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Keller K, Schmitt VH, Brochhausen C, Hahad O, Engelhardt M, Espinola-Klein C, Münzel T, Lurz P, Konstantinides S, Hobohm L. Sarcopenia influences usage of reperfusion treatment in patients with pulmonary embolism aged 75 years and older. IJC HEART & VASCULATURE 2024; 53:101470. [PMID: 39132305 PMCID: PMC11314863 DOI: 10.1016/j.ijcha.2024.101470] [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: 05/21/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024]
Abstract
Background Although pulmonary embolism (PE) and sarcopenia are common diseases, only a few studies have assessed the impact of sarcopenia in PE on usage of reperfusion treatments in PE. Methods All hospitalizations of PE patients aged ≥75 years 2005-2020 in Germany were included in this study and stratified for sarcopenia. Impact of sarcopenia on treatment procedures and adverse in-hospital events were investigated. Results Overall, 576,364 hospitalizations of PE patients aged ≥75 years (median age 81.0 [78.0-85.0] years; 63.3 % females) were diagnosed in Germany during the observational period 2005-2020. Among these, 2357 (0.4 %) were coded with sarcopenia. PE patients with sarcopenia were in median 2 years older (83.0 [79.0-87.0] vs. 81.0 [78.0-85.0] years, P<0.001) and showed an aggravated comorbidity-profile (Charlson Comorbidity Index 7.00 [5.00-9.00] vs. 6.00 [4.00-7.00], P<0.001). Although signs of hemodynamic compromise such as shock (5.2 % vs. 4.1 %, P=0.005) and tachycardia (4.1 % vs. 2.8 %, P<0.001) were more prevalent in sarcopenic PE patients, systemic thrombolysis (1.9 % vs. 3.5 %, P<0.001) was less often used in these patients. Sarcopenia was independently related to an underuse of systemic thrombolysis (OR 0.537 [95 %CI 0.398-0.725], P<0.001). This underuse might driven by higher rates of bleeding events (gastro-intestinal bleeding: 3.1 % vs. 1.9 %, P<0.001, necessity of transfusion of blood constituents: 18.9 % vs. 11.3 %, P<0.001), but also stroke (5.6 % vs. 3.3 %, P<0.001). Conclusions Sarcopenia represents a widely overlooked condition in PE patients. Although sarcopenic PE patients were more often afflicted by hemodynamic compromise, systemic thrombolysis was less often administered. This underuse might be caused by contraindications like bleeding events and stroke.
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Affiliation(s)
- Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Volker H. Schmitt
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University Medical Center Mannheim, Heidelberg University, Germany
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Martin Engelhardt
- Department for Orthopedics, Trauma surgery and Hand surgery, Klinikum Osnabrück, Osnabrück, Germany
- Institute for Applied Training Science Leipzig, Germany
| | - Christine Espinola-Klein
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Philipp Lurz
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Korzonek-Szlacheta I, Hudzik B, Zubelewicz-Szkodzińska B, Czuba ZP, Szlacheta P, Tomasik A. The Association between Circulating Cytokines and Body Composition in Frail Patients with Cardiovascular Disease. Nutrients 2024; 16:1227. [PMID: 38674917 PMCID: PMC11054213 DOI: 10.3390/nu16081227] [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: 03/11/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
The burden of cardiovascular disease and the percentage of frail patients in the aging population will increase. This study aims to assess the circulating levels of several cytokines in frail patients. This is an ancillary analysis of the FRAPICA trial. The ratio of men/women changed from robust through frail groups from 3:1 to 1:2. The groups are comparable in terms of age and body measurements analysis (weight, height, and BMI), yet the frail patients have significantly reduced fat-free mass, and more often have been diagnosed with diabetes. Frail patients have higher fibroblast growth factor basic (FGF basic) and follistatin levels (borderline significance). In multiple linear regression modeling of fat-free mass, we identified FGF basic, osteopontin, stem cell factor, soluble suppression of tumorigenicity 2, soluble epidermal growth factor receptor, soluble human epidermal growth factor receptor 2, follistatin, prolactin, soluble interleukin 6 receptor alfa, platelet endothelial cell adhesion molecule 1, soluble vascular endothelial cell growth factor receptor 1, leptin, soluble angiopoietin/tyrosine kinase 2, and granulocyte colony-stimulating factor. We have identified a few cytokines that correlate with fat-free mass, a hallmark of frailty. They comprise the kinins implicated in bone and muscle metabolism, fibrosis, vascular wall function, inflammation, endocrine function, or regulation of bone marrow integrity.
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Affiliation(s)
- Ilona Korzonek-Szlacheta
- Department of Cardiovascular Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland; (I.K.-S.); (B.H.)
| | - Bartosz Hudzik
- Department of Cardiovascular Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland; (I.K.-S.); (B.H.)
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, M. Skłodowskiej-Curie 9, 41-800 Zabrze, Poland
| | - Barbara Zubelewicz-Szkodzińska
- Department of Nutrition-Related Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland;
| | - Zenon P. Czuba
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 19, 41-808 Zabrze, Poland;
| | - Patryk Szlacheta
- Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland
| | - Andrzej Tomasik
- II Department of Cardiology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
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Terbah R, Testro A, Gow P, Majumdar A, Sinclair M. Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis-Pathogenesis, Implications and Therapeutic Opportunities. Nutrients 2023; 16:35. [PMID: 38201864 PMCID: PMC10780673 DOI: 10.3390/nu16010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Malnutrition and sarcopenia are highly prevalent in patients with decompensated cirrhosis and are associated with poorer clinical outcomes. Their pathophysiology is complex and multifactorial, with protein-calorie malnutrition, systemic inflammation, reduced glycogen stores and hormonal imbalances all well reported. The direct contribution of portal hypertension to these driving factors is however not widely documented in the literature. This review details the specific mechanisms by which portal hypertension directly contributes to the development of malnutrition and sarcopenia in cirrhosis. We summarise the existing literature describing treatment strategies that specifically aim to reduce portal pressures and their impact on nutritional and muscle outcomes, which is particularly relevant to those with end-stage disease awaiting liver transplantation.
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Affiliation(s)
- Ryma Terbah
- Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia; (R.T.); (A.T.); (P.G.); (A.M.)
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Adam Testro
- Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia; (R.T.); (A.T.); (P.G.); (A.M.)
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Paul Gow
- Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia; (R.T.); (A.T.); (P.G.); (A.M.)
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Avik Majumdar
- Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia; (R.T.); (A.T.); (P.G.); (A.M.)
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Marie Sinclair
- Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia; (R.T.); (A.T.); (P.G.); (A.M.)
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
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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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Piétri-Rouxel F, Falcone S, Traoré M. [GDF5: a therapeutic candidate for combating sarcopenia]. Med Sci (Paris) 2023; 39 Hors série n° 1:47-53. [PMID: 37975770 DOI: 10.1051/medsci/2023143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Sarcopenia is a complex age-related muscular disease affecting 10 to 16 % of people over 65 years old. It is characterized by excessive loss of muscle mass and strength. Despite a plethora of studies aimed at understanding the physiological mechanisms underlying this pathology, the pathophysiology of sarcopenia remains poorly understood. To date, there is no pharmacological treatment for this disease. In this context, our team develop therapeutic approaches based on the GDF5 protein to counteract the loss of muscle mass and function in various pathological conditions, including sarcopenia. After deciphering one of the molecular mechanisms governing GDF5 expression, we have demonstrated the therapeutic potential of this protein in the preservation of muscle mass and strength in aged mice.
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Affiliation(s)
- France Piétri-Rouxel
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, F-75013 Paris, France
| | - Sestina Falcone
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, F-75013 Paris, France
| | - Massiré Traoré
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, F-75013 Paris, France
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Teraž K, Marusic U, Kalc M, Šimunič B, Pori P, Grassi B, Lazzer S, Narici MV, Blenkuš MG, di Prampero PE, Reggiani C, Passaro A, Biolo G, Gasparini M, Pišot R. Sarcopenia parameters in active older adults - an eight-year longitudinal study. BMC Public Health 2023; 23:917. [PMID: 37208654 DOI: 10.1186/s12889-023-15734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/22/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUD Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population. METHODS The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants' overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements. RESULTS In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and - 48.5%; p < .001, respectively). CONCLUSIONS Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature. TRIAL REGISTRATION The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.
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Affiliation(s)
- Kaja Teraž
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Miloš Kalc
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Primož Pori
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
| | | | | | - Pietro Enrico di Prampero
- Emeritus Professor of Physiology, University of Udine, Udine, Italy
- Department of Sport Science, Exelio SRL, Udine, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Gianni Biolo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Mladen Gasparini
- Department of General Surgery, Izola General Hospital, Izola, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
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Nutrition and physical activity knowledge, attitudes, and practices of inpatient cirrhosis care providers. Eur J Gastroenterol Hepatol 2023; 35:453-460. [PMID: 36719821 DOI: 10.1097/meg.0000000000002512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hospitalization is a high-risk period for cirrhosis-associated sarcopenia and frailty. This study aimed to measure the knowledge, attitudes, and practice patterns (KAP) of multidisciplinary cirrhosis providers about inhospital nutrition and physical activity care. METHODS We conducted an online survey of cirrhosis care providers at a combination of 38 hospitals and healthcare centres in Alberta, Canada. Analysis included descriptive statistics and content analysis. RESULTS Three hundred thirty-eight responses were analyzed. Across all providers, nutrition and physical activity knowledge and attitude (KA) scores were higher than practice (P) scores. Physicians had lower nutrition KA ( P = 0.010) and nutrition P ( P < 0.001) scores than nonphysicians. Previous cirrhosis-related nutrition or physical activity education was associated with higher nutrition KA ( P < 0.001), nutrition P ( P = 0.036), and physical activity P scores ( P < 0.001). Over half of the participants reported not providing patients with educational resources for nutrition or physical activity and not carrying out nutrition screening. Participant suggestions to optimize care included enhancing patient and provider education, standardizing screening and intervention processes, increasing patient-centered support, and promoting collaboration within the healthcare team. Eighty percentage of participants were willing to provide patients with resources if these were readily available. CONCLUSION While provider knowledge and attitudes about the importance of nutrition and physical activity in hospitalized patients with cirrhosis are reasonable, there is considerable room to optimize the delivery of best practices in this patient population. Optimization will require readily available educational and personnel resources and interdisciplinary collaboration to promote system change.
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Xi L, Xuemei Z, Ling Y, Changchun C, Zhuo H, Jinyang Q, Xin W. Correlation between frailty and cardiac structure and function in echocardiography in elderly patients with normal ejection fraction. Aging Clin Exp Res 2023; 35:775-784. [PMID: 36871112 DOI: 10.1007/s40520-023-02363-5] [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: 12/06/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE This study aims to accurately evaluate the cardiac structure and function of the frail population in elderly patients with normal ejection fraction (EF) using the 3D volume quantification and speckle tracking of echocardiography, to explore the correlation between frailty and cardiac structure and function. METHODS A total of 350 elderly aged 65 and above in-patients, excluding those with congenital heart disease, cardiomyopathy, and severe valvular heart disease, were included in the study. Patients were divided into non-frail, pre-frail, and frail group. Echocardiography techniques including speckle tracking and 3D volume quantification, were used to analyze the cardiac structure and function of the study subjects. Comparative analysis was statistically significant if P < 0.05. RESULTS The cardiac structure of the frail group was different compared with non-frail patients, the frail group demonstrated increased left ventricular myocardial mass index (LVMI), but decreased stroke volume. Cardiac function was also impaired in the frail group: reservoir strain and conduit strain of left atrium, strain of right ventricular (RV) free wall, strain of RV septum, 3D EF of RV, and global longitudinal strain of LV were significantly decreased. Frailty was significantly and independently associated with LV hypertrophy (OR 1.889; 95% CI 1.240,2.880; P = 0.003), LV diastolic dysfunction (OR 1.496; 95% CI 1.016,2.203; P = 0.041), left ventricular global longitudinal strain (LVGLS) reduction (OR 1.697; 95% CI 1.192, 2.416; P = 0.003), and reduced RV systolic function (OR 2.200; 95% CI 1.017, 4.759; P = 0.045). CONCLUSION Frailty is closely associated with several heart structural and functional alterations, which not only manifested as LV hypertrophy and reduced LV systolic function, but also decreased LV diastolic function, RV systolic function, and left atrial systolic function. Frailty is an independent risk factor for LV hypertrophy, LV diastolic dysfunction, LVGLS reduction, and reduced RV systolic function. TRIAL REGISTRATION NUMBER ChiCTR2000033419. Date of registration: May 31, 2020.
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Affiliation(s)
- Li Xi
- Department of Cardiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, China
| | - Zhong Xuemei
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Ling
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chen Changchun
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hou Zhuo
- Department of Cardiology, West China Tianfu Hospital of Sichuan University, Chengdu, China
| | - Qin Jinyang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Xin
- Department of Cardiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, China.
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Ghanemi A, Yoshioka M, St-Amand J. Secreted Protein Acidic and Rich in Cysteine ( SPARC)-Mediated Exercise Effects: Illustrative Molecular Pathways against Various Diseases. Diseases 2023; 11:diseases11010033. [PMID: 36810547 PMCID: PMC9944512 DOI: 10.3390/diseases11010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
The strong benefits of exercise, in addition to the development of both the therapeutic applications of physical activity and molecular biology tools, means that it has become very important to explore the underlying molecular patterns linking exercise and its induced phenotypic changes. Within this context, secreted protein acidic and rich in cysteine (SPARC) has been characterized as an exercise-induced protein that would mediate and induce some important effects of exercise. Herein, we suggest some underlying pathways to explain such SPARC-induced exercise-like effects. Such mechanistic mapping would not only allow us to understand the molecular processes of exercise and SPARC effects but would also highlight the potential to develop novel molecular therapies. These therapies would be based on mimicking the exercise benefits via either introducing SPARC or pharmacologically targeting the SPARC-related pathways to produce exercise-like effects. This is of a particular importance for those who do not have the ability to perform the required physical activity due to disabilities or diseases. The main objective of this work is to highlight selected potential therapeutic applications deriving from SPARC properties that have been reported in various publications.
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Affiliation(s)
- Abdelaziz Ghanemi
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada
| | - Mayumi Yoshioka
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada
| | - Jonny St-Amand
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada
- Correspondence: ; Tel.: +1-(418)-654-2296; Fax: +1-(418)-654-2761
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Farsijani S, Cauley JA, Peddada SD, Langsetmo L, Shikany JM, Orwoll ES, Ensrud KE, Cawthon PM, Newman AB. Relation Between Dietary Protein Intake and Gut Microbiome Composition in Community-Dwelling Older Men: Findings from the Osteoporotic Fractures in Men Study (MrOS). J Nutr 2023; 152:2877-2887. [PMID: 36205552 PMCID: PMC9839986 DOI: 10.1093/jn/nxac231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Little is known about the association of specific nutrients, especially proteins, on age-related gut dysbiosis. OBJECTIVES To determine the associations between the quantity and sources (vegetable and animal) of dietary protein intake and gut microbiome composition in community-dwelling older men. METHODS We performed a cross-sectional analysis on 775 older men from the Osteoporotic Fractures in Men Study (MrOS) (age 84.2 ± 4.0 y) with available dietary information and stool samples at visit 4 (2014-2016). Protein intake was estimated from a brief FFQ and adjusted to total energy intake. The gut microbiome composition was determined by 16S (v4) sequencing (processed by DADA2 and SILVA). A total of 11,534 amplicon sequence variants (ASVs) were identified and assigned to 21 phyla with dominance of Firmicutes (45%) and Bacteroidetes (43%). We performed α-diversity, β-diversity, and taxa abundance (by Analysis of Compositions of Microbiomes with Bias Correction [ANCOM-BC]) to determine the associations between protein intake and the gut microbiome. RESULTS Median protein intake was 0.7 g/(kg body weight · d). Participants with higher energy-adjusted protein intakes had higher Shannon and Chao1 α-diversity indices (P < 0.05). For β-diversity analysis, participants with higher protein intakes had a different center in weighted and unweighted UniFrac Principal Co-ordinates Analysis (PCoA) compared with those with lower intake (P < 0.05), adjusted for age, race, education, clinical center, batch number, fiber and energy intake, weight, height, and medications. Similarly, higher protein consumptions from either animal or vegetable sources were associated with higher gut microbiome diversity. Several genus-level ASVs, including Christensenellaceae, Veillonella, Haemophilus, and Klebsiella were more abundant in participants with higher protein intakes, whereas Clostridiales bacterium DTU089 and Desulfovibrio were more abundant in participants with lower protein intake (Bonferroni corrected P < 0.05). CONCLUSIONS We observed significant associations between protein intake and gut microbiome diversity in community-living older men. Further studies are needed to elucidate the mediation role of the gut microbiome on the relation between protein intake and health outcomes in older adults.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shyamal D Peddada
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Lisa Langsetmo
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, MN, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric S Orwoll
- Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kristine E Ensrud
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, University of California San Francisco, San Francisco, CA, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
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11
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Haß U, Heider S, Kochlik B, Herpich C, Pivovarova-Ramich O, Norman K. Effects of Exercise and Omega-3-Supplemented, High-Protein Diet on Inflammatory Markers in Serum, on Gene Expression Levels in PBMC, and after Ex Vivo Whole-Blood LPS Stimulation in Old Adults. Int J Mol Sci 2023; 24:ijms24020928. [PMID: 36674453 PMCID: PMC9863449 DOI: 10.3390/ijms24020928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Inflammaging is related to cell senescence and reflects an erratic immune system, which promotes age-associated diseases. Exercise and nutrition, particularly omega-3 fatty acids, are able to affect inflammation. Therefore, we examined the effects of an 8-week exercise and dietary intervention on the inflammatory response in community-dwelling old adults. All participants received weekly vibration and home-based resistance exercise. Furthermore, participants were randomized to either a control, high-protein (1.2-1.5 g/kg), or high-protein, omega-3-enriched (2.2 g/day) diet. Before and after treatment, inflammatory markers in fasting serum and after whole-blood ex vivo lipopolysaccharide (LPS) stimulation were assessed. Gene expression levels of inflammatory markers were quantified in peripheral blood mononuclear cells (PBMC). Sixty-one participants (age: 70.6 ± 4.7 years; 47% men) completed the study. According to generalized linear mixed models, a high-protein, omega-3-enriched diet decreased circulating anti-inflammatory interleukin (IL-) 10 and IL-1 receptor antagonist (IL-1RA). Sex-stratified analyses showed also significantly reduced pro-inflammatory markers in men with a high-protein, omega-3-enriched diet. Gene expression of IL-1RA was significantly reduced after both protein-enriched diets compared with controls. In comparison to a high-protein diet, exercise alone showed lower LPS-induced release of c-c motif chemokine ligand-2 (CCL-2), which tended to be more pronounced in men compared with women. Eight weeks of a high-protein, omega-3-enriched diet combined with exercise decreased circulating anti-inflammatory markers, and pro-inflammatory markers in men. A high-protein diet attenuated anti-inflammatory markers on gene expression level in PBMC. Exercise alone resulted in a lower pro-inflammatory response to LPS-exposure in whole-blood cultures.
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Affiliation(s)
- Ulrike Haß
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
| | - Sarah Heider
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
- Research Group Molecular Nutritional Medicine, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Bastian Kochlik
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Catrin Herpich
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Olga Pivovarova-Ramich
- Research Group Molecular Nutritional Medicine, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
- Department of Endocrinology, Diabetes and Nutrition, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
| | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
- Correspondence:
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12
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Delinocente MLB, Luiz MM, de Oliveira DC, de Souza AF, Ramírez PC, de Oliveira Máximo R, Soares NC, Steptoe A, de Oliveira C, da Silva Alexandre T. Are Serum 25-Hydroxyvitamin D Deficiency and Insufficiency Risk Factors for the Incidence of Dynapenia? Calcif Tissue Int 2022; 111:571-579. [PMID: 36109388 PMCID: PMC9613743 DOI: 10.1007/s00223-022-01021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022]
Abstract
Epidemiological evidence showing the association between low 25(OH)D and age-related reduction in neuromuscular strength (dynapenia) is a paucity and controversial and, to date, the effect of osteoporosis and vitamin D supplementation on these associations has not been measured. Thus, we analyze whether serum 25(OH)D deficiency and insufficiency are risk factors for the incidence of dynapenia in individuals aged 50 or older and whether osteoporosis or vitamin D supplementation modify these associations. For that, 3205 participants of the ELSA study who were non-dynapenic at baseline were followed for 4 years. Vitamin D was measured at baseline by the serum concentration of 25(OH)D and classified as sufficient (> 50 nmol/L), insufficient (≥ 30 and ≤ 50 nmol/L) or deficient (< 30 nmol/L). The incidence of dynapenia was determined by a grip strength < 26 kg for men and < 16 kg for women at the end of the 4-year follow-up. Poisson regression models were adjusted by sociodemographic, behavioral, clinical and biochemical characteristics. Serum 25(OH)D deficient was a risk factor for the incidence of dynapenia (IRR = 1.70; 95% CI 1.04-2.79). When only individuals without osteoporosis and those who did not use vitamin D supplementation were analyzed, both serum 25(OH)D deficiency (IRR = 1.78; 95% CI 1.01-3.13) and insufficiency (IRR = 1.77; 95% CI 1.06-2.94) were risk factors for the incidence of dynapenia. In conclusion, a serum level of 25(OH)D < 30 nmol/L is a risk factor for the incidence of dynapenia. Among individuals without osteoporosis and those who do not take vitamin D supplementation, the threshold of risk is higher (≤ 50 nmol/L).
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Affiliation(s)
| | - Mariane Marques Luiz
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Aline Fernanda de Souza
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Paula Camila Ramírez
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | - Natália Cochar Soares
- Post Graduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Post Graduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil.
- Post Graduate Program in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil.
- Department of Epidemiology and Public Health, University College London, London, UK.
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, SP-310, Brazil.
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13
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Prognostic Effect of Thoracic Sarcopaenia on Short- and Long-Term Clinical Outcomes in Patients Underwent Cardiac Valve Surgery. Heart Lung Circ 2022; 31:1408-1418. [PMID: 35961821 DOI: 10.1016/j.hlc.2022.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/05/2022] [Accepted: 05/15/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND As the proportion of elderly patients increases, higher incidence of malnutrition is found among patients with valvular heart disease. Sarcopaenia is one of the main manifestations of malnutrition. Studies have shown the certain predictive effect of sarcopaenia on the clinical outcome in different cases. This study aims to clarify the impact of computed tomography (CT)-derived thoracic sarcopaenia on clinical outcomes of patients underwent cardiac valve surgery. METHODS The clinical data of 216 patients who underwent cardiac valve surgery from December 2015 to June 2020 were retrospectively collected. Skeletal muscle mass at 12th thoracic vertebra level was measured to diagnose thoracic sarcopaenia. Postoperative complications and follow-up data were collected. Medium follow-up was 3.2 years. RESULTS The prevalence of thoracic sarcopaenia was 16.7% in this study. The incidence of total complications and in-hospital mortality were higher in thoracic sarcopaenia group (p=0.024 and p=0.014, respectively). Multivariate analysis revealed that thoracic sarcopaenia is a significant predictor for postoperative complications (OR 2.319; 95% CI 1.003-5.366; p=0.049). Decreased long-term survival was observed in patients with thoracic sarcopaenia. Thoracic sarcopaenia (HR 4.178; 95% CI 2.062-8.465; p<0.001) was determined to be an independent risk factor for late mortality. CONCLUSION Thoracic sarcopaenia defined by chest CT was independently associated with higher incidence of postoperative complications and long-term mortality. Routine preoperative evaluation of thoracic sarcopaenia deserves further consideration to enhance the predictive performance for operation risk.
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14
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Ram E, Peled Y, Miller TB, Dray EM, Karni E, Raanani E, Sternik L. Frailty and clinical outcomes following aortic valve replacement. J Card Surg 2022; 37:3036-3043. [PMID: 35920838 PMCID: PMC9544524 DOI: 10.1111/jocs.16801] [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: 03/02/2022] [Revised: 04/11/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
Background and Aims The Norton score is a well‐known scale to assess frailty. Frailty and a low Norton score are associated with complications and mortality in hospitalized patients. We aimed to evaluate whether a low Norton score is associated with surgical complications and death after aortic valve replacement (AVR). Methods From 2004 through 2020, we performed an observational study in a large tertiary medical center, which included all patients who had undergone isolated AVR surgery. Of the 1469 study patients, 618 patients (42%) had a low (<18) and 851 patients (58%) a high Norton score (≥18). Results Frailer patients with a low Norton score had higher in‐hospital mortality compared to those with a high Norton score (5.5% vs. 0.8%, p < .001). The Norton score was significantly higher among patients who survived compared to those who died (17.5 ± 2.4 vs. 11.5 ± 5.2, p < .001). A low Norton score was associated with a threefold increased risk of in‐hospital mortality (odds ratio 3.03; 95% confidence interval [CI] 1.14–0.09, p = .034). Ten‐year mortality rate was higher among frailer patients with a low compared with a high Norton score (25.9%, 13.3%; hazard ratio 0.69, CI 0.48‐0.82, p < .001). By adding a Norton score to standard prognostic factors (age, gender, comorbidities, left ventricular ejection fraction, functional class) we showed a significant improvement of 59.4% (p < .001) for predicting 1‐year mortality, and 40.6% (p < .001) for predicting 10‐year mortality. Conclusions Our findings show that the admission Norton score is a powerful marker of short‐ and long‐term mortality, and, therefore, should be considered as a risk stratification tool in patients who are candidates for AVR.
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Affiliation(s)
- Eilon Ram
- Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Sheba Talpiot Medical Leadership Program, Ramat Gan, Israel
| | - Yael Peled
- Department of Cardiology, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali B Miller
- Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat M Dray
- Department of Cardiology, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Karni
- Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Raanani
- Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leonid Sternik
- Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Reid-McCann RJ, Brennan SF, McKinley MC, McEvoy CT. The effect of animal versus plant protein on muscle mass, muscle strength, physical performance and sarcopenia in adults: protocol for a systematic review. Syst Rev 2022; 11:64. [PMID: 35418173 PMCID: PMC9006591 DOI: 10.1186/s13643-022-01951-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/05/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The evidence base for the role of dietary protein in maintaining good muscle health in older age is strong; however, the importance of protein source remains unclear. Plant proteins are generally of lower quality, with a less favourable amino acid profile and reduced bioavailability; therefore, it is possible that their therapeutic effects may be less than that of higher quality animal proteins. This review aims to evaluate the effectiveness of plant and animal protein interventions on muscle health outcomes. METHODS A robust search strategy was developed to include terms relating to dietary protein with a focus on protein source, for example dairy, meat and soy. These were linked to terms related to muscle health outcomes, for example mass, strength, performance and sarcopenia. Five databases will be searched: MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Embase and Web of Science. Studies included will be randomised controlled trials with an adult population (≥ 18) living in the community or residential homes for older adults, and only English language articles will be included. Two independent reviewers will assess eligibility of individual studies. The internal validity of included studies will be assessed using Cochrane Risk of Bias 2.0 tool. Results will be synthesised in narrative format. Where applicable, standardised mean differences (SMD) (95% confidence interval [CI]) will be combined using a random-effects meta-analysis, and tests of homogeneity of variance will be calculated. DISCUSSION Dietary guidelines recommend a change towards a plant-based diet that is more sustainable for health and for the environment; however, reduction of animal-based foods may impact protein quality in the diet. High-quality protein is important for maintenance of muscle health in older age; therefore, there is a need to understand whether replacement of animal protein with plant protein will make a significant difference in terms of muscle health outcomes. Findings from this review will be informative for sustainable nutritional guidelines, particularly for older adults and for those following vegan or vegetarian diets. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD420201886582.
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Affiliation(s)
- Rachel J Reid-McCann
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science A, 1st Floor, Grosvenor Road, Belfast, BT12 6BJ, UK.
| | - Sarah F Brennan
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science A, 1st Floor, Grosvenor Road, Belfast, BT12 6BJ, UK
| | - Michelle C McKinley
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science A, 1st Floor, Grosvenor Road, Belfast, BT12 6BJ, UK
| | - Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science A, 1st Floor, Grosvenor Road, Belfast, BT12 6BJ, UK
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16
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Padilha de Lima A, Macedo Rogero M, Araujo Viel T, Garay-Malpartida HM, Aprahamian I, Lima Ribeiro SM. Interplay between Inflammaging, Frailty and Nutrition in Covid-19: Preventive and Adjuvant Treatment Perspectives. J Nutr Health Aging 2022; 26:67-76. [PMID: 35067706 PMCID: PMC8713542 DOI: 10.1007/s12603-021-1720-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/06/2021] [Indexed: 02/06/2023]
Abstract
As humans age, their immune system undergoes modifications, including a low-grade inflammatory status called inflammaging. These changes are associated with a loss of physical and immune resilience, amplifying the risk of being malnourished and frail. Under the COVID-19 scenario, inflammaging increases the susceptibility to poor prognostics. We aimed to bring the current concepts of inflammaging and its relationship with frailty and COVID-19 prognostic; highlight the importance of evaluating the nutritional risk together with frailty aiming to monitor older adults in COVID-19 scenario; explore some compounds with potential to modulate inflammaging in perspective to manage the COVID-19 infection. Substances such as probiotics and senolytics can help reduce the high inflammatory status. Also, the periodic evaluation of nutrition risk and frailty will allow interventions, assuring the appropriate care.
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Affiliation(s)
- A Padilha de Lima
- Sandra Maria Lima Ribeiro, University of São Paulo- Public Health School, Av Dr. Arnaldo 715, Sao Paulo- SP- Brazil, e-mail:
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17
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Haß U, Herpich C, Kochlik B, Weber D, Grune T, Norman K. Dietary Inflammatory Index and Cross-Sectional Associations with Inflammation, Muscle Mass and Function in Healthy Old Adults. J Nutr Health Aging 2022; 26:346-351. [PMID: 35450990 DOI: 10.1007/s12603-022-1753-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Inflammaging is considered a driver of age-related loss of muscle mass and function (sarcopenia). As nutrition might play a role in this process, the Dietary Inflammatory Index® (DII) has been developed to quantify the inflammatory potential of an individual diet. OBJECTIVES We aimed to examine associations between the DII, inflammation, oxidative stress and sarcopenia-related parameters in healthy old compared to young adults. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included data of 79 community-dwelling, healthy old adults (65-85 years) and 59 young adults (18-35 years) who participated in a randomized controlled trial from April to December 2019. MEASUREMENTS The DII was computed with dietary data collected from 24-h recall interviews. Associations between the DII, inflammatory and oxidative stress markers as well as bioimpedance-derived body composition, handgrip strength and gait speed were determined with multiple linear regression analyses adjusted for age, sex, physical activity and insulin resistance. RESULTS Regression analyses revealed significant relationships between a higher interleukin (IL) 6 and IL-6:IL-10-ratio and higher percentage fat mass (%FM), waist-to-height-ratio (WHtR) as well as lower percentage skeletal muscle mass (%SMM) and gait speed exclusively in old adults. Subsequent analyses showed that IL-6 was associated with a pro-inflammatory diet as indicated by a higher DII, again exclusively in old adults (beta coefficient (β)= 0.027, standard error (SE) 0.013, p=0.037). While the DII was not related with handgrip strength or oxidative stress in neither old nor young adults, linear models confirmed that a higher DII was inversely associated with gait speed in old participants (β= -0.022, SE 0.006, p<0.001). Finally, a pro-inflammatory diet was significantly associated with higher %FM, WHtR and lower %SMM in both age groups. CONCLUSION AND RELEVANCE A pro-inflammatory diet reflected by the DII is associated with higher systemic inflammation, slower gait speed as well as lower muscle mass in old adults. Intervention studies are needed to examine whether anti-inflammatory dietary approaches can help to improve muscle mass and function and thus minimize the risk for sarcopenia in the long-term.
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Affiliation(s)
- U Haß
- Prof. Dr. Kristina Norman, University of Potsdam, Institute of Nutritional Science, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany,
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18
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Noor H, Reid J, Slee A. Resistance exercise and nutritional interventions for augmenting sarcopenia outcomes in chronic kidney disease: a narrative review. J Cachexia Sarcopenia Muscle 2021; 12:1621-1640. [PMID: 34585539 PMCID: PMC8718072 DOI: 10.1002/jcsm.12791] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 08/02/2021] [Accepted: 08/23/2021] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is an age-related progressive muscle disease characterized by loss of muscle mass, muscle strength and physical performance with high prevalence in chronic kidney disease (CKD). CKD is associated with decreased muscle protein synthesis and muscle breakdown due to a number of factors including, the uremic inflammatory environment of the disease. CKD patients are highly sedentary and at risk of malnutrition which may exacerbate sarcopenia outcomes even further. Short and long-term exercise and nutritional interventions have been studied and found to have some positive effects on sarcopenia measures in CKD. This narrative review summarized evidence between 2010 and 2020 of resistance exercise (RE) alone or combined with nutritional interventions for improving sarcopenia outcomes in CKD. Due to lack of CKD-specific sarcopenia measures, the second European Working Group on Sarcopenia in Older People (EWGSOP2) definition has been used to guide the selection of the studies. The literature search identified 14 resistance exercise-based studies and 5 nutrition plus RE interventional studies. Muscle strength outcomes were increased with longer intervention duration, intervention supervision, and high participant adherence. Data also suggested that CKD patients may require increased RE intensity and progressive loading to obtain detectable results in muscle mass. Unlike muscle strength and muscle mass, physical performance was readily improved by all types of exercise in long or short-term interventions. Four studies used RE with high-protein nutritional supplementation. These showed significant benefits on muscle strength and physical performance in dialysis patients while non-significant results were found in muscle mass. More research is needed to confirm if a combination of RE and vitamin D supplementation could act synergistically to improve muscle strength in CKD. The current evidence on progressive RE for sarcopenia in CKD is encouraging; however, real-life applications in clinical settings are still very limited. A multidisciplinary patient-centred approach with regular follow-up may be most beneficial due to the complexity of sarcopenia in CKD. Long-term randomized control trials are needed to verify optimal RE prescription and explore safety and efficacy of other nutritional interventions in CKD.
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Affiliation(s)
- Hanaa Noor
- Division of Medicine, University College London, London, UK.,Diaverum Holding AB Branch, Riyadh, Saudi Arabia
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Adrian Slee
- Division of Medicine, University College London, London, UK
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19
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MicroRNAs associated with signaling pathways and exercise adaptation in sarcopenia. Life Sci 2021; 285:119926. [PMID: 34480932 DOI: 10.1016/j.lfs.2021.119926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 01/06/2023]
Abstract
Considering the expansion of human life-span over the past few decades; sarcopenia, a physiological consequence of aging process characterized with a diminution in mass and strength of skeletal muscle, has become more frequent. Thus, there is a growing need for expanding our knowledge on the molecular mechanisms of muscle atrophy in sarcopenia which are complex and involve many signaling pathways associated with protein degradation and synthesis. MicroRNAs (miRNAs) as evolutionary conserved small RNAs, could complementarily bind to their target mRNAs and post-transcriptionally inhibit their translation. Aberrant expression of miRNAs contributes to the development of sarcopenia by regulating the expression of critical genes involved in age-related skeletal muscle mass loss. Here we have a review on the signaling pathways along with the miRNAs controlling their components expression and subsequently we provide a brief overview on the effects of exercise on expression pattern of miRNAs in sarcopenia.
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20
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Hasegawa Y, Tsuji S, Nagai K, Sakuramoto-Sadakane A, Tamaoka J, Oshitani M, Ono T, Sawada T, Shinmura K, Kishimoto H. The relationship between bone density and the oral function in older adults: a cross-sectional observational study. BMC Geriatr 2021; 21:591. [PMID: 34686146 PMCID: PMC8539774 DOI: 10.1186/s12877-021-02547-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Falls among older adults with a low bone density can lead to a bedridden state. Declining bone density increases the risk of falls resulting fractures in older adults. A person's physical performance is known to be closely related to bone density, and a relationship between the physical performance and the oral function is also known to exist. However, there currently is a lack of evidence regarding the relationship between bone density and the oral function. We assessed the relationship between the bone density and the both the oral function and physical performance among older adults. PATIENTS AND METHODS 754 older adults aged 65 years or older who independently lived in rural regions and who were not taking any medications for osteoporosis participated. We checked all participants for osteoporosis using an ultrasonic bone density measuring device. Regarding the oral function, we evaluated the following factors: remaining teeth, occlusal support, masticatory performance, occlusal force, and tongue pressure. We also evaluated body mass index (BMI) and skeletal muscle mass Index as clinical characteristics. The normal walking speed, knee extension force and one-leg standing test were evaluated as physical performance. For the statistical analyses, we used the Mann-Whitney U test, chi-square test, the Kruskal-Wallis, and a multiple regression analysis. RESULTS Eighty-one percent of the females and 58% of the males had osteoporosis or a decreased bone mass. The occlusal force, masticatory performance and the tongue pressure showed significant association with the bone density. The participants physical performance showed a significant association with their bone states except for walking speed. According to a multiple regression analysis, clinical characteristics (sex, age, BMI), one-leg standing and occlusal force showed independent associations with the bone density. It was suggested that the bone density tends to increase if the occlusal force is high and/or the one-leg standing test results are good. CONCLUSIONS The bone density in the older adults showed a significant relationship not only with clinical characteristics or physical performance, but also with occlusal force. It may also be effective to confirm a good oral function in order to maintain healthy living for older adults.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata, 951-8514 Japan
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo Japan
| | - Ayumi Sakuramoto-Sadakane
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Joji Tamaoka
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Masayuki Oshitani
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata, 951-8514 Japan
| | - Takashi Sawada
- Hyogo Dental Association, 5-7-18 Yamamoto-dori, Chuo-ku, Kobe, Hyogo Japan
| | - Ken Shinmura
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Japan
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21
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Kim SH, Choi G, Song Y, Yoon H, Jeong HM, Gu JE, Han M, Heo J, Yoo JJ, Yoon JW, Kim H. Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure. J Clin Med 2021; 10:3698. [PMID: 34441991 PMCID: PMC8396811 DOI: 10.3390/jcm10163698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/22/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Sarcopenia involves an age-related decline in skeletal muscle mass with functional disability or low muscle strength. Vascular calcification (VC) occurs commonly in patients with chronic kidney disease, in whom it is associated with cardiovascular disease. We aimed to investigate the correlations of low muscle mass with the quantified vascular calcification score (VCS) of the arm of vascular access, as well as whether low muscle mass is associated with the incidence of vascular access failure. Methods: The VCS was measured on non-contrast, arm computed tomography using the Agatston method. The lower muscle mass (LMM) group comprised subjects whose skeletal muscle mass of the lower extremities, as measured using bioelectrical impedance, was lower than the median. Higher VC was defined as a score of 500 or above, corresponding to the highest 40% of VCS. The relationship between LMM and VC was explored using univariate and multivariate logistic regression analyses. Results: Seventy-five patients were included, of whom forty-two (56.0%) were men. The median age was 64 years (interquartile range 58-72 years). Of the 75 patients, 73 satisfied the diagnostic criteria for sarcopenia. The median hemodialysis vintage was 49.4 months (range 32.1-99.2 months). No significant differences were found between the non-LMM and LMM groups in sex, end-stage renal disease etiology, and type of vascular access, although the LMM group showed significantly older age and hemodialysis vintage. LMM presented a significant association with VC (hazard ratio (HR) 3.562; 95% CI, 1.341-9.463; p = 0.011). Upon adjustment for hemodialysis vintage, diabetes, and systolic blood pressure, LMM demonstrated an independent association with VC (HR, 10.415; 95% CI, 2.357-46.024; p = 0.002). The risk of vascular access failure was higher in the LMM group (HR, 3.652; 95%, CI 1.135-11.749; p = 0.03). VC was a full mediator in the relationship of LMM with recurrent vascular access failure. Conclusions: We quantified LMM via bioimpedance analysis and found a heretofore-unreported association between LMM and vascular access failure. LMM increases the risk of VC and has the potential to predict vascular access failure.
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Affiliation(s)
- Seok-hyung Kim
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Gwangho Choi
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Youngjin Song
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hojung Yoon
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hae Min Jeong
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Jae Eon Gu
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Miyeun Han
- Department of Internal Medicine, Hangang Sacred Heart Hospital, Seoul 07247, Korea;
| | - Jongho Heo
- National Assembly Futures Institute, Seoul 07233, Korea;
| | - Jeong-Ju Yoo
- Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon 14584, Korea;
| | - Jong-woo Yoon
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
| | - Hyunsuk Kim
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea; (S.-h.K.); (G.C.); (Y.S.); (H.Y.); (H.M.J.); (J.E.G.); (J.-w.Y.)
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22
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Malnutrition in Older Adults-Recent Advances and Remaining Challenges. Nutrients 2021; 13:nu13082764. [PMID: 34444924 PMCID: PMC8399049 DOI: 10.3390/nu13082764] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022] Open
Abstract
Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.
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23
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Lin HTV, Wu HX, Sung WC. Hardness and quality of abalone (Haliotis discus hannai diversicolor diversicolor) muscle as suitably softened for seniors. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2021. [DOI: 10.1080/10942912.2021.1909618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hong-Ting Victor Lin
- Department of Food Science, National Taiwan Ocean University, Keelung, Republic of China (R.O.C.)
- Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung, Republic of China (R.O.C.)
| | - Hao-Xuan Wu
- Department of Food Science, National Taiwan Ocean University, Keelung, Republic of China (R.O.C.)
| | - Wen-Chieh Sung
- Department of Food Science, National Taiwan Ocean University, Keelung, Republic of China (R.O.C.)
- Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung, Republic of China (R.O.C.)
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24
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Liao X, Wu M, Hao Y, Deng H. Exploring the Preventive Effect and Mechanism of Senile Sarcopenia Based on "Gut-Muscle Axis". Front Bioeng Biotechnol 2020; 8:590869. [PMID: 33251202 PMCID: PMC7674676 DOI: 10.3389/fbioe.2020.590869] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/09/2020] [Indexed: 12/11/2022] Open
Abstract
Age-related sarcopenia probably leads to chronic systemic inflammation and plays a vital role in the development of the complications of the disease. Gut microbiota, an environmental factor, is the medium of nutritional support to muscle cells, having significant impact on sarcopenia. Consequently, a significant amount of studies explored and showed the presence of gut microbiome–muscle axis (gut–muscle axis for short), which was possibly considered as the disease interventional target of age-related sarcopenia. However, a variety of nutrients probably affect the changes of the gut–muscle axis so as to affect the healthy balance of skeletal muscle. Therefore, it is necessary to study the mechanism of intestinal–muscle axis, and nutrients play a role in the treatment of senile sarcopenia through this mechanism. This review summarizes the available literature on mechanisms and specific pathways of gut–muscle axis and discusses the potential role and therapeutic feasibility of gut microbiota in age-related sarcopenia to understand the development of age-related sarcopenia and figure out the novel perspective of the potential therapeutic interventional targets.
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Affiliation(s)
- Xiaoshan Liao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengting Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuting Hao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hong Deng
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou, China
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25
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Ribeiro SML, Fernandez SSM, Rogero MM. Nutrition and Diabetes in the Context of Inflammaging. CURRENT GERIATRICS REPORTS 2020. [DOI: 10.1007/s13670-020-00338-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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26
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Lee HJ, Lee JY, Lee MJ, Kim HK, Kim N, Kim GU, Lee JS, Park HW, Chang HS, Yang DH, Choe J, Byeon JS. Association of low skeletal muscle mass with the presence of advanced colorectal neoplasm: integrative analysis using three skeletal muscle mass indices. Colorectal Dis 2020; 22:1293-1303. [PMID: 32363686 DOI: 10.1111/codi.15103] [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: 10/07/2019] [Accepted: 04/14/2020] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to evaluate an association between colorectal neoplasm (CRN) and skeletal muscle mass using three widely accepted skeletal muscle mass indices (SMIs) in a large population at average risk. METHOD We performed a cross-sectional study using a screening colonoscopy database of 33 958 asymptomatic subjects aged 40-75 years. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analyser. ASM adjusted for height squared (ASM/ht2 ), weight (ASM/wt) and body mass index (ASM/BMI) were used as indices for muscle mass. Logistic regression models were used to evaluate the association between SMIs and CRN. RESULTS In a multivariable-adjusted model, the risk of an advanced CRN increased linearly with decreasing quartiles for all three SMIs. The adjusted odds ratios (ORs) for advanced CRN in quartiles 1, 2 and 3 of ASM/wt compared with that in quartile 4 were 1.279, 1.196 and 1.179, respectively (Ptrend = 0.017); for ASM/BMI, ORs were 1.307, 1.144 and 1.091, respectively (Ptrend = 0.002); and for ASM/ht2 , ORs were 1.342, 1.169 and 1.062, respectively (Ptrend = 0.002). The risk of distally located advanced CRN was higher in quartile 1 than in quartile 4 for all three SMIs (ASM/wt, OR = 1.356; ASM/BMI, OR = 1.383; ASM/ht2 , OR = 1.430). CONCLUSION Our study demonstrated that low skeletal muscle mass was consistently associated with the presence of advanced CRN in a population at average risk regardless of the operational definition of the SMI, and it was particularly associated with distal advanced CRN.
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Affiliation(s)
- H J Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Y Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M J Lee
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-K Kim
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - N Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G-U Kim
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H W Park
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-S Chang
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D-H Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Choe
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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27
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Sooragonda BG, Agarwal S, Benjamin RN, Prabhakar AT, Sivadasan A, Kapoor N, Cherian KE, Jebasingh FK, Aaron S, Thomas N, Mathew V, Asha HS, Paul TV. Bone Mineral Density and Body Composition in Males with Motor Neuron Disease: A Study from Teaching Hospital in Southern Part of India. Ann Indian Acad Neurol 2020; 24:211-216. [PMID: 34220065 PMCID: PMC8232495 DOI: 10.4103/aian.aian_293_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/26/2020] [Accepted: 05/17/2020] [Indexed: 11/04/2022] Open
Abstract
Background Osteoporosis and sarcopenia are important aspects of motor neuron disease (MND). Individuals with amyotrophic lateral sclerosis (MND-ALS) have an increased risk of falls and fractures. Currently, the standard of care does not involve a routine assessment of bone mineral density (BMD) and body composition in these patients. We aimed to assess BMD, bone mineral parameters and body composition in men with MND and compared them with healthy controls. Methods Consecutive males between 50 and 80 years of age diagnosed as MND-ALS by revised El Escorial criteria and able to walk unassisted attending Neurology outpatient clinic were recruited into the study. Age, gender and body mass index (BMI) matched healthy controls were recruited from the local community. BMD and body composition were assessed by dual-energy x-ray absorptiometry (DXA). Bone mineral parameters and bone turnover markers (BTMs) were also assessed in them. Results A total of 30 subjects with MND-ALS and 33 controls were recruited. The mean age (years) was 59.2 in cases and 61.2 in controls. The mean BMD (g/cm2) between the two groups was similar; however, BTMs were significantly higher in the MND group (P < 0.05). Subjects with MND-ALS had significantly lower mean appendicular lean mass (ALM) (19.9 versus 22.4 kg; P = 0.007) and ALM corrected for BMI than the healthy control group (0.858 versus 0.934 kg/kg/m2; P = 0.034). Sarcopenic obesity (Percentage fat mass >27% + ALM/BMI <0.786 kg/kg/m2) was more prevalent in MND-ALS compared to controls (44.5% versus 16.7%; P = 0.03). Conclusion Although BMD was not significantly different between subjects with MND-ALS and healthy controls, BTMs were significantly higher in the MND group indicating a high bone turnover state. Sarcopenia and sarcopenic obesity were also more in MND-ALS group than controls. Routine assessment for bone health parameters and body composition indices may be included in management of the patients with MND.
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Affiliation(s)
| | - Sandeep Agarwal
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - A T Prabhakar
- Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ajith Sivadasan
- Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nitin Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Kripa E Cherian
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Felix K Jebasingh
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sanjith Aaron
- Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vivek Mathew
- Department of Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Hesarghatta S Asha
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thomas V Paul
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
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Yamamoto K, Tsuchihashi-Makaya M, Kinugasa Y, Iida Y, Kamiya K, Kihara Y, Kono Y, Sato Y, Suzuki N, Takeuchi H, Higo T, Miyazawa Y, Miyajima I, Yamashina A, Yoshita K, Washida K, Kuzuya M, Takahashi T, Nakaya Y, Hasebe N, Tsutsui H. Japanese Heart Failure Society 2018 Scientific Statement on Nutritional Assessment and Management in Heart Failure Patients. Circ J 2020; 84:1408-1444. [PMID: 32655089 DOI: 10.1253/circj.cj-20-0322] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | | | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Yuki Iida
- Department of Rehabilitation Medicine, Kainan Hospital
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical & Health Sciences
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital
| | - Yukihito Sato
- Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki General Medical Center
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Harumi Takeuchi
- Department of Clinical Nutrition, Nagoya University Hospital
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Yasushi Miyazawa
- Department of Clinical Nutrition, Tokyo Medical University Hospital
| | - Isao Miyajima
- Department of Clinical Nutrition, Chikamori Hospital
| | | | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science
| | - Koichi Washida
- Faculty of Nursing, Kobe Women's University.,Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center
| | - Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University.,Department of Rehabilitation, Juntendo University Hospital
| | - Yutaka Nakaya
- Department of Internal Medicine, Touto Kasukabe Hospital
| | - Naoyuki Hasebe
- Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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Louis J, Vercruyssen F, Dupuy O, Bernard T. Nutrition for Master Athletes: Is There a Need for Specific Recommendations? J Aging Phys Act 2020; 28:489-498. [PMID: 31743086 DOI: 10.1123/japa.2019-0190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/14/2019] [Accepted: 08/26/2019] [Indexed: 11/18/2022]
Abstract
Master athletes are often considered exemplars of successful aging, thanks to their capacity to maintain a high sports performance during their entire life. A high training capacity, regular participation in sporting competitions, and delayed alterations in body composition and physiological capacities have been listed among the main factors contributing to impressive master athletes' performances. However, there is a paucity of data on the metabolism and dietary habits of master athletes, and the question of whether they need to adapt their nutrition to the aging process remains open. Herein, the authors presented a contemporary overview of the metabolic challenges associated with aging, including the risk of low energy availability, anabolic resistance, and periods of metabolic crisis due to forced immobilization. After assembling scientific evidence to show that master athletes must adapt their dietary intake, the authors proposed a summary of nutritional recommendations for master athletes and suggested the next stage of research.
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Utilization of Hydroxyl-Methyl Butyrate, Leucine, Glutamine and Arginine Supplementation in Nutritional Management of Sarcopenia-Implications and Clinical Considerations for Type 2 Diabetes Mellitus Risk Modulation. J Pers Med 2020; 10:jpm10010019. [PMID: 32213854 PMCID: PMC7151606 DOI: 10.3390/jpm10010019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/14/2020] [Accepted: 03/19/2020] [Indexed: 01/06/2023] Open
Abstract
While onset characteristics may vary, sarcopenia gradually develops over time as a result of the aging process, leading to muscle loss, disturbance of the muscle to fat ratio, and a variety of negative symptoms undermining the wellbeing, quality of life, and lifespan in the aging population globally. There is evidence that sarcopenia may be a cause and consequence of type 2 diabetes mellitus (T2DM) in the aging population. The importance of nutritional management in the prevention and/or deceleration of sarcopenia is critical, with the main focus placed on the amount and quality of protein intake. Significant efforts are being made towards the development of medical nutrition therapies involving certain amino acids and amino compounds, as well as their combinations, for the improvement in muscle strength, muscle function and protein synthesis. This may reduce hospitalization times and hasten the recovery of patients with sarcopenia. The administration of protocols with varying dose and frequencies, as well as their efficacy, is being investigated. In the work herein, we present and evaluate data derived from human trials regarding the utilization of hydroxyl-methyl butyrate (HMB), L-leucine (Leu), L-glutamine (Gln) and L-arginine (Arg) supplementation for optimal management of sarcopenia in geriatric patients, a topic of significant clinical nutrition interest which may have important implications in T2DM status.
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31
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Effects of Different Softening Processes on the Hardness and Quality of Thawed Neritic Squid (Uroteuthis edulis) Muscle. Processes (Basel) 2020. [DOI: 10.3390/pr8020135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
While attempting to develop a soft, seafood-based product as a potential food item for senior citizens, we evaluated the effects of different softening methods on the hardness and quality of thawed muscular mantle tissue of the neritic squid (Uroteuthis edulis) versus controls. Comparisons were made among injection with proteolytic enzymes (papain, bromelain); soaking in these enzymes or in alkali solutions (NaHCO3, NaOH); various soaking regimes combined with either orbital shaking under vacuum, ultrasonic processing, or ultrasonic cleaning; or hot-air drying and rehydration. Elderly panelists’ sensory impressions of thawed and heat-sterilized squid mantle subjected to these treatments were recorded, together with the total volatile basic nitrogen (TVBN), pH, color, protein breakdown profile (SDS-PAGE), and histological characteristics of thawed squid mantle subjected to the same treatments but not heat-sterilized. TVBN measurements showed that squid mantle remained in a close-to-fresh state under all treatments except for hot-air drying. The pH and hardness decreased and the muscles turned white when soaked in either enzymes or alkali. Orbital shaking under vacuum while soaking in 0.3% papain for 12 h produced the softest product, the next softest being obtained by injection with 0.3% papain. After orbital shaking under vacuum in 1.0% papain, protein degradation was confirmed by SDS-PAGE, and broken muscle fibers were evident in histological sections. Sensory evaluation panelists with unimpeded chewing ability rated mushy, papain-treated squid mantle poorly. Soaking in 2% NaHCO3 in an ultrasonic processor, following by washing out of the alkali, proved to be a better tenderizing method than either enzyme treatment or hot-air drying for neritic squid mantle intended for consumption by senior citizens.
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Wołoszyn-Horák E, Salamon R, Chojnacka K, Brzosko A, Bieda Ł, Standera J, Płoszaj K, Stępień E, Nowalany-Kozielska E, Tomasik A. Frailty syndrome in daily practice of interventional cardiology ward-rationale and design of the FRAPICA trial: A STROBE-compliant prospective observational study. Medicine (Baltimore) 2020; 99:e18935. [PMID: 32000408 PMCID: PMC7004665 DOI: 10.1097/md.0000000000018935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The effect of frailty on short and long term results of interventional treatment of coronary heart disease is not well defined. The evaluation of frailty may be helpful in appointment of most suitable treatment option and timing of patient follow-up. The frailty syndrome in daily practice of interventional cardiology ward (FRAPICA) study objective is to evaluate prognostic capability of the Fried frailty scale and instrumental activities of daily living scale (IADL) in elderly patients with symptomatic coronary heart disease.This is a single center, prospective, observational study. Patients aged ≥65 years are eligible. The objectives are to report Fried frailty scale and IADL scale dispersion before hospital discharge and to assess predictive impact of both scores. The endpoints are: success of interventional treatment, its complications (procedure related myocardial infarction, dye-induced renal function deterioration, loss of blood), 3-year mortality, either all-cause and cardiovascular, re-infarction, re-intervention, stroke, new-onset heart failure, any hospital readmission, and a combination of all above mentioned. Secondary analyses will focus on distinct clinical patient presentations, sub-classifications of frailty for modeling of long-term risk.FRAPICA trial will improve understanding of the associations between frailty syndrome, cardiovascular system diseases, their invasive treatment, and short and long-term outcomes. It will allow for more individualized assessment of risk and will identify new goals for interventions. (ClinicalTrials.gov Identifier NCT03209414).
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Affiliation(s)
- Ewa Wołoszyn-Horák
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Robert Salamon
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Katarzyna Chojnacka
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Aleksandra Brzosko
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Łukasz Bieda
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Jakub Standera
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | | | - Ewa Stępień
- Department of Medical Physics, Faculty of Physics, Institute of Physics, Astronomy and Applied Computer Science of the Jagiellonian University, Cracow, Poland
| | - Ewa Nowalany-Kozielska
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
| | - Andrzej Tomasik
- II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice
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Lewandowicz A, Sławiński P, Kądalska E, Targowski T. Some clarifications of terminology may facilitate sarcopenia assessment. Arch Med Sci 2020; 16:225-232. [PMID: 32051727 PMCID: PMC6963130 DOI: 10.5114/aoms.2020.91293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/13/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
- Andrzej Lewandowicz
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Sławiński
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Ewa Kądalska
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths. Nutrients 2019; 11:nu11122985. [PMID: 31817648 PMCID: PMC6950466 DOI: 10.3390/nu11122985] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation within the liver affecting 1 in 4 people worldwide. As the new silent killer of the twenty-first century, NAFLD impacts on both the request and the availability of new liver donors. The liver is the first line of defense against endogenous and exogenous metabolites and toxins. It also retains the ability to switch between different metabolic pathways according to food type and availability. This ability becomes a disadvantage in obesogenic societies where most people choose a diet based on fats and carbohydrates while ignoring vitamins and fiber. The chronic exposure to fats and carbohydrates induces dramatic changes in the liver zonation and triggers the development of insulin resistance. Common believes on NAFLD and different diets are based either on epidemiological studies, or meta-analysis, which are not controlled evidences; in most of the cases, they are biased on test-subject type and their lifestyles. The highest success in reverting NAFLD can be attributed to diets based on high protein instead of carbohydrates. In this review, we discuss the impact of NAFLD on body metabolic plasticity. We also present a detailed analysis of the most recent studies that evaluate high-protein diets in NAFLD with a special focus on the liver and the skeletal muscle protein metabolisms.
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Bhanji RA, Montano-Loza AJ, Watt KD. Sarcopenia in Cirrhosis: Looking Beyond the Skeletal Muscle Loss to See the Systemic Disease. Hepatology 2019; 70:2193-2203. [PMID: 31034656 DOI: 10.1002/hep.30686] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/16/2019] [Indexed: 12/18/2022]
Abstract
Sarcopenia is a common complication of cirrhosis and is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. Sarcopenia is associated with poor prognosis and increased mortality. How sarcopenia and muscle wasting relate to such poor outcomes requires looking beyond the overt muscle loss and at this entity as a systemic disease that affects muscles of vital organs including cardiac and respiratory muscles. This review explores the pathophysiological pathways and mechanisms that culminate in poor outcomes associated with sarcopenia. This provides a launching pad to identify potential targets for therapeutic intervention and optimization to improve patient outcomes.
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Affiliation(s)
- Rahima A Bhanji
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.,Division of Gastroenterology (Liver Unit), University of Alberta Hospital, Edmonton, AB, Canada
| | - Aldo J Montano-Loza
- Division of Gastroenterology (Liver Unit), University of Alberta Hospital, Edmonton, AB, Canada
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
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Age-associated changes in the mechanical properties of human cadaveric pelvic floor muscles. J Biomech 2019; 98:109436. [PMID: 31708240 DOI: 10.1016/j.jbiomech.2019.109436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 12/12/2022]
Abstract
Proper function of the female pelvic floor requires intact pelvic floor muscles (PFMs). The prevalence of pelvic floor disorders (PFDs) increases substantially with age, in part due to clinically identified deterioration of PFM function with age. However, the etiology of this decline remains largely unknown. We previously demonstrated that PFMs undergo age-related fibrotic changes. This study sought to determine whether aging also impacts PFMs' passive mechanical properties that are largely determined by the intramuscular extracellular matrix. Biopsies from younger (≤52y) and older (>52y) female cadaveric donors were procured from PFMs, specifically coccygeus (C) and two portions of the levator ani - iliococcygeus (IC) and pubovisceralis (PV), and the appendicular muscles - obturator internus (OI) and vastus lateralis (VL). Muscle bundles were subjected to a passive loading protocol, and stress-sarcomere length (Ls) relationships calculated. Muscle stiffness was compared between groups using 2-way ANOVA and Sidak pairwise comparisons, α < 0.05. The mean age was 43.4 ± 11.6y and 74.9 ± 11.9y in younger (N = 5) and older (N = 10) donors, respectively. In all PFMs, the quadratic coefficient of parabolic regression of the stress-Ls curve, a measure of stiffness, was lower in the younger versus older group: C: 33.7 ± 13.9 vs 87.2 ± 10.7, P = 0.02; IC: 38.3 ± 12.7 vs 84.5 ± 13.9, P = 0.04; PV: 24.7 ± 8.8 vs 74.6 ± 9.6, P = 0.04. In contrast, non-PFM stiffness was not affected by aging: OI: 14.5 ± 4.7 vs 32.9 ± 6.2, P = 0.8 and VL: 13.6 ± 5.7 vs 30.1 ± 5.3, P = 0.9. Age-associated increase in PFM stiffness is predicted to negatively impact PFM function by diminishing muscle load-bearing, excursional, contractile, and regenerative capacity, thus predisposing older women to PFDs.
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López Plaza B, Gómez Candela C, Bermejo López LM. [Nutritional problematic related to frailty and sarcopenia in older]. NUTR HOSP 2019; 36:49-52. [PMID: 31368339 DOI: 10.20960/nh.02809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Introduction: frailty and sarcopenia are prevalent conditions in older adults which diagnosis and treatment often overlap. Objective: to analyze the nutritional problematic related to frailty and sarcopenia in older adults. Methods: a literature review, about particularities of frailty and sarcopenia, diagnosis and nutritional treatment, has been carried out. Results: frailty is a geriatric syndrome that can be identified by at least three of the following criteria: weight loss, exhaustion, reduced physical activity, increased walk time, low grip strength. Sarcopenia is a muscular disease characterized by low muscle mass and reduced muscle strength as the main determinant. Both conditions can benefit from adequate protein intake (1-1.5 g/kg/day) and regular physical activity. Conclusion: identification, prevention, monitoring and nutritional treatment of frailty and sarcopenia in older adults is important because of its high prevalence. The main goal is to maintain the muscular integrity and minimize muscle loss in older adults. A healthy aging includes regular physical activity and the fulfillment of the protein requirements of this population.
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Groenendijk I, den Boeft L, van Loon LJ, de Groot LC. High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis. Comput Struct Biotechnol J 2019; 17:1101-1112. [PMID: 31462966 PMCID: PMC6704341 DOI: 10.1016/j.csbj.2019.07.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Protein may play a beneficial role in the prevention of bone loss and in slowing down osteoporosis. The effect of dietary protein may be different in older adults compared to younger adults, since this population has a greater need for protein. The aim of this systematic review and meta-analysis was to investigate the impact of a dietary protein intake above the Recommended Dietary Allowance (RDA) of 0.8 g/kg body weight/day from any source on Bone Mineral Density (BMD)/Bone Mineral Content (BMC), bone turnover markers, and fracture risk in older adults compared to a lower dietary protein intake. A systematic search was conducted through October 2018 in 3 databases: CENTRAL, MEDLINE, and EMBASE. We included all prospective cohort studies and Randomized Controlled Trials (RCTs) among adults aged ≥65 years that examined the relation between protein intake on bone health outcomes. Two investigators independently conducted abstract and full-text screenings, data extractions, and risk of bias assessments. Authors were contacted for missing data. After screening of 523 records, twelve cohort studies and one RCT were included. Qualitative evaluation showed a positive trend between higher protein intakes and higher femoral neck and total hip BMD. Meta-analysis of four cohort studies showed that higher protein intakes resulted in a significant decrease in hip fractures (pooled hazard ratio: 0.89; 95% confidence interval: 0.84, 0.94). This systematic review supports that a protein intake above the current RDA may reduce hip fracture risk and may play a beneficial role in BMD maintenance and loss in older adults.
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Affiliation(s)
- Inge Groenendijk
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, the Netherlands
| | - Laura den Boeft
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, the Netherlands
| | - Luc J.C. van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - Lisette C.P.G.M. de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, the Netherlands
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Le Bacquer O, Combe K, Patrac V, Ingram B, Combaret L, Dardevet D, Montaurier C, Salles J, Giraudet C, Guillet C, Sonenberg N, Boirie Y, Walrand S. 4E-BP1 and 4E-BP2 double knockout mice are protected from aging-associated sarcopenia. J Cachexia Sarcopenia Muscle 2019; 10:696-709. [PMID: 30927336 PMCID: PMC6596930 DOI: 10.1002/jcsm.12412] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sarcopenia is the loss of muscle mass/function that occurs during the aging process. The links between mechanistic target of rapamycin (mTOR) activity and muscle development are largely documented, but the role of its downstream targets in the development of sarcopenia is poorly understood. Eukaryotic initiation factor 4E-binding proteins (4E-BPs) are targets of mTOR that repress mRNA translation initiation and are involved in the control of several physiological processes. However, their role in skeletal muscle is still poorly understood. The goal of this study was to assess how loss of 4E-BP1 and 4E-BP2 expression impacts skeletal muscle function and homeostasis in aged mice and to characterize the associated metabolic changes by metabolomic and lipidomic profiling. METHODS Twenty-four-month-old wild-type and whole body 4E-BP1/4E-BP2 double knockout (DKO) mice were used to measure muscle mass and function. Protein homeostasis was measured ex vivo in extensor digitorum longus by incorporation of l-[U-14 C]phenylalanine, and metabolomic and lipidomic profiling of skeletal muscle was performed by Metabolon, Inc. RESULTS The 4E-BP1/2 DKO mice exhibited an increase in muscle mass that was associated with increased grip strength (P < 0.05). Protein synthesis was higher under both basal (+102%, P < 0.05) and stimulated conditions (+65%, P < 0.05) in DKO skeletal muscle. Metabolomic and complex lipid analysis of skeletal muscle revealed robust differences pertaining to amino acid homeostasis, carbohydrate abundance, and certain aspects of lipid metabolism. In particular, levels of most free amino acids were lower within the 4E-BP1/2 DKO muscle. Interestingly, although glucose levels were unchanged, differences were observed in the isobaric compound maltitol/lactitol (33-fold increase, P < 0.01) and in several additional carbohydrate compounds. 4E-BP1/2 depletion also resulted in accumulation of medium-chain acylcarnitines and a 20% lower C2/C0 acylcarnitine ratio (P < 0.01) indicative of reduced β-oxidation. CONCLUSIONS Taken together, these findings demonstrate that deletion of 4E-BPs is associated with perturbed energy metabolism in skeletal muscle and could have beneficial effects on skeletal muscle mass and function in aging mice. They also identify 4E-BPs as potential targets for the treatment of sarcopenia.
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Affiliation(s)
- Olivier Le Bacquer
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Kristell Combe
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Véronique Patrac
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | | | - Lydie Combaret
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Dominique Dardevet
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Christophe Montaurier
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Jérôme Salles
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Christophe Giraudet
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Christelle Guillet
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Nahum Sonenberg
- Department of Biochemistry, McGill University, Montreal, QC, Canada
| | - Yves Boirie
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service Nutrition Clinique, Clermont-Ferrand, France
| | - Stéphane Walrand
- INRA, UMR1019, Université Clermont Auvergne, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
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Abstract
BACKGROUND Frailty assessment is recommended to evaluate the candidacy of adults referred for orthotopic heart transplantation (OHT). Psoas muscle area (PMA) is an easily measured biomarker for frailty. There has yet to be a study examining the prognostic impact of PMA in OHT patients. METHODS In this retrospective study, preoperative and postoperative computed tomography (CT) scans were retrieved for adults transplanted between 2000 and 2015 at a tertiary care hospital. Psoas muscle area was measured on a single axial image. Outcomes of interest were all-cause mortality over 6 years and a composite of in-hospital mortality or major morbidity (prolonged ventilation, stroke, dialysis, mediastinitis, or reoperation). RESULTS Of 161 adult patients transplanted, 82 had at least 1 abdominal CT scan. At baseline, mean PMA was 25.7 ± 5.8 cm in men and 16.0 ± 3.6 cm in women, and decreased by 8% from the first to the last available CT scan. Adjusting for age, sex, body mass index, and cardiomyopathy etiology, every 1-cm increase in PMA was found to be associated with a 9% reduction in long-term mortality (hazard ratio, 0.91; 95% confidence interval [CI], 0.83-0.99; P = 0.031) and a 17% reduction in in-hospital mortality or major morbidity (odds ratio, 0.83; 95% CI, 0.72-0.96; P = 0.014). When PMA was smaller than the sex-specific median, the risk of mortality or major morbidity increased fourfold (odds ratio, 4.29; 95% CI, 1.19-15.46; P = 0.026). CONCLUSIONS Muscle mass is an independent predictor of mortality and major morbidity after OHT. Further research is needed to determine whether frail OHT patients with low PMA may benefit from muscle-building interventions to improve outcomes.
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Cedeno-Veloz B, López-Dóriga Bonnardeauxa P, Duque G. [Osteosarcopenia: A narrative review]. Rev Esp Geriatr Gerontol 2019; 54:103-108. [PMID: 30471719 DOI: 10.1016/j.regg.2018.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 06/09/2023]
Abstract
Osteosarcopenia is a phenotype resulting from the combination of sarcopenia and low bone mineral density. Based on the relationship between bone and muscle, this phenotype is associated with a higher risk of falls, fractures, dependence, and health care costs than its individual components. Given its characteristics, it can be considered as a new geriatric syndrome. Therefore, understanding its pathophysiology and diagnosis, as well as its non-pharmacological and pharmacological management is a task of great importance. The problem in addressing this phenotype arises from the tradition of managing sarcopenia and osteoporosis separately. There is also a lack of consensus on what to call it (sarco-osteopenia, sarco-osteoporosis, osteosarcopenia). The aim of this review is to outline the epidemiology, pathophysiology, diagnoses, adverse events, and management of osteosarcopenia.
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Affiliation(s)
- Bernardo Cedeno-Veloz
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia; Department of Medicine-Western Health, The University of Melbourne, St. Albans, VIC, Australia; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Madrid, España.
| | | | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia; Department of Medicine-Western Health, The University of Melbourne, St. Albans, VIC, Australia
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Mancini A, Vitucci D, Randers MB, Schmidt JF, Hagman M, Andersen TR, Imperlini E, Mandola A, Orrù S, Krustrup P, Buono P. Lifelong Football Training: Effects on Autophagy and Healthy Longevity Promotion. Front Physiol 2019; 10:132. [PMID: 30837897 PMCID: PMC6390296 DOI: 10.3389/fphys.2019.00132] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/04/2019] [Indexed: 12/30/2022] Open
Abstract
Aging is a physiological process characterized by a progressive decline of biological functions and an increase in destructive processes in cells and organs. Physical activity and exercise positively affects the expression of skeletal muscle markers involved in longevity pathways. Recently, a new mechanism, autophagy, was introduced to the adaptations induced by acute and chronic exercise as responsible of positive metabolic modification and health-longevity promotion. However, the molecular mechanisms regulating autophagy in response to physical activity and exercise are sparsely described. We investigated the long-term adaptations resulting from lifelong recreational football training on the expression of skeletal muscle markers involved in autophagy signaling. We demonstrated that lifelong football training increased the expression of messengers: RAD23A, HSPB6, RAB1B, TRAP1, SIRT2, and HSBPB1, involved in the auto-lysosomal and proteasome-mediated protein degradation machinery; of RPL1, RPL4, RPL36, MRLP37, involved in cellular growth and differentiation processes; of the Bcl-2, HSP70, HSP90, PSMD13, and of the ATG5-ATG12 protein complex, involved in proteasome promotion and autophagy processes in muscle samples from lifelong trained subjects compared to age-matched untrained controls. In conclusion, our results indicated that lifelong football training positively influence exercise-induced autophagy processes and protein quality control in skeletal muscle, thus promoting healthy aging.
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Affiliation(s)
- Annamaria Mancini
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | | | - Morten Bredsgaard Randers
- Department of Sports and Clinical Biomechanics, Sport and Health Sciences Cluster, University of Southern Denmark, Odense, Denmark
| | - Jakob Friis Schmidt
- Copenhagen Centre for Team Sport and Health, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Marie Hagman
- Department of Sports and Clinical Biomechanics, Sport and Health Sciences Cluster, University of Southern Denmark, Odense, Denmark
| | - Thomas Rostgaard Andersen
- Department of Sports and Clinical Biomechanics, Sport and Health Sciences Cluster, University of Southern Denmark, Odense, Denmark
| | | | - Annalisa Mandola
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Stefania Orrù
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy.,IRCCS SDN, Naples, Italy
| | - Peter Krustrup
- Department of Sports and Clinical Biomechanics, Sport and Health Sciences Cluster, University of Southern Denmark, Odense, Denmark.,Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, United Kingdom
| | - Pasqualina Buono
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy.,IRCCS SDN, Naples, Italy
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Alwerdt J, Small BJ. Fecal incontinence as a moderator between dietary intake and depressive symptoms among a sample of older adults obtained from the National Health and Nutrition Examination Survey (NHANES). Aging Ment Health 2019; 23:222-232. [PMID: 29171958 DOI: 10.1080/13607863.2017.1399348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Many studies have established a relationship between diet and mental health, as well as the importance of bowel health. Further, with increased evidence of a gut-brain bidirectional relationship, an indication of dysbiosis as a potential moderator between diet and depression may be a viable target for future interventions. The current study investigated the relationship between diet and depressive symptoms (DS) among older adults, as well as gender, and whether a symptom of dysbiosis, fecal incontinence severity (FIS), moderated this relationship. METHOD Using moderated regressions, we examined whether FIS moderates the relationship between diet and DS while controlling for covariates in the overall sample (N = 1918), as well as among the male (n = 841) and female sample (n = 1077). The dietary variables were reduced using a factor analysis. RESULTS Results indicated significant moderating effects of FIS between Component 4 and polyunsaturated fatty acids (PFA) in the overall sample. Component 4, protein, carbohydrates, and alcohol were significant in males only while PFA only in females. Further analysis of protein/carbohydrate ratio groups indicated significant differences within males. Higher scores of FIS were related to higher DS and less consumption of Component 4 nutrients, PFA, and protein. Males that consumed higher protein and carbohydrates resulted in lower DS with increased FIS. CONCLUSION Outcomes from the current study provide further evidence of the importance of healthy bowel function and the potential of modifying the diet to improve DS in older adults.
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Affiliation(s)
- J Alwerdt
- a Center For Healthy Aging , The Pennsylvania State University , University Park , PA , USA.,b School of Aging Studies , The University of South Florida , Tampa , FL , USA
| | - B J Small
- b School of Aging Studies , The University of South Florida , Tampa , FL , USA
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Is there sufficient evidence to supplement omega-3 fatty acids to increase muscle mass and strength in young and older adults? Clin Nutr 2019; 39:23-32. [PMID: 30661906 DOI: 10.1016/j.clnu.2019.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 01/01/2023]
Abstract
Omega-3 (ω-3) is a polyunsaturated fatty acid with anti-inflammatory properties that presents three main forms: alpha-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid. Recently, studies performed in both young and older adults suggest that ω-3 may improve gains in muscle mass and/or enhance physical function. Thus, the aim of this narrative review was to evaluate the current evidence of ω-3 intake/supplementation on muscle/lean mass (LM) and physical function in young and older adults, and draw research-based conclusions as to the practical implications of findings. We first assessed whether ω-3 intake is associated with muscle mass and strength (observational studies), and then sought to determine whether evidence shows that supplementation of ω-3 increases muscle protein synthesis, LM and strength in adults and older adults (interventional studies). The search was carried out in PubMed and Scopus databases for the periods between 1997 and November 2018. The following keywords were used alone and in combination: ω-3, fish oil, muscle protein synthesis, muscle mass, lean mass, body composition, and physical function. In general, the evidence is mixed as to the effects of ω-3 supplementation on muscle mass in sedentary young and older adults; the hypertrophic effects of supplementation when combined with resistance training remain equivocal. Moreover, there is conflicting evidence as to whether supplementation confers a beneficial effect on muscle function in older adults. Importantly, this conclusion is based on limited data and more studies are needed before ω-3 supplementation can be recommended as a viable strategy for such purposes in clinical practice.
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Regular Practice of Moderate Physical Activity by Older Adults Ameliorates Their Anti-Inflammatory Status. Nutrients 2018; 10:nu10111780. [PMID: 30453505 PMCID: PMC6266855 DOI: 10.3390/nu10111780] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 12/16/2022] Open
Abstract
A chronic inflammatory state is a major characteristic of the aging process, and physical activity is proposed as a key component for healthy aging. Our aim was to evaluate the body composition, hypertension, lipid profile, and inflammatory status of older adults, and these factors’ association with physical activity. A total of 116 elderly volunteers were categorized into terciles of quantitative metabolic equivalents of task (MET). Subjects in the first and third terciles were defined as sedentary and active subjects, respectively. Anthropometric and biochemical parameters, hemograms, and inflammatory markers were measured in plasma or peripheral mononuclear blood cells (PBMCs). The active groups exercised more than their sedentary counterparts. The practice of physical activity was accompanied by lower weight, fat mass, body mass index, and diastolic blood pressure when compared to a more sedentary life-style. Physical activity also lowered the haematocrit and total leukocyte, neutrophil, and lymphocyte counts. The practice of exercise induced a decrease in the IL-6 circulating levels and the TLR2 protein levels in PBMCs, while the expression of the anti-inflammatory IL-10 was activated in active subjects. The regular practice of physical activity exerts beneficial effects on body composition and the anti-inflammatory status of old people.
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Decreased Basal Metabolic Rate Can Be an Objective Marker for Sarcopenia and Frailty in Older Males. J Am Med Dir Assoc 2018; 20:58-63. [PMID: 30122323 DOI: 10.1016/j.jamda.2018.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of this study is to demonstrate the ability of the basal metabolic rate (BMR) to detect frailty and sarcopenia in older males. SETTING AND PARTICIPANTS A total of 305 male patients undergoing comprehensive geriatric assessment were included in the study. MEASURES The frailty status was assessed with the Fried criteria. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criteria. BMR is calculated by bioimpedance analysis. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of BMR in detecting sarcopenia. RESULTS The mean age was 74.52 ± 7.51 years. Among the patients in the sample, 95 (31.1%) had sarcopenia and 55 (18%) had frailty. Patients who had a BMR <1612 kcal/d had a higher frequency of frailty than those who had a BMR ≥1612 kcal/d (67.3 vs 32.7, P < .001). Results were similar for sarcopenia (77.9 vs 22.1, P < .001). When BMR was divided by body surface area (BSA), BMR/BSA with a cut-off of 874 kcal/m2 had a sensitivity of 80% and a specificity of 68%, and the AUC was 0.82 for BMR/BSA, in diagnosing sarcopenia (P < .01). The participants without sarcopenia had a higher BMR/BSA for the unadjusted (OR = 8.00, 95% CI 4.52-14.19, P < .001) and adjusted analyses (OR = 6.60, 95% CI 3.52-12.38, P < .001). CONCLUSIONS Older male patients with sarcopenia and frailty have a higher BMR reduction. Therefore, it should be kept in mind that patients with low BMR should alert us to screen sarcopenia and frailty. BMR/BSA may play a role in objective screening to detect sarcopenia in older males.
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Ni Lochlainn M, Bowyer RCE, Steves CJ. Dietary Protein and Muscle in Aging People: The Potential Role of the Gut Microbiome. Nutrients 2018; 10:E929. [PMID: 30036990 PMCID: PMC6073774 DOI: 10.3390/nu10070929] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/13/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022] Open
Abstract
Muscle mass, strength, and physical function are known to decline with age. This is associated with the development of geriatric syndromes including sarcopenia and frailty. Dietary protein is essential for skeletal muscle function. Resistance exercise appears to be the most beneficial form of physical activity for preserving skeletal muscle and a synergistic effect has been noted when this is combined with dietary protein. However, older adults have shown evidence of anabolic resistance, where greater amounts of protein are required to stimulate muscle protein synthesis, and response is variable. Thus, the recommended daily amount of protein is greater for older people. The aetiologies and mechanisms responsible for anabolic resistance are not fully understood. The gut microbiota is implicated in many of the postulated mechanisms for anabolic resistance, either directly or indirectly. The gut microbiota change with age, and are influenced by dietary protein. Research also implies a role for the gut microbiome in skeletal muscle function. This leads to the hypothesis that the gut microbiome might modulate individual response to protein in the diet. We summarise the existing evidence for the role of the gut microbiota in anabolic resistance and skeletal muscle in aging people, and introduce the metabolome as a tool to probe this relationship in the future.
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Affiliation(s)
- Mary Ni Lochlainn
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
- Clinical Age Research Unit, Kings College Hospital Foundation Trust, London SE5 9RS, UK.
| | - Ruth C E Bowyer
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
| | - Claire J Steves
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
- Clinical Age Research Unit, Kings College Hospital Foundation Trust, London SE5 9RS, UK.
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Verschuren O, Smorenburg AR, Luiking Y, Bell K, Barber L, Peterson MD. Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: a narrative review of the literature. J Cachexia Sarcopenia Muscle 2018; 9:453-464. [PMID: 29392922 PMCID: PMC5989853 DOI: 10.1002/jcsm.12287] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/23/2017] [Accepted: 01/07/2018] [Indexed: 12/16/2022] Open
Abstract
In individuals with cerebral palsy (CP), smaller muscle and atrophy are present at young age. Many people with CP also experience a decline in gross motor function as they age, which might be explained by the loss of muscle mass. The clinical observation of muscle wasting has prompted a comparison with sarcopenia in older adults, and the term accelerated musculoskeletal ageing is often used to describe the hallmark phenotype of CP through the lifespan. However, there has been very little research emphasis on the natural history of ageing with CP and even less with respect to the determinants or prevention of muscle loss with CP. Considering the burgeoning interest in the science of muscle preservation, this paper aims to (i) describe the characteristics of accelerated musculoskeletal ageing in people with CP, (ii) describe the pathophysiology of sarcopenia and parallels with CP, and (iii) discuss possible therapeutic approaches, based on established approaches for sarcopenia.
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Affiliation(s)
- Olaf Verschuren
- Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, De Hoogstraat RehabilitationUniversity Medical Center UtrechtRembrandtkade 10Utrecht3583TMThe Netherlands
| | | | - Yvette Luiking
- Nutricia ResearchAdvanced Medical NutritionUtrechtThe Netherlands
| | - Kristie Bell
- Child Health Research CentreThe University of QueenslandBrisbaneAustralia
- Lady Cilento Children's HospitalSouth BrisbaneQueenslandAustralia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of MedicineThe University of QueenslandBrisbaneAustralia
| | - Mark D. Peterson
- Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborMIUSA
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Frailty, Sarcopenia and Falls. PERSPECTIVES IN NURSING MANAGEMENT AND CARE FOR OLDER ADULTS 2018. [DOI: 10.1007/978-3-319-76681-2_2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sureda A, Bibiloni MDM, Julibert A, Aparicio-Ugarriza R, Palacios-Le Blé G, Pons A, Gonzalez-Gross M, Tur JA. Trace element contents in toenails are related to regular physical activity in older adults. PLoS One 2017; 12:e0185318. [PMID: 28985222 PMCID: PMC5630118 DOI: 10.1371/journal.pone.0185318] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 09/11/2017] [Indexed: 11/18/2022] Open
Abstract
The aim was to assess the trace element contents in toenails of older adults and its association with regular physical activity. Cross-sectional multicentre study in Spain, collecting data from a random sample of 380 participants (54% female) aged 55–80 years (men) and 60–80 years (women) with no previously documented cardiovascular disease. Physical activity performed was measured using the Minnesota Leisure-time Physical Activity Questionnaire. The 25 most inactive and 25 most active individuals for each sex were selected for this study (final sample n = 100). Anthropometric measurements were performed and toenail samples collected for calcium (Ca), chromium (Cr), iron (Fe), cobalt (Co), nickel (Ni), zinc (Zn), selenium (Se) and mercury (Hg) analysis. Significant differences between sexes were reported in Ca concentrations, women having lower concentrations than men. No differences were reported in trace element contents between active and inactive men. Active women showed higher Ca, Cr, Fe, Co, and Zn and lower Hg contents than their inactive peers (all p<0.05). Inactive women showed lower Ca and Co levels (735.0 mg/kg and 4.5 μg/kg, respectively) than inactive men (1170.0 mg/kg and 7.9 μg/kg, respectively). Active women had lower Ca and higher levels of Cr (936.0 mg/kg and 1230.0 μg/kg, respectively) than active men (1070.0 mg/kg and 522.0 μg/kg, respectively). The present data added new information on the element contents in toenails of healthy Spanish older adults. The concentration of trace elements was similar in both sexes except for Ca which were lower in women. The trace element contents in women’s toenails, but not in men, were markedly influenced by physical activity, with higher levels of Ca and Fe and lower Hg among active females.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Aparicio-Ugarriza
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Technical University of Madrid, Madrid, Spain
| | - Gonzalo Palacios-Le Blé
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Technical University of Madrid, Madrid, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
| | - Marcela Gonzalez-Gross
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Technical University of Madrid, Madrid, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
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