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da Silva RC, Chaves GV, Bergmann A, Frajacomo FTT. Assessment of myosteatosis and functionality in pretreatment gynecological cancer patients. Support Care Cancer 2024; 32:339. [PMID: 38733544 DOI: 10.1007/s00520-024-08558-4] [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: 01/24/2024] [Accepted: 05/07/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE We aimed to investigate the relationship between pretreatment gynecologic cancer survival and the physical function of patients with myosteatosis. Understanding this relationship prior to treatment would help healthcare providers identify and refer patients with poor muscle quality to an exercise program prior to treatment. METHODS We conducted a cross-sectional analysis of 73 GC patients. Physical function was quantified using handgrip strength and an adapted version of the Senior Fitness Test (aerobic endurance not included). The EORTC QLC-C30 was used to evaluate general health quality. Myosteatosis (values below the median muscle radiodensity), muscle mass, and adipose tissue variables were calculated from the computed tomography (CT) scan at the third lumbar vertebra using specific software. RESULTS Seventy patients (50.9 ± 15.2) were included; 41.5% had stage III or IV disease, and 61.4% had cervical cancer. The myosteatosis group was 11.9 years older and showed reduced functioning compared to the normal-radiodensity group. Age and Timed Up and Go (TUG) test results were shown to be the most reliable predictors of muscle radiodensity in pretreatment gynecological patients according to multivariate regression analysis (R2 = 0.314). CONCLUSION Gynecological healthcare professionals should be aware that prompt exercise programs might be especially beneficial for older patients with reduced TUG performance to preserve muscle function and quality.
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Affiliation(s)
- Regielly Candido da Silva
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil
| | - Gabriela Villaça Chaves
- Department of Nutrition and Dietetics, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Anke Bergmann
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil
| | - Fernando Tadeu Trevisan Frajacomo
- Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Andre Cavalcanti Av. 37, Rio de Janeiro, 20231050, Brazil.
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Fielding RA, Lustgarten MS. Impact of a Whole-Food, High-Soluble Fiber Diet on the Gut-Muscle Axis in Aged Mice. Nutrients 2024; 16:1323. [PMID: 38732569 PMCID: PMC11085703 DOI: 10.3390/nu16091323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Previous studies have identified a role for the gut microbiome and its metabolic products, short-chain fatty acids (SCFAs), in the maintenance of muscle mass and physical function (i.e., the gut-muscle axis), but interventions aimed at positively impacting the gut-muscle axis during aging are sparse. Gut bacteria ferment soluble fiber into SCFAs, and accordingly, to evaluate the impact of a high-soluble-fiber diet (HSFD) on the gut-muscle axis, we fed a whole-food, 3×-higher-soluble fiber-containing diet (relative to standard chow) to aged (98 weeks) C57BL/6J mice for 10 weeks. The HSFD significantly altered gut bacterial community structure and composition, but plasma SCFAs were not different, and a positive impact on muscle-related measures (when normalized to body weight) was not identified. However, when evaluating sex differences between dietary groups, female (but not male) HSFD-fed mice had significant increases for SCFAs, the quadriceps/body weight (BW) ratio, and treadmill work performance (distance run × BW), which suggests that an HSFD can positively impact the gut-muscle axis. In contrast, consistent effects in both male and female HSFD-fed mice included weight and fat loss, which suggests a positive role for an HSFD on the gut-adipose axis in aged mice.
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Affiliation(s)
| | - Michael S. Lustgarten
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, MA 02111, USA;
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Tateoka K, Tsuji T, Shoji T, Tokunaga S, Okura T. Relationship between Acceleration in a Sit-To-Stand Movement and Physical Function in Older Adults. Geriatrics (Basel) 2023; 8:123. [PMID: 38132494 PMCID: PMC10742784 DOI: 10.3390/geriatrics8060123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/18/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Acceleration parameters in sit-to-stand (STS) movements are useful for measuring lower-limb function in older adults. The purpose of this study was to examine the relationship between acceleration in STS movements and physical function and the test-retest reliability of acceleration parameters in older adults. We performed cross-sectional analyses on 244 older adults including 107 men (mean age: 77.4 ± 4.7) and 137 women (mean age: 75.6 ± 5.3). Four acceleration parameters were measured in STS movements: maximum acceleration (MA), maximum velocity (MV), maximum power (MP), and stand-up time (ST). Good intraclass correlation coefficients (ICC > 0.70) were observed for all parameters. For the acceleration parameters, MA, MV, and MP were relatively strongly associated with the 5-time STS test (men: r = -0.36~-0.47; women: r = -0.37~-0.45) and the timed up and go test (men: r = -0.39~0.47, women: r = -0.43~-0.51): MP was also strongly associated with grip strength (men: r = 0.48, women: r = 0.43). All acceleration parameters were poorer in participants reporting mobility limitations than in those reporting no mobility limitations. These findings support the usefulness of sensor-based STS measurement. The system is expected to be useful in various settings where care prevention is addressed.
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Affiliation(s)
- Korin Tateoka
- Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8571, Japan
| | - Taishi Tsuji
- Institute of Health and Sport Sciences, University of Tsukuba, Tokyo 112-0012, Japan; (T.T.); (T.O.)
| | - Takuro Shoji
- Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8571, Japan; (T.S.); (S.T.)
| | - Satoshi Tokunaga
- Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8571, Japan; (T.S.); (S.T.)
| | - Tomohiro Okura
- Institute of Health and Sport Sciences, University of Tsukuba, Tokyo 112-0012, Japan; (T.T.); (T.O.)
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Johri N, Vengat M, Kumar D, Nagar P, John D, Dutta S, Mittal P. A comprehensive review on the risks assessment and treatment options for Sarcopenia in people with diabetes. J Diabetes Metab Disord 2023; 22:995-1010. [PMID: 37975099 PMCID: PMC10638272 DOI: 10.1007/s40200-023-01262-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/03/2023] [Indexed: 11/19/2023]
Abstract
Objectives This comprehensive review aims to examine the reciprocal interplay between Type 2 diabetes mellitus (T2DM) and sarcopenia, identify prevailing research gaps, and discuss therapeutic approaches and measures to enhance healthcare practices within hospital settings. Methods A thorough literature review was conducted to gather relevant studies and articles on the relationship between T2DM and sarcopenia. Various databases were searched, including Google Scholar, PubMed, Scopus, and Science Direct databases. The search terms included T2DM, sarcopenia, inflammation, insulin resistance, advanced glycation end products, oxidative stress, muscle dimensions, muscle strength, muscle performance, aging, nutrition, hormone levels, and physical activity. The collected articles were critically analysed to extract key findings and identify gaps in current research. Results The prevalence and incidence of metabolic and musculoskeletal disorders, notably T2DM and sarcopenia, have surged in recent years. T2DM is marked by inflammation, insulin resistance, accumulation of advanced glycation end products, and oxidative stress, while sarcopenia involves a progressive decline in skeletal muscle mass and function. The review underscores the age-related correlation between sarcopenia and adverse outcomes like fractures, falls, and mortality. Research gaps regarding optimal nutritional interventions for individuals with T2DM and sarcopenia are identified, emphasizing the necessity for further investigation in this area. Conclusions The reciprocal interplay between T2DM and sarcopenia holds significant importance. Further research is warranted to address knowledge gaps, particularly in utilizing precise measurement tools during clinical trials. Lifestyle modifications appear beneficial for individuals with T2DM and sarcopenia. Additionally, practical nutritional interventions require investigation to optimize healthcare practices in hospital settings. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01262-w.
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Affiliation(s)
- Nishant Johri
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
| | | | - Deepanshu Kumar
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
| | - Priya Nagar
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
| | - Davis John
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
| | - Shubham Dutta
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
| | - Piyush Mittal
- Department of Pharmacy Practice, Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh India
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Wu X, Guo J, Chen X, Han P, Huang L, Peng Y, Zhou X, Huang J, Wei C, Zheng Y, Zhang Z, Li M, Guo Q. Comparison of the relationship between cognitive function and future falls in Chinese community-dwelling older adults with and without diabetes mellitus. J Formos Med Assoc 2023; 122:603-611. [PMID: 36336606 DOI: 10.1016/j.jfma.2022.10.008] [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: 05/10/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine whether cognitive function is associated with future falls in older patients with diabetes mellitus (DM) compared with those without DM. Cognitive function was divided into several domains to further analyze. METHODS A total of 678 individuals met the inclusion criteria and comprised the final study population. The mean age was 74.35 ± 5.35 years, and 58.9% of the participants were female (n = 400). At the baseline, cognitive function was measured by the Mini Mental State Examination (MMSE), and DM diagnoses were determined by medical records. The self-reported any falls data were obtained via face-to-face questioning at the 1-year follow-up. RESULTS At baseline, 15.6% of participants (n = 106) were diagnosed with DM. According to whether they had any falls during 1-year follow-up, there was a significant difference between the two group in fasting plasma glucose (p = 0.012) and DM (p = 0.036) at baseline. Among the older adults with DM, those who had experienced any falls had poorer cognitive function (p = 0.014). After adjusting for various covariates, we found that MMSE (95% CI 0.790-0.991, p = 0.034), orientation to place (95% CI 0.307-0.911, p = 0.022) and registration (95% CI 0.162-0.768, p = 0.009) were significantly associated with falls in the follow-up. CONCLUSION Our study found that in patients with DM, cognitive function is related to future falls. Not only overall cognitive function, but also orientation to place and registration were all associated with future falls in older adults with DM. When completing the fall risk assessment of elderly patients with DM, clinicians should give more attention to the testing of cognitive function.
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Affiliation(s)
- Xinze Wu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China; Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Jinlong Guo
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xinlong Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Liqin Huang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Youran Peng
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Xin Zhou
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Jiasen Huang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Chengyao Wei
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | | | | | - Ming Li
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China.
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Leng J, Chang X, Bai Q, Wang Y, Liu X, Zhang J, Gao P, Fan Y, Zou X, Zhang H, Zhang B. Fatty infiltration of hip muscles and trochanteric soft tissue thickness are associated with hip fractures in the elderly. INTERNATIONAL ORTHOPAEDICS 2022; 46:2963-2969. [PMID: 36123405 DOI: 10.1007/s00264-022-05563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Apart from bone conditions, muscle and soft tissue parameters might also influence hip fractures. We aimed to evaluate the association between hip muscle and trochanteric soft tissue parameters and hip fractures. METHODS We retrospectively reviewed 60 patients with hip fractures and 114 controls without hip fractures. Cases and controls were matched for age, sex, and body mass index using propensity score matching. Muscle cross-sectional area (CSA), mean attenuation, and fatty infiltration rate (FIR) (proportion of intramuscular fat content) were measured on CT images for the gluteus maximus, the gluteus medius/minimus, and the anterior and medial compartments of the upper thigh. Trochanteric soft tissue thickness (TSTT) and femoral neck attenuation were also measured. Univariate and multivariate analyses were conducted to identify potential risk factors of hip fractures. RESULTS Patients with hip fractures had significantly lower femoral neck attenuation, TSTT, and CSA of the gluteus maximus and anterior compartment than controls. FIR of all hip muscle groups were significantly higher in hip fracture patients than controls. Multivariate analysis revealed that every 1% increase in FIR of medial compartment independently increased the odds of hip fractures by 23.7% (OR = 1.237, 95% CI = 1.093-1.401) and every 1 cm longer TSTT independently decreased the odds by 32.8% (OR = 0.672, 95% CI = 0.477-0.946). CONCLUSION Fatty infiltration of hip muscles can better discriminate hip fractures than muscle area. Increased TSTT is independently associated with low fracture risk.
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Affiliation(s)
- Junsheng Leng
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Xiao Chang
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Qiushi Bai
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Yun Wang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Xingyu Liu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Jia Zhang
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Peng Gao
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Yu Fan
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Xiongfei Zou
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Hengyan Zhang
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Baozhong Zhang
- Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences (CAMS), Beijing, China.
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Laskou F, Westbury LD, Fuggle NR, Harvey NC, Patel HP, Cooper C, Ward KA, Dennison EM. Determinants of muscle density and clinical outcomes: Findings from the Hertfordshire Cohort Study. Bone 2022; 164:116521. [PMID: 35985467 DOI: 10.1016/j.bone.2022.116521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE The age-related loss of skeletal muscle mass and strength is associated with adverse health outcomes. However, to date, peripheral quantitative computed tomography (pQCT)-derived muscle density has been little studied. We used a well characterised cohort of older adults to identify lifestyle and anthropometric determinants of pQCT-derived muscle density measured 11 years later, and to report relationships between pQCT-derived muscle density with history of falls and prevalent fractures. METHODS A lifestyle questionnaire was administered to 197 men and 178 women, aged 59-70 at baseline. After a median of 11.5 (IQR 10.9, 12.3) years, pQCT (Stratec XCT2000) of the radius and tibia was performed to measure forearm muscle density (FMD) and calf muscle density (CMD). Presence of falls and fractures since the age of 45 were determined through participant recall; vertebral fractures were also ascertained through vertebral fracture assessment using iDXA. Total hip BMD (TH aBMD) was assessed using DXA. Baseline characteristics in relation to muscle density at follow-up were examined using linear regression; associations between muscle density and prior falls and fractures were investigated using logistic regression. All analyses were adjusted for sex and age. RESULTS Mean (SD) age at muscle density measurement was 76.3 (2.6) years. Mean (SD) FMD was 79.9 (3.1) and 77.2 (3.2) among males and females, respectively; CMD was 80.7 (2.6) and 78.5 (2.6) among males and females, respectively. Significant sex-differences in muscle density were observed at each site (p < 0.001). Female sex, lower weight, and lower body mass index were associated (p < 0.05) with both lower FMD and CMD. Additional correlates of lower CMD included older age and shorter stature. Lifestyle measures were not associated with muscle density in this cohort. Lower FMD was related to increased risk of previous fracture (odds ratio (95 % CI) per SD lower FMD: 1.42 (1.07, 1.89), p = 0.015) but not after adjustment for TH aBMD (p > 0.08). No significant relationships were seen between muscle density and falls. CONCLUSION Female sex, older age, and lower BMI were associated with subsequent lower muscle density in older community-dwelling adults. Lower FMD was related to increased risk of previous fracture. Changes in muscle density over time might precede adverse outcomes such as falls and fractures and may be a long-term predictor of frailty. It could be also suggested that muscle density could be a more clinically meaningful surrogate of functional decline and disability than muscle size or mass, but more studies are needed to support this notion.
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Affiliation(s)
- Faidra Laskou
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Leo D Westbury
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Nicholas R Fuggle
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; The Alan Turing Institute, London, UK
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Harnish P Patel
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK; Medicine for Older People, University Hospital Southampton, Southampton, UK; Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Kate A Ward
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Elaine M Dennison
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; Victoria University of Wellington, Wellington, New Zealand.
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Yamada M, Kimura Y, Ishiyama D, Otobe Y, Suzuki M, Koyama S, Arai H. Combined effect of lower muscle quality and quantity on incident falls and fall-related fractures in community-dwelling older adults: A 3-year follow-up study. Bone 2022; 162:116474. [PMID: 35752409 DOI: 10.1016/j.bone.2022.116474] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Falls and fractures are serious geriatric adverse events worldwide, and skeletal muscle is considered to be a key factor in these incidents. The objective of this study was to investigate the combined effect of lower muscle quality and quantity on the incidence of falls and fall-related fractures in a 3-year follow-up period among community-dwelling older adults. METHODS We recruited community-dwelling adults aged 65 years and older who were living independently in 2018. A total of 773 older participants were analyzed in this study. The outcomes were incident falls and fall-related fractures during the 3-year follow-up period. At baseline, we assessed muscle quality and quantity using ultrasonography, and we categorized the participants into four groups based on their combination of poor/better muscle quality and poor/better muscle quantity. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of the relationships among items in the four groups and the time to incident falls and fall-related fractures. RESULTS During the 3-year follow-up period, 178 participants (23.0 %) had a fall incident and 51 participants (6.6 %) had fall-related fractures. Older adults with lower muscle quality and quantity had significantly elevated risks of incident falls according to multivariate analyses using older adults with better muscle quality and quantity as the reference (adjusted HR: 1.54 [95 % CI 1.06-2.23]). However, there were no significant differences in fall-related fractures among the four groups. CONCLUSION We found that lower muscle quality and quantity led to higher incidents of falls; thus, identifying community-dwelling older adults with lower muscle quality and quantity is necessary to provide them fall preventive measures and maybe to reduce fall-related outcomes.
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Affiliation(s)
- Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi 474-8511, Japan.
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10
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Candow DG, Chilibeck PD, Forbes SC, Fairman CM, Gualano B, Roschel H. Creatine supplementation for older adults: Focus on sarcopenia, osteoporosis, frailty and Cachexia. Bone 2022; 162:116467. [PMID: 35688360 DOI: 10.1016/j.bone.2022.116467] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
Sarcopenia refers to the age-related reduction in strength, muscle mass and functionality which increases the risk for falls, injuries and fractures. Sarcopenia is associated with other age-related conditions such as osteoporosis, frailty and cachexia. Identifying treatments to overcome sarcopenia and associated conditions is important from a global health perspective. There is evidence that creatine monohydrate supplementation, primarily when combined with resistance training, has favorable effects on indices of aging muscle and bone. These musculoskeletal benefits provide some rationale for creatine being a potential intervention for treating frailty and cachexia. The purposes of this narrative review are to update the collective body of research pertaining to the effects of creatine supplementation on indices of aging muscle and bone (including bone turnover markers) and present possible justification and rationale for its utilization in the treatment of frailty and cachexia in older adults.
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Affiliation(s)
- Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Scott C Forbes
- Department of Physical Education Studies, Brandon University Brandon, MB, Canada
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculty of Medicine FMUSP, University of Sao Paulo, Sao Paulo, Brazil
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11
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Dietzel R, Wiegmann S, Borucki D, Detzer C, Zeiner KN, Schaumburg D, Buehring B, Buttgereit F, Armbrecht G. Prevalence of sarcopenia in patients with rheumatoid arthritis using the revised EWGSOP2 and the FNIH definition. RMD Open 2022; 8:rmdopen-2022-002600. [PMID: 36180102 PMCID: PMC9528715 DOI: 10.1136/rmdopen-2022-002600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
Objective In rheumatoid arthritis (RA), chronic inflammation can enhance the development of sarcopenia with a depletion of muscle mass, strength and performance. Currently, a consensus definition for sarcopenia and solid results for the prevalence of sarcopenia in patients with RA are lacking. Methods In this cross-sectional study, 289 patients ≥18 years with RA were recruited. Dual X-ray absorptiometry was performed to measure appendicular lean mass. Assessment of muscle function included grip strength, gait speed and chair rise time. Prevalence of sarcopenia was defined using the updated European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) definition. In addition, the RA study population was compared with existing data of healthy controls (n=280). Results 4.5% of patients (59.4±11.3 years) and 0.4% of controls (62.9±11.9 years) were affected by sarcopenia according to the EWGSOP2 definition. Body weight (OR 0.92, 95% CI 0.86 to 0.97), body mass index (BMI) (OR 0.70, 95% CI 0.57 to 0.87), C reactive protein (CRP) (OR 1.05, 95% CI 1.01 to 1.10), disease duration (OR 1.08, 95% CI 1.02 to 1.36), current medication with glucocorticoids (OR 5.25, 95% CI 2.14 to 24.18), cumulative dose of prednisone equivalent (OR 1.04, 95% CI 1.02 to 1.05) and Health Assessment Questionnaire (HAQ) (OR 2.50, 95% CI 1.27 to 4.86) were associated with sarcopenia in patients with RA. In contrast, the prevalence was 2.8% in patients compared with 0.7% in controls when applying the FNIH definition, and body height (OR 0.75, 95% CI 0.64 to 0.88), BMI (OR 1.20, 95% CI 1.02 to 1.41), CRP (OR 1.06, 95% CI 1.01 to 1.11) and HAQ (OR 2.77, 95% CI 1.17 to 6.59) were associated with sarcopenia. Conclusion Sarcopenia is significantly more common in patients with RA compared with controls using the EWGSOP2 criteria. The FNIH definition revealed sarcopenia in individuals with high BMI and fat mass, regardless of the presence of RA. Trial registration number It was registered at the German Clinical Trials Registry (DRKS) as well as WHO Clinical Trials Registry (ICTRP) (DRKS00011873, registered on 16 March 2017).
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Affiliation(s)
- Roswitha Dietzel
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Wiegmann
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Diana Borucki
- Deutsche Rheuma-Liga Bundesverband e.V, Bonn, Germany
| | | | - Kim Nikola Zeiner
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Désirée Schaumburg
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bjoern Buehring
- Bergisches Rheuma-Zentrum, Krankenhaus St. Josef, Wuppertal, Germany.,Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriele Armbrecht
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
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12
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Zhang SB, Chen H, Xu HW, Yi YY, Fang XY, Wang SJ. Computed tomography-based paravertebral muscle density predicts subsequent vertebral fracture risks independently of bone mineral density in postmenopausal women following percutaneous vertebral augmentation. Aging Clin Exp Res 2022; 34:2797-2805. [PMID: 36001272 DOI: 10.1007/s40520-022-02218-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 07/29/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The risk of subsequent vertebral fractures (SVF) after the primary vertebral fracture cannot be explained by lower bone mineral density (BMD) alone. Computed tomography (CT) measurements of paravertebral muscle density (PMD) are recognized radiographic markers used to predict physical function, fragile fractures. AIMS This study aims to investigate the relationship between PMD and the risk of SVF in cohorts of postmenopausal women, and to determine if combining both PMD and BMD measures derived from CT can improve the accuracy of predicting SVF. METHODS This study enrolled 305 postmenopausal women between the ages of 50 and 88 for 3 years of follow-up studies. Trabecular attenuation (Hounsfield units, HU) was measured at L1 level and muscle attenuation of paravertebral muscle at L3 level on preoperative lumbar CT scans to determine the L1 BMD and L3 PMD. Kaplan-Meier analysis was applied to evaluate SVF-free survival. The hazard ratios (HRs) of PMD for SVF events were estimated with the Cox proportional hazards model. The predictive values of L1 BMD and L3 PMD for SVF were quantified using the Receiver-Operating Characteristic (ROC) curve. RESULT During the 3 years of follow-up studies, 88 patients (28.9%) suffered an SVF. ROC curve analysis demonstrated that an L3 PMD threshold of 32 HU had a sensitivity of 89.8% and a specificity of 62% for the prediction of SVF. Kaplan-Meier analysis showed that L3 PMD ≤ 32 HU was significantly associated with lower SVF-free survival (p < 0.001; log-rank test). After adjusting for age, BMI, diabetes, postoperative osteoporosis treatment, handgrip strength, L1 BMD, multivariate analyses also indicated a persistent modest effect of L3 PMD on SVF-free survival. The area under the ROC curve of L3 PMD and L1 BMD, combined to predict the risk of SVF, was 0.790, which was significantly higher than the value for L1 BMD alone (0.735). L3 PMD and L1 BMD significantly improved the accuracy of SVF risk prediction compared with L1 BMD alone, which was confirmed by reclassification improvement measures. The inclusion of handgrip strength and postoperative osteoporosis treatment in the model further improved SVF prediction accuracy, and PMD remained significant in the model. CONCLUSION Decreased L3 PMD is an independent risk predictor of SVF. Combined CT-based L1 BMD and L3 PMD can significantly improve the accuracy of predicting the risk of SVF in postmenopausal women who have suffered prior osteoporotic vertebral fractures.
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Affiliation(s)
- Shu-Bao Zhang
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China
| | - Hao Chen
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China
| | - Hao-Wei Xu
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China
| | - Yu-Yang Yi
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China
| | - Xin-Yue Fang
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China
| | - Shan-Jin Wang
- Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China. .,Department of Orthopedic, East Hospital, Ji'an Hospital, Jiangxi, 343000, China.
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13
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Kitagawa F, Ogawa M, Yoshiko A, Oshida Y, Koike T, Akima H, Tanaka NI. Factors related to trunk intramuscular adipose tissue content - A comparison of younger and older men. Exp Gerontol 2022; 168:111922. [PMID: 35964898 DOI: 10.1016/j.exger.2022.111922] [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: 05/18/2022] [Revised: 08/02/2022] [Accepted: 08/06/2022] [Indexed: 11/18/2022]
Abstract
The present study investigated factors related to trunk intramuscular adipose tissue (IntraMAT) content in younger and older men. Twenty-three healthy younger (20 to 29 years) and 20 healthy older men (63 to 79 years) participated in this study. The trunk IntraMAT content was measured using magnetic resonance imaging at the height of the 3rd lumbar vertebra. In addition to blood properties and physical performance, dietary intake was assessed by a self-administered diet history questionnaire. The dietary intake status was quantified using the nutrient adequacy score for the intake of 10 selected nutrients by summing the number of items that met the criteria of dietary reference intakes for Japanese individuals. The results obtained revealed that the trunk IntraMAT content was significantly higher in the older group than in the younger group (p < 0.05). In the younger group, the trunk IntraMAT content significantly correlated with systolic and diastolic blood pressure and HbA1c (rs = 0.443 to 0.464, p < 0.05). In the older group, significant and negative correlations were observed between the trunk IntraMAT content and 5-m usual walking speed, handgrip strength, and nutrient adequacy scores (rs = -0.485 to -0.713, p < 0.05). These results indicate that factors associated with the trunk IntraMAT content differed in an age dependent manner. In the younger group, the trunk IntraMAT content correlated with the metabolic status such as blood pressure and HbA1c. In the older group, physical performance and the dietary intake status negatively correlated with the trunk IntraMAT content.
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Affiliation(s)
- Funa Kitagawa
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan.
| | - Madoka Ogawa
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan
| | - Akito Yoshiko
- Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa, Nagoya, Aichi 466-8550, Japan
| | - Yoshiharu Oshida
- Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa, Nagoya, Aichi 466-8550, Japan; Research Center of Health, Fitness and Sports, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan
| | - Teruhiko Koike
- Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa, Nagoya, Aichi 466-8550, Japan; Research Center of Health, Fitness and Sports, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan
| | - Hiroshi Akima
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan; Research Center of Health, Fitness and Sports, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan
| | - Noriko I Tanaka
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan; Research Center of Health, Fitness and Sports, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8601, Japan
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14
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Implication of Exercise for Healthy Longevity in Older People. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Candow DG, Chilibeck PD, Gordon JJ, Kontulainen S. Efficacy of Creatine Supplementation and Resistance Training on Area and Density of Bone and Muscle in Older Adults. Med Sci Sports Exerc 2021; 53:2388-2395. [PMID: 34107512 DOI: 10.1249/mss.0000000000002722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine the efficacy of creatine (Cr) supplementation and any sex differences during supervised whole-body resistance training (RT) on properties of bone and muscle in older adults. METHODS Seventy participants (39 men, 31 women; mean age ± standard deviation: 58 ± 6 yr) were randomized to supplement with Cr (0.1 g·kg-1·d-1) or placebo (Pl) during RT (3 d·wk-1 for 1 yr). Bone geometry (radius and tibia) and muscle area and density (forearm and lower leg) were assessed using peripheral quantitative computed tomography. RESULTS Compared with Pl, Cr increased or maintained total bone area in the distal tibia (Cr, Δ +17 ± 27 mm2; Pl, Δ -1 ± 22 mm2; P = 0.031) and tibial shaft (Cr, Δ 0 ± 9 mm2; Pl, Δ -5 ± 7 mm2; P = 0.032). Men on Cr increased trabecular (Δ +28 ± 31 mm2; P < 0.001) and cortical bone areas in the tibia (Δ +4 ± 4 mm2; P < 0.05), whereas men on Pl increased trabecular bone density (Δ +2 ± 2 mg·cm-3; P < 0.01). There were no bone changes in the radius (P > 0.05). Cr increased lower leg muscle density (Δ +0.83 ± 1.15 mg·cm-3; P = 0.016) compared with Pl (Δ -0.16 ± 1.56 mg·cm-3), with no changes in the forearm muscle. CONCLUSIONS One year of Cr supplementation and RT had some favorable effects on measures of bone area and muscle density in older adults.
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Affiliation(s)
- Darren G Candow
- Faculty of Kinesiology, University of Regina, Regina, SK, CANADA
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, CANADA
| | - Julianne J Gordon
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, CANADA
| | - Saija Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, CANADA
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16
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Ponzano M, Tibert N, Bansal S, Katzman W, Giangregorio L. Exercise for improving age-related hyperkyphosis: a systematic review and meta-analysis with GRADE assessment. Arch Osteoporos 2021; 16:140. [PMID: 34546447 DOI: 10.1007/s11657-021-00998-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/22/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED We reviewed exercise trials in men and women ≥ 45 years with hyperkyphosis at the baseline and performed meta-analyses for kyphosis and health-related outcomes. PURPOSE To determine the effects of exercise interventions on kyphosis angle, back extensor muscle strength or endurance, physical functioning, quality of life, pain, falls, and adverse events in adults 45 years or older with hyperkyphosis. METHODS Multiple databases were searched to May 2020. Randomized controlled trials (RCTs), non-RCT, and pre-post intervention studies that had at least one group with a mean kyphosis angle of at least 40° at the baseline were included. RESULTS Twenty-four studies were included. Exercise or physical therapy improved kyphosis outcomes (SMD - 0.31; 95% confidence intervals [CI] - 0.46, - 0.16; moderate certainty evidence), back extensor muscle strength (MD 10.51 N; 95% CI 6.65, 14.38; very low certainty evidence), and endurance (MD 9.76 s; 95% CI 6.40, 13.13; low certainty evidence). Meta-analyses showed improvements in health-related quality of life (HRQoL) (SMD 0.21; 95% CI 0.06, 0.37; moderate certainty of evidence), general pain (MD - 0.26; 95% CI - 0.39, - 0.13; low certainty of evidence), and performance on the timed up and go (TUG) test (MD - 0.28 s; 95% CI - 0.48, - 0.08; very low certainty of evidence). The effects on the rate of falls (incidence rate ratio [IRR] 1.15; 95% CI 0.64, 2.05; low certainty evidence) or minor adverse events (IRR 1.29; 95% CI 0.95, 1.74; low certainty evidence) are uncertain. No serious adverse events were reported in the included studies. CONCLUSIONS Interventions targeting hyperkyphosis may improve kyphosis outcomes in adults with hyperkyphosis.
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Affiliation(s)
- Matteo Ponzano
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Nicholas Tibert
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Symron Bansal
- Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Wendy Katzman
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, USA
| | - Lora Giangregorio
- Department of Kinesiology, University of Waterloo, Waterloo, Canada. .,Schlegel-UW Research Institute for Aging, Waterloo, Canada.
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17
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Lawson C, Ferreira V, Carli F, Chevalier S. Effects of multimodal prehabilitation on muscle size, myosteatosis, and dietary intake of surgical patients with lung cancer - a randomized feasibility study. Appl Physiol Nutr Metab 2021; 46:1407-1416. [PMID: 34265218 DOI: 10.1139/apnm-2021-0249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Many patients with lung cancer undergo surgery, which can increase the risk for muscle loss, leading to worsened outcomes. A multimodal prehabilitation intervention integrating dietary and muscle assessment may help clinicians better understand changes in these outcomes. This pilot assessed feasibility of multimodal prehabilitation in early-stage surgical lung cancer patients and explored relationships between body composition, muscle characteristics and dietary intake, as well as muscle changes due to prehabilitation. Patients were randomized to one of two groups: multimodal prehabilitation including nutritional supplements (fish oil with vitamin D3 + whey protein with leucine), exercise and relaxation, or standard of care. Physical function, dietary intake and muscle were evaluated at 0 and 4 weeks pre-operatively. Of 87 patients assessed for eligibility, 34 (39%) were randomized and 3 (9%) were lost to follow-up. Median age was 69 years and baseline protein intake was 1.0 g/kg/d. Adherence to exercise (86%) and supplements was high (93%); 3 patients (16%) reported side effects. Supplements significantly increased protein, omega-3 fatty acid, leucine and vitamin D intake. There were no significant changes in muscle characteristics. Multimodal prehabilitation with dietary and muscle analyses proved to be feasible. An adequately powered randomized controlled trial is warranted. ClinicalTrials.gov registration no: NCT04610606. Novelty: • Multimodal prehabilitation incorporating dietary assessment and muscle analysis is feasible for early-stage surgical lung cancer patients. • An adequately powered randomized controlled trial is warranted to further explore functional and post-operative outcomes.
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Affiliation(s)
- Claire Lawson
- McGill University, 5620, School of Human Nutrition, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, 507266, Montreal, Quebec, Canada;
| | - Vanessa Ferreira
- McGill University, 5620, Department of Kinesiology and Physical Education, Montreal, Quebec, Canada;
| | - Francesco Carli
- McGill University, 5620, Department of Anesthesia, Montreal, Quebec, Canada;
| | - Stéphanie Chevalier
- McGill University, School of Human Nutrition, Ste-Anne-de-Bellevue, Quebec, Canada.,Research Institute of the McGill University Health Centre, 507266, Montreal, Quebec, Canada;
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18
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Ponzano M, Rodrigues IB, Hosseini Z, Ashe MC, Butt DA, Chilibeck PD, Stapleton J, Thabane L, Wark JD, Giangregorio LM. Progressive Resistance Training for Improving Health-Related Outcomes in People at Risk of Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther 2021; 101:6048920. [PMID: 33367736 DOI: 10.1093/ptj/pzaa221] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Osteoporosis clinical practice guidelines recommend exercise to prevent fractures, but the efficacy of exercise depends on the exercise types, population studied, or outcomes of interest. The purpose of this systematic review was to assess the effects of progressive resistance training (PRT) on health-related outcomes in people at risk of fracture. METHODS Multiple databases were searched in October 2019. Eligible articles were randomized controlled trials of PRT interventions in men and women ≥50 years with low bone mineral density (BMD) or fracture history. Descriptive information and mean difference (MD) and SD were directly extracted for included trials. A total of 53 studies were included. RESULTS The effects of PRT on the total number of falls (incidence rate ratio [IRR] = 1.05; 95% CI = 0.91 - 1.21; 7 studies) and on the risk of falling (risk ratio [RR] = 1.23; 95% CI = 1.00 - 1.51; 5 studies) are uncertain. PRT improved performance on the Timed "Up and Go" test (MD = -0.89 seconds; 95% CI = -1.01 to -0.78; 13 studies) and health-related quality of life (standardized MD = 0.32; 95% CI = 0.22-0.42; 20 studies). PRT may increase femoral neck (MD = 0.02 g/cm2; 95% CI = 0.01-0.03; 521 participants, 5 studies) but not lumbar spine BMD (MD = 0.02 g/cm2; 95% CI = -0.01-0.05; 4 studies), whereas the effects on total hip BMD are uncertain (MD = 0.00 g/cm2; 95% CI = 0.00-0.01; 435 participants, 4 studies). PRT reduced pain (standardized MD = -0.26; 95% CI = -0.37 to -0.16; 17 studies). Sensitivity analyses, including PRT-only studies, confirmed these findings. CONCLUSION Individuals at risk of fractures should be encouraged to perform PRT, as it may improve femoral neck BMD, health-related quality of life, and physical functioning. PRT also reduced pain; however, whether PRT increases or decreases the risk of falls, the number of people experiencing a fall, or the risk of fall-related injuries is uncertain. IMPACT Individuals at risk of fractures should be encouraged to perform PRT, as it may have positive effects on femoral neck BMD, health-related quality of life, physical functioning, and pain, and adverse events are rare. LAY SUMMARY Exercise is recommended for people at risk of osteoporotic fractures. Our study showed that progressive resistance training improves physical functioning, quality of life, and reduces pain. The effects of progressive resistance training on the risk of falling are unclear. Adverse events are rare, and often minor (eg, soreness, pain, musculoskeletal injury). Considering the benefits and safety, people at risk of fractures should engage in progressive resistance training interventions.
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Affiliation(s)
| | | | | | - Maureen C Ashe
- The University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver, Canada
| | - Debra A Butt
- University of Toronto, Toronto, Canada.,Scarborough Health Network, Scarborough, Canada
| | | | | | - Lehana Thabane
- McMaster University, Hamilton, Canada.,St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - John D Wark
- University of Melbourne, Melbourne, Australia.,Royal Melbourne Hospital, Parkville, Australia
| | - Lora M Giangregorio
- University of Waterloo, Waterloo, Canada.,Schlegel-UW Research Institute for Aging, Waterloo, Canada
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19
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Skuladottir SS, Ramel A, Hjaltadottir I, Launer LJ, Cotch MF, Siggeirsdottir K, Gudnason V, Sigurdsson G, Steingrimsdottir L, Halldorsson T. Characteristics of incidence hip fracture cases in older adults participating in the longitudinal AGES-Reykjavik study. Osteoporos Int 2021; 32:243-250. [PMID: 32808140 PMCID: PMC11190885 DOI: 10.1007/s00198-020-05567-x] [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: 02/06/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022]
Abstract
Poor physical function and body composition my partly predict the risk of falls leading to fracture regardless of bone mineral density. INTRODUCTION To examine the relationship between body composition, physical function, and other markers of health with hip fractures in older community-dwelling Icelandic adults. METHODS A prospective cohort of 4782 older adults from the AGES-Reykjavik study. Baseline recruitment took place between 2002 and 2006, and information on hip fractures occurring through 2012 was extracted from clinical records. Using multivariate regression analyses, baseline measures of bone health, physical function, and body composition were compared between those who later experienced hip fractures and to those who did not. Associations with the risk of fractures were quantified using Cox regression. RESULTS Mean age was 76.3 years at baseline. After adjustment for age, regression showed that male hip fracture cases compared with non-cases had (mean (95% confidence interval)) significantly lower thigh muscle cross-sectional area - 5.6 cm2 (- 10.2, - 1.1), poorer leg strength - 28 N (- 49, - 7), and decreased physical function as measured by longer timed up and go test 1.1 s (0.5, 1.7). After adjustment for age, female cases had, compared with non-cases, lower body mass index - 1.5 kg/m2 (- 2.1, - 0.9), less lean mass - 1.6 kg (- 2.5, - 0.8), thigh muscle cross-sectional area - 4.4 cm2 (- 6.5, - 2.3), and worse leg strength - 16 N (- 25, - 6). These differences largely persisted after further adjustment for bone mineral density (BMD), suggesting that body composition may contribute to the risk of fracture independent of bone health. When examining the association between these same factors and hip fractures using Cox regression, the same conclusions were reached. CONCLUSIONS After accounting for age and BMD, older adults who later experienced a hip fracture had poorer baseline measures of physical function and/or body composition, which may at least partly contribute to the risk of falls leading to fracture.
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Affiliation(s)
- S S Skuladottir
- The Icelandic Gerontological Research Institute, Tungata 5, 101, Reykjavik, Iceland.
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
- Landspitali National University Hospital of Iceland, Reykjavik, Iceland.
| | - A Ramel
- The Icelandic Gerontological Research Institute, Tungata 5, 101, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - I Hjaltadottir
- Landspitali National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Nursing, University of Iceland, Reykjavik, Iceland
| | - L J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MA, USA
| | - M F Cotch
- Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, National Institutes of Health, Bethesda, MA, USA
| | - K Siggeirsdottir
- Icelandic Heart Association Research Institute, Kopavogur, Iceland
| | - V Gudnason
- Landspitali National University Hospital of Iceland, Reykjavik, Iceland
- Icelandic Heart Association Research Institute, Kopavogur, Iceland
| | - G Sigurdsson
- Landspitali National University Hospital of Iceland, Reykjavik, Iceland
- Icelandic Heart Association Research Institute, Kopavogur, Iceland
| | - L Steingrimsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - T Halldorsson
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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20
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Sui SX, Williams LJ, Holloway-Kew KL, Hyde NK, Anderson KB, Tembo MC, Addinsall AB, Leach S, Pasco JA. Skeletal Muscle Density and Cognitive Function: A Cross-Sectional Study in Men. Calcif Tissue Int 2021; 108:165-175. [PMID: 32984908 DOI: 10.1007/s00223-020-00759-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/15/2020] [Indexed: 01/08/2023]
Abstract
We aimed to investigate cross-sectional associations between skeletal muscle density, a proxy measure for fatty infiltration into muscle, and cognition. Contributions from body fat mass, systemic inflammation and lifestyle were explored, as these factors have been identified in both muscle and cognitive deterioration. For 281 men (60-95 year) from the Geelong Osteoporosis Study, radial and tibial muscle density were measured using peripheral quantitative computed tomography. Body fat and appendicular lean mass were measured using dual-energy X-ray absorptiometry. Cognitive function was assessed for psychomotor function (DET), visual identification/attention (IDN), visual learning (OCL) and working memory (OBK) (CogState Brief Battery). Composite scores signified overall cognitive function (OCF). Higher scores represent poorer performance except for OCL and OCF. Regression analyses examined associations between muscle density and cognition; potential confounders included age, muscle cross-sectional area (CSA), body composition, lifestyle and serum markers of inflammation. Negative associations with age were evident for muscle density, all cognitive domains and OCF. Muscle density at both sites was positively associated with DET, OCL and OCF. After adjustment for age, the association persisted for DET (radius: B = - 0.006, p = 0.02; tibia: B = - 0.003, p = 0.04) and OCL (radius B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). At the radius, further adjustment for serum TNF-α explained the association between muscle density (B = - 0.002, p = 0.66) and DET. Education and physical activity contributed to the model for radial muscle density and DET. There were no contributions from muscle CSA, appendicular lean mass, body fat mass, other markers of inflammation or other potential confounders. At the tibia, the association between muscle density and DET (B = - 0.003, p = 0.04) was independent of TNF-α. There was an age-adjusted association between muscle density and OCL at both sites (radius: B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). None of the potential confounders contributed to the models. Muscle density was associated with cognitive function in the DET and OCL domains. However, there was little evidence that this was explained by inflammation or body fat mass. No associations were identified between muscle density and IDN or OBK.
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Affiliation(s)
- Sophia X Sui
- Deakin University, IMPACT Institute, Geelong, VIC, Australia.
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT Institute, Deakin University, Barwon Health, PO Box 281, Geelong, VIC, 3220, Australia.
| | - Lana J Williams
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | | | - Natalie K Hyde
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Kara B Anderson
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Monica C Tembo
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | | | | | - Julie A Pasco
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
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21
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Wang L, Yin L, Zhao Y, Su Y, Sun W, Liu Y, Yang M, Yu A, Blake GM, Cheng X, Wu X, Veldhuis A, Engelke K. Muscle density discriminates hip fracture better than computed tomography X-ray absorptiometry hip areal bone mineral density. J Cachexia Sarcopenia Muscle 2020; 11:1799-1812. [PMID: 32894000 PMCID: PMC7749550 DOI: 10.1002/jcsm.12616] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/02/2020] [Accepted: 07/07/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Muscle weakness is a key factor in the increase risk of falls and might also play a significant role in the increase of risk of hip fracture. Computed tomography-measured muscle size and muscle density are well-established imaging biomarkers used in studies of physical function, frailty or cancer, but limited to hip fracture. In particular, it is warranted to have a better understanding of the performance of muscle size and density in the discrimination of acute hip fractures. We also aim to determine age-related differences of muscle size and density in healthy controls and hip fracture patients. METHODS Four hundred thirty-eight low-energy acute hip fracture cases and 316 healthy controls from the China Action on Spine and Hip Status study were included in the study. Muscle cross-sectional area and density were measured for the gluteus maximus and gluteus medius and minimus. Areal bone mineral density (aBMD) of the femoral neck and total hip was measured. Using propensity score matching, we generated three samples with cases and controls matched for age, body mass index, and gender: femoral neck fracture (FNF), intertrochanteric fracture (ITF), and any hip fracture vs. controls, respectively. RESULTS Handgrip strength, gluteus muscle area and density, and bone parameters of the matched hip fracture groups were lower than those of the correspondence control groups, respectively (P < 0.05). The univariate analysis showed that associations of aBMD with FNF and with ITF were significantly weaker than associations between fracture and muscle parameters. Gluteus medius and minimus muscle density showed the highest areas under the curve (AUC) with FNF (0.88, 95% confidence interval, 0.85-0.92) and trochanteric fracture (0.95, 95% confidence interval, 0.92-0.97). The model including all muscle and bone parameters provided the highest AUC (FNF: AUC 0.912; ITF: AUC 0.958), and AUC results of another selected model without muscle density showed that association with fracture significantly dropped (FNF: AUC 0.755; ITF: AUC 0.858). Separate results for the two age groups younger and older than 70 years showed no age-related significant differences in discriminate models. CONCLUSIONS Muscle density performs better than aBMD from hip computed tomography X-ray absorptiometry and muscle size in discrimination of hip fracture. Combination of aBMD and muscle density provided the best discrimination. The integration of muscle assessments may trigger a paradigm shift in hip fracture prediction. Gluteus muscle density should also be evaluated as treatment outcome.
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Affiliation(s)
- Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Lu Yin
- Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Beijing, China
| | - Yue Zhao
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Yongbin Su
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Wei Sun
- Xinjiekou Community Health Service Center, Beijing, China
| | - Yandong Liu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Minghui Yang
- Department of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China
| | - Aihong Yu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Glen Mervyn Blake
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, UK
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Xinbao Wu
- Department of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China
| | - Annegreet Veldhuis
- Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands.,Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, The Netherlands
| | - Klaus Engelke
- Department of Medicine 3, FAU University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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22
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Scott D, Johansson J, Ebeling PR, Nordstrom P, Nordstrom A. Adiposity Without Obesity: Associations with Osteoporosis, Sarcopenia, and Falls in the Healthy Ageing Initiative Cohort Study. Obesity (Silver Spring) 2020; 28:2232-2241. [PMID: 33012137 DOI: 10.1002/oby.22984] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Obesity is commonly defined by BMI rather than adiposity, which may have differential effects on musculoskeletal health. Musculoskeletal outcomes were compared in older adults with normal adiposity and normal BMI (NA-NBMI), those with high adiposity but normal BMI (HA-NBMI), and those with high adiposity and high BMI (HA-HBMI). METHODS In 3,411 70-year-olds, obesity was defined as BMI ≥ 30 kg/m2 and adiposity as body fat percentage ≥ 25% (men) or ≥ 35% (women) from dual-energy x-ray absorptiometry. Bone parameters were measured by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Sarcopenia was defined as low handgrip strength with or without low appendicular lean mass. Falls were self-reported 6 and 12 months later. RESULTS Prevalence of NA-NBMI, HA-NBMI, and HA-HBMI was 14.2%, 68.1%, and 17.7%, respectively. Compared with HA-HBMI, HA-NBMI had increased likelihood for sarcopenia (adjusted odds ratio: 3.99; 95% CI: 1.41-11.32) and osteoporosis (2.91; 95% CI: 2.35-3.61) but similar likelihood of falls (P > 0.05). HA-NBMI had lower values for bone geometry parameters, as well as grip strength, than both NA-NBMI and HA-HBMI (all P < 0.05). CONCLUSIONS High adiposity without high BMI is more common than BMI-defined obesity in older Swedish adults but does not provide similar protection from osteoporosis and sarcopenia.
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Affiliation(s)
- David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School-Western Campus, The University of Melbourne, St Albans, Victoria, Australia
| | - Jonas Johansson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Peter Nordstrom
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordstrom
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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23
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Sui SX, Pasco JA. Obesity and Brain Function: The Brain-Body Crosstalk. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E499. [PMID: 32987813 PMCID: PMC7598577 DOI: 10.3390/medicina56100499] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
Dementia comprises a wide range of progressive and acquired neurocognitive disorders. Obesity, defined as excessive body fat tissue, is a common health issue world-wide and a risk factor for dementia. The adverse effects of obesity on the brain and the central nervous system have been the subject of considerable research. The aim of this review is to explore the available evidence in the field of body-brain crosstalk focusing on obesity and brain function, to identify the major research measurements and methodologies used in the field, to discuss the potential risk factors and biological mechanisms, and to identify the research gap as a precursor to systematic reviews and empirical studies in more focused topics related to the obesity-brain relationship. To conclude, obesity appears to be associated with reduced brain function. However, obesity is a complex health condition, while the human brain is the most complicated organ, so research in this area is difficult. Inconsistency in definitions and measurement techniques detract from the literature on brain-body relationships. Advanced techniques developed in recent years are capable of improving investigations of this relationship.
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Affiliation(s)
- Sophia X. Sui
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia;
| | - Julie A. Pasco
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3220, Australia;
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC 3021, Australia
- Barwon Health, Geelong, VIC 3220, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3181, Australia
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24
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Harding AT, Weeks BK, Lambert C, Watson SL, Weis LJ, Beck BR. A Comparison of Bone-Targeted Exercise Strategies to Reduce Fracture Risk in Middle-Aged and Older Men with Osteopenia and Osteoporosis: LIFTMOR-M Semi-Randomized Controlled Trial. J Bone Miner Res 2020; 35:1404-1414. [PMID: 32176813 DOI: 10.1002/jbmr.4008] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 03/04/2020] [Accepted: 03/16/2020] [Indexed: 12/25/2022]
Abstract
The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial examined efficacy and safety of two novel exercise programs in older men with low BMD. Men with low hip and/or LS BMD were randomized to high-intensity progressive resistance and impact training (HiRIT) or machine-based isometric axial compression (IAC) and compared to a nonrandomized matched control (CON). Outcomes included: hip and LS BMD; calcaneal ultrasound parameters; anthropometry; body composition; function (timed up-and-go [TUG], five-times sit-to-stand [FTSTS]); back extensor strength (BES); leg extensor strength (LES); compliance and adverse events. Ninety-three men (67.1 ± 7.5 years; 82.1 ± 11.6 kg; 175.2 ± 6.7 cm; FN T-score -1.6 ± 0.6) were randomized to HiRIT (n = 34) or IAC (n = 33), or allocated to CON (n = 26). HiRIT improved trochanteric BMD (2.8 ± 0.8%; -0.1 ± 0.9%, p = .024), LS BMD (4.1 ± 0.7%; 0.9 ± 0.8%, p = .003), BUA (2.2 ± 0.7%; -0.8 ± 0.9%, p = .009), stiffness index (1.6 ± 0.9%; -2.0 ± 1.1%, p = .011), lean mass (1.5 ± 0.8%; -2.4 ± 0.9%, p = .002), TUG, FTSTS, BES, and LES (p < .05) compared with CON. IAC improved lean mass (0.8 ± 0.8%; -2.4 ± 0.9%, p = .013) and FTSTS (-4.5 ± 1.6%; 7.5 ± 2.0%, p < .001) compared with CON. HiRIT improved LS BMD (4.1 ± 0.7%; 2.0 ± 0.7%, p = .039), stiffness index (1.6 ± 0.9%; -1.3 ± 0.9%, p = .025), and FTSTS (-10.7 ± 1.6%; -4.5 ± 1.7%, p = .010) compared with IAC. Exercise compliance was high (HiRIT 77.8 ± 16.6%; IAC 78.5 ± 14.8%, p = .872). There were five minor adverse events (HiRIT, 2; IAC, 3). HiRIT was well-tolerated and improved bone, function and fracture risk more than CON or IAC. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Conor Lambert
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | | | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,The Bone Clinic, Brisbane, Australia
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25
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Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J Clin Med 2019; 8:E488. [PMID: 30978926 PMCID: PMC6518405 DOI: 10.3390/jcm8040488] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia, defined as the age-related decrease in muscle mass, strength and physical performance, is associated with reduced bone mass and elevated low-grade inflammation. From a healthy aging perspective, interventions which overcome sarcopenia are clinically relevant. Accumulating evidence suggests that exogenous creatine supplementation has the potential to increase aging muscle mass, muscle performance, and decrease the risk of falls and possibly attenuate inflammation and loss of bone mineral. Therefore, the purpose of this review is to: (1) summarize the effects of creatine supplementation, with and without resistance training, in aging adults and discuss possible mechanisms of action, (2) examine the effects of creatine on bone biology and risk of falls, (3) evaluate the potential anti-inflammatory effects of creatine and (4) determine the safety of creatine supplementation in aging adults.
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Affiliation(s)
- Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2, Canada.
| | - Scott C Forbes
- Department of Physical Education, Brandon University, Brandon, MB R7A 6A9, Canada.
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK S7N 5B2, Canada.
| | - Stephen M Cornish
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL 33314, USA.
| | - Richard B Kreider
- Department of Health and Kinesiology, Texas A&M University, College Station, TX 77843-4253, USA.
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26
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Yamada M, Kimura Y, Ishiyama D, Nishio N, Otobe Y, Tanaka T, Ohji S, Koyama S, Sato A, Suzuki M, Ogawa H, Ichikawa T, Ito D, Arai H. Synergistic effect of bodyweight resistance exercise and protein supplementation on skeletal muscle in sarcopenic or dynapenic older adults. Geriatr Gerontol Int 2019; 19:429-437. [PMID: 30864254 DOI: 10.1111/ggi.13643] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/16/2019] [Accepted: 01/31/2019] [Indexed: 12/31/2022]
Abstract
AIM The objective of this trial was to investigate the synergistic effects of bodyweight resistance exercise and a protein supplement with vitamin D on skeletal muscle in sarcopenic or dynapenic older adults. METHODS This was a four-arm randomized controlled trial. Sarcopenic or dynapenic older adults were recruited for this trial. After screening, a total of 112 older adults were randomly allocated among four groups; 28 older adults each were enrolled in the combined resistance exercise and nutritional supplementation group, the exercise alone group, the nutritional supplementation alone group, and the control group. Participants in the combined group and exercise alone groups took part in a bodyweight resistance exercise program for 12 weeks. Protein and vitamin D supplements were provided every day for 12 weeks for the participants in the combined group and nutritional supplementation alone groups. We assessed the echo intensity of participants' thigh muscle using ultrasonography, measured their appendicular muscle mass using a bioelectrical impedance data acquisition system, and tested their knee extension strength and physical function. RESULTS Participants in the combined group had a significantly greater improvement in rectus femoris echo intensity and knee extension torque than those in the other groups (P < 0.05). Furthermore, the combined program increased appendicular muscle mass in sarcopenic older adults (P < 0.05), but not in older adults with low physical function with normal muscle mass. CONCLUSIONS The present study confirmed the synergistic effect of bodyweight resistance exercise and protein supplement with vitamin D on muscle quality and muscle strength in sarcopenic or dynapenic older adults. Geriatr Gerontol Int 2019; 19: 429-437.
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Affiliation(s)
- Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,National Center for Geriatrics and Gerontology, Morioka, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Naohito Nishio
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Tomoya Tanaka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shunsuke Ohji
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Atsushi Sato
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hideyuki Ogawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Takeo Ichikawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Daisuke Ito
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Morioka, Japan
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27
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Scott D, Johansson J, McMillan LB, Ebeling PR, Nordstrom A, Nordstrom P. Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative. Bone 2019; 120:446-451. [PMID: 30537557 DOI: 10.1016/j.bone.2018.12.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/19/2018] [Accepted: 12/07/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lower skeletal muscle density, indicating greater infiltration of adipose tissue into muscles, is associated with higher fracture risk in older adults. We aimed to determine whether mid-calf muscle density is associated with falls risk and bone health in community-dwelling older adults. METHODS 2214 community-dwelling men and women who participated in the Healthy Ageing Initiative (Sweden) study at age 70 were included in this analysis. Mid-calf muscle density (mg/cm3) at the proximal tibia, and volumetric bone mineral density (vBMD) and architecture at the distal and proximal tibia and radius, were assessed by peripheral quantitative computed tomography. Whole-body lean and fat mass, lumbar spine and total hip areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. Participants completed seven-day accelerometer measurements of physical activity intensity, and self-reported falls data were collected 6 and 12 months later. RESULTS 302 (13.5%) participants reported a fall at the 6- or 12-month interview, and 29 (1.3%) reported a fall at both interviews. After adjustment for confounders, each standard deviation decrease in mid-calf muscle density was associated with a trend towards greater likelihood of experiencing a fall (OR 1.13; 95% CI 1.00, 1.29 per SD lower) and significantly greater likelihood of multiple falls (1.61; 1.16, 2.23). Higher muscle density was not associated with total hip aBMD, and was associated with lower lumbar spine aBMD (B = -0.003; 95% CI -0.005, -0.001 per mg/cm3) and higher proximal cortical vBMD (0.74; 0.20, 1.28) at the radius. At the tibia, muscle density was positively associated with distal total and trabecular vBMD, and proximal total and cortical vBMD, cortical thickness, cortical area and stress-strain index (all P < 0.05). Only moderate/vigorous (%) intensity physical activity, not sedentary time or light activity, was associated with higher mid-calf muscle density (0.086; 0.034, 0.138). CONCLUSIONS Lower mid-calf muscle density is independently associated with higher likelihood for multiple incident falls and appears to have localised negative effects on bone structure in older adults.
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Affiliation(s)
- David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia.
| | - Jonas Johansson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Lachlan B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Anna Nordstrom
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Peter Nordstrom
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
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28
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Zheng Y, Wang X, Zhang ZK, Guo B, Dang L, He B, Zhang C, Zhou J, Shi W, Zhao Y, Zhan H, Xu Y, Liang C, Liu J, Guan D, Wang L, Wu X, Li J, Zhuo Z, Lin Z, Qiu H, Zhong L, Bian Z, Shi Y, Zhang BT, Zhang G, Lu A. Bushen Yijing Fang Reduces Fall Risk in Late Postmenopausal Women with Osteopenia: A Randomized Double-blind and Placebo-controlled Trial. Sci Rep 2019; 9:2089. [PMID: 30765762 PMCID: PMC6375933 DOI: 10.1038/s41598-018-38335-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/20/2018] [Indexed: 01/06/2023] Open
Abstract
Falls in late postmenopausal women with osteopenia usually cause fractures with severe consequences. This 36-month randomized, double-blind and placebo-controlled trial with a 10-year observational follow-up study aimed to investigate the long-term effect of herbal formula Bushen Yijing Fang (BSYJF) on fall risk in the late postmenopausal women with osteopenia. 140 late postmenopausal women (Femoral neck T-score, −2.5~−2 SD) were recruited and randomized to orally receive calcium carbonate 300 mg daily with either BSYJF or placebo for 36 months. The effect was further investigated for another 10-year follow-up. During the 36-month administration, there were 12 falls in BSYJF group and 28 falls in placebo group, respectively, indicating 64% lower risk of falls (RR 0.36 [95% CI, 0.18 to 0.71]; P = 0.004) in BSYJF group. During the 10-year follow-up, 36% lower fall risk (RR 0.64 [95% CI, 0.46 to 0.89]; P = 0.009) was observed in BSYJF group. No significant difference was found in safety profile between two groups. Thirty-six-month administration of BSYJF reduced fall risk with an increase in bone mass, and its latent effect on fall risk was continually observed in the 10-year follow-up in late postmenopausal women with osteopenia. This clinical trial was registered at Chinese clinical trial registry (ChiCTR-IOR-16008942).
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Affiliation(s)
- Yuxin Zheng
- Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuezong Wang
- Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zong-Kang Zhang
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Baosheng Guo
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.,School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Dang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Bing He
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.,Institute of Integrated Bioinformedicine and Translational Science, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Chi Zhang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jiwei Zhou
- Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wanzhong Shi
- Preparation Center of Traditional Chinese Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongfang Zhao
- Institute of Orthopaedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hongsheng Zhan
- Institute of Orthopaedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yu Xu
- Institute of Orthopaedics and Traumatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Chao Liang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jin Liu
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Daogang Guan
- Institute of Integrated Bioinformedicine and Translational Science, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Luyao Wang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Xiaohao Wu
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jie Li
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhenjian Zhuo
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhixiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lidan Zhong
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Zhaoxiang Bian
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Yinyu Shi
- Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bao-Ting Zhang
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ge Zhang
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.
| | - Aiping Lu
- Institute for Advancing Translational Medicine in Bone & Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China. .,Institute of Integrated Bioinformedicine and Translational Science, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China. .,School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Park WC, Kim M, Kim S, Yoo J, Kim BS, Chon J, Jeong SJ, Won CW. Introduction of Fall Risk Assessment (FRA) System and Cross-Sectional Validation Among Community-Dwelling Older Adults. Ann Rehabil Med 2019; 43:87-95. [PMID: 30852875 PMCID: PMC6409653 DOI: 10.5535/arm.2019.43.1.87] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/07/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p<0.001). CONCLUSION FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.
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Affiliation(s)
- Woo-Chul Park
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, Graduate School of Kyung Hee University, Seoul, Korea
- East-West Medical Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jinho Yoo
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Byung Sung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jinmann Chon
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Su Jin Jeong
- Statistics Support Department, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Elderly Frailty Research Center, Kyung Hee University Medical Center, Seoul, Korea
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Metabolic Syndrome and Its Associations with Components of Sarcopenia in Overweight and Obese Older Adults. J Clin Med 2019; 8:jcm8020145. [PMID: 30691198 PMCID: PMC6406767 DOI: 10.3390/jcm8020145] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 12/25/2022] Open
Abstract
Ageing, obesity and the metabolic syndrome (MetS) may all contribute to poor muscle health (sarcopenia). This study aimed to determine the cross-sectional associations between MetS (International Diabetes Federation classification) and sarcopenia (revised European Working Group on Sarcopenia in Older People definition) in 84 overweight and obese older adults. Components of sarcopenia included muscle strength (hand grip and leg extension), physical performance (stair climb test and short physical performance battery (SPPB), including gait speed and repeated chair stands time), muscle mass (appendicular lean mass (ALM), dual-energy X-ray absorptiometry), muscle size (peripheral quantitative computed tomography-determined calf and forearm cross-sectional area (CSA)) and muscle quality (muscle density and strength normalised to lean mass). Waist circumference was associated with greater muscle size, but poorer leg extension strength, chair stands and stair climb time, gait speed, SPPB scores and muscle quality measures (all p < 0.05). MetS was positively associated with ALM and forearm muscle CSA, and negatively associated with muscle quality measures and chair stands time (all p < 0.05). MetS is associated with larger muscle size, yet poorer muscle quality in overweight and obese older adults. Assessments of muscle function and quality should be considered for obese older adults and those with MetS.
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Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes 2019; 12:1057-1072. [PMID: 31372016 PMCID: PMC6630094 DOI: 10.2147/dmso.s186600] [Citation(s) in RCA: 262] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/07/2019] [Indexed: 12/05/2022] Open
Abstract
The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the age-related loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter- and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Correspondence: Jakub MesinovicDepartment of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, Victoria3068, AustraliaTel + 6 138 572 2919Fax + 6 139 594 6495Email
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Barbora De Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, VIC, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
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Mühlberg A, Museyko O, Bousson V, Pottecher P, Laredo JD, Engelke K. Three-dimensional Distribution of Muscle and Adipose Tissue of the Thigh at CT: Association with Acute Hip Fracture. Radiology 2018; 290:426-434. [PMID: 30457478 DOI: 10.1148/radiol.2018181112] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose To evaluate determinants of hip fracture by assessing soft-tissue composition of the upper thigh at CT. Materials and Methods In this retrospective analysis of prospectively collected data, CT studies in 55 female control participants (mean age, 73.1 years ± 9.3 [standard deviation]) were compared with those in 40 female patients (mean age, 80.2 years ± 11.0) with acute hip fractures. Eighty-seven descriptors of the soft-tissue composition were determined. A multivariable best subsets analysis was used to extract parameters best associated with hip fracture. Results were adjusted for age, height, and weight. Results of soft-tissue parameters were compared with bone mineral density (BMD) and cortical bone thickness. Areas under the receiver operating characteristic curve (AUCs) adjusted for multiple comparisons were determined to discriminate fracture. Results The hip fracture group was characterized by lower BMD, lower cortical thickness, lower relative adipose tissue volume of the upper thigh, and higher extramyocellular lipid (EML) surface density. The relative volume of adipose tissue combined with EML surface density (model S1) was associated with hip fracture (AUC, 0.85; 95% confidence interval [CI]: 0.78, 0.93), as well as trochanteric trabecular BMD combined with neck cortical thickness (model B2) (AUC, 0.84; 95% CI: 0.75, 0.92). The model including all four parameters provided significantly better (P < .01) discrimination (AUC, 0.92; 95% CI: 0.86, 0.97) than model S1 or B2. Conclusion In addition to bone mineral density and geometry of the proximal femur, the amount of adipose tissue of the upper thigh and the distribution of the adipocytes in the muscles are significantly associated with acute hip fracture at CT. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Alexander Mühlberg
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Oleg Museyko
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Valérie Bousson
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Pierre Pottecher
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Jean-Denis Laredo
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Klaus Engelke
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
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Kim M, Kim S, Won CW. Test-retest Reliability and Sensitivity to Change of a New Fall Risk Assessment System: A Pilot Study. Ann Geriatr Med Res 2018; 22:80-87. [PMID: 32743251 PMCID: PMC7387613 DOI: 10.4235/agmr.2018.22.2.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 11/05/2022] Open
Abstract
Background The new fall risk assessment (FRA) system is a composite and comprehensive assessment tool developed to predict the risk of falls. The aim of this pilot study was to examine the new FRA system’s test-retest reliability and sensitivity to change in community-dwelling older adults. Methods This was an observational study with a test-retest design and an 8-week fall prevention exercise program. A sample of 28 community-dwelling older adults with a mean age of 73.0 years (range, 65–80 years) participated in the study. The new FRA system was administered twice within a 7-day period for test-retest reliability expressed as intraclass correlation coefficient (ICC) and standard error of measurement (SEM) assessment. Eighteen subjects of them completed the 8-week fall prevention exercise intervention to evaluate the new FRA system’s sensitivity to change. Results In the evaluation of interrater reliability for the new FRA system, the ICC (95% confidence interval) of the total score was 0.77 (0.47–0.98), with good reliability. The SEM was 11.61 for the total FRA score. A good to excellent reliability was observed, with ICC levels of 0.73 to 0.91 for the 4 composite scores of the new FRA system. Following the 8-week exercise intervention, the mean total FRA score (effect size, 0.58) significantly increased (p=0.028). Conclusion The new FRA system has generally moderate to excellent interrater reliability and reliable sensitivity to change in community-dwelling older adults. Our findings provide support for the reliability of the new FRA system in healthy older adults without a fall history.
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Affiliation(s)
- Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
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Frank-Wilson AW, Chalhoub D, Figueiredo P, Jónsson PV, Siggeirsdóttir K, Sigurdsson S, Eiriksdottir G, Guðnason V, Launer L, Harris TB. Associations of Quadriceps Torque Properties with Muscle Size, Attenuation, and Intramuscular Adipose Tissue in Older Adults. J Gerontol A Biol Sci Med Sci 2018; 73:931-938. [PMID: 29342246 PMCID: PMC6001898 DOI: 10.1093/gerona/glx262] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background Atrophy and fatty infiltration of muscle with aging are associated with fractures and falls, however, their direct associations with muscle function are not well described. It was hypothesized that participants with lower quadriceps muscle attenuation, area, and greater intramuscular adipose tissue (IMAT) will exhibit slower rates of torque development (RTD) and lower peak knee extension torques. Methods Data from 4,842 participants (2,041 men, 2,801 women) from the Age Gene/Environment Susceptibility Reykjavik Study (mean age 76 ± 0.1 years) with complete thigh computed tomography and isometric knee testing. Regression models were adjusted for health, behavior, and comorbidities. Muscle attenuation was further adjusted for muscle area and IMAT; muscle area adjusted for IMAT and attenuation; and IMAT adjusted for muscle area and attenuation. Standardized betas (β) indicate association effect sizes. Results In the fully-adjusted models, attenuation (men β = 0.06, 95% CI: 0.01, 0.11; women β = 0.07, 95% CI: 0.03, 0.11) and muscle area (men β = 0.13, 95% CI: 0.07, 0.19; women β = 0.10, 95% CI: 0.06, 0.15) were associated with knee RTD. Attenuation (men β = 0.12, 95% CI: 0.08, 0.16; women β = 0.12, 95% CI: 0.09, 0.16) and muscle area (men β = 0.38, 95% CI: 0.33, 0.43; women β = 0.33, 95% CI: 0.29, 0.37) were associated with peak torque. Conclusions These data suggest that muscle attenuation and area are independently associated with RTD and peak torque; and that area and attenuation demonstrate similar contributions to RTD.
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Affiliation(s)
- Andrew W Frank-Wilson
- Laboratory of Epidemiology and Population Science, National Institute on Aging (NIA), Bethesda, Maryland
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Didier Chalhoub
- Laboratory of Epidemiology and Population Science, National Institute on Aging (NIA), Bethesda, Maryland
| | - Pedro Figueiredo
- Laboratory of Epidemiology and Population Science, National Institute on Aging (NIA), Bethesda, Maryland
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Portugal
| | - Pálmi V Jónsson
- Department of Geriatrics, Landspítali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik
| | | | | | | | - Vilmundur Guðnason
- Faculty of Medicine, University of Iceland, Reykjavik
- Icelandic Heart Association Research Institute, Reykjavik, Iceland
| | - Lenore Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging (NIA), Bethesda, Maryland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging (NIA), Bethesda, Maryland
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Associations of components of sarcopenic obesity with bone health and balance in older adults. Arch Gerontol Geriatr 2018; 75:125-131. [DOI: 10.1016/j.archger.2017.12.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/29/2022]
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Duff WRD, Andrushko JW, Renshaw DW, Chilibeck PD, Farthing JP, Danielson J, Evans CD. Impact of Pilates Exercise in Multiple Sclerosis: A Randomized Controlled Trial. Int J MS Care 2018; 20:92-100. [PMID: 29670495 DOI: 10.7224/1537-2073.2017-066] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Pilates is a series of exercises based on whole-body movement and may improve mobility in people with multiple sclerosis (MS). The purpose of this study was to determine the effect of Pilates on walking performance in people with MS. Methods 30 individuals with MS who were not restricted to a wheelchair or scooter (Patient-Determined Disease Steps scale score <7) were randomized to receive Pilates (twice weekly) and massage therapy (once weekly) or once-weekly massage therapy only (control group). The Pilates was delivered in a group setting (five to ten participants per session). The primary outcome was change in walking performance (6-Minute Walk Test) after 12 weeks. Secondary outcomes included functional ability (Timed Up and Go test), balance (Fullerton Advanced Balance Scale), flexibility (sit and reach test), body composition (dual-energy X-ray absorptiometry), core endurance (plank-hold test), and muscle strength and voluntary activation (quadriceps). Intention-to-treat analysis was performed using a two-factor repeated-measures analysis of variance. Results Walking distance increased by a mean (SD) of 52.4 (40.2) m in the Pilates group versus 15.0 (34.1) m in the control group (group × time, P = .01). Mean (SD) time to complete the Timed Up and Go test decreased by 1.5 (2.8) seconds in the Pilates group versus an increase of 0.3 (0.9) seconds in the control group (group × time, P = .03). There were no other significant differences between groups over time. Conclusions Pilates improved walking performance and functional ability in persons with MS and is a viable exercise option to help manage the disease.
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Chan ACH, Adachi JD, Papaioannou A, Wong AKO. Investigating the Effects of Motion Streaks on pQCT-Derived Leg Muscle Density and Its Association With Fractures. J Clin Densitom 2018; 21:130-139. [PMID: 28065423 DOI: 10.1016/j.jocd.2016.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/30/2016] [Accepted: 12/05/2016] [Indexed: 11/28/2022]
Abstract
Lower peripheral quantitative computed tomography (pQCT)-derived leg muscle density has been associated with fragility fractures in postmenopausal women. Limb movement during image acquisition may result in motion streaks in muscle that could dilute this relationship. This cross-sectional study examined a subset of women from the Canadian Multicentre Osteoporosis Study. pQCT leg scans were qualitatively graded (1-5) for motion severity. Muscle and motion streak were segmented using semi-automated (watershed) and fully automated (threshold-based) methods, computing area, and density. Binary logistic regression evaluated odds ratios (ORs) for fragility or all-cause fractures related to each of these measures with covariate adjustment. Among the 223 women examined (mean age: 72.7 ± 7.1 years, body mass index: 26.30 ± 4.97 kg/m2), muscle density was significantly lower after removing motion (p < 0.001) for both methods. Motion streak areas segmented using the semi-automated method correlated better with visual motion grades (rho = 0.90, p < 0.01) compared to the fully automated method (rho = 0.65, p < 0.01). Although the analysis-reanalysis precision of motion streak area segmentation using the semi-automated method is above 5% error (6.44%), motion-corrected muscle density measures remained well within 2% analytical error. The effect of motion-correction on strengthening the association between muscle density and fragility fractures was significant when motion grade was ≥3 (p interaction <0.05). This observation was most dramatic for the semi-automated algorithm (OR: 1.62 [0.82,3.17] before to 2.19 [1.05,4.59] after correction). Although muscle density showed an overall association with all-cause fractures (OR: 1.49 [1.05,2.12]), the effect of motion-correction was again, most impactful within individuals with scans showing grade 3 or above motion. Correcting for motion in pQCT leg scans strengthened the relationship between muscle density and fragility fractures, particularly in scans with motion grades of 3 or above. Motion streaks are not confounders to the relationship between pQCT-derived leg muscle density and fractures, but may introduce heterogeneity in muscle density measurements, rendering associations with fractures to be weaker.
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Affiliation(s)
- Adrian C H Chan
- Osteoporosis Program, University Health Network, Toronto, ON, Canada
| | | | - Alexandra Papaioannou
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Geriatric Education and Research in Aging Sciences (GERAS) Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Andy Kin On Wong
- Osteoporosis Program, University Health Network, Toronto, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
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Drey M, Berr CM, Reincke M, Fazel J, Seissler J, Schopohl J, Bidlingmaier M, Zopp S, Reisch N, Beuschlein F, Osswald A, Schmidmaier R. Cushing's syndrome: a model for sarcopenic obesity. Endocrine 2017; 57:481-485. [PMID: 28702888 DOI: 10.1007/s12020-017-1370-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/30/2017] [Indexed: 01/04/2023]
Abstract
PURPOSE Obesity and its metabolic impairments are discussed as major risk factors for sarcopenia leading to sarcopenic obesity. Cushing's syndrome is known to be associated with obesity and muscle atrophy. We compared Cushing's syndrome with matched obese controls regarding body composition, physical performance, and biochemical markers to test the hypothesis that Cushing's syndrome could be a model for sarcopenic obesity. METHODS By propensity score matching, 47 controls were selected by body mass index and gender as obese controls. Fat mass and muscle mass were measured by bioelectrical impedance analysis. Muscle function was assessed by chair rising test and hand grip strength. Biochemical markers of glucose and lipid metabolism and inflammation (hsCRP) were measured in peripheral blood. RESULTS Muscle mass did not differ between Cushing's syndrome and obese controls. However, Cushing's syndrome patients showed significantly greater chair rising time (9.5 s vs. 7.3 s, p = 0.008) and significantly lower hand grip strength (32.1 kg vs. 36.8 kg, p = 0.003). Cushing's syndrome patients with impaired fasting glucose have shown the highest limitations in hand grip strength and chair rising time. CONCLUSIONS Similar to published data in ageing medicine, Cushing's syndrome patients show loss of muscle function that cannot be explained by loss of muscle mass. Impaired muscle quality due to fat infiltration may be the reason. This is supported by the observation that Cushing's syndrome patients with impaired glucose metabolism show strongest deterioration of muscle function. Research in sarcopenic obesity in elderly is hampered by confounding comorbidities and polypharmacy. As Cushing's syndrome patients are frequently free of comorbidities and as Cushing's syndrome is potentially curable we suggest Cushing's syndrome as a clinical model for further research in sarcopenic obesity.
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Affiliation(s)
- Michael Drey
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie, Klinikum der Universität München (LMU), Munich, Germany.
| | - Christina M Berr
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Julia Fazel
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Jochen Seissler
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Jochen Schopohl
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Martin Bidlingmaier
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Stefanie Zopp
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Andrea Osswald
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
| | - Ralf Schmidmaier
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie, Klinikum der Universität München (LMU), Munich, Germany
- Medizinische Klinik und Poliklinik IV, Schwerpunkt Endokrinologie, Klinikum der Universität München (LMU), Munich, Germany
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Hamasaki H. Lower Extremity Skeletal Muscle Mass, but Not Upper Extremity Skeletal Muscle Mass, Is Inversely Associated with Hospitalization in Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:2303467. [PMID: 28848767 PMCID: PMC5564125 DOI: 10.1155/2017/2303467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/30/2017] [Indexed: 12/25/2022] Open
Abstract
AIM To investigate the association of skeletal muscle mass with metabolic parameters and hospitalization in patients with type 2 diabetes. METHODS A retrospective observational study was conducted in patients with type 2 diabetes between May 2013 and November 2015. Body composition was measured by bioelectrical impedance analysis. Multiple regression analysis was performed to identify the association between skeletal muscle mass and metabolic parameters. Cox proportional hazard analysis was performed to assess the association between skeletal muscle mass and hospitalization. RESULTS A total of 121 patients were enrolled in this study. The mean age of patients was 59.4 ± 14.2 years. During a mean follow-up of 730 ± 253 days, three patients (2.8%) died and 79 patients (65.3%) were admitted to our hospital. After adjustment for age, sex, height, and weight, it was found that lower extremity skeletal muscle mass (LSM) was inversely associated with brachial-ankle pulse wave velocity (β = -0.108, P = 0.008). Moreover, LSM was significantly associated with reduced risk of hospitalization (hazard ratio = 0.752; 95% confidence interval, 0.601-0.942; P = 0.013). In contrast, upper extremity skeletal muscle mass (USM) did not exhibit any significant association. CONCLUSION LSM, but not USM, is important for managing patients with type 2 diabetes. This trial is registered with UMIN000023010.
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Affiliation(s)
- Hidetaka Hamasaki
- Hamasaki Clinic, Kagoshima, Japan
- Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- *Hidetaka Hamasaki:
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