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Olmos Martínez JM, Hernández Martínez P, González Macías J. Frailty, Sarcopenia and Osteoporosis. Med Clin (Barc) 2024; 163:e17-e23. [PMID: 38724319 DOI: 10.1016/j.medcli.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 02/17/2024] [Accepted: 03/07/2024] [Indexed: 07/16/2024]
Abstract
Frailty, sarcopenia and osteoporosis are entities specific to the elderly, who share some risk factors. For this reason, their relationship has been studied in different works, which have provided disparate results, probably because these studies have not always focused on the same aspects. This article reviews the relationship of frailty and sarcopenia with osteoporosis.
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Affiliation(s)
- José Manuel Olmos Martínez
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Cantabria, España; Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Cantabria, España; Instituto de Investigación Valdecilla (IDIVAL), Cantabria, España.
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Xie WQ, He M, Yu DJ, Li HZ, Jin HF, Ji BZ, Yang G, Chen LL, Rahmati M, Li YS. Correlation study between bone metabolic markers, bone mineral density, and sarcopenia. J Endocrinol Invest 2024; 47:1559-1572. [PMID: 38097848 DOI: 10.1007/s40618-023-02252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To investigate the correlation between bone metabolism markers, bone mineral density (BMD), and sarcopenia. METHODS A total of 331 consecutive patients aged ≥ 60 years who were hospitalized between November 2020 and December 2021 were enrolled. Participants were divided into sarcopenia and non-sarcopenia groups according to the Asian Working Group on Sarcopenia criteria (AWGS, 2019). The clinical data, bone metabolism markers (β-CTX, N-MID, and TP1NP), and BMD were compared between the two groups. RESULTS Age, β-CTX, and N-MID of the sarcopenia group were higher than those of the non-sarcopenia group (P < 0.05), but the BMD T values were lower than those of the non-sarcopenia group (P < 0.05). Binary logistic regression analysis showed that increased femoral neck BMD (FNBMD) was a protective factor for sarcopenia, while increased β-CTX was a risk factor. Pearson/Spearman correlation analysis showed that the diagnostic indices of sarcopenia were positively correlated with FNBMD and negatively correlated with β-CTX and N-MID. Multiple linear regression analysis revealed that BMI and FNBMD significantly positively affected muscle strength and appendicular skeletal muscle mass (ASM). The FNBMD significantly positively affected physical performance, while β-CTX significantly negatively affected muscle strength, ASM, and physical performance. CONCLUSION Increased FNBMD may be a protective factor against sarcopenia, and increased β-CTX may be a risk factor. The FNBMD significantly positively affected the diagnostic indices of sarcopenia, while β-CTX significantly negatively affected them. BMD and bone metabolism marker levels may be considered in early screening for sarcopenia.
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Affiliation(s)
- W Q Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - M He
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - D J Yu
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H Z Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H F Jin
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - B Z Ji
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - G Yang
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - L L Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, 410000, Hunan, China
| | - M Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Y S Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Chiu YC, Tsai PC, Lee SH, Wu WT, Yu TC, Lee RP, Chen IH, Wang JH, Yeh KT. Research of Global Tilt and Functional Independence: Insights into Spinal Health of Older Women. Bioengineering (Basel) 2024; 11:493. [PMID: 38790360 PMCID: PMC11118819 DOI: 10.3390/bioengineering11050493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Spinal alignment intricately influences functional independence, particularly in older women with osteopenia experiencing mild neck and back pain. This study elucidates the interplay between spinal alignment, bone mineral density (BMD), and muscle strength in elderly women presenting with mild neck and back pain. Focusing on a cohort of 189 older women, we examined the associations among global tilt (GT), coronal and sagittal alignment, BMD, grip strength, and functional independence as gauged by the Barthel index. Our findings indicate significant associations between functional capacity and grip strength, bone density, GT, and pelvic tilt (PT). Elderly women with a Barthel Index above 80 demonstrated higher grip strength and better bone quality, reflected by less negative average T scores. These individuals also exhibited lower values of GT and PT, suggesting a better sagittal alignment compared to those with a Barthel index of 80 or below. The results highlight that deviations in GT and PT are significantly associated with decreased functional independence. These insights emphasize the importance of maintaining optimal spinal alignment and muscle strength to support functional independence in elderly women. This study underscores the potential for targeted interventions that improve postural stability and manage pain effectively in this vulnerable population.
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Affiliation(s)
- Yu-Chieh Chiu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
| | - Ping-Chiao Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
| | - Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
| | - Wen-Tien Wu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan;
| | - Tzai-Chiu Yu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
| | - Ru-Ping Lee
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan;
| | - Ing-Ho Chen
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan;
| | - Kuang-Ting Yeh
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.); (W.-T.W.); (T.-C.Y.); (I.-H.C.)
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan;
- Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
- Graduate Institute of Clinical Pharmacy, Tzu Chi University, Hualien 970, Taiwan
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Fang XY, Xu HW, Chen H, Zhang SB, Yi YY, Ge XY, Wang SJ. The efficacy of nutritional screening indexes in predicting the incidence of osteosarcopenia and major osteoporotic fracture in the elderly. J Bone Miner Metab 2024; 42:372-381. [PMID: 38795128 DOI: 10.1007/s00774-024-01514-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/22/2024] [Indexed: 05/27/2024]
Abstract
INTRODUCTION The effect of nutritional status on osteosarcopenia (OS) and major osteoporotic fracture (MOF) among the elderly is still unclear. So we aimed to compare the efficacy of the Mini-Nutrition Assessment-Short Form (MNA-sf), the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) for predicting OS and MOF among the elderly. MATERIALS AND METHODS A total of 409 participants were enrolled in this prospective study. Blood biochemical indexes, nutritional status, and bone- and muscle-related examinations were assessed at initial visit to the outpatient. Participants were divided into 4 groups: (1) control; (2) osteopenia/osteoporosis; (3) sarcopenia; (4) osteosarcopenia, and then followed for 5 years, recording the occurrence time of MOF. RESULTS The frequency values of osteopenia/osteoporosis, sarcopenia, and OS, at baseline, were respectively 13.4, 16.1, and 12% among the study samples. Correlation analysis showed that nutritional status scores were associated with body mass index, handgrip strength, albumin, bone mineral density, and physical functions. According to multivariate models, poor nutritional status was significantly associated with a higher risk of OS and MOF (P < 0.05). Survival analysis showed that the MOF rate in malnutrition group was significantly higher than normal nutrition group (P < 0.05). The receiver operator characteristic curve shows that the value of MNA-sf to diagnose OS and MOF is greater (P < 0.05). CONCLUSION The poor nutritional status was associated with a higher risk of both OS and MOF. MNA-sf showed a superior diagnostic power for OS and MOF among the elderly. Early nutrition assessments and interventions may be key strategies to prevent OS and fractures.
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Affiliation(s)
- Xin-Yue Fang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hao-Wei Xu
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hao Chen
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Shu-Bao Zhang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Yu-Yang Yi
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Xiao-Yong Ge
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Shan-Jin Wang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
- Institute of Spinal Diseases, Jinggangshan University, Jiangxi, China.
- Department of Orthopedic, Shanghai East Hospital, Ji'An Hospital, Jiangxi, China.
- , 150# Jimo RD, Pudong New Area, Shanghai, 200120, China.
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Pourhassan M, Buehring B, Stervbo U, Rahmann S, Mölder F, Rütten S, Neuendorff NR, Westhoff TH, Babel N, Wirth R. Three-Year Mortality of Older Hospitalized Patients with Osteosarcopenia: Data from the OsteoSys Study. Nutrients 2024; 16:1328. [PMID: 38732575 PMCID: PMC11085630 DOI: 10.3390/nu16091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Osteosarcopenia, the concurrent presence of sarcopenia and osteopenia/osteoporosis, poses a significant health risk to older adults, yet its impact on clinical outcomes is not fully understood. The aim of this prospective, longitudinal multicentre study was to examine the impact of osteosarcopenia on 3-year mortality and unplanned hospitalizations among 572 older hospitalized patients (mean age 75.1 ± 10.8 years, 78% female). Sarcopenia and low bone mineral density (BMD) were evaluated using Dual Energy X-ray Absorptiometry and the European Working Group on Sarcopenia in Older People (EWGSOP2) and WHO criteria, respectively. Among participants, 76% had low BMD, 9% were sarcopenic, and 8% had osteosarcopenia. Individuals with osteosarcopenia experienced a significantly higher rate of mortality (46%, p < 001) and unplanned hospitalization (86%, p < 001) compared to those without this condition. Moreover, "healthy" subjects-those without sarcopenia or low BMD-showed markedly lower 3-year mortality (9%, p < 001) and less unplanned hospitalization (53%, p < 001). The presence of osteosarcopenia (p = 0.009) increased the 3-year mortality risk by 30% over sarcopenia alone and by 8% over low BMD alone, underscoring the severe health implications of concurrent muscle and bone deterioration. This study highlights the substantial impact of osteosarcopenia on mortality among older adults, emphasizing the need for targeted diagnostic and therapeutic strategies.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
| | - Bjoern Buehring
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, 44649 Herne, Germany;
- Bergisches Rheuma-Zentrum Wuppertal, 42105 Wuppertal, Germany
| | - Ulrik Stervbo
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
| | - Sven Rahmann
- Algorithmic Bioinformatics, Center for Bioinformatics Saar, Saarland University, Saarland Informatics Campus, 66123 Saarbrücken, Germany;
| | - Felix Mölder
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Sebastian Rütten
- Center for Orthopedics and Trauma Surgery, St. Anna Hospital, St. Elisabeth Gruppe, 44649 Herne, Germany;
| | - Nina Rosa Neuendorff
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
| | - Timm Henning Westhoff
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
| | - Nina Babel
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.)
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (N.R.N.); (R.W.)
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Yoshii I, Sawada N, Chijiwa T. Prognostic nutritional index as an indicator for the development of bone fragility fracture in patients with rheumatoid arthritis. Mod Rheumatol 2024; 34:493-499. [PMID: 37338283 DOI: 10.1093/mr/road058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/03/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES The validity of prognostic nutritional index (PNI) as an index of incident bone fragility fracture (inc-BFF) in rheumatoid arthritis (RA) patients was investigated. METHODS RA patients whom continuously followed up for >3 years were picked up. Patients were classified in accordance with inc-BFF positivity (BFF+ and BFF-). Their clinical background including PNI was statistically examined for inc-BFF. The background factors were compared between the two groups. Patients were narrowed into subgroups according to the factor that showed a significant difference between the two groups, and they were statistically examined according to the PNI for the inc-BFF. The two groups were narrowed with propensity score matching and compared to the PNI. RESULTS A total of 278 patients with 44 BFF+ and 234 BFF- were recruited. In the background factors, the presence of prevalent BFF and the simplified disease activity index remission rate had a significantly higher risk ratio. In a subgroup who comorbid lifestyle-related diseases, PNI had a significantly higher risk ratio for the inc-BFF. After the propensity score matching, the PNI showed no significant difference between the two groups. CONCLUSIONS PNI is available when patients with RA comorbid lifestyle-related diseases. PNI is not an independent key for the inc-BFF in RA patients.
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Affiliation(s)
- Ichiro Yoshii
- Department of Musculoskeletal Medicine, Yoshii Hospital, Kochi, Japan
| | - Naoya Sawada
- Department of Rheumatology, Dohgo Onsen Hospital Rheumatology Center, Ehime, Japan
| | - Tatsumi Chijiwa
- Department of Rheumatology, Kochi Memorial Hospital, Kochi, Japan
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Jing C, Wang H, Liu P, Yang S, Zhang L, Yang P, Gan M. Effect of sarcopenia on refractures of adjacent vertebra after percutaneous kyphoplasty. BMC Musculoskelet Disord 2024; 25:210. [PMID: 38475772 DOI: 10.1186/s12891-024-07295-3] [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: 02/08/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE To explore the effect of sarcopenia on recurrent fractures of adjacent vertebra after percutaneous kyphoplasty (PKP). METHODS A total of 376 osteoporotic vertebral compression fractures (OVCFs) patients over 55 years old who were admitted to the Hospital from August 2020 to January 2021 were selected. Among them, 38 patients with recurrent fractures in adjacent vertebra after PKP were selected as the refracture group (RG), and the remaining 338 patients were selected as the non-refracture group (NRG). The age, gender, grip strength, body mass index (BMI), bone mineral density (BMD), visual analogue scale (VAS) of pain before and one month after surgery, Oswestry disability index (ODI) before and one month after surgery and the occurrence of sarcopenia were compared between the two groups. Logistic regression analysis was used to evaluate the effect of related risk factors on refracture after vertebral PKP. RESULTS The results of t-test and Chi-square test showed that there were no obvious differences in gender, BMI, preoperative VAS score (t=-0.996, P = 0.320) and ODI (t=-0.424, P = 0.671), one month postoperative VAS score (t=-0.934, P = 0.355) and ODI score (t=-0.461, P = 0.645). while the age and grip strength showed significant differences between the two groups. Logistic regression analysis showed that BMI and gender had no significant effect on refracture after PKP, while sarcopenia and advanced age were independent risk factors for refracture after PKP. Also, increased BMD was a protective factor for refracture after PKP. CONCLUSION Sarcopenia is an independent risk factor for recurrent fractures after PKP in OVCF patients. The screening and diagnosis of sarcopenia should be strengthened. At the same time, anti-sarcopenia treatment should be actively performed after surgery.
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Affiliation(s)
- Chengnan Jing
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Huazheng Wang
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Peng Liu
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Shaofeng Yang
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Linlin Zhang
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Peng Yang
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Minfeng Gan
- The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
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Lambeaux C, Lapègue F, Fayolle H, Degboe Y, Chiavassa-Gandois H, Basselerie H, Goumarre C, Bilger R, Sans N, Faruch-Bilfeld M. Lumbar muscle involvement in the occurrence of osteoporotic vertebral fracture. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2024; 9:100037. [PMID: 39076584 PMCID: PMC11265192 DOI: 10.1016/j.redii.2023.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/26/2023] [Indexed: 07/31/2024]
Abstract
Objective To determine if a lumbar musculature deficiency (paravertebral - PVM - and psoas - PM - muscles) is associated with a higher prevalence of vertebral fractures in osteoporotic patients. Methods To constitute the fracture group, data were collected retrospectively from patients with one or more recent osteoporotic vertebral fractures between T10 and L5 such as non-injected computerized tomography (CT), dual-energy X-ray absorptiometry (DXA). A control group was made by matching the patients on age, bone mineral density measured by DXA and gender. We analyzed PM and PVM atrophy based on cross-sectional area (CSA) adjusted to the body area as well as fatty infiltration on a 3-level scale and the average muscle density in Hounsfield units (HU). Results One hundred seventeen patients were included in each group. The fracture group had a lower PVM CSA than the control group (2197.92 ± 460.19 versus 2335.20 ± 394.42 mm2.m-2, respectively p = 0.015), but there was no significant difference in the PM (746.92 ± 197.89 versus 731.74 ± 215.53 mm2.m-2, respectively p = 0.575). The fracture group had a higher grade of fatty infiltration than the control group (PM: 1.3 ± 0.46 versus 1.07 ± 0.25, p < 0.001; PVM: 1.93 ± 0.5 versus 1.74 ± 0.5, p = 0.003) and a lower average muscle density (PM: 26.99 ± 12.83 versus 33.91 ± 8.12 HU, p < 0.001; PVM: 3.42 ± 21.06 versus 12.94 ± 18.88 HU, p < 0.001). Conclusion This study shows an association between a lack of axial musculature and the occurrence of osteoporotic vertebral fractures. Preventive strengthening exercises could be proposed to osteoporotic patients.
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Affiliation(s)
- Constance Lambeaux
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Franck Lapègue
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Hélio Fayolle
- Nuclear medicine department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Yannick Degboe
- Rheumatology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Hélène Chiavassa-Gandois
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Hubert Basselerie
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Céline Goumarre
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Romain Bilger
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Nicolas Sans
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
| | - Marie Faruch-Bilfeld
- Radiology department, hôpital Pierre-Paul-Riquet, CHU Toulouse Purpan, avenue du Professeur-Jean-Dausset, 31300 Toulouse, France
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Das C, Das PP, Kambhampati SBS. Sarcopenia and Osteoporosis. Indian J Orthop 2023; 57:33-41. [PMID: 38107805 PMCID: PMC10721746 DOI: 10.1007/s43465-023-01022-1] [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: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 12/19/2023]
Abstract
Osteoporosis and sarcopenia are major health issues which are going to have a significant impact in an aging global population. Osteoporosis, which reduces bone density and increases fracture risk, and sarcopenia, which causes muscle loss and strength loss, have a complicated risk profile with consequences that go beyond bone and muscle health. This chapter illuminates the complex link between osteoporosis and sarcopenia, including overlapping causes, clinical consequences, and new treatments. This chapter covers bone and muscle biology, age-related changes that cause osteoporosis and sarcopenia, and the importance of physical exercise and diet in their prevention and management. It also discusses clinical evaluation methods, risk assessment and diagnostic criteria for early diagnosis and intervention. Novel therapies and continuing research in the management of osteoporosis and sarcopenia are also discussed. Medications, exercise, and nutrition can promote bone and muscle health. This chapter aims to explore the recent concepts by elucidating the complex relationship between osteoporosis and sarcopenia and advocating for integrated care paradigms.
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Affiliation(s)
- Chinmoy Das
- Department of Orthopedics, Tezpur Medical College and Hospital, Tezpur, Assam India
| | - Partha Pratim Das
- Department of Orthopedics, Tezpur Medical College and Hospital, Tezpur, Assam India
| | - Srinivas B. S. Kambhampati
- Sri Dhaatri Orthopaedic, Maternity and Gynaecology Center, SKDGOC, Vijayawada, Andhra Pradesh 531127 India
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Chou YY, Lin CF, Lee YS, Weng SC, Kuo FH, Hsu CY, Lin SY. The associations of osteoporosis and possible sarcopenia with disability, nutrition, and cognition in community-dwelling older adults. BMC Geriatr 2023; 23:730. [PMID: 37950206 PMCID: PMC10638752 DOI: 10.1186/s12877-023-04431-x] [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: 08/28/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Osteoporosis and sarcopenia, respectively, have detrimental impact on health, and combination of both conditions, termed osteosarcopenia, is becoming an increasingly important disorder in older adults as populations age. This study aimed to explore the relationship between osteoporosis and possible sarcopenia and their joint effect on physical performance, nutritional status, and cognition in community-dwelling older adults. METHODS This study was conducted at a medical center in Taiwan, which included the adjacent community care station. The participants were recruited through regular activities at the community care station between January 01, 2015 and February 28, 2022. During the study period, dual-energy X-ray absorptiometry and comprehensive geriatric assessment consisting of comorbidity burden, functional status, cognition, mood, and nutritional status were performed during the study period. Possible sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia in 2019 using the criteria of low muscle strength alone, and osteoporosis was defined by the World Health Organization criteria. Accordingly, the study subjects were divided into four groups: normal, only osteoporosis, only possible sarcopenia, and possible osteosarcopenia. RESULTS There were 337 participants (68.6% female) with a median age of 78.0 years (interquartile range: 71.0-85.0 y/o). According to the clinical definition of osteosarcopenia, 78 participants were normal, 69 participants showed possible sarcopenia, 61 participants had osteoporosis, and 129 had osteoporosis with possible sarcopenia. Among the four groups, the prevalence rates of chronic illness, functional capacity, physical performance, cognitive impairment, and malnutrition revealed statistically significant differences. Using logistic regression analysis after adjusting for the other covariates, osteoporosis with possible sarcopenia was associated with an increased odds ratio of cognitive impairment. CONCLUSIONS The findings suggest that compared to osteoporosis or possible sarcopenia alone, osteoporosis with possible sarcopenia was more likely to be associated with cognitive impairment. Early identification and targeted interventions for cognitive impairment in older adults with osteosarcopenia may be valuable in maintaining cognitive well-being and overall quality of life.
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Affiliation(s)
- Yin-Yi Chou
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Cheng-Fu Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Occupational Medicine, Department of Emergency, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
| | - Yu-Shan Lee
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Neurology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
| | - Fu-Hsuan Kuo
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Division of Neurology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan.
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan.
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan.
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan.
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Chen SW, Lin CY, Chen CY, Lin CL, Hsieh TL, Tsai FJ, Chang KH. Long-term exposure to air pollution and risk of Sarcopenia in adult residents of Taiwan: a nationwide retrospective cohort study. BMC Public Health 2023; 23:2172. [PMID: 37932727 PMCID: PMC10629182 DOI: 10.1186/s12889-023-17091-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Sarcopenia is an age-related, multifactorial syndrome. Previous studies have shown that air pollutants are associated with inflammation and oxidative stress. However, the association between long-term exposure to air pollution and sarcopenia is not completely understood. METHODS The Taiwan National Health Research Database (NHIRD) contains medical records of almost all Taiwanese residents. Daily air pollution data collected by the Taiwan Environmental Protection Agency was used to analyze concentrations of sulfur oxide (SO2), carbon monoxide (CO), nitrogen monoxide (NO), nitrogen dioxide (NO2), and particulate matter (PM2.5, PM10). The databases were merged according to the insurants' living area and the location of the air quality monitoring station. We categorized the pollutants into quartiles (Q1, Q2, Q3, and Q4). RESULTS Our study population consisted of 286,044 patients, among whom 54.9% were female and 45.1% were male. Compared to Q1 levels of pollutants, Q4 levels of SO2 (adjusted hazard ratio [aHR] = 8.43; 95% confidence interval [CI] = 7.84, 9.07); CO (aHR = 3.03; 95%CI = 2.83, 3.25); NO (aHR = 3.47; 95%CI = 3.23, 3.73); NO2 (aHR = 3.72; 95%CI = 3.48, 3.98); PM2.5 (aHR = 21.9; 95% CI = 19.7, 24.5) and PM10 (aHR = 15.6; 95%CI = 14.1, 17.4) increased risk of sarcopenia. CONCLUSIONS Our findings indicated a significantly increased risk of sarcopenia in both male and female residents exposed to high levels of air pollutants.
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Affiliation(s)
- Ssu-Wen Chen
- Department of Family Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan
| | - Chih-Ying Lin
- Department of Public Health, China Medical University, Taichung, 404, Taiwan
| | - Chiu-Ying Chen
- Department of Public Health, China Medical University, Taichung, 404, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan
- College of Medicine, China Medical University, Taichung, 404, Taiwan
| | - Tsai-Ling Hsieh
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan
- Department of Otolaryngology, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 404, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung, 404, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, 413, Taiwan
| | - Kuang-Hsi Chang
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan.
- Center for General Education, China Medical University, Taichung, 404, Taiwan.
- General Education Center, Nursing and Management, Jen-Teh Junior College of Medicine, Miaoli, 356, Taiwan.
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Takahashi K, Wakabayashi H, Maeda K, Nagai T, Momosaki R. Impact of body mass index on outcomes of inpatients with vertebral compression fractures in Japan: A retrospective cohort study. Geriatr Gerontol Int 2023; 23:788-794. [PMID: 37735145 DOI: 10.1111/ggi.14676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023]
Abstract
AIM The present study examined the relationship between body mass index and the ability to perform the activities of daily living in patients with vertebral compression fractures. METHODS A retrospective cohort analysis of patients aged >65 years hospitalized with a vertebral compression fracture was carried out using a nationwide database in Japan. Body mass index was categorized as underweight (<18.5 kg/m2 ), normal weight (18.5-22.9 kg/m2 ), overweight (23.0-27.4 kg/m2 ) and obese (≥27.5 kg/m2 ) according to the World Health Organization criteria for the Asia-Pacific region. The primary outcome was Barthel Index gain, namely, the change in the Barthel Index score at discharge from that at admission. Secondary outcomes were the length of hospital stay and readmission within 30 days of discharge. RESULTS Among 41 423 participants, 24.5% were classified as underweight, excluding those with missing body mass index data. The underweight group had a significantly lower Barthel Index gain than the normal, overweight and obese groups (median 20 vs 25 vs 30 vs 30, respectively, P < 0.001). The underweight group also had longer hospital stays and higher 30-day readmission rates than the other groups. A multivariable analysis showed that being underweight was independently associated with a Barthel Index gain -3.63 points (95% confidence interval -4.58 to -2.68) lower than normal weight. Furthermore, being underweight was an independent variable affecting the length of hospital stay and readmission within 30 days (P < 0.001). CONCLUSIONS In patients with vertebral compression fractures, being underweight leads to lower Barthel Index scores, longer hospital stays and increased readmissions within 30 days of discharge. Geriatr Gerontol Int 2023; 23: 788-794.
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Affiliation(s)
- Kohei Takahashi
- Tamura Surgical Hospital Department of Rehabilitation, Tamura Surgical Hospital, Kawasaki-shi, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Morioka, Japan
| | - Takako Nagai
- Department of Rehabilitation Medicine, Nihon University Hospital, Tokyo, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Japan
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Wang Z, Du W, Ou Y, Han M, Hu J, Quan R. Association between the ratio of serum creatinine to cystatin C and bone mineral density in middle-aged and older adults: a cross-sectional study from NHANES database. J Int Med Res 2023; 51:3000605231206305. [PMID: 37882728 PMCID: PMC10605689 DOI: 10.1177/03000605231206305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To investigate the association between creatinine to cystatin C ratio (CCR) and bone mineral density (BMD) in middle-aged and older adults. METHODS This cross-sectional study investigated participants aged 50-85, using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2002. The correlation between CCR and total BMD was assessed by multivariate linear regression models, using stratified analysis by age, sex and race (Mexican American, other Hispanic, non-Hispanic White, non-Hispanic Black, and other race) to distinguish various special populations. RESULTS Among 2992 patients, multiple regression models revealed a significant positive correlation between CCR and total BMD: model 1, 0.030 (95% confidence interval [CI] 0.029, 0.031); model 2, 0.009 (95% CI 0.008, 0.010); model 3, 0.010 (95% CI 0.009, 0.013). After controlling for all covariates, a positive correlation was observed between CCR and total BMD in both men and women, and was further strengthened in older age groups. When stratifying by race, the positive correlation was most significant among 'other Hispanic' participants; there was no significant correlation among those of 'other race'. CONCLUSIONS A positive correlation was demonstrated between CCR and total BMD in middle-aged and older adults aged 50-85 years, with the most significant positive correlation in the older 'other Hispanic' population. No significant correlation was observed among participants of 'other race'.
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Affiliation(s)
- Zhenwei Wang
- Research Institute of Orthopaedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Weibin Du
- Research Institute of Orthopaedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Yuanbin Ou
- Research Institute of Orthopaedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Meichun Han
- Research Institute of Orthopaedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Jintao Hu
- Orthopedics and Traumatology Department, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Renfu Quan
- Research Institute of Orthopaedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China
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Tian S, Guo L, Song Y, Miao J, Peng M, Fang X, Bai M, Miao M. Transcriptomic analysis the mechanisms of anti-osteoporosis of desert-living Cistanche herb in ovariectomized rats of postmenopausal osteoporosis. Funct Integr Genomics 2023; 23:237. [PMID: 37439895 DOI: 10.1007/s10142-023-01154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
Desert-living Cistanche herb (DC), as a traditional Chinese medicine for tonifying kidney yang, is often used to treat postmenopausal osteoporosis (PMOP). Total phenylethanoid glycosides are instruction ingredients for discrimination and assay according to the China pharmacopoeia for DC. This research aimed to reveal the anti-osteoporosis mechanism of total phenylethanoid glycosides of DC (PGC) by transcriptomic analysis of ovariectomized rats. Serum levels of BGP were evaluated by ELISA, the bone weight was measured, and transmission electron microscopy was used to examine the ultrastructure of osteoblasts in rats. In addition, micro-CT was used to detect the bone volume (Tb.BS/BV), bone mineral density (Tb.BMD), and bone mineral content (Tb.BMC) in trabecular bone, and the ratio of cortical bone area to total area (Ct.ar/Tt.ar), and the level of bone mineral content (Ct.BMC) in cortical bone. Differential expressed genes (DEGs) after PGC treatment were analyzed by transcriptomics. Then, a bioinformatics analysis of DEGs was carried out through GO enrichment, KEGG enrichment, and selection of the nucleus gene through the protein-protein interaction network. Through qRT-PCR analysis, the DEGs were verified. The analysis results indicated that PGC increased the secretion of osteogenic markers, and ultrastructural characterization of osteoblasts and bone morphology were improved in ovariectomized rats. A total of 269 genes were differentially expressed, including 201 genes that were downregulated and 68 genes that were upregulated between the model group and the PGC group. Bioinformation analysis results prompt the conclusion that PGC could promote the bone metabolism by muscle cell development, myofibril assembly, etc. In addition, our study also found that PGC has a good effect on osteoporosis complicated with cardiomyopathy, and it also provided evidence for the correlation between sarcopenia and osteoporosis.
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Affiliation(s)
- Shuo Tian
- Academy of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 450046, China
- Henan Collaborative Innovation Center for Research and Development on the Whole Industry Chain of Yu-Yao, Henan University of Chinese Medicine, Zheng Zhou, 450046, China
| | - Lin Guo
- Department of Pharmacology, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Yagang Song
- Academy of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Jinxin Miao
- Academy of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Mengfan Peng
- Department of Pharmacology, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Xiaoyan Fang
- Department of Pharmacology, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Ming Bai
- Academy of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Mingsan Miao
- Academy of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, 450046, China.
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15
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Liu M, Wang Y, Shi W, Yang C, Wang Q, Chen J, Li J, Chen B, Sun G. PCDH7 as the key gene related to the co-occurrence of sarcopenia and osteoporosis. Front Genet 2023; 14:1163162. [PMID: 37476411 PMCID: PMC10354703 DOI: 10.3389/fgene.2023.1163162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/06/2023] [Indexed: 07/22/2023] Open
Abstract
Sarcopenia and osteoporosis, two degenerative diseases in older patients, have become severe health problems in aging societies. Muscles and bones, the most important components of the motor system, are derived from mesodermal and ectodermal mesenchymal stem cells. The adjacent anatomical relationship between them provides the basic conditions for mechanical and chemical signals, which may contribute to the co-occurrence of sarcopenia and osteoporosis. Identifying the potential common crosstalk genes between them may provide new insights for preventing and treating their development. In this study, DEG analysis, WGCNA, and machine learning algorithms were used to identify the key crosstalk genes of sarcopenia and osteoporosis; this was then validated using independent datasets and clinical samples. Finally, four crosstalk genes (ARHGEF10, PCDH7, CST6, and ROBO3) were identified, and mRNA expression and protein levels of PCDH7 in clinical samples from patients with sarcopenia, with osteoporosis, and with both sarcopenia and osteoporosis were found to be significantly higher than those from patients without sarcopenia or osteoporosis. PCDH7 seems to be a key gene related to the development of both sarcopenia and osteoporosis.
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Affiliation(s)
- Mingchong Liu
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yongheng Wang
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wentao Shi
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chensong Yang
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qidong Wang
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jingyao Chen
- Institute for Regenerative Medicine, Shanghai East Hospital, The Institute for Biomedical Engineering and Nano Science, Tongji University School of Medicine, Shanghai, China
| | - Jun Li
- Institute for Regenerative Medicine, Shanghai East Hospital, The Institute for Biomedical Engineering and Nano Science, Tongji University School of Medicine, Shanghai, China
| | - Bingdi Chen
- Institute for Regenerative Medicine, Shanghai East Hospital, The Institute for Biomedical Engineering and Nano Science, Tongji University School of Medicine, Shanghai, China
| | - Guixin Sun
- Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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Grande G, Graziani A, Di Mambro A, Selice R, Ferlin A. Osteoporosis and bone metabolism in patients with Klinefelter syndrome. Endocr Connect 2023; 12:e230058. [PMID: 37166398 PMCID: PMC10388662 DOI: 10.1530/ec-23-0058] [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: 04/14/2023] [Accepted: 05/11/2023] [Indexed: 05/12/2023]
Abstract
Low bone mass is common in men with Klinefelter syndrome (KS), with a prevalence of 6-15% of osteoporosis and of 25-48% of osteopenia. Reduced bone mass has been described since adolescence and it might be related to both reduced bone formation and higher bone resorption. Although reduced testosterone levels are clearly involved in the pathogenesis, this relation is not always evident. Importantly, fracture risk is increased independently from bone mineral density (BMD) and testosterone levels. Here we discuss the pathogenesis of osteoporosis in patients with KS, with a particular focus on the role of testosterone and testis function. In fact, other hormonal mechanisms, such as global Leydig cell dysfunction, causing reduced insulin-like factor 3 and 25-OH vitamin D levels, and high follicle-stimulating hormone and estradiol levels, might be involved. Furthermore, genetic aspects related to the supernumerary X chromosome might be involved, as well as androgen receptor expression and function. Notably, body composition, skeletal mass and strength, and age at diagnosis are other important aspects. Although dual-energy x-ray absorptiometry is recommended in the clinical workflow for patients with KS to measure BMD, recent evidence suggests that alterations in the microarchitecture of the bones and vertebral fractures might be present even in subjects with normal BMD. Therefore, analysis of trabecular bone score, high-resolution peripheral quantitative computed tomography and vertebral morphometry seem promising tools to better estimate the fracture risk of patients with KS. This review also summarizes the evidence on the best available treatments for osteoporosis in men with KS, with or without hypogonadism.
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Affiliation(s)
- Giuseppe Grande
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy
| | | | - Antonella Di Mambro
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy
| | - Riccardo Selice
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy
| | - Alberto Ferlin
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy
- Department of Medicine, University of Padova, Padova, Italy
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Gielen E, Dupont J, Dejaeger M, Laurent MR. Sarcopenia, osteoporosis and frailty. Metabolism 2023; 145:155638. [PMID: 37348597 DOI: 10.1016/j.metabol.2023.155638] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/21/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
Muscles and bones are intricately connected tissues displaying marked co-variation during development, growth, aging, and in many diseases. While the diagnosis and treatment of osteoporosis are well established in clinical practice, sarcopenia has only been classified internationally as a disease in 2016. Both conditions are associated with an increased risk of adverse health outcomes such as fractures, dysmobility and mortality. Rather than focusing on one dimension of bone or muscle mass or weakness, the concept of musculoskeletal frailty captures the overall loss of physiological reserves in the locomotor system with age. The term osteosarcopenia in particular refers to the double jeopardy of osteoporosis and sarcopenia. Muscle-bone interactions at the biomechanical, cellular, paracrine, endocrine, neuronal or nutritional level may contribute to the pathophysiology of osteosarcopenia. The paradigm wherein muscle force controls bone strength is increasingly facing competition from a model centering on the exchange of myokines, osteokines and adipokines. The most promising results have been obtained in preclinical models where common drug targets have been identified to treat these conditions simultaneously. In this narrative review, we critically summarize the current understanding of the definitions, epidemiology, pathophysiology, and treatment of osteosarcopenia as part of an integrative approach to musculoskeletal frailty.
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Affiliation(s)
- Evelien Gielen
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Jolan Dupont
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Marian Dejaeger
- Gerontology and Geriatrics Unit, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Michaël R Laurent
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium; Geriatrics Department, Imelda Hospital, Bonheiden, Belgium.
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Huang T, Li C, Chen F, Xie D, Yang C, Chen Y, Wang J, Li J, Zheng F. Prevalence and risk factors of osteosarcopenia: a systematic review and meta-analysis. BMC Geriatr 2023; 23:369. [PMID: 37322416 PMCID: PMC10273636 DOI: 10.1186/s12877-023-04085-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Osteosarcopenia is a syndrome with a concomitant presence of both sarcopenia and osteopenia/osteoporosis. It increases the risk of frailty, falls, fractures, hospitalization, and death. Not only does it burden the lives of older adults, but it also increases the economic burden on health systems around the world. This study aimed to review the prevalence and risk factors of osteosarcopenia to generate important references for clinical work in this area. METHODS Pubmed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CBM, and VIP databases were searched from inception until April 24th, 2022. The quality of studies included in the review was evaluated using the NOS and AHRQ Scale. Pooled effects of the prevalence and associated factors were calculated using random or fixed effects models. Egger's test, Begg's test, and funnel plots were used to test the publication bias. Sensitivity analysis and subgroup analysis were conducted to identify the sources of heterogeneity. Statistical analysis was performed using Stata 14.0 and Review Manager 5.4. RESULTS A total of 31 studies involving 15,062 patients were included in this meta-analysis. The prevalence of osteosarcopenia ranged from 1.5 to 65.7%, with an overall prevalence of 21% (95% CI: 0.16-0.26). The risk factors for osteosarcopenia were female (OR 5.10, 95% CI: 2.37-10.98), older age (OR 1.12, 95% CI: 1.03-1.21), and fracture (OR 2.92, 95% CI: 1.62-5.25). CONCLUSION The prevalence of osteosarcopenia was high. Females, advanced age, and history of fracture were independently associated with osteosarcopenia. It is necessary to adopt integrated multidisciplinary management.
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Affiliation(s)
- Tianjin Huang
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Chen Li
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Faxiu Chen
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
| | - Dunan Xie
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Chuhua Yang
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yuting Chen
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jintao Wang
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jiming Li
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Fei Zheng
- Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Saeki C, Kanai T, Ueda K, Nakano M, Oikawa T, Torisu Y, Saruta M, Tsubota A. Osteosarcopenia predicts poor survival in patients with cirrhosis: a retrospective study. BMC Gastroenterol 2023; 23:196. [PMID: 37277731 DOI: 10.1186/s12876-023-02835-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Osteosarcopenia, defined as the coexistence of sarcopenia and osteoporosis, is associated with adverse clinical outcomes. The present study investigated the prognostic significance of osteosarcopenia in patients with cirrhosis. METHODS This retrospective study evaluated 126 patients with cirrhosis. Participants were classified into three groups based on the presence or absence of (1) sarcopenia and/or osteoporosis; and (2) Child-Pugh (CP) class B/C cirrhosis and/or osteosarcopenia, and the cumulative survival rates were compared between the groups. Cox proportional hazards model was used to identify independent factors associated with mortality. Sarcopenia and osteoporosis were diagnosed according to the Japan Society of Hepatology and the World Health Organization criteria, respectively. RESULTS Among the 126 patients, 24 (19.0%) had osteosarcopenia. Multivariate analysis identified osteosarcopenia as a significant and independent prognostic factor. The cumulative survival rates were significantly lower in patients with osteosarcopenia than in those without (1/3/5-year survival rates = 95.8%/73.7%/68.0% vs. 100%/93.6%/86.5%, respectively; p = 0.020). Patients with osteosarcopenia, but not sarcopenia or osteoporosis alone, had significantly lower cumulative survival rates than those without both conditions (p = 0.019). Furthermore, patients with both CP class B/C and osteosarcopenia had significantly lower cumulative survival rates than those without both (p < 0.001) and with either condition (p < 0.001). CONCLUSIONS Osteosarcopenia was significantly associated with mortality in patients with cirrhosis. The cumulative survival rates were lower in patients with osteosarcopenia than in those without both conditions. Additionally, comorbid osteosarcopenia worsened the prognosis of patients with CP class B/C. Therefore, simultaneous evaluation of both sarcopenia and osteoporosis is crucial to better predict the prognosis.
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Affiliation(s)
- Chisato Saeki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Fuji-Shi, Shizuoka, Japan.
| | - Tomoya Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Fuji-Shi, Shizuoka, Japan
| | - Kaoru Ueda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Masanori Nakano
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Fuji-Shi, Shizuoka, Japan
| | - Tsunekazu Oikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Yuichi Torisu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Fuji-Shi, Shizuoka, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Akihito Tsubota
- Project Research Units, Research Center for Medical Science, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.
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Chen PY, Lee YH, Chiang CH, Chang HH, Lu CW, Huang KC. Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength. Gerontology 2023; 69:1056-1064. [PMID: 37276853 DOI: 10.1159/000531371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/30/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Impaired handgrip strength is an indication for sarcopenia and frailty screening, and is associated with increased osteoporotic risks and all-cause mortality. Osteocalcin, secreted by osteoblasts, is a versatile factor that participates in bone turnover and muscle adaptation. The role of osteocalcin in muscle strength has mainly been discussed in animal models and requires more human data. The study aimed to investigate the association between the serum osteocalcin level and handgrip strength in middle-aged individuals and older adults with diabetes. METHODS Adult participants (aged 40 and above, N = 237) with diabetes were enrolled in a medical center in northern Taiwan. Subjects were divided into normal, low muscle mass without dynapenia, dynapenia without low muscle mass, and groups of low muscle mass with dynapenia according to their handgrip strength and muscle mass measurements. Physical performance, including handgrip strength, repeated sit-to-stand tests, walking speed, and short physical performance batteries, was documented. Body composition was measured by bioelectrical impedance analysis. RESULTS The median serum osteocalcin level was highest in the dynapenic group without low muscle mass (median [Q1, Q3], 14.1 [11.2, 16.3] ng/mL). Multivariate logistic regression showed that a higher serum osteocalcin level was associated with worse handgrip strength (OR: 3.89, 95% CI: 1.66-9.10) after adjusting for body mass index (adiposity), skeletal muscle mass index (muscle), and medication with dipeptidyl peptidase-4 inhibitor. Further sex stratification revealed a more significant association between serum osteocalcin level and impaired handgrip strength in women but not in men. The female groups showed increases in the risk of impaired handgrip strength: 4.84-fold in the osteocalcin T2 group (11.4 ≤ osteocalcin <15.0 ng/mL) and 4.54-fold in the osteocalcin T3 group (osteocalcin ≥15.0 ng/mL). Moreover, after adjusting for various confounders, 8.41-fold and 8.03-fold increases in the risk of impaired handgrip strength were observed in the osteocalcin T2 group (11.4≤ osteocalcin <15.0 ng/mL) and osteocalcin T3 group (osteocalcin ≥14.5 ng/mL), respectively. CONCLUSION Higher serum osteocalcin is associated with increased risks of impaired handgrip strength and impaired physical performance. Dose-dependent associations were found especially in postmenopausal women but not in men.
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Affiliation(s)
- Pei-Yun Chen
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Hsieh Chiang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
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21
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Watanabe T, Ohno R, Kajitani R, Sahara K, Munechika T, Matsumoto Y, Aisu N, Kojima D, Yoshimatsu G, Hasegawa S. Comparison of changes in health-related quality of life between elderly and non-elderly patients undergoing elective surgery for colorectal cancer. Int J Colorectal Dis 2023; 38:149. [PMID: 37256438 DOI: 10.1007/s00384-023-04440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Elderly people are thought to be more likely than their non-elderly counterparts to experience a decline in activities of daily living (ADL) and quality of life (QOL) due to the onset and treatment of disease. In this study, we investigated whether there was an age-related difference in changes in health-related QOL indices after surgical resection of colorectal cancer (CRC). METHODS Patients who underwent elective surgery for primary CRC at our hospital between September 2017 and November 2021 were enrolled. Changes in QOL after surgery were evaluated after dividing the study population into a non-elderly (NE) group (younger than 75 years) and an elderly (E) group. A Short-Form 36-Item Health Survey was used as an index of QOL. The subscale and component summary scores before and 6 months after surgery were compared. RESULTS Forty-seven patients were included in the E group and 166 patients were the NE group. The E group had significantly worse preoperative performance and physical status than the NE group. However, indices of physical function were not worsened after surgery in either group. In the NE group, there were significant decreases in role physical and role component summary scores and significant increases in general health, mental health, and mental component summary scores. In the E group, there were no significant changes in the subscale or component summary scores after surgery. CONCLUSION Our study demonstrated elderly patient did not necessarily show a decline in QOL more than non-elderly patients after CRC surgery. Surgical resection for CRC should be considered even for elderly patients, while considering possible risk factors for worsening ADL and QOL.
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Affiliation(s)
- Toshifumi Watanabe
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan.
| | - Ryo Ohno
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Ryuji Kajitani
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Kurumi Sahara
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Taro Munechika
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Yoshiko Matsumoto
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Naoya Aisu
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Daibo Kojima
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Gumpei Yoshimatsu
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45‑1 Nanakuma, Jonan‑ku, Fukuoka, 814-0180, Japan
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Alajlouni DA, Bliuc D, Tran TS, Blank RD, Center JR. Muscle strength and physical performance contribute to and improve fracture risk prediction in older people: A narrative review. Bone 2023; 172:116755. [PMID: 37028582 DOI: 10.1016/j.bone.2023.116755] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/20/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023]
Abstract
Osteoporotic fractures present a major health problem with an increasing prevalence in older people. Fractures are associated with premature mortality, reduced quality of life, subsequent fracture, and increased costs. Hence, it is crucial to identify those at higher risk of fracture. Fracture risk assessment tools incorporated clinical risk factors to improve fracture predictive power over BMD alone. However, fracture risk prediction using these algorithms remains suboptimal, warranting further improvement. Muscle strength and physical performance measurements have been associated with fracture risk. In contrast, the contribution of sarcopenia, the composite condition of low muscle mass, muscle strength and/or physical performance, to fracture risk is unclear. It is uncertain whether this is due to the problematic definition of sarcopenia per se or limitations of the diagnostic tools and cut-off points of the muscle mass component. The recent position statement from the Sarcopenia Definition and Outcomes Consortium confirmed the inclusion of muscle strength and performance in the definition of sarcopenia but not DXA-assessed lean mass. Therefore, clinicians should focus on functional assessment (muscle strength and performance) rather than muscle mass, at least as assessed by DXA, as predictors of fractures. Muscle strength and performance are modifiable risk factors. Resistance exercise improves muscle parameters in the elderly, potentially leading to reduced risk of falls and fractures in the general population and in those who sustained a fracture. Therapists may consider exercise intervention to improve muscle parameters and potentially reduce the risk of fractures. The aim of this review was to explore 1) the contribution of muscle parameters (i.e., muscle mass, strength, and physical performance) to fracture risk in older adults, and 2) the added predictive accuracy of these parameters beyond the existing fracture assessment tools. These topics provide the rationale for investigating strength and physical performance interventions to reduce fracture risk. Most of the included publications showed that muscle mass is not a good predictor of fracture risk, while poor muscle strength and performance are associated with an increased risk of fracture, particularly in men, independent of age, BMD, and other risk factors for fractures. Muscle strength and performance can potentially improve the predictive accuracy in men beyond that obtained by the fracture risk assessment tools, Garvan FRC and FRAX.
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Affiliation(s)
- Dima A Alajlouni
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia.
| | - Dana Bliuc
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia.
| | - Thach S Tran
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia; School of Biomedical Engineering, University of Technology, Sydney, New South Wales, Australia.
| | - Robert D Blank
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jacqueline R Center
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia.
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23
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Chen L, Wu J, Ren W, Li X, Luo M, Hu Y. Association of osteoporosis and skeletal muscle loss with serum type I collagen carboxyl-terminal peptide β glypeptide: A cross-sectional study in elder Chinese population. Open Med (Wars) 2023; 18:20230642. [PMID: 36820065 PMCID: PMC9938641 DOI: 10.1515/med-2023-0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 02/17/2023] Open
Abstract
Type I collagen carboxyl-terminal peptide β (β-CTX) increases in osteoporosis. The study aimed to explore the relationship between serum β-CTX and the risk of osteoporosis as well as sarcopenia in Chinese elderly inpatients. Around 228 patients whose age >65 years were recruited in this cross-sectional study. Dual-energy X-ray scanning was used to access skeletal muscle and bone mass. Serum concentration of β-CTX as well as the prevalence of osteoporosis were significantly higher in low skeletal muscle index (SMI) group than that in the normal SMI group (P < 0.05). Serum β-CTX levels negatively correlated with SMI and bone mass (P < 0.05). Total muscle mass, appendicular skeletal muscle mass, SMI, total bone mass, and bone mass at various sites including the limbs, spine, and pelvis decreased significantly, and the prevalence of low SMI increased with the increase of the quartiles of β-CTX. Higher serum β-CTX had an increased risk of low SMI and osteoporosis (P < 0.05). Summarily, with increasing serum β-CTX levels, both muscle and bone mass decreased in Chinese elderly inpatients. Serum β-CTX was positively associated with the risk of not only osteoporosis but also skeletal muscle loss.
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Affiliation(s)
- Lingyan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai200032, China
| | - Jiayu Wu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai200032, China
| | - Weiying Ren
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai200032, China
| | - Xi Li
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai200032, China
| | - Man Luo
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai200032, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai200032, China
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Ren J, Wang J, Yao X, Wu Y, Shi M, Shi X, Du X. Investigation of the Underlying Mechanism of Sclerosteosis Expression in Muscle Tissue in Multiple Myeloma with Sarcopenia. J Inflamm Res 2023; 16:563-578. [PMID: 36818195 PMCID: PMC9930682 DOI: 10.2147/jir.s391465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Objective To explore the role of sclerosteosis (SOST) gene expression in the occurrence and development of multiple myeloma (MM) complicated with sarcopenia. Methods Analysis of the SOST expression in skeletal muscle tissue of patients with MM using high-throughput sequencing combined with transcriptomics; observation of morphological changes of the mouse C2C12 myoblasts co-cultured with SP2/0 myeloma cells in Transwell; observation of the SOST expression in the C2C12 myoblasts using the immunofluorescence labeling method; and assessment of the changes in exercise capacity of mice with MM using ethology; and the measurement of the SOST expression in muscles of mice using immunohistochemistry. Results The transcription level of the SOST gene in the muscle tissue was significantly higher in patients with MM and sarcopenia than in patients with MM without sarcopenia and elderly patients with sarcopenia; the area of C2C12 mouse myoblasts co-cultured with SP2/0 myeloma cells was 167,904 ± 8653.7 pix; this was significantly lower than the area of 402,994 ± 13,575.0 pix in the control group (CG); the fluorescence intensity of SOST in the cells of the experimental group (EG) was 159,389 ± 10,534 AU; this was significantly higher than the intensity of 26,338 ± 6059 AU in the CG; the differences in results of the coat-hanger test, the tail suspension test, the weight-bearing forced swimming test, and the grip strength test between the tumor-bearing mice in the EG and the CG were statistically significant; and the quantitative result of SOST expression in the muscle tissue of the EG mice was 11,515 ± 1573 pix; this was significantly higher than the result of 3399 ± 798.8 pix in the CG. Conclusion The SOST gene expression was significantly higher in muscle of mice in EG than in CG; and increased SOST gene expression might be a pathogenesis of MM complicated with sarcopenia.
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Affiliation(s)
- Jie Ren
- Department of Orthopaedics, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China
| | - Jingzhou Wang
- Department of Orthopaedics, Beijing Daxing District People’s Hospital, Beijing, 102600, People’s Republic of China
| | - Xingchen Yao
- Department of Orthopaedics, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China
| | - Yue Wu
- Department of Orthopaedics, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China
| | - Ming Shi
- Department of Orthopaedics, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China
| | - Xiangjun Shi
- Department of Hematology, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China
| | - Xinru Du
- Department of Orthopaedics, Beijing Chao-yang Hospital, Beijing, 100020, People’s Republic of China,Correspondence: Xinru Du, Department of orthopaedics, Beijing Chao-yang Hospital, No. 8 of Gongti South Road, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +86 13683156652, Email
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25
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Luo X, Cai B, Jin W. The Prevalence Rate of Adult Sarcopenic Obesity and Correlation of Appendicular Skeletal Muscle Mass Index with Body Mass Index, Percent Body Fat, Waist-Hip Ratio, Basal Metabolic Rate, and Visceral Fat Area. Metab Syndr Relat Disord 2023; 21:48-56. [PMID: 36318808 DOI: 10.1089/met.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: This study aimed to investigate the prevalence rate of adult sarcopenic obesity and discuss its predisposing factors. Methods: A total of 14,608 participants including 7521 men and 7087 women aged 18-93 years were enrolled in this study. The definition of sarcopenia was based on appendicular skeletal muscle mass index (ASMI) standards (≤7.0 kg/m2 for men and ≤5.7 grams/m2 for women). The definition of obesity followed percent body fat (PBF) ≥25% for men and ≥35% for women. Sarcopenic obesity was defined as the combination of sarcopenia and obesity diagnosis. Risk factors for the onset of sarcopenic obesity were analyzed by logistic regression analysis, followed by diagnostic value assessment. Results: There were 496 cases of sarcopenic obesity, including 308 male patients and 188 female patients. The overall prevalence rate was 3.4%, with 4.10% for men and 2.65% for women. Compared with nonsarcogenic obesity group, the subjects with sarcogenic obesity showed shorter height and circumference of limbs, arm muscle, neck, chest, waist and hip, lighter weight, lower body mass index (BMI), bone mineral content (BMC), skeletal muscle mass, basal metabolic rate (BMR), body cell mass, fitness score and ASMI, and higher body fat mass, PBF, waist-hip ratio (WHR), visceral fat area (VFA), extracellular fluid/total body fat, and extracellular water/total body water (ECW/TBW; P < 0.01). Based on logistic regression analysis, BMI, BMC, PBF, WHR, BMR, VFA, fitness score, lean balance trunk, lean balance left leg, ASMI, ECW/TBW and the circumference of left arm, left leg, arm muscle, chest waist and hip were considered as risk factors for sarcogenic obesity (P < 0.05). After receiver operating characteristic (ROC) curve analysis of basic condition, muscle mass, and limb condition, ASMI [area under the curve (AUC) = 0.75] showed relatively high diagnostic value for adult sarcopenic obesity; other indicators (AUC <0.75) showed moderate diagnostic value for adult sarcopenic obesity, except for fitness score. According to joint ROC analysis, combination of BMC, PBF, VFA, and ASMI (AUC = 0.78) showed high diagnostic value for adult sarcopenic obesity. ASMI was correlated with BMI (r = 0.246, P < 0.001), BMC (r = 0.798, P < 0.001), WHR (r = 0.197, P < 0.001), BMR (r = 0.932, P < 0.001), PBF (r = -0.761, P < 0.001), and VFA (r = -0.530, P < 0.001). In adult patients with sarcopenic obesity, a decrease in ASMI indicators may be accompanied by a decrease in BMI, BMC, WHR, and BMR as well as an increase in PBF and VFA. Conclusion: The prevalence rate of adult sarcopenic obesity was 3.40%. ASMI was closely correlated with BMI, BMC, PBF, WHR, BMR, and VFA, which may serve as early indicators in the diagnosis of adult sarcopenic obesity.
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Affiliation(s)
- Xi Luo
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Bin Cai
- Department of Quality Management, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Shaoxing People's Hospital, Shaoxing, China
| | - Weiwei Jin
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Zhou Z, Huang Y, Wang J, Su H, Tang H, Wang Y. A novel digital biomarker of sarcopenia in frail elderly: New combination of gait parameters under dual-task walking. Front Aging Neurosci 2023; 15:1087318. [PMID: 36891555 PMCID: PMC9986265 DOI: 10.3389/fnagi.2023.1087318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Background Frailty caused by deterioration in multiple physiological systems has led to a significant increase in adverse events such as falls, disability, and death in frail older people. Similar to frailty, sarcopenia, defined as loss of skeletal muscle mass and strength, is tightly related to mobility disorders, falls, and fractures. With population aging, co-occurrences of frailty and sarcopenia are increasingly common in the elderly, which are more deleterious for the health and independence of older adults. But the high similarity and overlap between the frailty and sarcopenia increase the difficulty of early recognition of frailty with sarcopenia. The purpose of this study is to use detailed gait assessment to determine the more convenient and sensitive digital biomarker of sarcopenia in the frail population. Methods Ninety-five frail elderly people (age = 86 ± 7 years old, BMI, and body mass index = 23.21 ± 3.40 kg/m2) were screened out by the evaluation of Fried criteria. Then, 41 participants (46%) were identified with sarcopenia, and 51 participants (54%) were identified without sarcopenia. Using a validated wearable platform, participants' gait performance was evaluated under single-task and dual-task (DT). Participants walked back and forth on the 7-m-long trail for 2 min at a habitual speed. Gait parameters of interest include cadence, gait cycle duration, step duration, gait speed, variability of gait speed, stride length, turn duration, and steps in turn. Results Our results showed that compared with the frail elderly without sarcopenia, the gait performance of the sarcopenic group in single-task and dual-task walking was worse. Overall, the parameters with high performance were the gait speed (DT) (OR 0.914; 95% CI 0.868-0.962) and turn duration (DT) (OR 7.907; 95% CI 2.401-26.039) under dual-task conditions, and the AUC in distinguishing between frail older adults with and without sarcopenia was 0.688 and 0.736, respectively. Turn duration in dual-task testing had larger observed effect than gait speed to identify sarcopenia in the frail population, this result remained significant even after controlling for potential confounds. When gait speed (DT) and turn duration (DT) were combined in the model, AUC increased from 0.688 to 0.763. Conclusion This study shows that gait speed and turn duration under dual-task are good predictors of sarcopenia in frail elderly, and turn duration (DT) has a better predictive ability. The gait speed (DT) combined with turn duration (DT) is a potential gait digital Biomarker of sarcopenia in the frail elderly. Dual-task gait assessment and detailed gait indexes provide important value for identification of sarcopenia in frail elderly people.
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Affiliation(s)
- Zheping Zhou
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yulun Huang
- Department of Neurosurgery, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Jing Wang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huan Su
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haiying Tang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yueju Wang
- Department of Geratology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Frailty, appendicular lean mass, osteoporosis and osteosarcopenia in peritoneal dialysis patients. J Nephrol 2022; 35:2333-2340. [PMID: 35816240 PMCID: PMC9700626 DOI: 10.1007/s40620-022-01390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The pattern of chronic kidney disease mineral bone disorder (CKD-MBD) is changing with increasing numbers of elderly patients now treated by dialysis. The risk of falls and bone fractures increases with frailty and sarcopenia. As such we wished to review the association between osteoporosis and frailty and loss of appendicular lean mass (ALM). METHODS Dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine and femoral neck bone mineral density (BMD) and body composition. Osteoporosis and osteopenia were defined according to T scores. ALM was indexed to height (ALMI). Frailty was classified using the clinical frailty scale (CFS). RESULTS DXA scans from 573 patients, 57.8% male, 36.8% diabetic, mean age 61.0 ± 15.8 years, with a median 6.0 (2-20) months of treatment with PD were reviewed. Forty-two (7.3%) were classified as clinically frail, 115 (20%) osteoporotic, and 198 (34.6%) ALMI meeting sarcopenic criteria, with 43% of osteoporotic patients being osteosarcopenic. In a multivariable model, femoral neck BMD was associated with weight, standardised β (St β) 0.29, p = 0.004, ALM St β 0.11, p = 0.03 and Black vs other ethnicities St β 0.19, p = 0.02, and negatively with age St β -0.24, p < 0.001, and frailty St β -2.1, p = 0.04. Z scores (adjusted for gender and age) were associated with ALMI (r = 0.18, p < 0.001). DISCUSSION Osteoporosis is increasing with the numbers of elderly dialysis patients. As frailty and sarcopenia increase with age, then the risk of falls and bone fractures increases with osteosarcopenia. Whether interventions with exercise and nutrition can improve bone heath remains to be determined.
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A New Index Based on Serum Creatinine and Cystatin C Can Predict the Risks of Sarcopenia, Falls and Fractures in Old Patients with Low Bone Mineral Density. Nutrients 2022; 14:nu14235020. [PMID: 36501049 PMCID: PMC9738634 DOI: 10.3390/nu14235020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/11/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
As new screening tools for sarcopenia, the serum sarcopenia index (SI) and creatinine/cystatin C ratio (CCR) had not been confirmd in a population with a high fragility fracture risk. This study aimed to evaluate whether SI and CCR indicators are useful for diagnosing sarcopenia and to determine their prediction values for future falls and fractures. A total of 404 hospitalized older adults were enrolled in this longitudinal follow-up study (mean age = 66.43 ± 6.80 years). The receiver operating curve (ROC) was used to assess the diagnostic accuracy of SI and CCR. Backward-selection binary logistic regression was applied to develop the optimal models for the diagnosis of new falls and fractures. SI had a significantly higher area under the curve (AUC) than CCR for predicting sarcopenia. The optimal models had acceptable discriminative powers for predicting new falls and fractures. Lower SI and CCR are the independent risks for sarcopenia, new falls, and fractures in the low-BMD population. SI and CCR, as easily accessible biochemical markers, may be useful in the detection of sarcopenia and in predicting the occurrence of new falls and fractures in patients with low BMD who have not previously experienced falls or fractures. However, further external validations are required.
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Yu X, Sun S, Zhang S, Hao Q, Zhu B, Teng Y, Long Q, Li S, Lv Y, Yue Q, Lu S, Teng Z. A pooled analysis of the association between sarcopenia and osteoporosis. Medicine (Baltimore) 2022; 101:e31692. [PMID: 36401390 PMCID: PMC9678526 DOI: 10.1097/md.0000000000031692] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Sarcopenia is a progressive generalized skeletal muscle disorder that causes the accelerated loss of muscle mass and function. Osteoporosis is a systemic condition of the skeleton that results in low bone mass and quality. Several studies have suggested that osteoporosis and sarcopenia are interrelated; however, a few studies indicate the lack of a significant association between sarcopenia and osteoporosis. We aimed to evaluate the association between sarcopenia and osteoporosis via a systematic review and pooled analysis. METHODS From the inception of the PubMed and Embase databases until September 2022, we conducted a systematic search for studies evaluating the relationship between sarcopenia and osteoporosis. Study appraisal and synthesis methods: We included observational studies that provided 95% confidence intervals (CIs) and risk estimates. Two reviewers independently extracted data and assessed the quality of the research. The random-effects model was applied to the pool analysis, and the odds ratios (ORs) and 95% CIs were finally calculated. RESULTS The primary statistic was the mutual risk between sarcopenia and osteoporosis. According to the inclusion criteria, 56 studies (796,914 participants) were finally included. Sarcopenia was significantly correlative to the risk of osteoporosis (OR, 3.06; 95% CI, 2.30-4.08), and each standard deviation increase in relative appendicular skeletal muscle mass was significantly related to a decreased risk of osteoporosis (OR, 0.65; 95% CI, 0.56-0.75). Osteoporosis observably referred to a higher risk of sarcopenia (OR, 2.63; 95% CI, 1.98-3.49). CONCLUSION Our research indicated that sarcopenia and osteoporosis are highly positively correlated. Osteoporosis is closely associated with the risk of sarcopenia. Our finding highlights the importance of sarcopenia screening for those at risk of osteoporosis, and vice versa. However, heterogeneity was noted among the studies, and this might have influenced the accuracy of the results. Therefore, the results of our study should be interpreted with caution.
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Affiliation(s)
- Xiaochao Yu
- Kunming Medical University, Kunming, Yunnan, China
- The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Shuo Sun
- Kunming Medical University, Kunming, Yunnan, China
| | | | - Qinggang Hao
- School of Life Sciences, Yunnan University, Kunming, Yunnan, China
| | - Boheng Zhu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yirong Teng
- Kunming Medical University, Kunming, Yunnan, China
| | - Qing Long
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Shujun Li
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yan Lv
- The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Qiaoning Yue
- Kunming Medical University, Kunming, Yunnan, China
| | - Sheng Lu
- The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Zhaowei Teng
- Kunming Medical University, Kunming, Yunnan, China
- The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
- * Correspondence: Zhaowei Teng, The First People’s Hospital of Yunnan Province, Kunming 650000, Yunnan, China (e-mail: )
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Kuriyama K, Matsui Y, Suzuki Y, Mizuno T, Watanabe T, Takemura M, Ishizuka S, Yamashita S, Imagama S, Arai H. Relationship between sarcopenia classification and thigh muscle mass, fat area, muscle CT value and osteoporosis in middle-aged and older Japanese adults. Bone 2022; 163:116487. [PMID: 35843483 DOI: 10.1016/j.bone.2022.116487] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/10/2022] [Accepted: 07/10/2022] [Indexed: 11/21/2022]
Abstract
Sarcopenia is one of the most important health issues in today's ageing society. As an evaluation method, computed tomography (CT) is an effective means of assessing not only the quantity but also the quality of skeletal muscle. We aimed to examine the relationship between sarcopenia severity and muscle/fat area, and osteoporosis. 321 patients (116 men and 205 women, mean age 77.2 ± 7.1 years, age range 53-96 years) who visited the Integrated Healthy Aging Clinic from 2016 to 2017 were included in this study. Based on the Asia Working Group for Sarcopenia2019 criteria, patients were divided into four groups: normal group, low-functional group (with normal skeletal muscle mass, but reduced muscle strength or physical function), sarcopenia group, and severe sarcopenia group. We measured the skeletal muscle (SM), intermuscular adipose tissue (IMAT), and subcutaneous adipose tissue (SAT) areas and the CT attenuation values (CTV) using cross sections of the mid-thigh CT. We also measured bone mineral density. Then, we compared each result among the four groups. We found a significant decrease in SM area in both men and women with sarcopenia (p < 0.001 for both sexes). In women, a decrease in SAT area was observed in the sarcopenia group (p < 0.001), and an increase in IMAT was observed in the low functional group (p < 0.001). The CTV decreased in men with sarcopenia and severe sarcopenia; similarly, women in the low functional and severe sarcopenia groups had decreased CTV (p < 0.001 for both sexes). An association between sarcopenia and osteoporosis in men was detected (p = 0.004). By using not only muscle mass but also fat mass and CTV, we were able to better examine the pathogenesis of sarcopenia and differences between men and women in Japanese middle-aged and older adults.
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Affiliation(s)
- Kanae Kuriyama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan; Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
| | - Yasuo Suzuki
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Faculty of Health Sciences, Department of Human Care Engineering, Nihon Fukushi University, Mihama, Aichi 470-3295, Japan.
| | - Takafumi Mizuno
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan; Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
| | - Tsuyoshi Watanabe
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
| | - Marie Takemura
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
| | - Shinya Ishizuka
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.
| | - Satoshi Yamashita
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.
| | - Hidenori Arai
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
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Cheng Y, Yang, H, Hai Y, Liu Y, Guan L, Pan A, Zhang Y. Low paraspinal lean muscle mass is an independent predictor of adjacent vertebral compression fractures after percutaneous kyphoplasty: A propensity score–matched case-control study. Front Surg 2022; 9:965332. [PMID: 36034343 PMCID: PMC9403076 DOI: 10.3389/fsurg.2022.965332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background To investigate the relationship between paraspinal lean muscle mass and adjacent vertebral compression fracture (AVCF) after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF). Methods The data of 272 patients who underwent two consecutive single-level PKP in our hospital from January 2017 to December 2019 were collected. 42 patients who met the inclusion and exclusion criteria were selected as AVCF group, and 42 propensity score-matched patients were selected as control group. There were 10 males and 32 females in each group; the ages were 75.55 ± 5.76 years and 75.60 ± 5.87 years, respectively. All patients underwent preoperative lumbar MRI. The total cross-sectional area (CSA), functional cross-sectional area (FCSA), cross-sectional area of vertebra index (CSA-VI), functional cross-sectional area of vertebra index (FCSA-VI) of the multifidus (MF), erector spinae (ES), psoas (PS), and paravertebral muscles (PVM) were measured. Other related parameters included preoperative bone mineral density (BMD), kyphotic angle (KA), anterior-to-posterior body height ratio (AP ratio), vertebral height restoration, and cement leakage into the disc. Logistic regression analysis was performed to find independent risk factors for AVCF using the parameters that were statistically significant in univariate analysis. Results At L3 and L4 levels, the mean CSA, FCSA, and FCSA-VI of MF, ES, PVM and PS were significantly lower in the AVCF group. DeLong test indicated that the AUC of ES (0.806 vs. 0.900) and PVM (0.861 vs. 0.941) of FCSA-VI at L4 level were significantly greater than L3 level. In the AVCF group, patients had a significantly lower BMD (93.55 ± 14.99 HU vs. 106.31 ± 10.95 HU), a greater preoperative KA (16.02° ± 17.36° vs. 12.87° ± 6.58°), and a greater vertebral height restoration rate (20.4% ± 8.1% vs. 16.4% ± 10.0%, p = 0.026). Logistic regression analysis showed that PVM with lower FCSA-VI at L4 level (OR 0.830; 95% CI 0.760–0.906) and lower BMD (OR 0.928; 95% CI 0.891–0.966) were independent risk factors for AVCF after PKP. Conclusions Low paraspinal lean muscle mass is an independent risk factor for AVCF after PKP. Surgeons should pay attention to evaluate the status of paraspinal muscle preoperatively. Postoperative reasonable nutrition, standardized anti-osteoporosis treatment, and back muscle exercise could reduce the incidence of AVCF.
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Affiliation(s)
| | | | - Yong Hai
- Correspondence: Yong Hai , Yuzeng Liu
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Shin SP, Koh DH. Clinical Impact of Sarcopenia on Cholangiocarcinoma. Life (Basel) 2022; 12:life12060815. [PMID: 35743846 PMCID: PMC9224765 DOI: 10.3390/life12060815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
Sarcopenia is considered an important factor affecting the prognosis of cancer patients. Only complete surgical resection confers the chance of curing cholangiocarcinoma with sarcopenia. However, the prognosis is poor, even for patients who undergo surgical resection. Data from 13 trials of patients with sarcopenia and intrahepatic cholangiocarcinoma (ICC) or perihilar cholangiocarcinoma (PHC) were collected and reviewed. During all trials, sarcopenia was assessed using the psoas muscle or total skeletal muscle at the L3 level on cross-sectional images. The data showed heterogeneity among the subjects and treatment options and discrepancies in methods of measuring muscle mass and setting the cut-off level. Despite conflicting results regarding morbidity, mortality, and recurrence, sarcopenia may be associated with poor overall survival and recurrence-free survival (RFS) for ICC patients. The impact of sarcopenia on the morbidity of ICC patients remains unclear. The impact of PHC on morbidity, mortality, and RFS is also unclear. Further well-designed studies are needed to elucidate the effects of sarcopenia on ICC and PHC.
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Affiliation(s)
- Suk-Pyo Shin
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon-si 24253, Gangwon-do, Korea;
| | - Dong-Hee Koh
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si 18450, Gyeonggi-do, Korea
- Correspondence: ; Tel.: +82-31-8086-2450
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Polito A, Barnaba L, Ciarapica D, Azzini E. Osteosarcopenia: A Narrative Review on Clinical Studies. Int J Mol Sci 2022; 23:ijms23105591. [PMID: 35628399 PMCID: PMC9147376 DOI: 10.3390/ijms23105591] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/09/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenia (OS) is defined by the concurrent presence of osteopenia/osteoporosis and sarcopenia. The pathogenesis and etiology of OS involve genetic, biochemical, mechanical, and lifestyle factors. Moreover, an inadequate nutritional status, such as low intake of protein, vitamin D, and calcium, and a reduction in physical activity are key risk factors for OS. This review aims to increase knowledge about diagnosis, incidence, etiology, and treatment of OS through clinical studies that treat OS as a single disease. Clinical studies show the relationship between OS and the risk of frailty, falls, and fractures and some association with Non-communicable diseases (NCDs) pathologies such as diabetes, obesity, and cardiovascular disease. In some cases, the importance of deepening the related mechanisms is emphasized. Physical exercise with adequate nutrition and nutritional supplementations such as proteins, Vitamin D, or calcium, represent a significant strategy for breaking OS. In addition, pharmacological interventions may confer benefits on muscle and bone health. Both non-pharmacological and pharmacological interventions require additional randomized controlled trials (RCT) in humans to deepen the synergistic effect of exercise, nutritional interventions, and drug compounds in osteosarcopenia.
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Lin YA, Chen LH, Chen FP, Wong AMK, Hsu CC, Chen JY. The Effectiveness of a Group Kickboxing Training Program on Sarcopenia and Osteoporosis Parameters in Community-Dwelling Adults Aged 50-85 Years. Front Med (Lausanne) 2022; 9:815342. [PMID: 35547204 PMCID: PMC9081979 DOI: 10.3389/fmed.2022.815342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sarcopenia and osteoporosis are important health issues faced by older people. These are often associated with each other and share common risk factors and pathologic mechanisms. In the recently revised consensus of the European Working Group on Sarcopenia in Older People, low muscle strength has been defined as the first characteristic of sarcopenia rather than a loss in muscle mass, and walking speed has been stated as an indicator of the severity of sarcopenia. It is believed that these markers of muscle function can be potentially reversed via exercise-based interventions. The purpose of this study was to evaluate the effects of kickboxing exercise training on the parameters of sarcopenia and osteoporosis in community-dwelling adults. Methods In total, one hundred eligible subjects were randomized into an intervention group (n = 50) with 76% women and control group (n = 50) with 86% women. Both the intervention and control groups were provided with classroom lectures and personal consultations pertaining to sarcopenia and osteoporosis, whereas a 12-week kickboxing exercise training was arranged only for the intervention group. All anthropometric, physical performance, body composition, and bone mineral density measurements along with participant completed questionnaires were conducted before and after the training period. Results After 12 weeks, 41 participants in the intervention group and 34 participants in the control group completed the final assessments. There was no difference between the intervention and control groups in terms of basic demographic data. The BMI (+1.14%) of the control group increased significantly during the study period. The waist circumference (−6.54%), waist-to-height ratio (−6.57%), waist–to–hip ratio (−4.36%), total body fat (−1.09%), and visceral fat area (−4.6%) decreased significantly in the intervention group. Handgrip strength (+5.46%) and gait speed (+5.71%) improved significantly in the intervention group. The lean body mass increased by 0.35% in the intervention group and by 0.9% in the control group. The femoral neck bone mineral density (−1.45%) and T score (−3.72%) of the control group decreased significantly. The intervention group had more improvement in the status of sarcopenia (OR 1.91) and osteoporosis over the control group. Finally, the intervention group had less deterioration in the status of sarcopenia (OR 0.2) and osteoporosis (OR 0.86) compared with the control group. Conclusion Our study demonstrated that a 12-week kickboxing exercise training program is effective for improving sarcopenic parameters of muscle strength and function, but not muscle mass in adults, aged 50–85 years. Furthermore, markers of osteoporosis also showed improvement. These findings suggest that a 12-week kickboxing program is effective for muscle and bone health among community-dwelling older individuals.
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Affiliation(s)
- Yen-An Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Lee-Hwa Chen
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Fang-Ping Chen
- Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan City, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
| | - Chih-Chan Hsu
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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Zhang HW, Tsai ZR, Chen KT, Hsu SL, Kuo YJ, Lin YC, Huang SW, Chen YP, Peng HC, Tsai JJP, Hsu CY. Enhanced Risk of Osteoporotic Fracture in Patients with Sarcopenia: A National Population-Based Study in Taiwan. J Pers Med 2022; 12:jpm12050791. [PMID: 35629213 PMCID: PMC9144914 DOI: 10.3390/jpm12050791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenia is a progressive and generalized skeletal muscle disorder associated with poor health outcomes in older adults. However, its association with the risk of fracture risk is yet to be clarified. Therefore, this study aimed to assess the incidence and consequence of osteoporosis-related fractures among patients with sarcopenia in Taiwan. A retrospective, population-based study on 616 patients with sarcopenia, aged >40 years, and 1232 individuals without sarcopenia was conducted to evaluate claims data from Taiwan’s National Health Insurance Research Database collected in the period January 2000−December 2013. The incidence rate of osteoporosis-related fracture was 18.13 and 14.61 per 1000 person years in the patients with sarcopenia and comparison cohort, respectively. Patients with sarcopenia had a greater osteoporotic fracture risk (adjusted hazard ratio [HR] 2.11; 95% confidence interval [CI] 1.47−3.04) after correcting for possible confounding. Additionally, females showed statistically significant correlations of sarcopenia with osteoporosis-related fracture risk (HR 1.53; CI 0.83−2.8 for males and HR 2.40, CI 1.51−3.81 for females). During this retrospective study on the fracture risk in Taiwan, an adverse impact of sarcopenia was observed, which substantiates the need to work toward sarcopenia prevention and interventions to reverse fracture susceptibility in patients with sarcopenia.
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Affiliation(s)
- Han-Wei Zhang
- Biomedica Corporation, New Taipei 23146, Taiwan; (H.-W.Z.); (H.-C.P.)
- Ph.D. Program for Aging, China Medical University, Taichung 40402, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
- Department of Electrical and Computer Engineering, Institute of Electrical Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Zhi-Ren Tsai
- Department of Computer Science & Information Engineering, Asia University, Taichung 41354, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Center for Precision Medicine Research, Asia University, Taichung 41354, Taiwan;
| | - Ko-Ta Chen
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 11031, Taiwan;
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
| | - Sheng-Lun Hsu
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan; (S.-L.H.); (Y.-C.L.)
| | - Yi-Jie Kuo
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan;
| | - Ying-Chin Lin
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan; (S.-L.H.); (Y.-C.L.)
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Geriatric Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Shu-Wei Huang
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan;
| | - Yu-Pin Chen
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan;
- Correspondence: ; Tel.: +886-933296411
| | - Hsiao-Ching Peng
- Biomedica Corporation, New Taipei 23146, Taiwan; (H.-W.Z.); (H.-C.P.)
| | - Jeffrey J. P. Tsai
- Center for Precision Medicine Research, Asia University, Taichung 41354, Taiwan;
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
| | - Chun-Yi Hsu
- Graduate Institute of Biomedical Science, China Medical University, Taichung 40402, Taiwan;
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Pugliese N, Arcari I, Aghemo A, Lania AG, Lleo A, Mazziotti G. Osteosarcopenia in autoimmune cholestatic liver diseases: Causes, management, and challenges. World J Gastroenterol 2022; 28:1430-1443. [PMID: 35582674 PMCID: PMC9048470 DOI: 10.3748/wjg.v28.i14.1430] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/05/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Primary biliary cholangitis and primary sclerosing cholangitis (PSC) are the most common cholestatic liver diseases (CLD) in adults and are both characterized by an immune pathogenesis. While primary biliary cholangitis is a model autoimmune disease, with over 90% of patients presenting very specific autoantibodies against mitochondrial antigens, PSC is considered an immune mediated disease. Osteoporosis is the most common bone disease in CLD, resulting in frequent fractures and leading to significant morbidity. Further, sarcopenia is emerging as a frequent complication of chronic liver diseases with a significant prognostic impact and severe implications on the quality of life of patients. The mechanisms underlying osteoporosis and sarcopenia in CLD are still largely unknown and the association between these clinical conditions remains to be dissected. Although timely diagnosis, prevention, and management of osteosarcopenia are crucial to limit the consequences, there are no specific guidelines for management of osteoporosis and sarcopenia in patients with CLD. International guidelines recommend screening for bone disease at the time of diagnosis of CLD. However, the optimal monitoring strategies and treatments have not been defined yet and vary among centers. We herein aim to comprehensively outline the pathogenic mechanisms and clinical implications of osteosarcopenia in CLD, and to summarize expert recommendations for appropriate diagnostic and therapeutic approaches.
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Affiliation(s)
- Nicola Pugliese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
| | - Ivan Arcari
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
| | - Alessio Aghemo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
| | - Andrea G Lania
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Department of Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
| | - Ana Lleo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
| | - Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
- Department of Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano 20089, MI, Italy
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Montenegro J, Klein MRST, Bregman R, Prado CM, Barreto Silva MI. Osteosarcopenia in patients with non-dialysis dependent chronic kidney disease. Clin Nutr 2022; 41:1218-1227. [DOI: 10.1016/j.clnu.2022.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/19/2022] [Accepted: 04/13/2022] [Indexed: 12/31/2022]
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Inoue T, Maeda K, Satake S, Matsui Y, Arai H. Osteosarcopenia, the co-existence of osteoporosis and sarcopenia, is associated with social frailty in older adults. Aging Clin Exp Res 2022; 34:535-543. [PMID: 34491548 PMCID: PMC8421463 DOI: 10.1007/s40520-021-01968-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/18/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Osteosarcopenia is a newly described, aging-associated condition. Social frailty is an important condition whose prevalence may have risen by physical distancing during the coronavirus disease 2019 pandemic. However, the relationship between these two remains unclear. AIMS To examine the association between osteosarcopenia and social frailty. METHODS This cross-sectional study was conducted using data from outpatients visiting general geriatric hospital frailty clinics. Bone mineral density (BMD) and muscle mass were measured using dual X-ray absorptiometry. Osteoporosis was defined as a BMD of < 70% of the young adult mean, according to the Japan Osteoporosis Society. Sarcopenia was diagnosed as per the Asian Working Group for Sarcopenia 2019 recommendation. Osteosarcopenia was defined as the co-existence of osteoporosis and sarcopenia. We defined social frailty using a questionnaire comprising four items: general resources, social resources, social behavior, and basic social needs. Ordinal logistic regression analysis was performed with social frailty status and osteosarcopenia as the dependent and independent variables, respectively. RESULTS We included 495 patients (mean age = 76.5 ± 7.2 years) in the analysis; of these, 58.2% were robust and 17.2%, 13.5%, and 11.1% had osteoporosis alone, sarcopenia alone, and osteosarcopenia, respectively. Social frailty prevalence increased stepwise from 8.0% in robust patients to 11.8%, 17.9%, and 29.1% among those with osteoporosis alone, sarcopenia alone, and osteosarcopenia, respectively (P < 0.001). Logistic regression analysis revealed that only osteosarcopenia was significantly associated with social frailty (pooled odds ratio: 2.117; 95% confidence interval: 1.104-4.213). DISCUSSION Comprehensive assessment of osteosarcopenia and social frailty is needed for disability prevention in older adults.
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Affiliation(s)
- Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan.
| | - Shosuke Satake
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
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Osteosarcopenia as a lifetime syndrome: Could it be prevented? OSTEOSARCOPENIA 2022. [DOI: 10.1016/b978-0-12-820088-9.00012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sasaki KI, Fukumoto Y. Sarcopenia as a comorbidity of cardiovascular disease. J Cardiol 2021; 79:596-604. [PMID: 34906433 DOI: 10.1016/j.jjcc.2021.10.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022]
Abstract
Sarcopenia, the lowered skeletal muscle mass, weakened skeletal muscle strength, and reduced physical performance with aging, is a component of frailty and high-risk factor for falls, resulting in an increase in mortality. In cardiovascular disease (CVD) patients, systemic inflammation, oxidative stress, overactivation of ubiquitin-proteasome system, endothelial dysfunction, lowering muscle blood flow, impaired glucose tolerance, hormonal changes, and physical inactivity possibly contribute to CVD-related sarcopenia. Prevalence of sarcopenia and osteosarcopenia, which is osteopenia and sarcopenia coexisting together, seems to be higher in CVD patients than in community-dwelling adults, suggesting the necessity of early diagnosis and prevention of CVD-related sarcopenia. Atrial stiffness, coronary artery calcification score, and serum vitamin D levels may be of help as the biomarkers to suspect sarcopenia, and renin-angiotensin-aldosterone system inhibitors may play a role in the medical prevention and treatment of CVD-related sarcopenia. There are few reports to convince the efficacies of dietary and antioxidant supplementation on sarcopenia at present, whereas aerobic and resistance training exercises have been recognized as an effective strategy to prevent and treat sarcopenia.
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Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
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Pourhassan M, Buehring B, Stervbo U, Rahmann S, Mölder F, Rütten S, Trampisch U, Babel N, Westhoff TH, Wirth R. Osteosarcopenia, an Asymmetrical Overlap of Two Connected Syndromes: Data from the OsteoSys Study. Nutrients 2021; 13:3786. [PMID: 34836043 PMCID: PMC8618221 DOI: 10.3390/nu13113786] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 01/06/2023] Open
Abstract
Osteoporosis and sarcopenia are two chronic conditions, which widely affect older people and share common risk factors. We investigated the prevalence of low bone mineral density (BMD) and sarcopenia, including the overlap of both conditions (osteosarcopenia) in 572 older hospitalized patients (mean age 75.1 ± 10.8 years, 78% women) with known or suspected osteoporosis in this prospective observational multicenter study. Sarcopenia was assessed according to the revised definition of the European Working Group on Sarcopenia in Older People (EWGSOP2). Low BMD was defined according to the World Health Organization (WHO) recommendations as a T-score < -1.0. Osteosarcopenia was diagnosed when both low BMD and sarcopenia were present. Low BMD was prevalent in 76% and the prevalence of sarcopenia was 9%, with 90% of the sarcopenic patients showing the overlap of osteosarcopenia (8% of the entire population). Conversely, only few patients with low BMD demonstrated sarcopenia (11%). Osteosarcopenic patients were older and frailer and had lower BMI, fat, and muscle mass, handgrip strength, and T-score compared to nonosteosarcopenic patients. We conclude that osteosarcopenia is extremely common in sarcopenic subjects. Considering the increased risk of falls in patients with sarcopenia, they should always be evaluated for osteoporosis.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (U.T.); (R.W.)
| | - Bjoern Buehring
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, 44649 Herne, Germany;
| | - Ulrik Stervbo
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.); (T.H.W.)
| | - Sven Rahmann
- Algorithmic Bioinformatics, Center for Bioinformatics, Saarland University, 66041 Saarbrücken, Germany;
| | - Felix Mölder
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Sebastian Rütten
- Center for Orthopedics and Trauma Surgery, St. Anna Hospital, St. Elisabeth Gruppe, 44649 Herne, Germany;
| | - Ulrike Trampisch
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (U.T.); (R.W.)
| | - Nina Babel
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.); (T.H.W.)
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin-Brandenburg Center for Regenerative Therapies, 10117 Berlin, Germany
| | - Timm Henning Westhoff
- Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany; (U.S.); (N.B.); (T.H.W.)
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (U.T.); (R.W.)
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Dautzenberg L, Pals JEM, Lefeber GJ, Stella PR, Abawi M, Emmelot-Vonk M, Koek HL. Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study. Open Heart 2021; 8:openhrt-2021-001766. [PMID: 34556561 PMCID: PMC8461740 DOI: 10.1136/openhrt-2021-001766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/03/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI. METHODS A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events. RESULTS This cohort included 490 patients who underwent TAVI (mean age 80.7±6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome. CONCLUSION Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines.
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Affiliation(s)
- Lauren Dautzenberg
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Judith E M Pals
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Geert J Lefeber
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Pieter R Stella
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Masieh Abawi
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Marielle Emmelot-Vonk
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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Inoue T, Shimizu A, Satake S, Matsui Y, Ueshima J, Murotani K, Arai H, Maeda K. Association between osteosarcopenia and cognitive frailty in older outpatients visiting a frailty clinic. Arch Gerontol Geriatr 2021; 98:104530. [PMID: 34562795 DOI: 10.1016/j.archger.2021.104530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/12/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Osteosarcopenia and cognitive frailty are both risk factors for falls and fractures. The purpose of this study was to determine the association between osteosarcopenia and cognitive frailty. MATERIALS AND METHODS This was a cross-sectional secondary data analysis of the Frailty Registry Study with outpatients aged ≥65 years who visited a frailty clinic at a geriatric hospital. Osteoporosis was defined as a bone mineral density < 70% of the young adult mean. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Cognitive frailty was defined as the coexistence of physical frailty and mild cognitive impairment. Physical frailty was evaluated according to Japanese Cardiovascular Health Study criteria, whereas mild cognitive impairment was defined as a Mini-Mental State Examination score ≥ 24 points and a score ≤ 25 points on the Japanese version of the Montreal Cognitive Assessment. We performed multivariable logistic regression analysis to investigate the association between osteosarcopenia and cognitive frailty. RESULTS The data of 432 patients were analysed. The prevalence of osteosarcopenia and cognitive frailty was 10.2% and 20.8%, respectively. Logistic regression analysis revealed that osteosarcopenia was independently associated with cognitive frailty with a higher odds ratio than osteoporosis or sarcopenia alone. Lost points in visuospatial abilities/executive functions and orientation were significantly associated with osteosarcopenia. CONCLUSIONS Combination of osteoporosis and sarcopenia is more likely to be associated with physical and cognitive decline than osteoporosis and sarcopenia alone. The mechanism by which osteosarcopenia is associated with decreased visuospatial abilities/executive functions and orientation needs to be addressed.
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Affiliation(s)
- Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Akio Shimizu
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan; Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Naka-ku, Hamamatsu, Shizuoka 433-8127, Japan
| | - Shosuke Satake
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan; Department of Frailty Research, Research Institute, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Higashi-Gotanda, Tokyo 141-8625, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, 67, Asahimachi, Kurume 830-0011, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
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Peng H, Hua Z, Yang H, Wang J. [Research progress on mechanism of myokines regulating bone tissue cells]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:923-929. [PMID: 34308604 DOI: 10.7507/1002-1892.202012062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the effects and mechanisms of various myokines secreted by skeletal muscle on various bone tissue cells. Methods Literature related to myokines and their regulation of bone tissue cells was reviewed and analyzed comprehensively in recent years. Results Bone and skeletal muscle are important members of the motor system, and they are closely related in anatomy, genetics, and physiopathology. In recent years, it has been found that skeletal muscle can secrete a variety of myokines to regulate bone marrow mesenchymal stem cells, osteoblasts, osteoclasts, and bone cells; these factors mutual crosstalk between myoskeletal unit, contact each other and influence each other, forming a complex myoskeletal micro-environment, and to some extent, it has a positive impact on bone repair and reconstruction. Conclusion Myokines are potential targets for the dynamic balance of bone tissue cells. In-depth study of its mechanism is helpful to the prevention and treatment of myoskeletal diseases.
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Affiliation(s)
- Hongcheng Peng
- Nanjing University of Traditional Chinese Medicine, Nanjing Jiangsu, 210023, P.R.China
| | - Zhen Hua
- Department of Orthopedics and Traumatology, Wuxi Affiliated Hospital, Nanjing University of Traditional Chinese Medicine, Wuxi Jiangsu, 214071, P.R.China
| | - Huilin Yang
- Department of Orthopedics, the First Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215006, P.R.China
| | - Jianwei Wang
- Department of Orthopedics and Traumatology, Wuxi Affiliated Hospital, Nanjing University of Traditional Chinese Medicine, Wuxi Jiangsu, 214071, P.R.China
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Ontan MS, Dokuzlar O, Ates Bulut E, Soysal P, Isik AT. The relationship between osteoporosis and sarcopenia, according to EWGSOP-2 criteria, in outpatient elderly. J Bone Miner Metab 2021; 39:684-692. [PMID: 33821303 DOI: 10.1007/s00774-021-01213-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Osteoporosis and sarcopenia are significant health problems that mainly affect older adults. This study aimed to investigate the relationship between sarcopenia and osteoporosis. MATERIALS AND METHODS The study included 444 participants who had undergone a dual-energy X-ray absorptiometry scan, handgrip test, 4-m walking speed test, and bioimpedance analysis within the past year. Participants were classified into control, osteopenia, or osteoporosis groups according to the World Health Organization classification. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People-2 criteria. RESULTS The mean age of the participants was 75.88 ± 7.20 years, and 80.9% were females. There were 144, 230, and 70 participants in the osteoporosis, osteopenia, and control groups, respectively. Probable sarcopenia was identified in 94 subjects, sarcopenia in 61, and severe sarcopenia in 72 participants. After adjusting for age, gender, and body mass index, probable sarcopenia and severe sarcopenia were associated with osteoporosis (p < 0.05). Low muscle strength, and low physical performance were associated with osteoporosis (p < 0.02). When osteoporosis was evaluated only according to the femoral neck T score, low muscle strength and low physical performance were found to be related not only to osteoporosis (p < 0.001), but also to osteopenia (p < 0.05). Additionally, probable sarcopenia was associated with femoral neck osteopenia (p < 0.01). CONCLUSIONS In this study, probable sarcopenia and severe sarcopenia were associated with osteoporosis in older adults. Furthermore, we found that low muscle strength, or dynapenia, which is the determining criterion of sarcopenia, was related to femoral neck osteopenia and osteoporosis.
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Affiliation(s)
- Mehmet Selman Ontan
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Esra Ates Bulut
- Department of Geriatric Medicine, Adana State Hospital, Adana, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Balcova, Izmir, 35340, Turkey.
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Tarantino U, Greggi C, Visconti VV, Cariati I, Tallarico M, Fauceglia M, Iundusi R, Albanese M, Chiaramonte C, Gasbarra E. T-Score and Handgrip Strength Association for the Diagnosis of Osteosarcopenia: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:2597. [PMID: 34204622 PMCID: PMC8231129 DOI: 10.3390/jcm10122597] [Citation(s) in RCA: 3] [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: 05/18/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Osteosarcopenia is a recently identified condition caused by the coexistence of osteoporosis and sarcopenia that affects the frail elderly population, leading to an increased risk of falls and fractures. Given the recent socio-economic interest associated with osteosarcopenia, the aim of this meta-analysis is to provide an overview of the factors potentially involved in its pathogenesis, assessing its population type, prevalence, and associated variables. METHODS A comprehensive systematic search for relevant studies, published from 2015 to 2020, was performed by using PubMed, EMBASE, and Cochrane databases. We analysed the variables of age, vitamin D, handgrip, and T-score in four different groups: healthy, osteopenic-osteoporotic, sarcopenic, and osteosarcopenic. RESULTS A total of 6504 patients from 16 studies were included in the final meta-analysis. The analysis of the individual variables reveals a statistically significant correlation between the handgrip test data and T-score (p < 0.001). CONCLUSIONS The correlation between T-score values and handgrip strength suggests a new potential parameter in the development of predictive models that could be used in clinical practice, highlighting its importance for the diagnosis of osteosarcopenia.
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Affiliation(s)
- Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy; (C.G.); (I.C.)
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Chiara Greggi
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy; (C.G.); (I.C.)
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Virginia Veronica Visconti
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
- Department of Biomedicine and Prevention, Medical Genetics Section, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Ida Cariati
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy; (C.G.); (I.C.)
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Mariagrazia Tallarico
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Matteo Fauceglia
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Riccardo Iundusi
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
| | - Marco Albanese
- Department of Statistics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.A.); (C.C.)
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.A.); (C.C.)
| | - Elena Gasbarra
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (V.V.V.); (M.T.); (M.F.); (R.I.); (E.G.)
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He N, Zhang Y, Zhang Y, Feng B, Zheng Z, Wang D, Zhang S, Ye H. Increasing Fracture Risk Associates With Plasma Circulating MicroRNAs in Aging People's Sarcopenia. Front Physiol 2021; 12:678610. [PMID: 34163374 PMCID: PMC8215392 DOI: 10.3389/fphys.2021.678610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Aging generally coincides with a gradual decline in mass and strength of muscles and bone mineral density (BMD). Sarcopenia is closely linked to osteoporosis in the elderly, which can lead to abnormal gait, balance disorders, and dysfunctions, as well as increase in the risks of falls, fractures, weakness, and death. MicroRNAs (miRNAs, miRs) are a kind of short and non-coding RNA molecules but can regulate posttranscriptional protein expression. However, we have known little about their participation in age-associated osteoporosis and sarcopenia. The current study aims to confirm those miRNAs as biomarkers for age-related reduction in muscular atrophy associated with human blood fractures. In our study, 10 fracture-risk-related miRNAs (miR-637, miR-148a-3p, miR-125b-5p, miR-124-3p, miR-122-5p, miR-100-5p, miR-93-5p, miR-21-5p, miR-23a-3p, and miR-24-3p) were analyzed. For the initial screening, we determined the abundance of fracture-risk-associated miRNAs by RT-PCR most frequently detected in enrolled 93 elderly with sarcopenia and non-sarcopenia, respectively. Statistically, the relative expression levels of plasma miR-23a-3p, miR-93-5p, and miR-637 in the sarcopenia group were significantly lower than that in the non-sarcopenia group, while the levels of other miRNAs did not change significantly. Moreover, we showed that the levels of ASM/height2, handgrip strength, and 4-m velocity in the sarcopenia group were significantly lower than in the non-sarcopenia group. Whereafter, we expanded the sample for further detection and analysis and revealed that the levels of plasma miR-23a-3p, miR-93-5p, and miR-637 in the sarcopenia group were significantly lower than that in the non-sarcopenia group, which is consistent with the initial screening experiment. From our analysis, changes in levels of plasma miR-93-5p and miR-637 were dramatically related to ASM/height2. Furthermore, changes in miR-23a and miR-93-5p were significantly affected by ASM/height2 in female individuals, with no significant correlations between miRNAs changes and these diagnostic indexes in male individuals after adjusting sex. The study showed that plasma miRNAs changed in an aging-related sarcopenia manner and were associated with increased fracture risk. In aging patients, plasma miR-23a-3p, miR-93-5p, and miR-637 have the potential as biomarkers of sarcopenia, which can affect the development of physiological dysfunction and may be also used in the fracture risk assessment of these patients.
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Affiliation(s)
- Nana He
- Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China
| | - Yuelin Zhang
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Yue Zhang
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Beili Feng
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Zaixing Zheng
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Dongjuan Wang
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Shun Zhang
- Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China
| | - Honghua Ye
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
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Abstract
Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.
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Che J, Xu C, Wu Y, Jia P, Han Q, Ma Y, Wang X, Du Y, Zheng Y. Early-senescent bone marrow mesenchymal stem cells promote C2C12 cell myogenic differentiation by preventing the nuclear translocation of FOXO3. Life Sci 2021; 277:119520. [PMID: 33887345 DOI: 10.1016/j.lfs.2021.119520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
AIMS Mouse bone marrow mesenchymal stem cells (BMSCs) are pluripotent cells with self-renewal and differentiation abilities. Since the effects of senescent BMSCs on C2C12 cells are not fully clear, the present study aimed to elucidate these effects. MAIN METHODS Senescence-associated β-galactosidase staining and western blotting were performed to confirm the senescence of BMSCs. Immunofluorescence and western blotting were used to assess myoblast differentiation in each group. The role of the AKT/P70 signaling pathway and forkhead box O3 (FOXO3) nuclear translocation was explored by western blotting. BMSC-derived exosomes were injected into the tibialis anterior of mice, and RT-qPCR was used to assess the role of exosomes in promoting muscle differentiation. KEY FINDINGS Conditioned medium (CM) from early-senescent BMSCs promoted myogenic differentiation in vitro, which was detected as enhanced expression of myosin heavy chain (MHC), myogenin (MYOG), and myogenic differentiation 1 (MyoD). The AKT signaling pathway was found to be regulated by CM, which inhibited FOXO3 nuclear translocation. RT-qPCR analysis results showed that MHC, MyoD, and MYOG mRNA expression increased in the tibialis anterior of mice after exosome injection. SIGNIFICANCE The present study demonstrated that early-senescent BMSCs accelerated C2C12 cell myogenic differentiation, and the transcription factor, FOXO3, was the target of senescent cells. Collectively, our results suggest that the AKT/P70 signaling pathway mediates the effect of BMSCs on neighboring cells.
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Affiliation(s)
- Ji Che
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Cuidi Xu
- Department of Osteoporosis and Bone Disease, Huadong Hospital, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Shanghai, China
| | - Yuanyuan Wu
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Peiyu Jia
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Qi Han
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Yantao Ma
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Xiaolei Wang
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China
| | - Yijie Du
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China; Institutes of Integrative Medicine, Fudan University, Shanghai, China; Qingpu Traditional Chinese Medicine Hospital, Shanghai, China.
| | - Yongjun Zheng
- Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, Shanghai, China.
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Mastavičiūtė A, Kilaitė J, Petroška D, Laurinavičius A, Tamulaitienė M, Alekna V. Associations between Physical Function, Bone Density, Muscle Mass and Muscle Morphology in Older Men with Sarcopenia: A Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:156. [PMID: 33572100 PMCID: PMC7915644 DOI: 10.3390/medicina57020156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022]
Abstract
Background and Objectives: It is thought that muscle and bone interact only on a biomechanical level, however, some research is now emerging that links bone and muscle on a cellular level. The aim of this study was to explore associations between physical function, muscle mass and bone density in community-dwelling elderly men with sarcopenia. A secondary goal was to analyze if muscle morphology was associated with bone density and physical functioning. Materials and Methods: Body composition was measured by dual-energy X-ray absorptiometry (DXA). Bone density was evaluated according to WHO criteria. Sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People (EWGSOP) criteria: low muscle mass and low muscle strength or low physical performance. Microbiopsy of musculus vastus lateralis was performed with a disposable muscle microbiopsy system. The perimeter and cross-sectional area of muscle fibers were calculated using image analysis software in whole slide images; type of fibers and their distribution were evaluated as well. Results: A total of 151 men, 60 years or older were included in this study. Mean age of the subjects was 72.9 ± 8.02 years. Sarcopenia was diagnosed in 45 (29.8%) men. Multiple significant correlations were found between bone mineral density, lean mass, appendicular lean mass, arm and leg lean mass, gait speed, balance test and handgrip strength in sarcopenic men. Lean mass was associated with femoral neck BMD (bone mineral density; r = 0.418, p = 0.006) and handgrip strength (r = 0.553, p < 0.001). In the sarcopenia group, 25 muscle biopsies were examined. In 9 sarcopenic men with T-scores equal or below -2.5, the muscle fiber area had a significant correlation with the balance test (r = 0.73, p = 0.025). Conclusions: In men with sarcopenia, low lean muscle mass was associated with low femoral neck BMD and low muscle strength. In sarcopenic men with osteoporosis, low muscle fiber area was associated with low scores in a balance test.
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Affiliation(s)
- Asta Mastavičiūtė
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (J.K.); (D.P.); (A.L.); (M.T.); (V.A.)
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