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M Y, Patel MG, Makwana HH, Kalariya H. Unraveling the enigma of sarcopenia and sarcopenic obesity in Indian adults with type 2 diabetes - a comparative cross-sectional study. Clin Diabetes Endocrinol 2024; 10:22. [PMID: 38880930 PMCID: PMC11181647 DOI: 10.1186/s40842-024-00179-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/08/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Sarcopenia and sarcopenic obesity are growing concerns associated with increasing diabetes incidence, but data from Indian diabetic cohorts are limited. This study examined the prevalence and clinical factors associated with sarcopenia and sarcopenic obesity. METHODS In this cross-sectional study, 750 participants aged 35-70 years were recruited by systematic stratification and a fixed quota sampling technique from medical camps and categorized into diabetic (n = 250), nondiabetic (n = 250), and obese nondiabetic (n = 250) groups. The assessments included questionnaires, muscle mass estimation by bioimpedance analysis, and blood tests. Sarcopenia was defined using the Asian Working Group consensus, and sarcopenic obesity was defined as sarcopenia with a BMI ≥ 25 kg/m2. Logistic regression was used to analyze risk factors. RESULTS Sarcopenia affected 60% of diabetic patients, 28% of nondiabetic patients, and 38% of nonobese nondiabetic patients (p < 0.001). The prevalence of sarcopenic obesity was 40%, 11%, and 30%, respectively (p < 0.001). Diabetes was associated with 2.3-fold greater odds (95% CI 1.1-4.7) of sarcopenia and 2.4-fold greater odds (1.1-5.0) of sarcopenic obesity after adjustment. A duration greater than 10 years, uncontrolled diabetes, age greater than 65 years, low physical activity, hypertension, and dyslipidemia also independently increased the odds. CONCLUSION Indian adults with type 2 diabetes have a high burden of sarcopenia and sarcopenic obesity. Early optimization of diabetes care and lifestyle changes are vital for preserving muscle health.
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Affiliation(s)
- Yogesh M
- Department of Community Medicine, M P Shah Government Medical College, New PG Hostel, Shri MP Shah Medical College campus, GG Hospital, Patel Colony Post, Jamnagar, Gujarat, 361008, India.
| | - Monika G Patel
- Department of Community Medicine, M P Shah Government Medical College, New PG Hostel, Shri MP Shah Medical College campus, GG Hospital, Patel Colony Post, Jamnagar, Gujarat, 361008, India
| | | | - Hardikkumar Kalariya
- Department of Community Medicine, M P Shah Government Medical College, New PG Hostel, Shri MP Shah Medical College campus, GG Hospital, Patel Colony Post, Jamnagar, Gujarat, 361008, India
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Quan L, Zhang F, Xu J, Wang F, Fan Y. Relationship between sarcopenia and fatty liver in middle-aged and elderly patients with type 2 diabetes mellitus. J Orthop Surg Res 2024; 19:250. [PMID: 38643133 PMCID: PMC11031894 DOI: 10.1186/s13018-024-04717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/05/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE In this study, we investigated the relationship between sarcopenia and fatty liver in middle-aged and elderly patients diagnosed with type 2 diabetes mellitus (T2DM) to provide a theoretical foundation for the prevention and treatment of sarcopenia. METHODS A total of 282 patients diagnosed with T2DM aged 50 and older and were admitted to the Endocrinology Department of Xin Medical University First Affiliated Hospital between December 2021 and February 2023, were selected. Body mass index (BMI), and limb and trunk muscle mass of the patients were measured, and data were collected. Patients were grouped based on the sarcopenia diagnostic criteria. All study participants underwent the same physical examinations and laboratory tests. The relationship between the onset of sarcopenia and fatty liver in middle-aged and elderly patients diagnosed with T2DM was then investigated using statistical analysis. RESULTS Comparing the sarcopenia group to the non-sarcopenia group revealed statistically significant variations in gender, BMI, fatty liver prevalence rate, uric acid (UA), alanine aminotransferase (ALT), blood glucose, blood lipid associated indicators, and limb skeletal muscle content. There were, however, no statistically significant differences in age, disease duration, hypertension, smoking, or alcohol intake. There was a positive correlation between BMI, UA, fasting c-peptide, and Appendicular Skeletal Muscle Index (ASMI). Higher levels of BMI, ASMI, and UA were identified as protective variables against sarcopenia by multifactorial logistic regression analysis. CONCLUSION Higher levels of BMI, ASMI, and UA can greatly reduce skeletal muscle atrophy in patients with T2DM. Patients with a fatty liver may be less vulnerable to sarcopenia. There is little evidence, however, that a fatty liver works as a preventive factor against sarcopenia.
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Affiliation(s)
- Li Quan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, department of endocrinology, The first Affiliated Hospital of Xinjiang Medical University, No. 137 of Liyushannan Street, Xinshi District, Urumqi, 830054, China
| | - Fang Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, department of endocrinology, The first Affiliated Hospital of Xinjiang Medical University, No. 137 of Liyushannan Street, Xinshi District, Urumqi, 830054, China
| | - Jing Xu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, department of endocrinology, The first Affiliated Hospital of Xinjiang Medical University, No. 137 of Liyushannan Street, Xinshi District, Urumqi, 830054, China
| | - Fei Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, department of endocrinology, The first Affiliated Hospital of Xinjiang Medical University, No. 137 of Liyushannan Street, Xinshi District, Urumqi, 830054, China
| | - Yong Fan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, department of endocrinology, The first Affiliated Hospital of Xinjiang Medical University, No. 137 of Liyushannan Street, Xinshi District, Urumqi, 830054, China.
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Wei L, Zeng J, Fan M, Chen B, Li X, Li Y, Xu S. Associations between handgrip strength and skeletal muscle mass with all-cause mortality and cardiovascular mortality in people with type 2 diabetes: A prospective cohort study of the UK Biobank. J Diabetes 2024; 16:e13464. [PMID: 37608605 PMCID: PMC10809293 DOI: 10.1111/1753-0407.13464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
AIMS To explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all-cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients. MATERIALS AND METHODS Data were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex-specific analyses were conducted. RESULTS A total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow-up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all-cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles (p trend <.05). A 1 SD decrease in HGS was found to both increase the all-cause risk (HR: 1.31 [95% CI: 1.24-1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22-1.50]) for men, and all-cause risk (HR: 1.26 [95% CI: 1.11-1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09-1.89]) for women. There was no statistically significant trend association between SMM/height2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height2 showed a U-shaped nonlinear relationship (pnonlinear <.05). CONCLUSIONS Grip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U-shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.
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Affiliation(s)
- Lingqi Wei
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Jingjing Zeng
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Menglin Fan
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Bo Chen
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Xiaying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Ying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Shaoyong Xu
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
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Lisco G, Disoteo OE, De Tullio A, De Geronimo V, Giagulli VA, Monzani F, Jirillo E, Cozzi R, Guastamacchia E, De Pergola G, Triggiani V. Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age. Nutrients 2023; 16:63. [PMID: 38201893 PMCID: PMC10780932 DOI: 10.3390/nu16010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Sarcopenia is an age-related clinical complaint characterized by the progressive deterioration of skeletal muscle mass and strength over time. Type 2 diabetes (T2D) is associated with faster and more relevant skeletal muscle impairment. Both conditions influence each other, leading to negative consequences on glycemic control, cardiovascular risk, general health status, risk of falls, frailty, overall quality of life, and mortality. PubMed/Medline, Scopus, Web of Science, and Google Scholar were searched for research articles, scientific reports, observational studies, clinical trials, narrative and systematic reviews, and meta-analyses to review the evidence on the pathophysiology of di-abetes-induced sarcopenia, its relevance in terms of glucose control and diabetes-related outcomes, and diagnostic and therapeutic challenges. The review comprehensively addresses key elements for the clinical definition and diagnostic criteria of sarcopenia, the pathophysiological correlation be-tween T2D, sarcopenia, and related outcomes, a critical review of the role of antihyperglycemic treatment on skeletal muscle health, and perspectives on the role of specific treatment targeting myokine signaling pathways involved in glucose control and the regulation of skeletal muscle metabolism and trophism. Prompt diagnosis and adequate management, including lifestyle inter-vention, health diet programs, micronutrient supplementation, physical exercise, and pharmaco-logical treatment, are needed to prevent or delay skeletal muscle deterioration in T2D.
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Affiliation(s)
- Giuseppe Lisco
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
| | - Olga Eugenia Disoteo
- Unit of Endocrinology, Diabetology, Dietetics and Clinical Nutrition, Sant Anna Hospital, 22020 San Fermo della Battaglia, Italy;
| | - Anna De Tullio
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
| | - Vincenzo De Geronimo
- Unit of Endocrinology, Clinical Diagnostic Center Morgagni, 95100 Catania, Italy;
| | - Vito Angelo Giagulli
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical & Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Emilio Jirillo
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
| | - Renato Cozzi
- Division of Endocrinology, Niguarda Hospital, 20162 Milan, Italy;
| | - Edoardo Guastamacchia
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
| | - Giovanni De Pergola
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.T.); (V.A.G.); (E.J.); (E.G.)
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Luo C, Liu RY, Zhang GW, Hu F, Jin YH, Liu BY. Possible sarcopenia and risk of new-onset type 2 diabetes mellitus in older adults in China: a 7-year longitudinal cohort study. BMC Geriatr 2023; 23:404. [PMID: 37400759 DOI: 10.1186/s12877-023-04104-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Previous studies have shown that type 2 diabetes mellitus (T2DM) can cause sarcopenia; however, these conditions may have a bidirectional association. This study aimed to explore the longitudinal association between possible sarcopenia and new-onset T2DM. METHODS We conducted a population-based cohort study using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). This study included participants aged ≥ 60 years who were free of diabetes during the baseline survey of CHARLS (2011 to 2012) and were followed up until 2018. Possible sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cox proportional hazards regression models were used to evaluate the effect of possible sarcopenia on new-onset T2DM. RESULTS In total, 3,707 individuals were enrolled in this study, with a median age of 66 years; the prevalence of possible sarcopenia was 45.1%. During the 7-year follow-up, 575 cases (15.5%) of incident diabetes were identified. Participants with possible sarcopenia were more likely to have new-onset T2DM than those without possible sarcopenia (hazard ratio: 1.27, 95% confidence interval: 1.07-1.50; p = 0.006). In subgroup analysis, we found a significant association between possible sarcopenia and T2DM in individuals aged < 75 years or with a BMI < 24 kg/m². However, this association was not significant in individuals aged ≥ 75 years or with a BMI ≥ 24 kg/m². CONCLUSIONS Possible sarcopenia is associated with an increased risk of new-onset T2DM in older adults, especially in individuals who are not overweight and aged 75 years or younger.
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Affiliation(s)
- Chun Luo
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Rui-Yan Liu
- Wenzhou Medical University Renji College, Wenzhou, China
| | - Guang-Wu Zhang
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Fei Hu
- Cixi Biomedical Research Institute, Wenzhou Medical University, Cixi, China
| | - Yu-Hong Jin
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Bing-Yang Liu
- Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China.
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Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, Triantafyllidis KK, Kechagias KS, Dionyssiotis Y, Cesari M, Ibrahim K, Scott D, Barbagallo M, Veronese N. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:671-683. [PMID: 36781175 PMCID: PMC10067503 DOI: 10.1002/jcsm.13190] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Society of Meta‐research and Biomedical InnovationLondonUK
| | - Panagiotis Giannos
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Jean Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and AgingLiègeBelgium
- Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and AgeingUniversity of LiègeLiègeBelgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and PaediatricsGhent UniversityGhentBelgium
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCAAnconaItaly
| | - Konstantinos K. Triantafyllidis
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Nutrition and DieteticsHomerton University Hospital Foundation TrustLondonUK
| | - Konstantinos S. Kechagias
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Metabolism, Digestion and Reproduction, Faculty of MedicineImperial College LondonLondonUK
| | - Yannis Dionyssiotis
- Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital PatrasUniversity of PatrasPatrasGreece
| | - Matteo Cesari
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Geriatric UnitIRCCS Istituti Clinici Scientifici MaugeriMilanItaly
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University Hospital SouthamptonUniversity of SouthamptonSouthamptonUK
- Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR)University of SouthamptonSouthamptonUK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Mario Barbagallo
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Nicola Veronese
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
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Neto NJ, Gomes CDS, Sousa ACPDA, Barbosa JFDS, Ahmed TIS, Borrero CLC, Maciel ÁCC, Guerra RO. HbA1c and physical performance in older adults from different aging epidemiological contexts: Longitudinal findings of the International Mobility in Aging Study (IMIAS). Arch Gerontol Geriatr 2023; 104:104823. [PMID: 36179459 DOI: 10.1016/j.archger.2022.104823] [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: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to assess the longitudinal predictions between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging. MATERIAL AND METHODS Longitudinal data of 1,337 older people from three countries (Canada, Brazil and Colombia) of the International Mobility in Aging Study (IMIAS) were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c and covariates on SPPB scores. RESULTS At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value < 0.05) and women (8.52 ± 2.33; p-value <0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women. CONCLUSION High HbA1c levels at baseline were longitudinally associated in older adults from different countries, and this association was observed only in men and not in women. This study highlights a possible influence of gender on this relationship.
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Affiliation(s)
- Nailton José Neto
- Graduate Program in Health Sciences; Federal University of Rio Grande do Norte; General Cordeiro de Faria Street, Natal, Brazil.
| | - Cristiano Dos Santos Gomes
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Senador Salgado Filho Avenue, Natal, Brazil
| | | | - Juliana Fernandes de Souza Barbosa
- Laboratory of Physical Therapy and Collective Health, Physical Therapy Department, Federal University of Pernambuco, Jornalista Aníbal Fernandes Avenue Recife, Brazil.
| | | | | | | | - Ricardo Oliveira Guerra
- Graduate Program in Health Sciences; Federal University of Rio Grande do Norte; General Cordeiro de Faria Street, Natal, Brazil.
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El Ghoch M, Rossi AP, Verde L, Barrea L, Muscogiuri G, Savastano S, Colao A. Understanding sarcopenic obesity in young adults in clinical practice: a review of three unsolved questions. Panminerva Med 2022; 64:537-547. [PMID: 36533664 DOI: 10.23736/s0031-0808.22.04784-x] [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: 09/25/2023]
Abstract
INTRODUCTION Our aim was to summarize the available literature on three yet unsolved questions, namely: 1) the dilemma surrounding definition of sarcopenic obesity (SO), especially in young adults; 2) the potential impact of this phenotype on weight-loss programme outcomes; and 3) the strategies for optimum management (prevention/treatment) of SO in clinical practice. EVIDENCE ACQUISITION A literature review using the PubMed/Medline database was conducted, and data were summarized based on a narrative approach. EVIDENCE SYNTHESIS Firstly, SO can be screened by the 30-sec sit-to-stand test; ≤25 and ≤21; and confirmed by the ratio of (appendicular lean mass/Body Mass Index) ≤0.789 and 0.512 in males and females, respectively. Secondly, SO is associated with impaired physical fitness, reduced resting energy expenditure and an inactive lifestyle, that seems to negatively impact on weight-management outcomes, namely increasing early dropout and difficulty in maintaining weight loss in the long term. Finally, prevention/treatment of SO in young adults must be realized through tailored lifestyle intervention (diet+exercise) to preserve and improve strength and muscle mass, even where weight loss is necessary. CONCLUSIONS Our findings have clinical implications since they may help in screening, managing and improving the weight-loss outcomes of patients with SO in clinical settings.
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Affiliation(s)
- Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Arab University of Beirut, Beirut, Lebanon
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea P Rossi
- Division of Geriatrics, Department of Medicine, Healthy Aging Center, University of Verona, Verona, Italy
- Division of Geriatrics, Department of Medicine, Ospedale Ca' Foncello ULSS2 Treviso, Treviso, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Human Sciences, Pegaso Telematic University, Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy -
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Silvia Savastano
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
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Erbas Sacar D, Kılıc C, Oren MM, Erdogan T, Ozkok S, Ozer Aydın C, Catikkas NM, Karan MA, Bahat G. Probable sarcopenia: associations with common geriatric syndromes and comorbidities in Turkish geriatric patients from a university hospital. Eur Geriatr Med 2022; 13:1299-1308. [PMID: 36029439 DOI: 10.1007/s41999-022-00691-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE EWGSOP2 defines "probable sarcopenia" as the presence of low muscle strength without non-muscle causes. The associations of probable sarcopenia have been studied in few reports to date, and our intention in this study is to identify associations of probable sarcopenia with common geriatric syndromes in a sample of older adults who attended the geriatric outpatient clinic of Istanbul University Hospital. METHODS The present study was designed as a retrospective cross-sectional study. We performed a comprehensive geriatric assessment to the participants. Univariate analyses were performed to determine relationship of probable sarcopenia with age, sex, common geriatric syndromes, i.e., frailty, falls, polypharmacy, malnutrition, and comorbidities, i.e., diabetes mellitus, hypertension, chronic kidney disease, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), depression, osteoporosis, and the variables found to be significant were included in logistic regression analyses. The results are presented as an odds ratio (OR), with a 95% confidence interval (CI). RESULTS Included in the study were 456 participants with a mean age of 74.6 ± 6.6 years, of which 71.1% were female. Probable sarcopenia was identified in 12.7% (n = 58) of the sample. A multivariate analysis was carried out, the factors associated with probable sarcopenia were identified as male sex (OR 0.269, 95% CI 0.142-0.510), frailty (OR 4.265, 95% CI 2.200-8.267) and chronic kidney disease (OR 3.084, 95% CI 1.105-8.608). CONCLUSION Probable sarcopenia was more significantly associated with frailty than with other geriatric syndromes, signifying its importance as a marker for frailty. The study further identified chronic renal failure as a factor significantly associated with probable sarcopenia among the variety of studied diseases that frequently accompany aging.
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Affiliation(s)
- Duygu Erbas Sacar
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey.
| | - Cihan Kılıc
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Meryem Merve Oren
- Department of Public Health, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul, Istanbul, Turkey
| | - Tugba Erdogan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Serdar Ozkok
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Caglar Ozer Aydın
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Mehmet Akif Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
| | - Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Topkapı Mahallesi, Turgut Özal Street No: 118, 34093 Fatih/İstanbul Capa, 34390, Istanbul, Turkey
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Rutherford M, Downer B, Li CY, Chou LN, Al Snih S. Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up. PLoS One 2022; 17:e0274290. [PMID: 36084053 PMCID: PMC9462817 DOI: 10.1371/journal.pone.0274290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSES The relationship between body mass index (BMI) and frailty in older Mexican Americans has not been previously studied. The objective of this study was to examine the relationship between BMI and frailty among non-frail older Mexican Americans at baseline over 18 years of follow up. METHODS Longitudinal population-based study of 1,648 non-institutionalized Mexican Americans aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13). Frailty phenotype was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. BMI (kg/m2) was classified as underweight (<18.5), normal weight (18.5-<25), overweight (25-< 30), obesity category I (30-<35), and obesity category II/morbid obesity (≥35). Covariates included socio-demographics, comorbidities, cognitive function, and depressive symptoms. Generalized Estimating Equation models were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of frailty as a function of BMI category. RESULTS Participants with underweight or obesity category II/ morbid obesity had greater odds of frailty over time compared to those with normal weight (OR = 2.39, 95% CI = 1.29-4.44 and OR = 1.62, 95% CI = 1.07-2.44, respectively) after controlling for all covariates. Participants with BMIs in the overweight or category I obesity were at lower odds of frailty over time. CONCLUSIONS Mexican American older adults with BMIs in the underweight or obesity category II/morbid obesity were at higher odds of frailty over time. This indicates that maintaining a healthy weight in this population may prevent future frailty.
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Affiliation(s)
- Megan Rutherford
- School of Medicine, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Brian Downer
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Chih-Ying Li
- Department of Occupational Therapy/School of Health Professions, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Lin-Na Chou
- Department of Biostatistics and Data Science/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, United States of America
- Division of Geriatrics & Palliative Medicine/Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States of America
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States of America
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