristics of musculoskeletal degeneration in middle-aged and elderly people need to be further revealed. We aimed to investigate the degenerate characteristics of lumbar and abdominal muscles in middle-aged and elderly people with varying bone mass. METHODS A total of 430 patients aged 40-88 years were divided into normal, osteopenia, and osteoporosis groups according to quantitative computed tomography (QCT) criteria. The skeletal muscular mass indexes (SMIs) of five muscles [abdominal wall muscles (AWM), rectus abdominis (RA), psoas major muscle (PMM), posterior vertebral muscles (PVM), and paravertebral muscles (PM)] included in lumbar and abdominal muscles were measured by QCT. Differences in SMIs among three groups, as well as the correlation between SMIs and volumetric bone mineral density (vBMD) were analyzed. The areas under the curves (AUCs) for SMIs for prediction of low bone mass and osteoporosis were calculated. RESULTS In male group, SMIs of RA and PM in osteopenia group were significantly lower than those in the normal group (P = 0.001 and 0.023, respectively). In female group, only SMI of RA in osteopenia group was significantly lower than that in the normal group (P = 0.007). SMI of RA was positively correlated with vBMD with the highest coefficients in male and female groups (r = 0.309 and 0.444, respectively). SMIs of AWM and RA had higher AUCs varying from 0.613 to 0.737 for prediction of low bone mass and osteoporosis in both genders. CONCLUSIONS The changes of SMIs of the lumbar and abdominal muscles in patients with varying bone mass are asynchronous. SMI of RA is expected to be a promising imaging marker for predicting abnormal bone mass. TRIAL REGISTRATION ChiCTR1900024511 (Registered 13-07-2019).
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Affiliation(s)
- Yun Tu
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Guangyu Tang
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Li Li
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Rui Ji
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Rui Tang
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Shuling Wang
- grid.412538.90000 0004 0527 0050Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072 China
| | - Jingqi Zhu
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China.
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11
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Luo X, Cai B, Jin W. The Prevalence Rate of Adult Sarcopenic Obesity and Correlation of Appendicular Skeletal Muscle Mass Index with Body Mass Index, Percent Body Fat, Waist-Hip Ratio, Basal Metabolic Rate, and Visceral Fat Area. Metab Syndr Relat Disord 2023; 21:48-56. [PMID: 36318808 DOI: 10.1089/met.2022.0035] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: This study aimed to investigate the prevalence rate of adult sarcopenic obesity and discuss its predisposing factors. Methods: A total of 14,608 participants including 7521 men and 7087 women aged 18-93 years were enrolled in this study. The definition of sarcopenia was based on appendicular skeletal muscle mass index (ASMI) standards (≤7.0 kg/m2 for men and ≤5.7 grams/m2 for women). The definition of obesity followed percent body fat (PBF) ≥25% for men and ≥35% for women. Sarcopenic obesity was defined as the combination of sarcopenia and obesity diagnosis. Risk factors for the onset of sarcopenic obesity were analyzed by logistic regression analysis, followed by diagnostic value assessment. Results: There were 496 cases of sarcopenic obesity, including 308 male patients and 188 female patients. The overall prevalence rate was 3.4%, with 4.10% for men and 2.65% for women. Compared with nonsarcogenic obesity group, the subjects with sarcogenic obesity showed shorter height and circumference of limbs, arm muscle, neck, chest, waist and hip, lighter weight, lower body mass index (BMI), bone mineral content (BMC), skeletal muscle mass, basal metabolic rate (BMR), body cell mass, fitness score and ASMI, and higher body fat mass, PBF, waist-hip ratio (WHR), visceral fat area (VFA), extracellular fluid/total body fat, and extracellular water/total body water (ECW/TBW; P < 0.01). Based on logistic regression analysis, BMI, BMC, PBF, WHR, BMR, VFA, fitness score, lean balance trunk, lean balance left leg, ASMI, ECW/TBW and the circumference of left arm, left leg, arm muscle, chest waist and hip were considered as risk factors for sarcogenic obesity (P < 0.05). After receiver operating characteristic (ROC) curve analysis of basic condition, muscle mass, and limb condition, ASMI [area under the curve (AUC) = 0.75] showed relatively high diagnostic value for adult sarcopenic obesity; other indicators (AUC <0.75) showed moderate diagnostic value for adult sarcopenic obesity, except for fitness score. According to joint ROC analysis, combination of BMC, PBF, VFA, and ASMI (AUC = 0.78) showed high diagnostic value for adult sarcopenic obesity. ASMI was correlated with BMI (r = 0.246, P < 0.001), BMC (r = 0.798, P < 0.001), WHR (r = 0.197, P < 0.001), BMR (r = 0.932, P < 0.001), PBF (r = -0.761, P < 0.001), and VFA (r = -0.530, P < 0.001). In adult patients with sarcopenic obesity, a decrease in ASMI indicators may be accompanied by a decrease in BMI, BMC, WHR, and BMR as well as an increase in PBF and VFA. Conclusion: The prevalence rate of adult sarcopenic obesity was 3.40%. ASMI was closely correlated with BMI, BMC, PBF, WHR, BMR, and VFA, which may serve as early indicators in the diagnosis of adult sarcopenic obesity.
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Affiliation(s)
- Xi Luo
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Bin Cai
- Department of Quality Management, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Shaoxing People's Hospital, Shaoxing, China
| | - Weiwei Jin
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
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12
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Yang J, Jiang T, Xu G, Liu W. Bibliometrics Analysis and Visualization of Sarcopenia Associated with Osteoporosis from 2000 to 2022. J Pain Res 2023; 16:821-837. [PMID: 36937229 PMCID: PMC10022445 DOI: 10.2147/jpr.s403648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Purpose Recent years have seen an increased awareness of sarcopenia in the cross field of osteoporosis and sarcopenia. The goal of this study was to evaluate current bibliometric characteristics and the status of cross-sectional studies between osteoporosis and sarcopenia. Methods Publications related to osteoporosis and sarcopenia published between January 2000 and November 2022 were extracted from the Web of Science Core Collection; bibliometric and visualization were performed by Microsoft Office Excel, VOSviewer, Citespace, and R. Results A total of 1128 documents written by 5791 authors from 1758 organizations in 62 countries and published in 405 journals were identified. USA was the leading country with the highest publication and total citation. University of Melbourne contributed the most publications, while Tufts University had the largest citations. Osteoporosis International was the most influential journals in this field with the highest publications, citations and H index. Cooper C was the most influential author, who published the 20 studies, had the highest local citations and the highest H index. The keywords were classified into 6 clusters: Cluster 1 (aging), Cluster 2 (frailty) and Cluster 3 (osteosarcopenia). Conclusion Our bibliometric results revealed that the global osteoporosis and sarcopenia-related research increased rapidly from 2000 to 2022, suggesting it was a promising area of research for the future. The future trends in the cross field of sarcopenia and osteoporosis would be the molecular mechanisms of crosstalk between muscles and bones, safety and efficacy interventions with a dual effect on muscle and bone and osteosarcopenia.
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Affiliation(s)
- Jiyong Yang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Tao Jiang
- Department of Orthopedics, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, People’s Republic of China
| | - Guangming Xu
- Department of Orthopedics, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, People’s Republic of China
| | - Wengang Liu
- Department of Orthopedics, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, People’s Republic of China
- Correspondence: Wengang Liu, Department of Orthopedics, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, 510095, People’s Republic of China, Email
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13
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Chen FP, Lin YJ, Chao AS, Lin YC, Sung CM, Chen JF, Wong AMK. Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population. Biomed J 2022; 45:931-939. [PMID: 34801764 PMCID: PMC9795362 DOI: 10.1016/j.bj.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/22/2021] [Accepted: 11/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To determine a reliable method to predict prevalent vertebral fractures (VF) by assessing the association between dysmobility syndrome (DS) and VF in a community-dwelling population. METHODS This cross-sectional study enrolled 518 participants from fracture-prevention educational activities held in multiple communities in Taiwan. Assessments included questionnaires, fracture risk assessment tool (FRAX), bone mineral density (BMD) and body composition using dual-energy x-ray absorptiometry (DXA), lateral thoracolumbar spine x-rays (specifically T8-S1), grip strength (GS), walking speed, and fall history. RESULTS DS was noted in 257 participants (49.6%) and VF was identified in 196 participants (37.8%). A higher prevalence of VF was noted in those with DS. The prevalence of VF was significantly associated with age, gender, FRAX both with and without BMD, osteoporosis, low GS, and DS. In multivariate models accounting for age and sex, the c-index was greater in those with low GS plus osteoporosis as compared to DS alone. Low GS, osteoporosis, and pre-BMD FRAX all had similar c-indexes. Pre-BMD FRAX plus low GS and osteoporosis was superior in predicting VF compared to pre-BMD FRAX plus low GS or osteoporosis alone. Besides the inclusion of age and gender, the nomogram with pre-BMD FRAX major osteoporosis fracture probability (MOF) plus low GS had improved correlation between the estimated and actual VF probability than those with pre-BMD FRAX MOF plus osteoporosis. CONCLUSIONS The constructed nomogram containing pre-BMD FRAX MOF plus low GS may be considered as a first-line prevalent VF screening method. Those with high-risk scores should subsequently undergo vertebral radiography and/or BMD.
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Affiliation(s)
- Fang-Ping Chen
- Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,Corresponding author. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, 222 Mai-Chin Rd., Keelung 204, Taiwan.
| | - Yu-Jr Lin
- Research Service Center for Health Information, Chang Gung University, Taoyuan, Taiwan
| | - An-Shine Chao
- Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yu-Ching Lin
- Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,Department of Radiology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Chen-Ming Sung
- Department of Radiology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Jung-Fu Chen
- Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,Department of Endocrinology and Metabolism, Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan
| | - Alice MK. Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
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14
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Laskou F, Patel H, Cooper C, Dennison E. Functional capacity, sarcopenia, and bone health. Best Pract Res Clin Rheumatol 2022; 36:101756. [PMID: 35691825 DOI: 10.1016/j.berh.2022.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are recognised as interacting tissues, the so-called 'muscle-bone unit', in which these two tissues communicate to coordinate their development (chemically and metabolically), as well as their response to loading or injury. Musculoskeletal disorders of ageing, specifically osteoporosis and sarcopenia, are highly prevalent in older individuals. They signify a significant burden for older people affecting their mobility, confidence, and quality of life, as well as being a major cost to healthcare systems worldwide. This review considers the coexistence of osteoporosis and sarcopenia in individuals and describes risk factors, clinical consequences, approaches to management, and the link with functional capacity.
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Affiliation(s)
- Faidra Laskou
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Harnish Patel
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
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15
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Dai H, Xu J. Creatinine-to-cystatin C ratio as a marker of sarcopenia for identifying osteoporosis in male patients with type 2 diabetes mellitus. BMC Musculoskelet Disord 2022; 23:672. [PMID: 35836165 PMCID: PMC9281094 DOI: 10.1186/s12891-022-05636-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is associated with the increased incidence rate of sarcopenia and osteoporosis. Serum creatinine-to-cystatin C ratio (CCR) is a novel and simple tool which can be used as an index of sarcopenia. This study aims to investigate the association between CCR and osteoporosis as well as bone mineral density (BMD) in T2DM patients. Methods Four hundred eighteen T2DM patients were recruited, including 166 females and 252 males. General information, BMD data and laboratory data were collected. The correlation between CCR, BMD, bone metabolism markers and osteoporosis was explored by spearman correlation, receiver-operating characteristic (ROC) curve analysis and multiple regression analysis. Results Spearman correlation analysis showed that there was a positive correlation between CCR and BMD as well as serum calcium in male patients (r = 0.181–0.381, P < 0.01), but such correlation was not found in the female group. In multivariate regression analysis, it was found that there was a significant correlation between CCR and BMD of total lumbar spine, hip as well as femoral neck in male patients. ROC curve showed that the optimal cut-off value of CCR for predicting osteoporosis in male patients was 6.73 with the sensitivity of 88% and specificity of 63%. Conclusion In male T2DM patients, CCR was negatively correlated with osteoporosis and positively correlated with BMD.
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Affiliation(s)
- Huifan Dai
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People's Republic of China.
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16
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Lee SH, Lee JY, Lim KH, Lee YS, Koh JM. Associations Between Plasma Growth and Differentiation Factor-15 with Aging Phenotypes in Muscle, Adipose Tissue, and Bone. Calcif Tissue Int 2022; 110:236-243. [PMID: 34499185 DOI: 10.1007/s00223-021-00912-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/27/2021] [Indexed: 02/04/2023]
Abstract
Growth and differentiation factor 15 (GDF-15) is associated with muscle, fat, and bone metabolism; however, this association has not been well characterized. Plasma GDF-15, appendicular skeletal muscle mass (ASM), fat mass (FM), and bone mineral density (BMD) were measured in 146 postmenopausal women. GDF-15 levels were higher in subjects with low Body Mass Index (BMI)-adjusted ASM than in those without (median [interquartile range] 831.3 [635.4-1011.4] vs. 583.8 [455.8-771.1] pg/mL, p = 0.018). The GDF-15 level was inversely correlated with BMI-adjusted ASM (r = - 0.377, p < 0.001) and BMD at femur neck (FN-BMD; r = - 0.201, p = 0.015), and positively correlated with percent FM (pFM; r = 0.328, p < 0.001). After adjusting for confounders, the GDF-15 level was inversely associated with BMI-adjusted ASM (β = -0.250, p = 0.006) and positively associated with pFM (β = 0.272, p = 0.004), and tended to be inversely associated with FN-BMD (β = - 0.176, p = 0.076). The area under the receiver-operating characteristic curve of GDF-15 level > 618.4 pg/mL for sarcopenia was 0.706 (95% confidence interval (CI) 0.625-0.779) with a sensitivity of 83.3% and a specificity of 54.5%. Using a GDF-15 level of 618.4 pg/mL as a cut-off, the GDF-15 level was associated with a significantly greater likelihood of sarcopenia (odds ratio [OR] 2.35; 95% CI 1.00-5.51; p = 0.049), obesity (OR 3.28; 95% CI 1.48-7.27; p = 0.001), osteopenic obesity (OR 3.10; 95% CI 1.31-7.30; p = 0.010), and sarcopenic or osteosarcopenic obesity (OR 4.84; 95% CI 0.88-26.69; p = 0.070). These findings support the potential of GDF-15 as a biomarker for age-related changes in muscle, fat, and bone.
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Affiliation(s)
- Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
| | - Jee Yang Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Kyeong-Hye Lim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Young-Sun Lee
- Asan Institute for Life Sciences, Seoul, 05505, Republic of Korea
| | - Jung-Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
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Abstract
INTRODUCTION The prevalence of metabolic syndrome has been reported to extremely vary depending on the gender, age, and ethnicity studied. Approximately, 25% of the worldwide adult population is affected by metabolic syndrome, indicating it as a significantly important public health challenge. Likewise, fragility fracture represents an important public health issue too, and the lifetime residual risk of its occurrence has been established in 50% in women and 30% in men over 50 years of age, respectively. Dysmobility syndrome summarizes a cluster of co-existing conditions such as osteoporosis, sarcopenia, obesity. Currently, clinical research focuses essentially on the cardiovascular risks associated with metabolic syndrome. Today, it is conceivable to incorporate all these conditions under a generic "disorder of energy metabolism." EVIDENCE ACQUISITION Animal and human studies suggest metabolic and dysmobility syndromes negatively impact on the risk for fragility fracture, contributing to increase the associated mortality rate. EVIDENCE SYNTHESIS In recent years, strong correlation between type 2 diabetes, a frequent constitutive part of metabolic syndrome and fragility fracture risk has been reported, but the possible molecular mechanisms by which it can occur are still to be defined. CONCLUSIONS Only very few human clinical studies faced these aspects, but they lack adequate endpoints for a good clinical practice in these subjects. Much more still needs to be done before appropriate therapeutic diagnostic pathways will be available for these patients at risk of bone and even generalized fragility. Suggestions for a future overall approach by generating global risk score for these conditions are given.
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Affiliation(s)
- Roberta Cosso
- Section of Bone and Mineral Diseases, San Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Alberto Falchetti
- Section of Bone and Mineral Diseases, San Giuseppe Hospital, Piancavallo, Verbania, Italy - .,Unit for Bone Metabolism Diseases and Diabetes, Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
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Lee Y, Lee HJ, Yoon S, Shin J, Park KC, Lee SY, Lee S. Association Between Overweight Sarcopenic Population and Acute Vertebral Osteoporotic Compression Fractures in Females: Retrospective, Cross-Sectional Study. Front Med (Lausanne) 2021; 8:790135. [PMID: 34926531 PMCID: PMC8678084 DOI: 10.3389/fmed.2021.790135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to determine whether the prevalence of acute vertebral osteoporotic compression fractures (VOCF) in the elderly population is related to the distribution of muscles and fat in the human body. Methods: Data of acute VOCF and non-VOCF patients presenting at our institution between January 2018 and May 2020 were analyzed. Patients aged 65 years and older, who underwent body composition test and dual-energy X-ray absorptiometry at the same time were enrolled. After applying exclusion criteria, patients were divided into four groups: normal, sarcopenia without obesity, obesity without sarcopenia, and sarcopenic obesity. Body mass index ≥25 kg/m2 was considered obesity, and sarcopenia was defined as skeletal muscle index lower than 7.0 kg/m2 in males and 5.4 kg/m2 in females. The VOCF rate was analyzed between the groups. Discussion: A total of 461 patients were included, of whom 103 were males. Among them, 163 (35.36%) had normal body composition, 151 (32.75%) had sarcopenia without obesity, 110 (23.86%) had obesity without sarcopenia, and 37 (8.03%) had sarcopenic obesity. The sarcopenic obesity group had the highest rate of acute VOCF (37.8%), which was statistically significant. Specifically, females with sarcopenic obesity and sarcopenia without obesity had significantly higher acute VOCF rates compared to those with normal body compositions. Multivariate analysis showed that sarcopenic obesity was significantly associated with acute VOCF rate overall, as well as in females. Conclusion: Sarcopenic obesity is strongly associated with acute VOCF, especially in females, and it could be an essential criterion for the prevention of acute VOCF.
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Affiliation(s)
- Younghun Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Ho-Jae Lee
- Department of Orthopaedic Surgery, CHA Gumi Medical Center, Gumi, South Korea
| | - Siyeong Yoon
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jaeyeon Shin
- Department of Computer Science, College of IT Engineering, SeMyung University, Jecheon, South Korea
| | - Kyung-Chae Park
- Department of Family Medicine, Health Promotion Center, CHA Bundang Medical Center, CHA University School of Medicine, Pocheon, South Korea
| | - So-young Lee
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
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Falchetti A, Capodaglio P. What Do We Talk About When We Talk About Frailty? FRONTIERS IN REHABILITATION SCIENCES 2021; 2:633961. [PMID: 36188860 PMCID: PMC9397822 DOI: 10.3389/fresc.2021.633961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Alberto Falchetti
- Bone Unit, S Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
- Endocrine and Metabolic Research Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, S Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, Torino, Italy
- *Correspondence: Paolo Capodaglio
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20
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Lee YS, Hong N, Witanto JN, Choi YR, Park J, Decazes P, Eude F, Kim CO, Chang Kim H, Goo JM, Rhee Y, Yoon SH. Deep neural network for automatic volumetric segmentation of whole-body CT images for body composition assessment. Clin Nutr 2021; 40:5038-5046. [PMID: 34365038 DOI: 10.1016/j.clnu.2021.06.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/04/2021] [Accepted: 06/23/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND & AIMS Body composition analysis on CT images is a valuable tool for sarcopenia assessment. We aimed to develop and validate a deep neural network applicable to whole-body CT images of PET-CT scan for the automatic volumetric segmentation of body composition. METHODS For model development, one hundred whole-body or torso 18F-fluorodeoxyglucose PET-CT scans of 100 patients were retrospectively included. Two radiologists semi-automatically labeled the following seven body components in every CT image slice, providing a total of 46,967 image slices from the 100 scans for training the 3D U-Net (training, 39,268 slices; tuning, 3116 slices; internal validation, 4583 slices): skin, bone, muscle, abdominal visceral fat, subcutaneous fat, internal organs with vessels, and central nervous system. The segmentation accuracy was assessed using reference masks from three external datasets: two Korean centers (4668 and 4796 image slices from 20 CT scans, each) and a French public dataset (3763 image slices from 24 CT scans). The 3D U-Net-driven values were clinically validated using bioelectrical impedance analysis (BIA) and by assessing the model's diagnostic performance for sarcopenia in a community-based elderly cohort (n = 522). RESULTS The 3D U-Net achieved accurate body composition segmentation with an average dice similarity coefficient of 96.5%-98.9% for all masks and 92.3%-99.3% for muscle, abdominal visceral fat, and subcutaneous fat in the validation datasets. The 3D U-Net-derived torso volume of skeletal muscle and fat tissue and the average area of those tissues in the waist were correlated with BIA-derived appendicular lean mass (correlation coefficients: 0.71 and 0.72, each) and fat mass (correlation coefficients: 0.95 and 0.93, each). The 3D U-Net-derived average areas of skeletal muscle and fat tissue in the waist were independently associated with sarcopenia (P < .001, each) with adjustment for age and sex, providing an area under the curve of 0.858 (95% CI, 0.815 to 0.901). CONCLUSIONS This deep neural network model enabled the automatic volumetric segmentation of body composition on whole-body CT images, potentially expanding adjunctive sarcopenia assessment on PET-CT scan and volumetric assessment of metabolism in whole-body muscle and fat tissues.
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Affiliation(s)
- Yoon Seong Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Namki Hong
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Ye Ra Choi
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Junghoan Park
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Pierre Decazes
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France
| | - Florian Eude
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea; MEDICALIP Co. Ltd., Seoul, South Korea.
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Pizzonia M, Casabella A, Natali M, Petrocchi L, Carmisciano L, Nencioni A, Molfetta L, Giannotti C, Bianchi G, Giusti A, Santolini F, Monacelli F. Osteosarcopenia in Very Old Age Adults After Hip Fracture: A Real-World Therapeutic Standpoint. Front Med (Lausanne) 2021; 8:612506. [PMID: 34095158 PMCID: PMC8172785 DOI: 10.3389/fmed.2021.612506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/24/2021] [Indexed: 12/16/2022] Open
Abstract
Loss of bone and muscle mass and strength (i. e., osteosarcopenia) is a highly prevalent clinical condition in older adults, associated with an increased risk of fragility fractures and unfavorable clinical outcomes. Although sarcopenia is a potential risk factor for osteoporosis and subsequent fracture, and the management of this hazardous duet is the key to preventing osteoporotic fracture, evidence pertaining to the treatment of sarcopenia for the purpose of preventing fragile fractures remains insufficient. Given this scenario we aimed at prospectively compare the long-term effectiveness of bisphosphonates vs. denosumab, on bone and muscle, in a cohort of old age hip fractured patients by virtue of a timely osteo-metabolic and sarcopenic assessment. Ninety-eight patients consecutively enrolled at the IRCCS Hospital San martino, Genoa, Italy, received at baseline comprehensive geriatric assessment and Bone Densitometry (DXA) with the quantitative and quantitative bone analysis and evaluation of relative skeletal muscle index (RSMI) and longitudinally after 1 year form hip surgery. The results showed a slightly and non-significant osteo-metabolic improvement in the Alendronate group compared to the Denosumab group, and a positive trend of RSMI measurements in the Denosumab group. Although preliminary in nature, this is the first report to longitudinally analyze osteosarcopenia in a real-world cohort of very old age patients after hip fracture and moved a step forward in the understanding of the best osteo-metabolic therapy for long- term treatment, exploring as well the potential dual role of denousumab as antiresorptive and muscle strength specific drug for osteosarcopenia in this vulnerable population.
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Affiliation(s)
- Monica Pizzonia
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Casabella
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Marta Natali
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Lorena Petrocchi
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Alessio Nencioni
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Luigi Molfetta
- DISC, Department of Integrated Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Chiara Giannotti
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Gerolamo Bianchi
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Andrea Giusti
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Federico Santolini
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiammetta Monacelli
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
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22
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Darvishi A, Hemami MR, Shafiee G, Daroudi R, Mohseni M, Shekarabi FH, Heshmat R. Sarcopenia screening strategies in older people: a cost effectiveness analysis in Iran. BMC Public Health 2021; 21:926. [PMID: 34001057 PMCID: PMC8127291 DOI: 10.1186/s12889-021-10511-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 02/26/2021] [Indexed: 01/06/2023] Open
Abstract
Background and objectives Sarcopenia is an important age-related disease which can lead to an increased risk of mortality, falls, fractures, and poor quality of life. So, timely detection can be effective in reducing the burden of disease. The aim of this study was to identify the most cost-effective strategy for sarcopenia screening in Iran. Materials and methods We constructed a Markov transition model over a life-time horizon based on natural history. Compared strategies included Sarcopenia scoring assessment models (SarSA-Mod), European working group on sarcopenia in older people (EWGSOP), Mini sarcopenia risk assessment (MSRA) and SARC-F. Parameters values were extracted from primary data and the literature, and the costs and Quality-adjusted life years (QALYs) were calculated for each strategy. Sensitivity analysis of uncertain parameters was also performed to determine the robustness of the model. Analysis was performed using 2020 version of TreeAge Pro software. Results All four screening strategies increased life time QALYs. After removing dominated strategy, the incremental cost per QALY gained for sarcopenia screening varied from $1875.67 for EWGSOP to $1898.33 for MSRA. Our base-case analysis showed that the most cost-effective strategy was EWGSOP and 2nd best was SarSA-Mod with $43,414.3 and $42,663.3 net monetary benefits given one GDP per capita ($5520.311) as willingness to pay, respectively. Sensitivity analysis of model parameters also showed robustness of results. Conclusions The results of the study, as the first economic evaluation of sarcopenia screening, showed that the EWGSOP strategy is more cost-effective than other strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10511-7.
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Affiliation(s)
- Ali Darvishi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina AVE, Tehran, 1417613151, Iran
| | - Mohsen Rezaei Hemami
- Aberdeen Centre for Health Data Sciences, University of Aberdeen, Foresthill, Aberdeen, AB252ZD, UK
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran.
| | - Rajabali Daroudi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina AVE, Tehran, 1417613151, Iran.,National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
| | - Mahsa Mohseni
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina AVE, Tehran, 1417613151, Iran
| | - Farkhondeh Hosseini Shekarabi
- Department of Mathematics, Faculty of Sciences, Shahid Rajaee Teacher Training University, Lavizan, Tehran, 1417613363, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, 1411713137, Iran
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Jung YW, Hong N, Kim CO, Kim HC, Youm Y, Choi JY, Rhee Y. The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study. Osteoporos Int 2021; 32:939-949. [PMID: 33128075 DOI: 10.1007/s00198-020-05708-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/20/2020] [Indexed: 12/25/2022]
Abstract
UNLABELLED Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool. INTRODUCTION Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs. METHODS In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance. RESULTS Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002). CONCLUSION Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.
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Affiliation(s)
- Y W Jung
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - N Hong
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - C O Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y Youm
- Department of Sociology, Yonsei University, Seoul, Korea
| | - J -Y Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Y Rhee
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
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Chen YF, Zong HX, Xu SQ, Chu YR, Wang JX, Li WJ, Chen KM. Synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture in Chinese patients with rheumatoid arthritis. Clin Rheumatol 2021; 40:3627-3637. [PMID: 33774766 DOI: 10.1007/s10067-021-05703-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/13/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This study aimed to investigate the synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture (VOPF) in Chinese patients with rheumatoid arthritis (RA). METHODS A total of 238 RA patients and 158 normal subjects were enrolled in the case-control study. Poor balance capability (Berg balance scale (BBS) score < 40) and sarcopenia (skeletal muscle mass index (SMI) <7.0 (male)/5.7 (female)) between RA patients and normal subjects were compared. Associations of poor balance capability or sarcopenia with disease activity, structural damage, and joint function in different groups were also investigated. RESULTS The incidence of sarcopenia in RA was 58.4%, significantly higher than that in controls (P<0.0001). Moreover, the percentages of low balance capacity (BBS<40) in RA were 43.7%, which was higher than that in controls (P<0.0001). The prevalence of VOPF in the case group was 19.3%, which was higher than that in the controls (P<0.0001). In the RA group, compared to RA patients without VOPF, RA patients with VOPF had higher percentages of poor balance and sarcopenia (P<0.05). Compared with RA patients without sarcopenia or good balance, RA patients with sarcopenia or poor balance had a higher incidence of VOPF, higher disease activity, severer structural damage, and worse joint function (P<0.05). The incidence of VOPF in patients combined with good balance and non-sarcopenia (4.8%) was significantly lower than that in patients combined with poor balance and sarcopenia (38.2%) (P<0.0001). Logistic regression indicated that higher SMI and higher BBS scores were protective factors for VOPF in RA patients, while age was a risk factor for VOPF in RA patients (P<0.0001). CONCLUSION Sarcopenia and poor balance are popular in Chinese patients with RA, and they are associated with disease activity and structural damage. There is a synergistic effect of sarcopenia and poor balance on VOPF in RA. Key Points • Sarcopenia and balance capability were popular (about a half) in patients with RA. • Sarcopenia and poor balance had a synergistic effect on VOPF in RA.
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Affiliation(s)
- Yang-Fan Chen
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - He-Xiang Zong
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Sheng-Qian Xu
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China.
| | - Yi-Ran Chu
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Jian-Xiong Wang
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Wan-Jun Li
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Ke-Ming Chen
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
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Dysmobility syndrome: a case-series study describing a musculoskeletal syndrome in postmenopausal Mexican women. Arch Osteoporos 2021; 16:54. [PMID: 33683487 DOI: 10.1007/s11657-021-00897-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/20/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED "Dysmobility Syndrome" (DS) is a term that correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls. The prevalence of DS is of 74% in this study. Further research with bigger sample sizes is needed to describe if prevalence and DS characteristics are similar in other studies. PURPOSE "Dysmobility Syndrome" (DS) correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls, all of which are related to adverse outcomes in the health of the elderly; however, there are no studies of DS in Mexican patients. In this study, we aimed to describe the characteristics of DS in Mexican postmenopausal women from a private practice. METHODS A case-series study was conducted; women of 60 years and older were invited to participate from August to December of 2019, a total of 50 patients were included. Medical history, physical tests, bone densitometry, and body composition analysis were performed; patients who met 3 or more of the following criteria were diagnosed with DS: osteoporosis: T-score ≤ -2.5, falls in a previous year, lean appendicular mass: ≤ 5.45 kg/m2, walking speed: < 1.0 m/s, grip strength: < 20 kg, and body fat percentage: > 40%. RESULTS Out of the total 50 patients, 37 were diagnosed with DS, with a prevalence of 74% in our study. Sixteen patients had a history of a non-vertebral fragility fracture, of which 14 had a diagnosis of DS (87%). CONCLUSIONS DS has a high frequency in our study group, and was found to be closely related to the presence of non-vertebral fragility fractures. More research is needed to describe the prevalence and characteristics of DS with a stronger statistical significance within our population, and among others across the country, to get an extensive understanding of its presentation in Mexican women. KEY POINTS • The frequency of DS in this study is higher than the one that is described in global literature. • DS diagnosis is closely related to the antecedent of non-vertebral fragility fracture.
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Metabolic Syndromes and Dysmobility: Why Should Physical Medicine and Rehabilitation Care? Am J Phys Med Rehabil 2021; 100:e32-e33. [PMID: 32412943 DOI: 10.1097/phm.0000000000001466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hong N, Siglinsky E, Krueger D, White R, Kim CO, Kim HC, Yeom Y, Binkley N, Rhee Y, Buehring B. Defining an international cut-off of two-legged countermovement jump power for sarcopenia and dysmobility syndrome. Osteoporos Int 2021; 32:483-493. [PMID: 32894301 PMCID: PMC7929946 DOI: 10.1007/s00198-020-05591-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022]
Abstract
UNLABELLED We aimed to establish jump power cut-offs for the composite outcome of either sarcopenia (EWGSOP2) or dysmobility syndrome using Asian and Caucasian cohorts. Estimated cut-offs were sex specific (women: < 19.0 W/kg; men: < 23.8 W/kg) but not ethnicity specific. Jump power has potential to be used in definitions of poor musculoskeletal health. PURPOSE Weight-corrected jump power measured during a countermovement jump may be a useful tool to identify individuals with poor musculoskeletal health, but no cut-off values exist. We aimed to establish jump power cut-offs for detecting individuals with either sarcopenia or dysmobility syndrome. METHODS Age- and sex-matched community-dwelling older adults from two cohorts (University of Wisconsin-Madison [UW], Korean Urban Rural Elderly cohort [KURE], 1:2) were analyzed. Jump power cut-offs for the composite outcome of either sarcopenia defined by EWGSOP2 or dysmobility syndrome were determined. RESULTS The UW (n = 95) and KURE (n = 190) cohorts were similar in age (mean 75 years) and sex distribution (68% women). Jump power was similar between KURE and UW women (19.7 vs. 18.6 W/kg, p = 0.096) and slightly higher in KURE than UW in men (26.9 vs. 24.8 W/kg, p = 0.050). In UW and KURE, the prevalence of sarcopenia (7.4% in both), dysmobility syndrome (31.6% and 27.9%), or composite of either sarcopenia or dysmobility syndrome (32.6% and 28.4%) were comparable. Low jump power cut-offs for the composite outcome differed by sex but not by ethnicity (< 19.0 W/kg in women; < 23.8 W/kg in men). Low jump power was associated with elevated odds of sarcopenia (adjusted odds ratio [aOR] 4.07), dysmobility syndrome (aOR 4.32), or the composite of sarcopenia or dysmobility syndrome (aOR 4.67, p < 0.01 for all) independent of age, sex, height, and ethnicity. CONCLUSION Sex-specific jump power cut-offs were found to detect the presence of either sarcopenia or dysmobility syndrome in older adults independent of Asian or Caucasian ethnicity.
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Affiliation(s)
- N Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - E Siglinsky
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
- UT Southwestern Medical Center, University of Texas Southwestern, Dallas, TX, USA
| | - D Krueger
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - R White
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - C O Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y Yeom
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea
| | - N Binkley
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - Y Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - B Buehring
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA.
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Germany.
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Xu X, Xu N, Wang Y, Chen J, Chen L, Zhang S, Chen J, Deng H, Luan X, Shen J. The longitudinal associations between bone mineral density and appendicular skeletal muscle mass in Chinese community-dwelling middle aged and elderly men. PeerJ 2021; 9:e10753. [PMID: 33552737 PMCID: PMC7821753 DOI: 10.7717/peerj.10753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/19/2020] [Indexed: 11/20/2022] Open
Abstract
Background The present study aimed to investigate longitudinal associations between bone mineral densities (BMDs) and appendicular skeletal muscle (ASM) mass in different regions of the body using three different indicators, in Chinese community-dwelling middle-aged and elderly men. Methods A total of 1,343 men aged ≥ 40 years from a Chinese community were assessed at baseline (2014-2016), one-year follow-up (2016-2017; n = 648), two-year follow-up (2017-2018; n = 407), and three-year follow up (2018-2019; n = 208). At all the four time-points, measurements included ASM mass and BMDs for all regions of the body using dual-energy X-ray absorptiometry. A questionnaire was completed by patients and biochemical markers were assessed. We applied three different indicators to define ASM mass or lean mass respectively, including the appendicular skeletal muscle index (ASM adjusted by height, ASMI, according to the Asian Working Group for Sarcopenia), skeletal muscle index (ASM adjusted by weight, SMI, according to the International Working Group on Sarcopenia), and the appendicular skeletal muscle/body mass index (ratio of ASM and Body mass index (BMI), ASM/BMI, according to the Foundation for the National Institutes of Health). After adjusting for potential confounders, the generalized additive mixed model (GAMM) was used to analyze the trend in ASM mass over time, and to test the association between ASM mass and regional and whole-body BMDs. Results The incidence of low lean mass was 8.2% defined by ASMI, 16.3% defined by SMI, and 8.3% defined by ASM/BMI. There was a linear relationship between BMDs and ASM mass, and ASMI, ASM/BMI, and SMI gradually decreased with time. After adjusting for covariances, GAMM analysis determined longitudinal associations between BMDs and ASM mass by three indicators respectively: the skull BMD was negatively associated with ASM mass. For each unit increase in skull BMD, ASMI decreased by 0.28 kg/m2 (95% confidence interval (CI) [-0.39 to -0.16]), ASM/BMI decreased by 0.02 m2 (95% CI [-0.03 to -0.00]), and SMI decreased by 0.01% (95% CI[-0.01 to -0.00]). The remaining parameters (including whole-body mean BMD, thoracic spinal BMD, lumbar spinal BMD, hip BMD, femoral neck BMD, pelvic BMD, left arm BMD, right arm BMD, left leg BMD, right leg BMD) were positively correlated with ASM mass. The ASMI increased by 3.07 kg/m2for each unit increase in the femoral neck BMD (95% CI [2.31-3.84]). The ASM/BMI increased by 0.22 m2for each unit increase in the left arm BMD (95% CI [0.12-0.33]), and the SMI increased by 0.05% per unit increase in the left arm BMD (95% CI [0.02-0.08]). Conclusions Compared to ASMI and ASM/BMI, SMI was more sensitive to screen for the low lean mass. Skull BMD was negatively associated with ASM mass, while BMDs throughout the rest of the body were positively correlated with ASM mass among the middle-aged and elderly Chinese men.
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Affiliation(s)
- Xuejuan Xu
- Department of Endocrinology, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Nuo Xu
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Ying Wang
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Jinsong Chen
- Department of Endocrinology, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Lushi Chen
- Department of Health Care, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Shengjian Zhang
- Department of Health Care, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Jingxian Chen
- Department of Hematology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Hongwen Deng
- Center of Genomics and Bioinformatics, Tulane University, New Orleans, LA, United States of America.,Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
| | - Xiaojun Luan
- Department of Endocrinology, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Jie Shen
- Department of Endocrinology, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
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Shoepe TC, LaBrie JW, Mello GT, Leggett AG, Almstedt HC. Intensity of resistance training via self-reported history is critical in properly characterizing musculoskeletal health. BMC Musculoskelet Disord 2020; 21:729. [PMID: 33172425 PMCID: PMC7654594 DOI: 10.1186/s12891-020-03753-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Intensity of resistance training history might be omitted or poorly ascertained in prescreening or data questionnaires involving musculoskeletal health. Failure to identify history of high-versus low-intensity training may overlook higher effect sizes with higher intensities and therefore diminish the precision of statistical analysis with resistance training as a covariate and bias the confirmation of baseline homogeneity for experimental group designation. The purpose was to determine the degree to which a single question assessing participant history of resistance training intensity predicted differences in musculoskeletal health. METHODS In the first research aim, participants were separated into groups with a history (RT) and no history (NRT) of resistance training. The second research aim evaluated the history of resistance training intensity on muscular strength, lean mass, and bone mineral density (BMD), RT participants were reassigned into a low- (LIRT) or high-intensity resistance training group (HIRT). 83 males and 87 females (19.3 ± 0.6 yrs., 171.1 ± 9.9 cm, 67.1 ± 10.5 kg, 22.9 ± 2.8 BMI, 26.2 ± 7.2% body fat) completed handgrip dynamometry (HG) and dual-energy x-ray absorptiometry scans (DXA) for BMD and bone mineral-free lean mass (BFLM). RESULTS A 3-group method (NRT, LIRT, HIRT) reduced type-I error compared with the 2-group method (NRT, RT) in characterizing the likely effects of one's history of resistance training. For the second aim, HIRT had significantly (p < 0.05) greater HG strength (76.2 ± 2.2 kg) and arm BFLM (6.10 ± 0.16 kg) than NRT (67.5 ± 1.3 kg; 4.96 ± 0.09 kg) and LIRT (69.7 ± 2.0 kg; 5.42 ± 0.14 kg) while also showing significantly lower muscle quality (HG/BFLM) than NRT (13.9 ± 0.2 vs. 12.9 ± 0.3). HIRT had greater BMD at all sites compared to NRT (whole body = 1.068 ± 0.008 vs. 1.120 ± 0.014; AP spine = 1.013 ± 0.011 vs. 1.059 ± 0.019; lateral spine = 0.785 ± 0.009 vs. 0.846 ± 0.016; femoral neck = 0.915 ± 0.013 vs. 0.970 ± 0.022; total hip = 1.016 ± 0.012 vs. 1.068 ± 0.021 g/cm2) while LIRT revealed no significant skeletal differences to NRT. CONCLUSIONS Retrospective identification of high-intensity history of resistance training appears critical in characterizing musculoskeletal health and can be ascertained easily in as little as a single, standalone question. Both retrospective-questionnaire style investigations and pre-screening for potential participation in prospective research studies should include participant history of resistance training intensity.
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Affiliation(s)
- Todd C Shoepe
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA.
| | - Joseph W LaBrie
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA
| | - Grant T Mello
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA
| | - Allison G Leggett
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA
| | - Hawley C Almstedt
- Health and Human Performance Laboratory, Department of Health and Human Sciences, Loyola Marymount University, Life Sciences Building 181, 1 LMU Drive, MS 8888, Los Angeles, CA, 90045, USA
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Pei YF, Liu YZ, Yang XL, Zhang H, Feng GJ, Wei XT, Zhang L. The genetic architecture of appendicular lean mass characterized by association analysis in the UK Biobank study. Commun Biol 2020; 3:608. [PMID: 33097823 PMCID: PMC7585446 DOI: 10.1038/s42003-020-01334-0] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/30/2020] [Indexed: 01/19/2023] Open
Abstract
Appendicular lean mass (ALM) is a heritable trait associated with loss of lean muscle mass and strength, or sarcopenia, but its genetic determinants are largely unknown. Here we conducted a genome-wide association study (GWAS) with 450,243 UK Biobank participants to uncover its genetic architecture. A total of 1059 conditionally independent variants from 799 loci were identified at the genome-wide significance level (p < 5 × 10-9), all of which were also significant at p < 5 × 10-5 in both sexes. These variants explained ~15.5% of the phenotypic variance, accounting for more than one quarter of the total ~50% GWAS-attributable heritability. There was no difference in genetic effect between sexes or among different age strata. Heritability was enriched in certain functional categories, such as conserved and coding regions, and in tissues related to the musculoskeletal system. Polygenic risk score prediction well distinguished participants with high and low ALM. The findings are important not only for lean mass but also for other complex diseases, such as type 2 diabetes, as ALM is shown to be a protective factor for type 2 diabetes.
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Affiliation(s)
- Yu-Fang Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China.
| | - Yao-Zhong Liu
- Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Xiao-Lin Yang
- Department of Research, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, PR China
| | - Hong Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
| | - Gui-Juan Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
| | - Xin-Tong Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China
| | - Lei Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China.
- Center for Genetic Epidemiology and Genomics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, PR China.
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Hwang AC, Lee WJ, Peng LN, Liu LK, Lin MH, Loh CH, Chen LK. Unfavorable body composition and quality of life among community-dwelling middle-aged and older adults: What really matters? Maturitas 2020; 140:34-40. [DOI: 10.1016/j.maturitas.2020.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/19/2020] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
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Dysregulated Autophagy Mediates Sarcopenic Obesity and Its Complications via AMPK and PGC1α Signaling Pathways: Potential Involvement of Gut Dysbiosis as a Pathological Link. Int J Mol Sci 2020; 21:ijms21186887. [PMID: 32961822 PMCID: PMC7555990 DOI: 10.3390/ijms21186887] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022] Open
Abstract
Sarcopenic obesity (SOB), which is closely related to being elderly as a feature of aging, is recently gaining attention because it is associated with many other age-related diseases that present as altered intercellular communication, dysregulated nutrient sensing, and mitochondrial dysfunction. Along with insulin resistance and inflammation as the core pathogenesis of SOB, autophagy has recently gained attention as a significant mechanism of muscle aging in SOB. Known as important cellular metabolic regulators, the AMP-activated protein kinase (AMPK) and the peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (PGC-1α) signaling pathways play an important role in autophagy, inflammation, and insulin resistance, as well as mutual communication between skeletal muscle, adipose tissue, and the liver. Furthermore, AMPK and PGC-1α signaling pathways are implicated in the gut microbiome-muscle axis. In this review, we describe the pathological link between SOB and its associated complications such as metabolic, cardiovascular, and liver disease, falls and fractures, osteoarthritis, pulmonary disease, and mental health via dysregulated autophagy controlled by AMPK and/or PGC-1α signaling pathways. Here, we propose potential treatments for SOB by modulating autophagy activity and gut dysbiosis based on plausible pathological links.
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Interleukin-6 and Lymphocyte Count Associated and Predicted the Progression of Frailty Syndrome in Prostate Cancer Patients Undergoing Antiandrogen Therapy. Cancers (Basel) 2020; 12:cancers12071716. [PMID: 32610428 PMCID: PMC7408184 DOI: 10.3390/cancers12071716] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023] Open
Abstract
Frailty syndrome is a functional state that includes a loss of ability to react to stressors, and is associated with poor outcomes, morbidity and premature mortality. The first line treatment in many men with prostate cancer (PCa) consists of an androgen-deprivation therapy (ADT) which can promote or favor frailty syndrome and ADT may therefore favor the progression of frailty over time. Among the pathophysiological bases of frailty, the presence of chronic low-grade inflammation has been associated with its adverse outcomes, but longitudinal studies are needed to validate these biomarkers. In this study, we prospectively evaluate frailty syndrome and blood inflammatory markers (IL1-beta, IL-6, IL-8, TNF alpha, C reactive protein) and leukocytes were measured at baseline and an average of 1 year later in PCa under ADT. Frailty was defined as having three or more of the following components: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those components. Multinomial regression analysis showed that among the inflammatory biomarkers, those significantly and repeatedly (baseline and follow-up time points) (p < 0.05) associated with frailty syndrome were high IL-6 levels and low lymphocyte counts in blood. Other biomarkers such as IL-8, monocyte counts and C reactive protein were significantly associated with frailty syndrome (p < 0.05) in cross-sectional analyses, but they do not predict frailty progression at 1 year-follow-up. Receiver operating characteristic curve analysis showed that both lymphocyte counts and IL-6 concentration significantly (p < 0.05) (although moderately) discriminate PCa patients that progressed in the severity of frailty syndrome. IL-6 and lymphocytes count are possible biomarkers, useful for identifying frail patients and predicting the progression of frailty in PCa under ADT. Our study suggests the use of these biomarkers to guide clinical decisions on prostate cancer treatment based on a multidisciplinary approach.
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Primary osteoporosis in men: an unmet medical need. Fertil Steril 2020; 112:791-798. [PMID: 31731933 DOI: 10.1016/j.fertnstert.2019.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/27/2022]
Abstract
Osteoporosis is a skeletal disease characterized by loss of bone strength and increased risk of fractures. Even though fracture prevalence is higher in women, fractures also constitute a significant public health issue in older men. Men are screened less and more frequently undertreated than female patients. It is the goal of this review, to summarize updated information about the current understanding of pathophysiology and clinical aspects of diagnosis and treatment of osteoporosis in men.
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Lobelo F, Muth ND, Hanson S, Nemeth BA. Physical Activity Assessment and Counseling in Pediatric Clinical Settings. Pediatrics 2020; 145:peds.2019-3992. [PMID: 32094289 DOI: 10.1542/peds.2019-3992] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Physical activity plays an important role in children's cardiovascular health, musculoskeletal health, mental and behavioral health, and physical, social, and cognitive development. Despite the importance in children's lives, pediatricians are unfamiliar with assessment and guidance regarding physical activity in children. With the release of the 2018 Physical Activity Guidelines by the US Department of Health and Human Services, pediatricians play a critical role in encouraging physical activity in children through assessing physical activity and physical literacy; providing guidance toward meeting recommendations by children and their families; advocating for opportunities for physical activity for all children in schools, communities, and hospitals; setting an example and remaining physically active personally; advocating for the use of assessment tools and insurance coverage of physical activity and physical literacy screening; and incorporating physical activity assessment and prescription in medical school curricula.
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Affiliation(s)
| | - Natalie D Muth
- Children's Primary Care Medical Group, Carlsbad, California; and
| | - Sara Hanson
- Nutrition and Health Sciences Program, Laney Graduate School and Exercise is Medicine Global Research and Collaboration Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Blaise A Nemeth
- American Family Children's Hospital and School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Wilson LAB, De Groote I, Humphrey LT. Sex differences in the patterning of age-related bone loss in the human hallucal metatarsal in rural and urban populations. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 171:628-644. [PMID: 31925961 DOI: 10.1002/ajpa.24002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/18/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Age-degenerative features of the metatarsals are poorly known despite the importance of metatarsal bone properties for investigating mobility patterns. We assessed the role of habitual activity in shaping the patterning and magnitude of sexual dimorphism in age-related bone loss in the hallucal metatarsal. MATERIALS AND METHODS Cross-sections were extracted at midshaft from micro-computed tomography scan models of individuals from medieval rural (Abingdon Vineyard) and early industrial urban (Spitalfields) settings (n = 71). A suite of cross-sectional geometry dimensions and biomechanical properties were compared between populations. RESULTS The rural group display generally stronger and larger metatarsals that show a greater capacity to resist torsion and that have comparatively greater bending strength along the medio-lateral plane. Men in both groups show greater values of cortical area than women, but only in the urban group do men show lower magnitudes of age-related decline compared to females. Women in rural and urban populations show different patterns of age-related decline in bone mass, particularly old women in the urban group show a marked decline in cortical area that is absent for women in the rural group. DISCUSSION Lifetime exposure to hard, physical activity in an agricultural setting has contributed to the attainment of greater bone mass and stronger bones in young adults. Furthermore, over the life-course, less of this greater amount of bone is lost, such that sustained activity levels may have acted to buffer against age-related decline, and this is most pronounced for women, who are expected to experience greater bone loss later in life than men.
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Affiliation(s)
- Laura A B Wilson
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Isabelle De Groote
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
- Department of Archaeology, Section Prehistory of western Europe, Ghent University, Ghent, Belgium
| | - Louise T Humphrey
- Department of Earth Sciences, The Natural History Museum London, London, UK
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37
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Eller-Vainicher C, Cairoli E, Grassi G, Grassi F, Catalano A, Merlotti D, Falchetti A, Gaudio A, Chiodini I, Gennari L. Pathophysiology and Management of Type 2 Diabetes Mellitus Bone Fragility. J Diabetes Res 2020; 2020:7608964. [PMID: 32566682 PMCID: PMC7262667 DOI: 10.1155/2020/7608964] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022] Open
Abstract
Individuals with type 2 diabetes mellitus (T2DM) have an increased risk of bone fragility fractures compared to nondiabetic subjects. This increased fracture risk may occur despite normal or even increased values of bone mineral density (BMD), and poor bone quality is suggested to contribute to skeletal fragility in this population. These concepts explain why the only evaluation of BMD could not be considered an adequate tool for evaluating the risk of fracture in the individual T2DM patient. Unfortunately, nowadays, the bone quality could not be reliably evaluated in the routine clinical practice. On the other hand, getting further insight on the pathogenesis of T2DM-related bone fragility could consent to ameliorate both the detection of the patients at risk for fracture and their appropriate treatment. The pathophysiological mechanisms underlying the increased risk of fragility fractures in a T2DM population are complex. Indeed, in T2DM, bone health is negatively affected by several factors, such as inflammatory cytokines, muscle-derived hormones, incretins, hydrogen sulfide (H2S) production and cortisol secretion, peripheral activation, and sensitivity. All these factors may alter bone formation and resorption, collagen formation, and bone marrow adiposity, ultimately leading to reduced bone strength. Additional factors such as hypoglycemia and the consequent increased propensity for falls and the direct effects on bone and mineral metabolism of certain antidiabetic medications may contribute to the increased fracture risk in this population. The purpose of this review is to summarize the literature evidence that faces the pathophysiological mechanisms underlying bone fragility in T2DM patients.
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Affiliation(s)
- C. Eller-Vainicher
- Unit of Endocrinology, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - E. Cairoli
- Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, Italy
- Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy
| | - G. Grassi
- Unit of Endocrinology, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy
| | - F. Grassi
- Ramses Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A. Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - D. Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - A. Falchetti
- Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, Italy
| | - A. Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, University Hospital ‘G. Rodolico', Catania, Italy
| | - I. Chiodini
- Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, Italy
- Dept. of Clinical Sciences & Community Health, University of Milan, Milan, Italy
| | - L. Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
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Gut Microbial, Inflammatory and Metabolic Signatures in Older People with Physical Frailty and Sarcopenia: Results from the BIOSPHERE Study. Nutrients 2019; 12:nu12010065. [PMID: 31887978 PMCID: PMC7019826 DOI: 10.3390/nu12010065] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 12/11/2022] Open
Abstract
Physical frailty and sarcopenia (PF&S) share multisystem derangements, including variations in circulating amino acids and chronic low-grade inflammation. Gut microbiota balances inflammatory responses in several conditions and according to nutritional status. Therefore, an altered gut-muscle crosstalk has been hypothesized in PF&S. We analyzed the gut microbial taxa, systemic inflammation, and metabolic characteristics of older adults with and without PF&S. An innovative multi-marker analytical approach was applied to explore the classification performance of potential biomarkers for PF&S. Thirty-five community dwellers aged 70+, 18 with PF&S, and 17 nonPF&S controls were enrolled. Sequential and Orthogonalized Covariance Selection (SO-CovSel), a multi-platform regression method developed to handle highly correlated variables, was applied. The SO-CovSel model with the best prediction ability using the smallest number of variables was built using seven mediators. The model correctly classified 91.7% participants with PF&S and 87.5% nonPF&S controls. Compared with the latter group, PF&S participants showed higher serum concentrations of aspartic acid, lower circulating levels of concentrations of threonine and macrophage inflammatory protein 1α, increased abundance of Oscillospira and Ruminococcus microbial taxa, and decreased abundance of Barnesiellaceae and Christensenellaceae. Future investigations are warranted to determine whether these biomediators are involved in PF&S pathophysiology and may, therefore, provide new targets for interventions.
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Wang WF, Lin CW, Xie CN, Liu HT, Zhu MY, Huang KL, Teng HL. The association between sarcopenia and osteoporotic vertebral compression refractures. Osteoporos Int 2019; 30:2459-2467. [PMID: 31482304 DOI: 10.1007/s00198-019-05144-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Abstract
UNLABELLED Sarcopenia was reported to be significantly associated with osteoporosis. In this study, we reported for the first time that sarcopenia was an independent risk predictor of osteoporotic vertebral compression refractures (OVCRFs). Other risk factors of OVCRFs are low bone mass density T-scores, female sex, and advanced age. INTRODUCTION The purpose of this study was to investigate the association between osteoporotic vertebral compression refractures (OVCRFs) and sarcopenia, and to identify other risk factors of OVCRFs. METHODS We evaluated 237 patients with osteoporotic vertebral compression fracture who underwent percutaneous kyphoplasty (PKP) in our hospital from August 2016 to December 2017. To diagnose sarcopenia, a cross-sectional computed tomography (CT) image at the inferior aspect of the third lumbar vertebra (L3) was selected for estimating muscle mass. Grip strength was used to assess muscle strength. Possible risk factors, such as age, sex, body mass index (BMI), bone mineral density (BMD), location of the treated vertebra, anterior-posterior ratio (AP ratio) of the fractured vertebra, cement leakage, and vacuum clefts, were assessed. The multivariable analysis was used to determine the risk factors of OVCRFs. RESULTS During the follow-up period, OVCRFs occurred in 64 (27.0%) patients. Sarcopenia was present in 48 patients (20.3%), including 21 OVCRFs and 27 non-OVCRFs patients. Sarcopenia was significantly correlated with advanced age, lower BMI, lower BMD, and hypoalbuminemia. Compared with non-sarcopenic patients, sarcopenic patients had higher OVCRFs risk. In univariate analysis, sarcopenia (p = 0.003), female (p = 0.024), advanced age (≥ 75 years; p < 0.001), lower BMD (p < 0.001), lower BMI (p = 0.01), TL junction (vertebral levels at the thoracolumbar junction) (p = 0.01), cardiopulmonary comorbidity (p = 0.042), and hypoalbuminemia (p = 0.003) were associated with OVCRFs. Multivariable analysis revealed that sarcopenia (OR 2.271; 95% CI 1.069-4.824, p = 0.033), lower BMD (OR 1.968; 95% CI 1.350-2.868, p < 0.001), advanced age (≥ 75 years; OR 2.431; 95% CI 1.246-4.744, p = 0.009), and female sex (OR 4.666; 95% CI 1.400-15.552, p = 0.012) were independent risk predictors of OVCRFs. CONCLUSIONS Sarcopenia is an independent risk predictor of osteoporotic vertebral compression refractures. Other factors affecting OVCRFs are low BMD T-scores, female sex, and advanced age.
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Affiliation(s)
- W-F Wang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-W Lin
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-N Xie
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-T Liu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - M-Y Zhu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - K-L Huang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-L Teng
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China.
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Qi H, Sheng Y, Chen S, Wang S, Zhang A, Cai J, Lai B, Ding G. Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin Exp Res 2019; 31:1549-1556. [PMID: 31317519 PMCID: PMC6825032 DOI: 10.1007/s40520-019-01266-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
Background As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear. Aims To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects. Methods 318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance. Results We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip. Conclusions The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.
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Affiliation(s)
- Hanmei Qi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Yunlu Sheng
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Shu Chen
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Siting Wang
- Division of Intensive Care Unit, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Aisen Zhang
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Jinmei Cai
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Bing Lai
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Guoxian Ding
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Sepúlveda-Loyola W, Phu S, Bani Hassan E, Brennan-Olsen SL, Zanker J, Vogrin S, Conzade R, Kirk B, Al Saedi A, Probst V, Duque G. The Joint Occurrence of Osteoporosis and Sarcopenia (Osteosarcopenia): Definitions and Characteristics. J Am Med Dir Assoc 2019; 21:220-225. [PMID: 31669290 DOI: 10.1016/j.jamda.2019.09.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/01/2019] [Accepted: 09/03/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We sought to examine the associations of osteosarcopenia with physical performance, balance, and falls and fractures in community-dwelling older adults. Additionally, we aimed to determine which clinical outcomes are associated with specific components of osteosarcopenia. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 253 participants (77% women; aged 77.9 ± 0.42 years) who presented for a falls and fractures risk assessment in Melbourne, Australia. METHODS Participants were mobile, community-dwelling older adults (≥65 years) free of cognitive impairment. Body composition (via dual-energy x-ray absorptiometry), physical performance [via Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB)], and balance [via Four-Square Step test (FSS) and posturography] were examined. Falls in the past year and fractures in the past 5 years were self-reported. Osteosarcopenia was defined as (1) low bone mineral density (BMD) [T score <-1 standard deviation (SD)] combined with sarcopenia and (2) osteoporosis (BMD T score ≤-2.5 SD) combined with severe sarcopenia. For sarcopenia, we employed the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP1), the revised criteria (EWGSOP2), and that of the Foundation for the National Institutes for Health (FNIH). Kruskal-Wallis and logistic regression tests were used for statistical analysis. RESULTS Osteosarcopenia was associated with worse SPPB, TUG, FSS, limit of stability, and falls and fractures history. Additionally, osteosarcopenia (using the severe sarcopenia classification) conferred an increased rate of falls [odds ratios (ORs) from 2.83 to 3.63; P < .05 for all] and fractures (ORs from 3.86 to 4.38; P < .05 for all) when employing the EWGSOP2 and FNIH definitions, respectively. CONCLUSIONS AND IMPLICATIONS Compared with the nonosteosarcopenic group, those with osteosarcopenia had greater impairment of physical performance and balance. The EWGSOP2 and FNIH criteria resulted in the strongest associations with physical performance and self-reported falls and fractures.
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Affiliation(s)
- Walter Sepúlveda-Loyola
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia; Masters and PhD Programme in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | - Steven Phu
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Ebrahim Bani Hassan
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Romy Conzade
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Ahmed Al Saedi
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia
| | - Vanessa Probst
- Masters and PhD Programme in Rehabilitation Sciences, Londrina State University (UEL) and University North of Paraná (UNOPAR), Londrina, Brazil
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia; Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, St Albans, Victoria, Australia.
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Hong N, Kim KJ, Lee SJ, Kim CO, Kim HC, Rhee Y, Youm Y, Choi JY, Park HY. Cohort profile: Korean Urban Rural Elderly (KURE) study, a prospective cohort on ageing and health in Korea. BMJ Open 2019; 9:e031018. [PMID: 31619427 PMCID: PMC6797282 DOI: 10.1136/bmjopen-2019-031018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The Korean Urban Rural Elderly (KURE) cohort was initiated to study the epidemiologic characteristics, physical performance, laboratory and imaging biomarkers and incidence of age-related diseases in an elderly population with respect to both clinical and social aspects to develop preventive and therapeutic strategies for combatting age-related diseases. PARTICIPANTS A total of 3517 adults aged 65 or older participated in the cohort at baseline from 2012 to 2015, recruited from three urban districts and one rural district in Korea. The second-wave follow-up survey is now being conducted at a 4-year interval from baseline (2016-2019; follow-up rate 71.5%). The data set included detailed information on anthropometric and socioeconomic factors, functional assessments, image scans (plain radiography, dual-energy X-ray absorptiometry and CT), biospecimens (ie, serum, urine and DNA) and social support networks along with the feasibility of linkage to a national claims database. FINDINGS TO DATE Mean age of participants at entry was 71.9±4.6 years and 67% were women. From the KURE participants enrolled in baseline recruitment, several studies were published in the fields of cardiometabolic diseases, musculoskeletal health and the association between social support network and diseases in ageing. FUTURE PLANS Participants will be observed actively and passively every 4-5 years and the first follow-up will be completed in 2020. The KURE data set has strength in comprehensive physical function assessments, quantifiable imaging data sets using CT and detailed information regarding the social support networks of participants from a large community-based elderly Korean population.
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Affiliation(s)
- Namki Hong
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwang-Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Su Jin Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea
| | - Jin-Young Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun-Young Park
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
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Anderson PA, Jeray KJ, Lane JM, Binkley NC. Bone Health Optimization: Beyond Own the Bone: AOA Critical Issues. J Bone Joint Surg Am 2019; 101:1413-1419. [PMID: 31393435 DOI: 10.2106/jbjs.18.01229] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Worldwide, osteoporosis management is in crisis because of inadequate delivery of care, competing guidelines, and confusing recommendations. Additionally, patients are not readily accepting the diagnosis of poor bone health and often are noncompliant with treatment recommendations. Secondary fracture prevention, through a program such as Own the Bone, has improved the diagnosis and medical management after a fragility fracture. In patients who undergo elective orthopaedic procedures, osteoporosis is common and adversely affects outcomes. Bone health optimization is the process of bone status assessment, identification and correction of metabolic deficits, and initiation of treatment, when appropriate, for skeletal structural deficits. The principles of bone health optimization are similar to those of secondary fracture prevention and can be initiated by all orthopaedic surgeons. Patients who are ≥50 years of age should be assessed for osteoporosis risk and, if they are in a high-risk group, bone density should be measured. All patients should be counseled to consume adequate vitamin D and calcium and to discontinue use of any toxins (e.g., tobacco products and excessive alcohol consumption). Patients who meet the criteria for pharmaceutical therapy for osteoporosis should consider delaying surgery for a minimum of 3 months, if feasible, and begin medication treatment. Orthopaedic surgeons need to assume a greater role in the care of bone health for our patients.
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Affiliation(s)
- Paul A Anderson
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, Wisconsin
| | - Kyle J Jeray
- Department of Orthopaedic Surgery, Greenville Health System, Greenville, South Carolina
| | | | - Neil C Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, Wisconsin
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44
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Prognostic value of muscle mass assessed by DEXA in elderly hospitalized patients. Clin Nutr ESPEN 2019; 32:118-124. [DOI: 10.1016/j.clnesp.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 12/16/2022]
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Dos Santos VR, Diniz TA, Batista VC, Júnior IFF, Gobbo LA. Practice of physical activity and dysmobility syndrome in community-dwelling older adults. J Exerc Rehabil 2019; 15:294-301. [PMID: 31111016 PMCID: PMC6509457 DOI: 10.12965/jer.1938034.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/24/2019] [Indexed: 01/10/2023] Open
Abstract
The aim this study was to analyze the association between insufficient physical activity and dysmobility syndrome (DS) in community-dwelling older adults. In total, 375 subjects were evaluated aged ≥60 years. For the diagnosis of DS the presence of ≥3 clinical factors was considered: (a) low muscle mass; (b) low muscular strength; (c) low gait speed; (d) high body fat, and (e) osteoporosis. Information relating to the practice of habitual physical activity (HPA) was obtained using a questionnaire and accelerometry. The chi-square test was used to verify the association between HPA and DS and analysis of binary logistic regression to build multiple models. Insufficiently active older adults are approximately 2 times (95% confidence interval, 1.14-3.79) more likely to have DS, independent of body mass index, smoking and ethnicity. The insufficient practice of physical activity is associated with DS in older adults, mainly in women and older.
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Affiliation(s)
- Vanessa Ribeiro Dos Santos
- Post-Graduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil.,Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Tiego Aparecido Diniz
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of Sao Paulo (USP), São Paulo, Brazil
| | - Vitor Cabrera Batista
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Ismael Forte Freitas Júnior
- Post-Graduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil.,Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Luís Alberto Gobbo
- Post-Graduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil.,Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
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46
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Balogun S, Winzenberg T, Wills K, Scott D, Callisaya M, Cicuttini F, Jones G, Aitken D. Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Arch Gerontol Geriatr 2019; 82:67-73. [PMID: 30716680 DOI: 10.1016/j.archger.2019.01.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/10/2018] [Accepted: 01/26/2019] [Indexed: 11/25/2022]
Abstract
AIM To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. METHODS 1032 participants (52% women; mean age 62.9 ± 7.4 years) were prospectively followed for 10 years. Mortality was ascertained from the death registry and fractures were self-reported. Baseline appendicular lean mass (ALM) was assessed using dual-energy X-ray absorptiometry and normalised to body mass index (BMI). Hand grip strength (HGS) was assessed by dynamometer. Osteosarcopenia and osteodynapenia were defined as having T-scores of the total hip and/or lumbar spine bone mineral density (BMD) < -1 combined with being in the lowest 20% of the sex-specific distribution for ALM/BMI or HGS respectively. RESULTS Incident fracture risk was significantly higher in participants who were osteodynapenic (RR = 2.07, 95% CI: 1.26-3.39), dynapenic alone (RR = 1.74, 95% CI: 1.05-2.87), and osteopenic alone (RR = 1.63, 95% CI: 1.15-2.31), compared to those without dynapenia or osteopenia. Mortality risk was significantly higher only in participants with osteosarcopenia (RR = 1.49, 95% CI: 1.01-2.21) compared to those without sarcopenia or osteopenia. However, osteosarcopenia and osteodynapenia did not lead to a significantly greater fracture or mortality risk compared to having these conditions on their own. CONCLUSION These findings suggest that the combined effect of osteopenia and sarcopenia or dynapenia on fracture and mortality risk, respectively, may not be greater than that of each individual condition.
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Affiliation(s)
- Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Australia; Faculty of Health, University of Tasmania, Australia.
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - David Scott
- Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia; Australian Institute for Musculoskeletal Science, Melbourne Medical School (Western Campus), the University of Melbourne, St Albans, Victoria, 3021, Australia.
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia.
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Australia.
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Age-related bone loss and sarcopenia in men. Maturitas 2019; 122:51-56. [PMID: 30797530 DOI: 10.1016/j.maturitas.2019.01.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/20/2022]
Abstract
Bone and muscle are required for mobility but they also have endocrine and metabolic functions. In ageing as well as in many chronic diseases, bone loss and muscle atrophy occur simultaneously, leading to concomitant osteoporosis and sarcopenia. This occurs in both genders but compared with postmenopausal women, men appear to be better protected against age-related bone and muscle decay. Sex steroids (both androgens like testosterone and oestrogens like estradiol) are mainly responsible for musculoskeletal sexual dimorphism. They stimulate peak bone and muscle mass accretion during puberty and midlife, and prevent subsequent loss in ageing men but not post-menopausal women. Still, recent studies have highlighted the importance of intrinsic ageing mechanisms such as cellular senescence and oxidative stress in both genders. Sarcopenia may predispose to dysmobility, frailty, falls and fractures, but whether so-called osteosarcopenia qualifies as a distinct entity remains debated. Although randomized clinical trials in male osteoporosis are smaller and therefore underpowered for some outcomes like hip fractures, the available evidence suggests that the clinical diagnostic and therapeutic approach to male osteoporosis is largely similar to that in postmenopausal women. There is a clear unmet medical need for effective and safe anabolic drugs to rebuild the ageing skeleton, muscle, and preferably both tissues simultaneously. The Wnt/sclerostin and myostatin/activin receptor signalling pathways appear particularly promising in this regard. In this narrative review, we aim to provide an overview of our current understanding of the pathophysiology and treatment of male osteoporosis and sarcopenia, and interactions between these two diseases.
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Yao S, Kaido T, Okumura S, Iwamura S, Miyachi Y, Shirai H, Kobayashi A, Hamaguchi Y, Kamo N, Uozumi R, Yagi S, Uemoto S. Bone mineral density correlates with survival after resection of extrahepatic biliary malignancies. Clin Nutr 2018; 38:2770-2777. [PMID: 30595376 DOI: 10.1016/j.clnu.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 10/13/2018] [Accepted: 12/04/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Osteopenia is a condition in which bone mineral density (BMD) is lower than normal, and it is an important determinant of bone fragility. However, the utility of osteopenia in assessing the risks of surgery is unclear. This study investigated the impact of preoperative low BMD on the outcomes in patients undergoing resection of extrahepatic biliary cancers. METHODS A retrospective analysis was performed with 181 patients who underwent resections of extrahepatic biliary cancers between 2005 and 2015. Their BMD was measured on preoperative computed tomography images. Overall survival (OS) and recurrence-free survival (RFS) rates were compared according to BMD (normal vs. low), and the prognostic factors after surgery were assessed. Propensity score matching was used to minimize the bias in patient background. RESULTS Older age and female were strongly associated with low BMD. These factors were used to construct the propensity score model, which yielded a matched cohort of 52 legs in each group. The OS (21.2% vs. 53.9% at 5 years, p < .001) and RFS (21.8% vs. 64.6% at 5 years, p < .001) rates were significantly lower in patients with low BMD (osteopenia) than in those with normal BMD (non-osteopenia). Multivariable analyses showed that low BMD was an independent factor predictive of poor OS (hazard ratio [HR]: 2.343, 95% confidence interval [CI]: 1.362-4.129, p = .002) and poor RFS (HR: 3.648, 95% CI: 1.986-6.990, p=<.001). CONCLUSIONS Preoperative low BMD is closely related to mortality and cancer recurrence after the resection of extrahepatic biliary cancers. BMD screening in patients with cancer should be further highlighted in the oncology field.
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Affiliation(s)
- Siyuan Yao
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshimi Kaido
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Shinya Okumura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sena Iwamura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Miyachi
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisaya Shirai
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Kobayashi
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuhei Hamaguchi
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoko Kamo
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shintaro Yagi
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Uemoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Chen YY, Kao TW, Wang CC, Chen YJ, Wu CJ, Chen WL. Exploring the link between metabolic syndrome and risk of dysmobility syndrome in elderly population. PLoS One 2018; 13:e0207608. [PMID: 30533044 PMCID: PMC6289450 DOI: 10.1371/journal.pone.0207608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 11/02/2018] [Indexed: 12/20/2022] Open
Abstract
Dysmobility syndrome (DMS) was considered as a comprehensive approach to evaluate the condition of musculoskeletal system and adverse health problems in older population. The objective of our study was to examine the association between metabolic syndrome (MetS) and DMS in a U.S. adult population. 1760 eligible participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 were enrolled in the study. The criteria of DMS consisted of six domains including increased body fat, declined muscle mass, reduced muscle strength, osteoporosis, slow gait speed, and balance problem. A multivariate regression analysis was investigated to clarify the relationship among MetS and its components and DMS. A positive association between increased number of MetS components and the presence of DMS achieved significance (β = 0.142, 95%CI = 0.035, 0.249, p = 0.009). Among the components of MetS, hyperglycemia had a central place in the DMS after adjustment of clinical variables (β = 0.083, 95%CI = 0.030, 0.136, p = 0.002). Notably, insulin resistance assessed by homeostatic model assessment (HOMA-IR) was correlated to increased body fat (r = 0.092, p<0.05), osteoporosis (r = -0.105, p<0.05) and balance (r = 0.105, p<0.05) among these participants with MetS. Our study demonstrated a strong relationship between DMS and the presence of MetS and its components in elderly population, highlighting a possible mechanism through insulin resistance.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ying-Jen Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Marzetti E, Cesari M, Calvani R, Msihid J, Tosato M, Rodriguez-Mañas L, Lattanzio F, Cherubini A, Bejuit R, Di Bari M, Maggio M, Vellas B, Dantoine T, Cruz-Jentoft AJ, Sieber CC, Freiberger E, Skalska A, Grodzicki T, Sinclair AJ, Topinkova E, Rýznarová I, Strandberg T, Schols AMWJ, Schols JMGA, Roller-Wirnsberger R, Jónsson PV, Ramel A, Del Signore S, Pahor M, Roubenoff R, Bernabei R, Landi F. The "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) randomized controlled trial: Case finding, screening and characteristics of eligible participants. Exp Gerontol 2018; 113:48-57. [PMID: 30261246 DOI: 10.1016/j.exger.2018.09.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/11/2018] [Accepted: 09/20/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND The ongoing "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT)" randomized controlled trial (RCT) is testing the efficacy of a multicomponent intervention in the prevention of mobility disability in older adults with physical frailty & sarcopenia (PF&S). Here, we describe the procedures followed for PF&S case finding and screening of candidate participants for the SPRINTT RCT. We also illustrate the main demographic and clinical characteristics of eligible screenees. METHODS The identification of PF&S was based on the co-occurrence of three defining elements: (1) reduced physical performance (defined as a score on the Short Physical Performance Battery between 3 and 9); (2) low muscle mass according to the criteria released by the Foundation for the National Institutes of Health; and (3) absence of mobility disability (defined as ability to complete the 400-m walk test in 15 min). SPRINTT was advertised through a variety of means. Site-specific case finding strategies were developed to accommodate the variability across centers in catchment area characteristics and access to the target population. A quick "participant profiling" questionnaire was devised to facilitate PF&S case finding. RESULTS During approximately 22 months, 12,358 prescreening interviews were completed in 17 SPRINTT sites resulting in 6710 clinic screening visits. Eventually, 1566 candidates were found to be eligible for participating in the SPRINTT RCT. Eligible screenees showed substantial physical function impairment and comorbidity burden. In most centers, project advertisement through mass media was the most rewarding case finding strategy. CONCLUSION PF&S case finding in the community is a challenging, but feasible task. Although largely autonomous in daily life activities, older adults with PF&S suffer from significant functional impairment and comorbidity. This subset of the older population is therefore at high risk for disability and other negative health-related events. Key strategies to consider for successfully intercepting at-risk older adults should focus on mass communication methods.
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Affiliation(s)
- Emanuele Marzetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Italy; Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
| | | | - Matteo Tosato
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Division of Geriatric Cardiology and Medicine, Department of Geriatrics and Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marcello Maggio
- Department of Geriatric Rehabilitation, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Bruno Vellas
- Gérontopôle, University Hospital of Toulouse, Toulouse, France
| | | | | | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-University, Nuremberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-University, Nuremberg, Germany
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Alan J Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Limited, Worcestershire, UK
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Timo Strandberg
- University of Helsinki, Clinicum, Helsinki, Finland; Helsinki University Hospital, Medicine and Rehabilitation, Helsinki, Finland; University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - Annemie M W J Schols
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Pálmi V Jónsson
- Department of Geriatrics, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Alfons Ramel
- Department of Geriatrics, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | | | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Ronenn Roubenoff
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Roberto Bernabei
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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