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Chow KL, Keating PE, Solanki K, Sapsford M, Lindsay K, O'Donnell JL. Anti-HMGCR myopathy: Diversity of clinical presentations in a national cohort in New Zealand. Semin Arthritis Rheum 2024; 68:152522. [PMID: 39079206 DOI: 10.1016/j.semarthrit.2024.152522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 05/21/2024] [Accepted: 07/08/2024] [Indexed: 09/10/2024]
Abstract
AIMS We describe the varied clinical presentations, barriers in diagnosis and outcomes of anti-HMGCR myopathy in a large national cohort. METHODS Adults found positive for serum anti-HMGCR autoantibodies via line blot or enzyme-immunoassay followed by immunoprecipitation were included in the study. RESULTS Of 75 patients identified, the records of 72 (96 %) described weakness as the presenting symptom. The records of 65 gave a reliable description of proximal weakness. In 22/65 (33.8 %) the weakness was described as predominantly or solely lower limb weakness. Forty-five of 75 (60 %) presented with a subacute onset (duration of symptoms >4 weeks -≤6 months), whilst 22/75 (29.3 %) presented with a more indolent chronic onset (duration of symptoms >6 months). Eighteen of 75 (24 %) suffered falls and 2/75 (2.7 %) had "general decline". In three patients no weakness was described: two presented with myalgia and one with a skin rash characterized as Jessner lymphocytic skin rash. Median creatine kinase at presentation was 7337 U/L (range 1050-25,500). Muscle biopsy was performed in 38 (50.7 %). Associated malignancy was infrequent. Four patients recovered without immunosuppression. Five-year and 10-year survival was 92.7 % (95 % CI 80.6-97.4 %), and 82.5 % (95 % CI 61.2-92.8 %) respectively. CONCLUSION Recurrent falls, a long prodrome and dominant lower limb proximal weakness were common in this anti-HMGCR myopathy cohort. These features overlap with frailty syndrome and sporadic inclusion body myositis emphasizing the importance of considering anti-HMGCR myopathy in that clinical context. A minority of patients recover after statin withdrawal alone.
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Affiliation(s)
- Ke Li Chow
- Department of Immunology, Canterbury Health Laboratories, Christchurch, New Zealand; Department of Immunology, NSW Health Pathology, Newcastle, NSW, Australia.
| | | | - Kamal Solanki
- Department of Rheumatology, Waikato Hospital, Hamilton, New Zealand
| | - Mark Sapsford
- Department of Rheumatology, Middlemore Hospital, Auckland, New Zealand
| | - Karen Lindsay
- Department of Immunology, Auckland City Hospital, Auckland, New Zealand; Department of Rheumatology, Auckland City Hospital, Auckland, New Zealand
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Niebla-Cárdenas A, Bueno-Hernández N, Hernández AP, Fuentes M, Méndez-Sánchez R, Arroyo-Anlló EM, Orera I, Lattanzio G, Juanes-Velasco P, Arias-Hidalgo C, Puente-González AS. Potential protein biomarkers in saliva for detection of frailty syndrome by targeted proteomics. Mech Ageing Dev 2024; 221:111974. [PMID: 39038666 DOI: 10.1016/j.mad.2024.111974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/23/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
Frailty is a physiological geriatric syndrome, caused by immunosenescence, inflammation and alterations at the protein level leading to metabolic and microbiota changes. Currently, this syndrome is evaluated clinically with the Frailty-VIG index. The aim of the study was therefore to investigate the potential suitability of saliva as a non-invasive proximal biological fluid for the characterisation and identification of possible protein-level biomarkers in frailty syndrome. This cross-sectional study was conducted in a rural population of older Spanish adults using the SMR proteomics technique. A differential protein profile of eight potential and surrogate proteins (CYTC, CYTD, CYTS, CYTB, MIF, ALBU, CD44 and B2MG) was detected in saliva, all of which correlated with factors characterising frailty syndrome, such as vascular ageing (arterial stiffness and cardiovascular disease), obesity, mood problems, global cognitive impairment, changes in gait and hand pressure strength. The proteins CYTD (r = 0.415, p = 0.013) and CYTC (r = 0.280, p = 0.026), which were detected differentially in the protein profile, were associated with the Frailty-VIG index. All analysed proteins are associated not only with the clinical symptoms of frailty syndrome, but also with an acute inflammatory response, endothelial cell proliferation and the complement system, among others.
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Affiliation(s)
- Alfonssina Niebla-Cárdenas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain
| | - Nallely Bueno-Hernández
- Laboratory for Proteomics and Metabolomics, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City 06720, Mexico
| | - Angela-Patricia Hernández
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain; Department of Pharmaceutical Sciences: Organic Chemistry, Faculty of Pharmacy, University of Salamanca, CIETUS, IBSAL, Salamanca 37007, Spain
| | - Manuel Fuentes
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca, Spain
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain; Institute of Biomedical Research of Salamanca (IBSAL). Physiotherapy, functional recovery and therapeutic exercise group, Salamanca 37007, Spain
| | - Eva María Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, Faculty of Psychology, University of Salamanca, Salamanca 37007, Spain
| | - Irene Orera
- Proteomics Research Core Facility, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza 50009, Spain
| | - Giuseppe Lattanzio
- Proteomics Research Core Facility, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza 50009, Spain
| | - Pablo Juanes-Velasco
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain
| | - Carlota Arias-Hidalgo
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain
| | - Ana Silvia Puente-González
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca, Spain.
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Wang D, Qi W, Mao X, Zhang Y, Miao Z, Zhu C, Shao Y, Ge G, Zhang W, Jin H, Zhu H, Pan H. Gui Qi Zhuang Jin Decoction ameliorates mitochondrial dysfunction in sarcopenia mice via AMPK/PGC-1α/Nrf2 axis revealed by a metabolomics approach. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 133:155908. [PMID: 39094439 DOI: 10.1016/j.phymed.2024.155908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 07/04/2024] [Accepted: 07/20/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE Sarcopenia, as a condition of muscle mass loss and functional decline typically diagnosed in elderly individuals, severely affects human physical activity, metabolic homeostasis, and quality of life. Gui Qi Zhuang Jin Decoction (GQZJD), an approved hospital-based prescription with years of clinical application, has been demonstrated to have a notable therapeutic effect on sarcopenia. However, its potential mechanism of action in the treatment of sarcopenia remains uncertain. METHODS Ultra-performance liquid chromatography paired with Q Exactive™ HF-X mass spectrometry (UPLC-QE-MS) was used to identify the ingredients of GQZJD. Subsequently, GQZJD observed the basic growth and muscles of the sarcopenia mouse, while the behavioral indicators were also tested. Muscle histopathology and serum oxidative stress biochemicals were also detected, and mitochondrial function and energy metabolism-related indicators in the gastrocnemius muscle were examined. Then, a metabolomics strategy was applied to predict possible pathways involving mitochondria by which GQZJD could improve sarcopenia. Finally, quantitative real-time polymerase chain reaction and western blot analyses were carried out to validate the effects of GQZJD on sarcopenia-induced mitochondrial dysfunction, together with uncovering the associated mechanisms. RESULTS Twenty-seven ingredients absorbed into the blood (IAIBs) of GQZJD were identified using UPLC-QE-MS, which were regarded as the main active ingredients behind its sarcopenia treatment effects. GQZJD administration increased the body weight, gastrocnemius muscle mass, and autonomic activity, mitigated muscle tissue morphology and pathology; and alleviated the oxidative stress levels in sarcopenia mice. Treatment with GQZJD also decreased the mitochondrial reactive oxygen species level and serum lipid peroxide Malonaldehyde concentration. and increased the mitochondrial membrane potential, adenosine triphosphate level, 8‑hydroxy-2-deoxyguanosine content, mitochondrial DNA copy number, and the mitochondrial fission factor dynamin-related protein 1. Non-targeted metabolomics suggested that the sarcopenia therapeutic effect of GQZJD on sarcopenia may occur through the glycerophospholipid metabolism, choline metabolism in cancer, phenylalanine metabolism and tyrosine metabolism pathways, implying an association with AMP-activated protein kinase (AMPK) and related signals. Further, the molecular docking results hinted that AMPK performed well in terms of binding energy with the 27 IAIBs of GQZJD (average binding energy, -7.5 kcal/mol). Finally, we determined that GQZJD significantly activated the key targets of the AMPK/peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)/nuclear factor erythroid 2-related factor 2 (Nrf2) axis.. CONCLUSIONS Our results demonstrated that GQZJD ameliorated d-galactose-induced sarcopenia by promoting the animal behaviours, facilitating mitochondrial function and restoring mitochondrial energy metabolism. with its effects mediated by the AMPK/PGC-1α/Nrf2 axis. Over all, GQZJD represents a promising therapeutic candidate that ameliorated sarcopenia in aging mice.
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Affiliation(s)
- Dong Wang
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China; Department of Orthopaedics, Hangzhou Dingqiao Hospital, Hangzhou 310021, PR China; Institute of Orthopaedics and Traumatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Weihui Qi
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Xinning Mao
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Yujun Zhang
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Zhimin Miao
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Chengyue Zhu
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China; Department of Orthopaedics, Hangzhou Dingqiao Hospital, Hangzhou 310021, PR China; Institute of Orthopaedics and Traumatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Yinyan Shao
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Guofen Ge
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - Wei Zhang
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China
| | - HongTing Jin
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China; Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310007, PR China.
| | - Hang Zhu
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China.
| | - Hao Pan
- Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China; Department of Orthopaedics, Hangzhou Dingqiao Hospital, Hangzhou 310021, PR China; Institute of Orthopaedics and Traumatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, PR China.
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Li X, Tang Y, Deng X, Zhou F, Huang X, Bai Z, Liang X, Wang Y, Lyu J. Modified frailty index effectively predicts adverse outcomes in sepsis patients in the intensive care unit. Intensive Crit Care Nurs 2024; 84:103749. [PMID: 38896964 DOI: 10.1016/j.iccn.2024.103749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Frailty and sepsis have a significant impact on patient prognosis. However, research into the relationship between frailty and sepsis in the general adult population remains inadequate. This paper aims to investigate the association between frailty and adverse outcomes in this population. METHOD This retrospective analysis investigated sepsis patients who were initially admitted to the intensive care unit (ICU). The Modified Frailty Index (MFI) was derived by tracking patients' International Classification of Diseases (ICD) codes during their hospitalization. Patients were classified into two groups based on their MFI scores: a frail group (MFI ≥ 3) and a non-frail group (MFI = 0-2). The key outcomes were mortality rates at 90 and 180 days, with secondary outcomes including the incidence of delirium and pressure injury. RESULT Of the 21,338 patients who were recruited for this study (median age about 68 years, 41.8 % female), 5,507 were classified as frail and 15,831 were classified as non-frail. Frail patients were significantly more likely to have delirium (48.9 % vs. 36.1 %, p < 0.001) and pressure injury (60.5 % vs. 51.4 %, p < 0.001). After controlling for confounding variables, the multifactorial Cox proportional hazard regression analyses revealed a significantly elevated mortality rate at 90 days (adjusted HR: 1.58, 95 % CI: 1.24-2.02, p < 0.001) and 180 days (adjusted HR: 1.47, 95 % CI: 1.18, 1.83, p < 0.001) in the frail group compared to their non-frail counterparts. CONCLUSIONS Frailty independently predisposes adult sepsis patients in the ICU to adverse outcomes. Future investigations should concentrate on evaluating frailty and developing targeted interventions to improve patient prognosis. IMPLICATION FOR CLINICAL PRACTICE The MFI provides a simple clinical assessment tool that can be integrated into electronic medical records for immediate calculation. This simplifies the assessment process and plays a key role in predicting patient outcomes.
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Affiliation(s)
- Xinya Li
- School of Nursing, Jinan University, Guangzhou, China
| | - Yonglan Tang
- School of Nursing, Jinan University, Guangzhou, China
| | - Xingwen Deng
- Department of Medical Information, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaxuan Huang
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zihong Bai
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xin Liang
- School of Nursing, Jinan University, Guangzhou, China
| | - Yu Wang
- School of Nursing, Jinan University, Guangzhou, China; Community Health Service Center of Jinan University, Guangzhou, China; Department of School Clinic, the First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Jun Lyu
- Department of Clinical Research, the First Affiliated Hospital of Jinan University, Guangzhou, China.
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Liu W, Qin R, Qiu Y, Luan T, Qiu B, Yan K, Chen Z, Miao B, Liu Y. Multidimensional frailty as a predictor of mortality among older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:793. [PMID: 39342128 PMCID: PMC11439258 DOI: 10.1186/s12877-024-05377-4] [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: 03/08/2024] [Accepted: 09/12/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE This systematic review examined studies that assessed the relationship between mortality risk and multidimensional frailty. The pooled risk of mortality was estimated via a meta-analysis. DESIGN A systematic review and meta-analysis. METHODS A systematic search for potentially eligible literature was conducted on January 2, 2023, using five electronic databases: Web of Science, CINAHL, PubMed, the Cochrane Library and Embase. This review included cohort or longitudinal studies examining the association between multidimensional frailty/prefrailty and mortality in older adults. The quality of the included studies was evaluated via the Quality in Prognosis Studies (QUIPS) tool. Two independent researchers identified eligible studies and extracted the data. The data analyses were performed via STATA, version 15.0. RESULTS A total of 24 studies with 34,664 participants were included. The 24 studies were published between 2012 and 2022, with most studies being performed in Italy (n = 16). The sample sizes of the included studies ranged from 71 to 12,020. Most included studies were conducted in hospital settings. The QUIPS bias assessment results showed that the most frequent source of potential bias was study confounding. The meta-analysis results showed that multidimensional frailty was a significant predictor of mortality (HR = 5.48, 95% CI = 3.91-7.67, p < 0.001). In addition, multidimensional prefrailty was also a significant predictor of mortality (HR = 2.56, 95% CI = 2.17-3.02, p < 0.001). The results of the meta-analysis using the ORs revealed that multidimensional frailty was a risk factor for mortality in older people (OR = 4.59, 95% CI = 2.47-8.55, p < 0.05). CONCLUSIONS AND IMPLICATIONS This systematic review of the relationship between multidimensional frailty and mortality found that multidimensional frailty/prefrailty is a predictor of mortality. More studies should be conducted in community dwelling populations and nursing homes.
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Affiliation(s)
- Wei Liu
- School of Nursing, Beihua University, 3999 Binjiang East Road, Jilin, 132013, China
| | - Rixin Qin
- School of Nursing, Beihua University, 3999 Binjiang East Road, Jilin, 132013, China
| | - Yiming Qiu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin , 130021, China
| | - Taiyuan Luan
- The First Hospital of Jilin University, 1 xinmin street, Changchun, 130021, China
| | - Borong Qiu
- Jilin Overseas Chinese Hospital, 8 Xiamen Street, Jilin, 132013, China
| | - Ke Yan
- The First Hospital of Jilin University, 1 xinmin street, Changchun, 130021, China
| | - Zhe Chen
- Jilin City People's Hospital, Zhongxin street, Jilin, 132001, China
| | - Beibei Miao
- School of Nursing, Beihua University, 3999 Binjiang East Road, Jilin, 132013, China.
| | - Yujin Liu
- Changchun Humanities and Sciences College, 1488 Boshuo Road, Changchun, 130119, China.
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Guo Z, Wang F, Xu J, Shan Z. Knowledge mapping of frailty and surgery: a bibliometric and visualized analysis. Langenbecks Arch Surg 2024; 409:290. [PMID: 39331205 PMCID: PMC11436438 DOI: 10.1007/s00423-024-03477-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 09/14/2024] [Indexed: 09/28/2024]
Abstract
PURPOSE Frailty is common in surgical patients and is closely associated with postoperative outcomes. AIMS This study employed bibliometric methods to summarize and analyze research related to frailty and surgery, comprehensively analyzing the research structure and providing visualized maps. METHODS This study analyzed the volume of publications, countries, institutions, authors, journals, references, and keywords related to perioperative frailty in the Web of Science Core Collection from 1978 to 2024. Visual bibliometric analyses were conducted from multiple perspectives, including collaboration networks, citation analysis, and keyword clustering. RESULTS From 1978 to 2024, 21,879 authors from 95 countries and regions published 4,119 papers on perioperative frailty in 973 journals worldwide. The United States has the most publications, while Italy has the highest degree of international collaboration. The University of California System has the highest number of publications. The University of Kansas Medical Center is the institution with the highest centrality. The top nine authors in terms of publication volume are all from the USA. Bowers Christian A. is the most prolific author. The Journal of Vascular Surgery is the journal with the most publications. Current research directions include preoperative risk assessment of frailty, the relationship between frailty and postoperative complications, elderly frailty, and the relationship between frailty and sarcopenia. Research hotspots include risk stratification, postoperative delirium, the elderly, and sarcopenia. CONCLUSION This study has identified the research hotspots and trends in perioperative frailty. Our findings will enable researchers to understand this field's knowledge structure better and identify future research directions.
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Affiliation(s)
- Zhiwei Guo
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Siming, Xiamen, Fujian, 361001, China
| | - Feifei Wang
- Department of Cardiac Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Siming, Xiamen, Fujian, 361001, China.
| | - Jiacheng Xu
- Department of Cardiac Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Siming, Xiamen, Fujian, 361001, China
| | - Zhonggui Shan
- Department of Cardiac Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Siming, Xiamen, Fujian, 361001, China.
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Mayer MH, Woldemariam S, Gisinger C, Dorner TE. Association of Gut Microbiome with Muscle Mass, Muscle Strength, and Muscle Performance in Older Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1246. [PMID: 39338129 PMCID: PMC11432054 DOI: 10.3390/ijerph21091246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/10/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
Sarcopenia, characterized by reduced muscle mass, strength, or performance, is a common condition in older adults. The association between the gut microbiome and sarcopenia remains poorly understood. This systematic review aims to evaluate the relationship between muscle parameters and the intestinal microbiome. A systematic search was conducted in PubMed, EMBASE, Cochrane Library, and Google Scholar for studies published between 2002 and 2022 involving participants aged 50+. Studies were included if they assessed sarcopenia using at least one measure of muscle mass (skeletal muscle mass, bioelectrical impedance analysis, MRI), muscle strength, or muscle performance (SARC-F questionnaire, Timed-Up-and-Go Test, Chair Stand Test, grip strength, gait speed, Short Physical Performance Battery, 400 m Walk Test). The microbiome was measured using at least RNA/DNA sequencing or shotgun metagenomic sequencing. Twelve studies were analyzed. Findings revealed that a higher abundance of bacterial species such as Desulfovibrio piger, and Clostridium symbiosum and reduced diversity of butyrate-producing bacteria was associated with sarcopenia severity, as indicated by decreased grip strength, muscle mass, or physical performance. The gut microbiome plays a significant role in age-related muscle loss. Probiotics, prebiotics, and bacterial products could be potential interventions to improve muscle health in older adults.
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Affiliation(s)
- Martin Hubert Mayer
- Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Selam Woldemariam
- Karl Landsteiner Institute for Health Promotion Research, 3062 Kirchstetten, Austria
- Center for Public Health, Department for Social and Preventive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Gisinger
- Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria
| | - Thomas Ernst Dorner
- Karl Landsteiner Institute for Health Promotion Research, 3062 Kirchstetten, Austria
- Center for Public Health, Department for Social and Preventive Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria
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Mittal N, Ataman M, Tintignac L, Ham DJ, Jörin L, Schmidt A, Sinnreich M, Ruegg MA, Zavolan M. Calorie restriction and rapamycin distinctly restore non-canonical ORF translation in the muscles of aging mice. NPJ Regen Med 2024; 9:23. [PMID: 39300171 DOI: 10.1038/s41536-024-00369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
Loss of protein homeostasis is one of the hallmarks of aging. As such, interventions that restore proteostasis should slow down the aging process and improve healthspan. Two of the most broadly used anti-aging interventions that are effective in organisms from yeast to mammals are calorie restriction (CR) and rapamycin (RM) treatment. To identify the regulatory mechanisms by which these interventions improve the protein homeostasis, we carried out ribosome footprinting in the muscle of mice aged under standard conditions, or under long-term treatment with CR or RM. We found that the treatments distinctly impact the non-canonical translation, RM primarily remodeling the translation of upstream open reading frames (uORFs), while CR restores stop codon readthrough and the translation of downstream ORFs. Proteomics analysis revealed the expression of numerous non-canonical ORFs at the protein level. The corresponding peptides may provide entry points for therapies aiming to maintain muscle function and extend health span.
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Affiliation(s)
- Nitish Mittal
- Biozentrum, University of Basel, Basel, Switzerland.
| | - Meric Ataman
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Lionel Tintignac
- Biozentrum, University of Basel, Basel, Switzerland
- Departments of Neurology and Biomedicine, University of Basel, Basel, Switzerland
- University Hospital Basel, Basel, Switzerland
| | - Daniel J Ham
- Biozentrum, University of Basel, Basel, Switzerland
| | - Lena Jörin
- Biozentrum, University of Basel, Basel, Switzerland
| | | | - Michael Sinnreich
- Departments of Neurology and Biomedicine, University of Basel, Basel, Switzerland
- University Hospital Basel, Basel, Switzerland
| | | | - Mihaela Zavolan
- Biozentrum, University of Basel, Basel, Switzerland.
- Swiss Institute of Bioinformatics, Lausanne, Switzerland.
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Song Q, Lin T, Liang R, Zhao Y, Ge N, Yue J. Creatinine-to-cystatin C ratio and frailty in older adults: a longitudinal cohort study. BMC Geriatr 2024; 24:753. [PMID: 39261791 PMCID: PMC11391795 DOI: 10.1186/s12877-024-05326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/23/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Creatinine-to-cystatin C ratio (CCR) has been associated with multiple adverse outcomes. However, little is known about its relationship with frailty. We aimed to explore the association between CCR and frailty among older adults. METHODS A total of 2599 participants aged ≥ 60 years (mean age 67.9 ± 6.0 years, 50.4% males) were included from the China Health and Retirement Longitudinal Study (2011-2015). Baseline CCR was calculated as plasma creatinine (mg/dL) / cystatin C (mg/L) × 10 and was grouped by quartiles. Frailty was evaluated by the validated physical frailty phenotype (PFP) scale and was defined as PFP score ≥ 3. The generalized estimating equations model was used to explore the relationship between CCR and frailty. RESULTS The frailty risk decreased gradually with increasing CCR in the quartiles (P for trend = 0.002), and the fourth CCR quartile was associated with a significantly lower risk of frailty compared with the lowest quartile (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19-0.70). When modeling as a continuous variable, per 1-unit increase in CCR was related to 17% decreased odds of frailty (OR 0.83, 95% CI 0.74-0.93). The association was consistent in male and female participants (P for interaction = 0.41). Poisson models revealed that frailty score was negatively associated with CCR (β= -0.11, 95% CI= -0.19 to -0.04), and sex did not significantly moderate the associations (P for interaction = 0.22). The results were not affected by further adjusting for high-sensitivity C-reactive protein. Similar results were observed by analyses with multiple imputation technique and analyses excluding participants with baseline frailty. CONCLUSIONS Higher CCR was associated with a lower frailty risk. CCR may be a simple marker for predicting frailty in older adults.
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Affiliation(s)
- Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Rui Liang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ning Ge
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
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Kim HJ, Nam HJ, Kim SH. Influence of Frailty Status on the Efficacy of Epidural Steroid Injections in Elderly Patients With Degenerative Lumbar Spinal Disease. Pain Res Manag 2024; 2024:5038496. [PMID: 39281846 PMCID: PMC11401664 DOI: 10.1155/2024/5038496] [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: 01/15/2024] [Revised: 06/10/2024] [Accepted: 08/17/2024] [Indexed: 09/18/2024]
Abstract
Background: The global increase in the elderly population has led to a higher prevalence of degenerative lumbar spinal diseases. Epidural steroid injection (ESI) is a widely used procedure for managing lower back pain. This study investigated the association of preprocedural frailty status with the efficacy of ESI in elderly patients diagnosed with degenerative lumbar spinal diseases. Methods: This retrospective observational study included patients aged 65 years and older who underwent lumbar ESI. Frailty status (robust, prefrail, and frail) assessed via the Frailty Phenotype Questionnaire was collected along with demographic and clinical parameters. Good analgesia was defined as a ≥ 50% reduction in pain score at 4-week follow-up evaluation. Multivariable logistic regression analyses were performed to identify factors associated with poor analgesia. Results: We included 289 patients in this study. Frailty status correlated with analgesic outcomes, with worsening frailty status correlating with increasingly poor analgesia after the injection (robust = 34.5%, prefrail = 40.8%, and frail = 60.0%, p=0.003), predominantly in female patients. After adjusting for demographic and clinical factors, frail patients demonstrated much higher odds of poor analgesia than robust individuals (adjusted odds ratio [aOR] = 2.673, 95% confidence interval [CI] = 1.338-5.342, p=0.005). Conversely, prefrail patients did not show a significant association with analgesic outcome (aOR = 1.293, 95% CI = 0.736-2.272, p=0.372). Conclusions: Frailty, but not prefrailty, appeared to be an independent factor associated with poor analgesic efficacy of ESI in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care.
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Affiliation(s)
- Hee Jung Kim
- Department of Anesthesiology and Pain MedicineAnesthesia and Pain Research InstituteYonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho Jae Nam
- Department of Anesthesiology and Pain MedicineAnesthesia and Pain Research InstituteYonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin Hyung Kim
- Department of Anesthesiology and Pain MedicineAnesthesia and Pain Research InstituteYonsei University College of Medicine, Seoul, Republic of Korea
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Padilla Isassi A, Samra Saad A, Cervera Gaviria J, Chamlati Kemps MP, Aguirre Domínguez JA, Narváez Valdivieso MJ. [Frailty as a predictor of 3-year mortality in older adult patients in long-term care in Mexico]. Rev Esp Geriatr Gerontol 2024; 59:101508. [PMID: 38823159 DOI: 10.1016/j.regg.2024.101508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION The objective of our study was to evaluate the long-term association between mortality and frailty in institutionalized patients in Mexico. Worldwide, there are limited lines of research in this population of geriatric patients and this entity generates a significant impact on the quality of life and prognosis of our patients. MATERIAL AND METHODS It is a prospective cohort study of 81 patients in long-term care who met the selection criteria. Frailty was determined using the FRAIL scale. Data on mortality were collected during the follow-up period, and diagnosis was monitored. The risk of presenting this event was determined by logistic regression, Kaplan-Meier, and Cox proportional hazards analysis, adjusted for age and sex. RESULTS The mean follow-up time of the patients was 36 months (1094 days), during which 33 subjects died (40.7%). In our population, at the beginning of the study the vast majority of frail patients had pathologies that independently generate risk of adverse events, disability (Barthel=30.9; SD 28.8), sarcopenia (n=40; 71.4%), one to 3 falls in the last year (n=17; 63%), ≥4 falls (n=4; 57.1%). Frail participants had a higher adjusted risk of mortality (HR 2.93; 95% CI 1.33-6.43; p=0.007). CONCLUSIONS The frailty entity is associated in the long term with mortality in institutionalized patients in Mexico. Timely treatment and approach may allow a good prognosis and quality of life.
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Cheng H, Xu X, Tang Y, Yang X, Ling Y, Tan S, Wang Z, Ming WK, Lyu J. Delirium Mediated the Association Between a History of Falls and Short-Term Mortality Risk in Critically Ill Ischemic Stroke Patients. Clin Nurs Res 2024; 33:545-559. [PMID: 39183563 DOI: 10.1177/10547738241273164] [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: 08/27/2024]
Abstract
Patients with ischemic stroke have an increased propensity to fall, resulting in significant physical and psychological distress. This study examined the association between falls in the 3 months prior to intensive care unit (ICU) admission and mortality within 28 days among 2950 adult ICU patients diagnosed with ischemic stroke from 2008 to 2019, focusing on the potential mediating role of delirium. The primary outcomes were short-term mortality (28, 60, and 90 days) and the risk of delirium. Each patient was followed for at least 1 year. Delirium was primarily assessed using the Confusion Assessment Method for the ICU and by reviewing nursing notes. Group differences between patients with and without a history of falls were compared using the Wilcoxon rank-sum test or the chi-squared test. Cox proportional risk or logistic regression models were used to explore the association between fall history and outcomes, and causal mediation analysis was performed. Results showed that patients with a recent fall history had a significantly increased risk of 28-day (hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.35-1.94), 60-day (HR: 1.67, 95% CI: 1.42-1.98), and 90-day mortality (HR: 1.66, 95% CI: 1.41-1.95), as well as an increased risk of delirium (odds ratio: 2.00, 95% CI: 1.66-2.42). Delirium significantly mediated the association between fall history and 28-day mortality (total effect: HR: 1.77, 95% CI: 1.45-2.16; natural indirect effect: HR: 1.12, 95% CI: 1.05-1.21; proportion mediated: 24.6%). These findings suggest that ischemic stroke patients with a recent fall have an increased risk of short-term mortality, partly mediated by delirium. Strategies aimed at preventing delirium may potentially improve prognosis in this patient population.
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Affiliation(s)
- Hongtao Cheng
- School of Nursing, Jinan University, Guangzhou, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiaozhen Xu
- Department of Respiratory and Critical Care Medicine, Kaiping Central Hospital, Jiangmen, China
| | - Yonglan Tang
- School of Nursing, Jinan University, Guangzhou, China
| | - Xin Yang
- School of Nursing, Jinan University, Guangzhou, China
| | - Yitong Ling
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shanyuan Tan
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zichen Wang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China
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Zhang N, Zhai L, Wong RMY, Cui C, Law SW, Chow SKH, Goodman SB, Cheung WH. Harnessing immunomodulation to combat sarcopenia: current insights and possible approaches. Immun Ageing 2024; 21:55. [PMID: 39103919 DOI: 10.1186/s12979-024-00458-9] [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: 05/21/2024] [Accepted: 07/24/2024] [Indexed: 08/07/2024]
Abstract
Sarcopenia is a complex age-associated syndrome of progressive loss of muscle mass and strength. Although this condition is influenced by many factors, age-related changes in immune function including immune cell dynamics, and chronic inflammation contribute to its progression. The complex interplay between the immune system, gut-muscle axis, and autophagy further underscores their important roles in sarcopenia pathogenesis. Immunomodulation has emerged as a promising strategy to counteract sarcopenia. Traditional management approaches to treat sarcopenia including physical exercise and nutritional supplementation, and the emerging technologies of biophysical stimulation demonstrated the importance of immunomodulation and regulation of macrophages and T cells and reduction of chronic inflammation. Treatments to alleviate low-grade inflammation in older adults by modulating gut microbial composition and diversity further combat sarcopenia. Furthermore, some pharmacological interventions, nano-medicine, and cell therapies targeting muscle, gut microbiota, or autophagy present additional avenues for immunomodulation in sarcopenia. This narrative review explores the immunological underpinnings of sarcopenia, elucidating the relationship between the immune system and muscle during ageing. Additionally, the review discusses new areas such as the gut-muscle axis and autophagy, which bridge immune system function and muscle health. Insights into current and potential approaches for sarcopenia management through modulation of the immune system are provided, along with suggestions for future research directions and therapeutic strategies. We aim to guide further investigation into clinical immunological biomarkers and identify indicators for sarcopenia diagnosis and potential treatment targets to combat this condition. We also aim to draw attention to the importance of considering immunomodulation in the clinical management of sarcopenia.
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Affiliation(s)
- Ning Zhang
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| | - Liting Zhai
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Can Cui
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Sheung-Wai Law
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
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He Y, Duan W, Xu P, Lin T, Xiang Q, Dong B, Ge N, Yue J. Exploring the impact of interleukins on sarcopenia development: A systematic review and meta-analysis. Exp Gerontol 2024; 193:112480. [PMID: 38852656 DOI: 10.1016/j.exger.2024.112480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND The role of interleukins in sarcopenia development has been acknowledged, yet the specifics of their involvement remain to be fully understood. This study aimed to explore alterations in interleukin levels among sarcopenia patients. METHODS Searches were conducted in Embase, Medline, and the Cochrane Library for literature published up to May 2023. Eligible observational studies with a diagnosis of sarcopenia were included. The Newcastle-Ottawa Scale was utilized for quality assessment. For data synthesis, a random-effects model was used, and the Mantel-Haenszel method was used for pooled estimates. RESULTS Of the 7685 articles screened, 37 met the inclusion criteria. Statistically significant differences in the levels of IL-1β, IL-6 and IL-10 were detected in sarcopenia patients. Specifically, IL-1β (95 % CI: 0.33 [0.12, 0.54], P < 0.05), IL-6 (95 % CI: 0.91 [0.59, 1.24], P < 0.05), and IL-10 (95 % CI: 0.11 [0.07,0.15], P < 0.05) were detected. However, no significant associations were found between serum IL-4 (95 % CI: 0.36 [-0.18, 0.42], P = 0.44), IL-8 (95 % CI: -1.05 [-3.06, 0.95], P = 0.3), IL-12 (95 % CI: -3.92 [-8.32,0.48], P = 0.08) or IL-17 (95 % CI: 0.22 [-2.43, 2.88], P = 0.87) and sarcopenia. Subgroup analysis showed no significant difference in IL-6 (95 % CI: -0.03 [-0.72, 0.66], P = 0.93) and IL-10 (95 % CI: 0.1 [-0.44, 0.64], P = 0.72) among patients with European standard sarcopenia. CONCLUSIONS Inflammation plays a role in sarcopenia, and the serum levels of IL-1β, IL-6, and IL-10 are associated with sarcopenia. Further research is needed to clarify these associations. CLINICAL TRIALS REGISTRATION NUMBER CRD42024506656.
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Affiliation(s)
- Yan He
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Geriatrics, The Second People's Hospital of Yibin, Yibin, Sichuan, China
| | - Wenrong Duan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Geriatrics, The Second People's Hospital of Yibin, Yibin, Sichuan, China
| | - Ping Xu
- Department of National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Taiping Lin
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiao Xiang
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Birong Dong
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ning Ge
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Jirong Yue
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Tang Y, Zhai Y, Song W, Zhu T, Xu Z, Jiang L, Li L, Liu D, Wu Q. Association between complete blood count-derived inflammatory markers and the risk of frailty and mortality in middle-aged and older adults. Front Public Health 2024; 12:1427546. [PMID: 39145178 PMCID: PMC11323558 DOI: 10.3389/fpubh.2024.1427546] [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: 05/08/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Abstract
Objective This study aimed to evaluate the association between six complete blood count (CBC)-derived inflammatory markers [neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), and pan-immune inflammation value (PIV)] and the risk of frailty and mortality. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Mortality was identified using the National Death Index until December 31, 2019. Multiple logistic regression analysis was conducted to evaluate the association between six CBC-derived inflammatory markers and frailty. The Cox regression model assessed the association between six CBC-derived inflammatory markers and mortality in frail populations. Restricted cubic spline (RCS) was used to visualize the association of the six CBC-derived inflammatory markers with mortality risk. The predictive value of CBC-derived inflammatory markers for mortality was further assessed using a random survival forest (RSF) approach. Results This study analyzed data from a total of 16,705 middle-aged and older participants. Among them, 6,503 participants were frail, with a mortality rate of 41.47%. Multiple logistic regression analysis showed that NLR, MLR, PLR, SII, SIRI, and PIV were positively associated with frailty risk. The Cox regression model revealed that participants in the highest quartile had a significantly increased risk of death compared to those in the lowest quartile: NLR (HR = 1.73, 95% CI:1.54, 1.94), MLR (HR = 1.71, 95% CI:1.51, 1.93), PLR (HR = 1.28, 95%CI: 1.15, 1.43), SII (HR = 1.50, 95%CI:1.34, 1.68), SIRI (HR = 1.88, CI 95%:1.67, 2.12), PIV (HR = 1.55, 95%CI:1.38, 1.73). Random survival forest (RSF) analyses demonstrated that MLR had the highest predictive value for mortality risk middle-aged and older adult frail participants. Conclusion The results suggest that CBC-derived inflammatory markers are associated with a higher risk of frailty as well as mortality in the middle and old-aged population of the United States.
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Affiliation(s)
- Yu Tang
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Ying Zhai
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wenjing Song
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Tengxiao Zhu
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zichen Xu
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Luqing Jiang
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lei Li
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Daoqin Liu
- Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Qiwen Wu
- Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Hernández-Urbán AJ, Drago-Serrano ME, Reséndiz-Albor AA, Sierra-Ramírez JA, Guzmán-Mejía F, Oros-Pantoja R, Godínez-Victoria M. Moderate Aerobic Exercise Induces Homeostatic IgA Generation in Senile Mice. Int J Mol Sci 2024; 25:8200. [PMID: 39125769 PMCID: PMC11311420 DOI: 10.3390/ijms25158200] [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: 06/14/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
A T-cell-independent (TI) pathway activated by microbiota results in the generation of low-affinity homeostatic IgA with a critical role in intestinal homeostasis. Moderate aerobic exercise (MAE) provides a beneficial impact on intestinal immunity, but the action of MAE on TI-IgA generation under senescence conditions is unknown. This study aimed to determine the effects of long-term MAE on TI-IgA production in young (3 month old) BALB/c mice exercised until adulthood (6 months) or aging (24 months). Lamina propria (LP) from the small intestine was obtained to determine B cell and plasma cell sub-populations by flow cytometry and molecular factors related to class switch recombination [Thymic Stromal Lymphopoietin (TSLP), A Proliferation-Inducing Ligand (APRIL), B Cell Activating Factor (BAFF), inducible nitric oxide synthase (iNOS), and retinal dehydrogenase (RDH)] and the synthesis of IgA [α-chain, interleukin (IL)-6, IL-21, and Growth Factor-β (TGF-β)]; and epithelial cells evaluated IgA transitosis [polymeric immunoglobulin receptor (pIgR), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), IL-4] by the RT-qPCR technique. The results were compared with data obtained from sedentary age-matched mice. Statistical analysis was computed with ANOVA, and p < 0.05 was considered to be a statistically significant difference. Under senescence conditions, MAE promoted the B cell and IgA+ B cells and APRIL, which may improve the intestinal response and ameliorate the inflammatory environment associated presumably with the downmodulation of pro-inflammatory mediators involved in the upmodulation of pIgR expression. Data suggested that MAE improved IgA and downmodulate the cytokine pro-inflammatory expression favoring homeostatic conditions in aging.
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Affiliation(s)
- Angel J. Hernández-Urbán
- Laboratorio de Citometría de Flujo, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - Maria-Elisa Drago-Serrano
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, Mexico City 04960, Mexico; (M.-E.D.-S.); (F.G.-M.)
| | - Aldo A. Reséndiz-Albor
- Laboratorio de Inmunidad de Mucosas, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - José A. Sierra-Ramírez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - Fabiola Guzmán-Mejía
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, Mexico City 04960, Mexico; (M.-E.D.-S.); (F.G.-M.)
| | - Rigoberto Oros-Pantoja
- Laboratorio de Neuroinmunoendocrinología, Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca 50180, Mexico;
| | - Marycarmen Godínez-Victoria
- Laboratorio de Citometría de Flujo, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
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Shamsalinia A, Hosseini SR, Bijani A, Ghadimi R, Kordbageri MR, Saadati K, Ghaffari F. Effects of Frailty Syndrome on Osteoporosis, Focusing on the Mediating Effect of Muscle Strength and Balance in Community-Dwelling Older Adults (≥60 years) in Iran: Results From the Amirkola Health and Aging Project Cohort Study. Geriatr Orthop Surg Rehabil 2024; 15:21514593241264647. [PMID: 39070931 PMCID: PMC11273585 DOI: 10.1177/21514593241264647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/21/2024] [Accepted: 06/09/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults. Material and Methods This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests. Results The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis. Conclusion From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis.
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Affiliation(s)
- Abbas Shamsalinia
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | | | - Kiyana Saadati
- Student Research Committee, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
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Lin D, Wu S, Li W, Ye P, Pan X, Zheng T, Gao F. A cross-tissue transcriptome-wide association study identifies new susceptibility genes for frailty. Front Genet 2024; 15:1404456. [PMID: 39071775 PMCID: PMC11272547 DOI: 10.3389/fgene.2024.1404456] [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: 04/08/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Background: Although genome-wide association studies (GWAS) have identified 14 loci associated with frailty index (FI) susceptibility, the underlying causative genes and biological mechanisms remain elusive. Methods: A cross-tissue transcriptome-wide association study (TWAS) was conducted utilizing the Unified Test for Molecular Markers (UTMOST), which integrates GWAS summary statistics from 164,610 individuals of European ancestry and 10,616 Swedish participants, alongside gene expression matrices from the Genotype-Tissue Expression (GTEx) Project. Validation of the significant genes was performed through three distinct methods: FUSION, FOCUS, and Multiple Marker Analysis of Genome-wide Annotation (MAGMA). Exploration of tissue and functional enrichment for FI-associated SNPs was conducted using MAGMA. Conditional and joint analyses, along with fine mapping, were employed to enhance our understanding of FI's genetic architecture. Mendelian randomization was employed to ascertain causal relationships between significant genes and FI, and co-localization analysis was utilized to investigate shared SNPs between significant genes and FI. Results: In this study, two novel susceptibility genes associated with the risk of FI were identified through the application of four TWAS methods. Mendelian randomization demonstrated that HTT may elevate the risk of developing frailty, whereas LRPPRC could offer protection against the onset of frailty. Additionally, co-localization analysis identified a shared SNP between LRPPRC and FI. Tissue enrichment analyses revealed that genomic regions linked to SNPs associated with frailty were predominantly enriched in various brain regions, including the frontal cortex, cerebral cortex, and cerebellar hemispheres. Conditional, combined analyses, and fine mapping collectively identified two genetic regions associated with frailty: 2p21 and 4q16.3. Functional enrichment analyses revealed that the pathways associated with frailty were primarily related to the MHC complex, PD-1 signaling, cognition, inflammatory response to antigenic stimuli, and the production of second messenger molecules. Conclusion: This investigation uncovers two newly identified genes with forecasted expression levels associated with the risk of FI, offering new perspectives on the genetic architecture underlying FI.
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Affiliation(s)
- Daoyi Lin
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Department of Anesthesia, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuyan Wu
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
| | - Wangyu Li
- Department of Pain Management, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
| | - Peng Ye
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou, China
| | - Xuan Pan
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
| | - Ting Zheng
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou, China
- Fujian Provincial Co-Constructed Laboratory of “Belt and Road”, Fujian Emergency Medical Center, Fuzhou, China
| | - Fei Gao
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou, China
- Fujian Provincial Co-Constructed Laboratory of “Belt and Road”, Fujian Emergency Medical Center, Fuzhou, China
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He L, Yang J, Fang Y. Longitudinal analysis on inflammatory markers and frailty progression: based on the English longitudinal study of aging. Eur Geriatr Med 2024:10.1007/s41999-024-00998-9. [PMID: 38987423 DOI: 10.1007/s41999-024-00998-9] [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: 03/20/2024] [Accepted: 05/17/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE Frailty is a common health state that is closely linked to adverse health outcomes in aging society. Although many inflammatory biomarkers have been cross-sectionally associated with frailty, knowledge on the longitudinal association is still limited. This study investigated the associations between inflammatory factors in clinical practice and frailty progression over time. METHODS To investigate the associations of three common inflammatory markers (hypersensitive C-reactive protein [hsCRP], white blood cell [WBC] and fibrinogen) with the progression of frailty. METHODS Data of 2316 participants (age 67.9 ± 6.1 years) were obtained from the English longitudinal study of aging (wave 4, 6 and 8) over an 8-year follow-up. The frailty index (FI) was calculated from 52 items. Mixed-effects models and Cox proportional hazards (Cox-PH) models were used to analyze the associations of hsCRP, WBC and fibrinogen with frailty progression. Values of inflammatory biomarkers were log-transformed. Age, sex and gross wealth were controlled. RESULTS Mixed-effects models showed that at a cross-sectional level, higher levels of hsCRP (β: 0.007, 95% CI 0.004-0.010), WBC (β: 0.021, 95% CI 0.010-0.032) and fibrinogen (β: 0.022, 95% CI 0.005-0.038) were associated with greater FI values while no significant time interaction was found. Cox-PH models showed that higher baseline levels of hsCRP (HR: 1.10, 95% CI 1.03-1.17) and WBC (HR: 1.23, 95% CI 1.10-1.37) were linked to a greater risk of developing frailty within 8 years. CONCLUSIONS We concluded that hsCRP, WBC and fibrinogen can reflect frailty status at a cross-sectional level while only hsCRP and WBC are associated with frailty progression over an 8-year period.
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Affiliation(s)
- Lingxiao He
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Jinzhu Yang
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
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Abdullah G, Akpan A, Phelan MM, Wright HL. New insights into healthy ageing, inflammageing and frailty using metabolomics. FRONTIERS IN AGING 2024; 5:1426436. [PMID: 39044748 PMCID: PMC11263002 DOI: 10.3389/fragi.2024.1426436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024]
Abstract
Human ageing is a normal process and does not necessarily result in the development of frailty. A mix of genetic, environmental, dietary, and lifestyle factors can have an impact on ageing, and whether an individual develops frailty. Frailty is defined as the loss of physiological reserve both at the physical and cellular levels, where systemic processes such as oxidative stress and inflammation contribute to physical decline. The newest "omics" technology and systems biology discipline, metabolomics, enables thorough characterisation of small-molecule metabolites in biological systems at a particular time and condition. In a biological system, metabolites-cellular intermediate products of metabolic reactions-reflect the system's final response to genomic, transcriptomic, proteomic, epigenetic, or environmental alterations. As a relatively newer technique to characterise metabolites and biomarkers in ageing and illness, metabolomics has gained popularity and has a wide range of applications. We will give a comprehensive summary of what is currently known about metabolomics in studies of ageing, with a focus on biomarkers for frailty. Metabolites related to amino acids, lipids, carbohydrates, and redox metabolism may function as biomarkers of ageing and/or frailty development, based on data obtained from human studies. However, there is a complexity that underpins biological ageing, due to both genetic and environmental factors that play a role in orchestrating the ageing process. Therefore, there is a critical need to identify pathways that contribute to functional decline in people with frailty.
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Affiliation(s)
- Genna Abdullah
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Asangaedem Akpan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- Division of Internal Medicine, University of Western Australia, Bunbury, WA, Australia
- Faculty of Health Sciences, Curtis University, Bunbury, WA, Australia
- Department of Geriatric Medicine, Bunbury Regional Hospital, Bunbury, WA, Australia
| | - Marie M. Phelan
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- High Field NMR Facility, Liverpool Shared Research Facilities University of Liverpool, Liverpool, United Kingdom
| | - Helen L. Wright
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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21
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Lin CL, Chen HC, Huang MH, Huang SW, Liao CD. Comparative Efficacy of Various Exercise Therapies and Combined Treatments on Inflammatory Biomarkers and Morphological Measures of Skeletal Muscle among Older Adults with Knee Osteoarthritis: A Network Meta-Analysis. Biomedicines 2024; 12:1524. [PMID: 39062097 PMCID: PMC11275072 DOI: 10.3390/biomedicines12071524] [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: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Osteoarthritis is associated with high risks of sarcopenia in older populations. Exercise interventions are promising treatments for musculoskeletal impairments in knee osteoarthritis (KOA). The purpose of this study was to identify the comparative effects of exercise monotherapy and its adjunct treatments on muscle volume and serum inflammation for older individuals with KOA. A literature search in the electronic databases was comprehensively performed from this study's inception until April 2024 to identify relevant randomized controlled trials (RCTs) that reported muscle morphology and inflammation outcomes after exercise. The included RCTs were analyzed through a frequentist network meta-analysis (NMA). The standard mean difference (SMD) with a 95% confidence interval was estimated for treatment effects on muscle morphology and inflammation biomarkers. The relative effects on each main outcome among all treatment arms were compared using surface under the cumulative ranking (SUCRA) scores. The certainty of evidence (CoE) was assessed by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) ranking system. Probable moderators of the treatment efficacy were investigated by network meta-regression analysis. This study included 52 RCTs (4255 patients) for NMA. Among the 27 identified treatment arms, isokinetic training plus physical modality as well as low-load resistance training plus blood-flow restriction yielded the most optimal treatment for inflammation reduction (-1.89; SUCRA = 0.97; CoE = high) and muscle hypertrophy (SMD = 1.28; SUCRA = 0.94; CoE = high). The patient's age (β = -0.73), the intervention time (β = -0.45), and the follow-up duration (β = -0.47) were identified as significant determinants of treatment efficacy on muscle hypertrophy. Exercise therapy in combination with noninvasive agents exert additional effects on inflammation reduction and muscle hypertrophy compared to its corresponding monotherapies for the KOA population. However, such treatment efficacy is likely moderated by the patient's age, the intervention time, and the follow-up duration.
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Affiliation(s)
- Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan
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22
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Shen L, Zong Y, Zhao J, Yang Y, Li L, Li N, Gao Y, Xie X, Bao Q, Jiang L, Hu W. Characterizing the skeletal muscle immune microenvironment for sarcopenia: insights from transcriptome analysis and histological validation. Front Immunol 2024; 15:1414387. [PMID: 39026669 PMCID: PMC11254692 DOI: 10.3389/fimmu.2024.1414387] [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: 04/08/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
Background Sarcopenia is a condition characterized by the age-related loss of skeletal muscle mass and function. The pathogenesis of the disease is influenced by chronic low-grade inflammation. However, the specific changes in the immune landscape changes of sarcopenic muscle are not yet fully understood. Methods To gain insights into the immune cell composition and interactions, we combined single-nucleus RNA sequencing data, bulk RNA sequencing dataset, and comprehensive bioinformatic analyses on the skeletal muscle samples from young, aged, and sarcopenic individuals. Histological staining was then performed on skeletal muscles to validate the distribution of immune cells in clinical samples. Results We analyzed the transcriptomes of 101,862 single nuclei, revealing a total of 10 major cell types and 6 subclusters of immune cell types within the human skeletal muscle tissues. Notable variations were identified in the immune microenvironment between young and aged skeletal muscle. Among the immune cells from skeletal muscle microenvironment, macrophages constituted the largest fraction. A specific marker gene LYVE1 for skeletal muscle resident macrophages was further identified. Cellular subclasses included four distinct groups of resident macrophages, which play different roles in physiological or non-physiological conditions. Utilizing bulk RNA sequencing data, we observed a significant enrichment of macrophage-rich inflammation in sarcopenia. Conclusions Our findings demonstrate age-related changes in the composition and cross-talk of immune cells in human skeletal muscle microenvironment, which contribute to chronic inflammation in aged or sarcopenia muscle. Furthermore, macrophages emerge as a potential therapeutic target, thus advancing our understanding of the pathogenesis of sarcopenia.
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Affiliation(s)
- Linhui Shen
- Department of Geriatrics, Ruijin hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Zong
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Jiawen Zhao
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Yang
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Li
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Li
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yiming Gao
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Xianfei Xie
- Hainan Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Qionghai, China
- Department of Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiyuan Bao
- Department of Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liting Jiang
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Weiguo Hu
- Department of Geriatrics, Ruijin hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Medical Center on Aging of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Xiong H, Wang D, Song P, Quan X, Zhang M, Huang S, Liu X, Chen Q, He X, Hu X, Yang X, Shi M. Development and validation of a major adverse limb events prediction model for peripheral arterial disease with frailty. J Vasc Surg 2024; 80:177-187.e2. [PMID: 38458361 DOI: 10.1016/j.jvs.2024.02.036] [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: 12/21/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the risk factors for major limb adverse events (MALE) in peripheral arterial disease (PAD) combined with frailty and to develop and validate a risk prediction model of MALE. METHODS This prospective study was performed in the vascular surgery department of patients in six hospitals in southwest China. Prospective collection of patients with PAD combined with frailty from February 1 to December 20, 2021, with MALE as the primary outcome, and followed for 1 year. The cohort was divided into a development cohort and a validation cohort. In the development cohort, a multivariate risk prediction model was developed to predict MALE using random forests for variable selection and multivariable Cox regression analysis. The model is represented by a visualized nomogram and a web-based calculator. The model performance was tested with the validation cohort and assessed using the C-statistic and calibration plots. RESULTS A total of 1179 patients were prospectively enrolled from February 1 to December 20, 2021. Among 816 patients with PAD who were included in the analysis, the median follow-up period for this study was 9 ± 4.07 months, the mean age was 74.64 ± 9.43 years, and 249 (30.5%) were women. Within 1 year, 222 patients (27.2%) developed MALE. Target lesion revascularizations were performed in 99 patients (12.1%), and amputations were performed in 131 patients (16.1%). The mortality rate within the whole cohort was 108 patients (13.2%). After controlling for competing risk events (death), the cumulative risk of developing MALE was not statistically different. Prealbumin (hazard ratio [HR], 0.6; 95% confidence interval [CI], 0.41-0.89; P = .010), percutaneous coronary intervention (HR, 2.31; 95% CI, 1.26-4.21; P = .006), Rutherford classification (HR, 1.77; 95% CI, 1.36-2.31; P < .001), white blood cell (HR, 1.85; 95% CI, 1.20-2.87; P = .005), high altitude area (HR, 3.1; 95% CI, 1.43-6.75; P = .004), endovascular treatment (HR, 10.2; 95% CI, 1.44-72.50; P = .020), and length of stay (HR, 1.01; 95% CI, 1.00-1.03; P = .012) were risk factors for MALE. The MALE prediction model had a C-statistic of 0.76 (95% CI, 0.70-0.79). The C-statistic was 0.68 for internal validation and 0.66 for external validation for the MALE prediction model. The MALE prediction model for PAD presented an interactive nomogram and a web-based network calculator. CONCLUSIONS In this study, the MALE prediction model has a discriminative ability to predict MALE among patients with PAD in frailty. The MALE model can optimize clinical decision-making for patients with PAD in frailty.
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Affiliation(s)
- Huarong Xiong
- Nursing School, Southwest Medical University, Luzhou, China; Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Dan Wang
- Nursing School, Southwest Medical University, Luzhou, China; Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Pan Song
- Nursing School, Southwest Medical University, Luzhou, China
| | - Xiaoyan Quan
- Nursing School, Southwest Medical University, Luzhou, China
| | - Mingfeng Zhang
- Department of Hepatology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Siyuan Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Liu
- Nursing School, Southwest Medical University, Luzhou, China
| | - Qin Chen
- Nursing School, Southwest Medical University, Luzhou, China; Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xinxin He
- Center of Gerontology and Geriatrics, Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuying Hu
- West China Hospital, Sichuan University, Chengdu, China; West China School of Nursing, Sichuan University/InNovation Center of Nursing Research, West China Hospital, Sichuan University/Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Xi Yang
- Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Meihong Shi
- Nursing School, Southwest Medical University, Luzhou, China; West China School of Nursing, Sichuan University/InNovation Center of Nursing Research, West China Hospital, Sichuan University/Nursing Key Laboratory of Sichuan Province, Chengdu, China.
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24
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Yun JS, Kim K, Ahn YB, Han K, Ko SH. Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients. Diabetes Metab J 2024; 48:531-545. [PMID: 39091004 PMCID: PMC11307114 DOI: 10.4093/dmj.2024.0310] [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: 06/14/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024] Open
Abstract
Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.
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Affiliation(s)
- Jae-Seung Yun
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyuho Kim
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu-Bae Ahn
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Seung-Hyun Ko
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kerr HL, Krumm K, Anderson B, Christiani A, Strait L, Li T, Irwin B, Jiang S, Rybachok A, Chen A, Dacek E, Caeiro L, Merrihew GE, MacDonald JW, Bammler TK, MacCoss MJ, Garcia JM. Mouse sarcopenia model reveals sex- and age-specific differences in phenotypic and molecular characteristics. J Clin Invest 2024; 134:e172890. [PMID: 39145448 PMCID: PMC11324300 DOI: 10.1172/jci172890] [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: 07/05/2023] [Accepted: 06/04/2024] [Indexed: 08/16/2024] Open
Abstract
Our study was to characterize sarcopenia in C57BL/6J mice using a clinically relevant definition to investigate the underlying molecular mechanisms. Aged male (23-32 months old) and female (27-28 months old) C57BL/6J mice were classified as non-, probable-, or sarcopenic based on assessments of grip strength, muscle mass, and treadmill running time, using 2 SDs below the mean of their young counterparts as cutoff points. A 9%-22% prevalence of sarcopenia was identified in 23-26 month-old male mice, with more severe age-related declines in muscle function than mass. Females aged 27-28 months showed fewer sarcopenic but more probable cases compared with the males. As sarcopenia progressed, a decrease in muscle contractility and a trend toward lower type IIB fiber size were observed in males. Mitochondrial biogenesis, oxidative capacity, and AMPK-autophagy signaling decreased as sarcopenia progressed in males, with pathways linked to mitochondrial metabolism positively correlated with muscle mass. No age- or sarcopenia-related changes were observed in mitochondrial biogenesis, OXPHOS complexes, AMPK signaling, mitophagy, or atrogenes in females. Our results highlight the different trajectories of age-related declines in muscle mass and function, providing insights into sex-dependent molecular changes associated with sarcopenia progression, which may inform the future development of novel therapeutic interventions.
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Affiliation(s)
- Haiming L. Kerr
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Kora Krumm
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Anthony Christiani
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lena Strait
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Theresa Li
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brynn Irwin
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Siyi Jiang
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Artur Rybachok
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Amanda Chen
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Elizabeth Dacek
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lucas Caeiro
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | | | - James W. MacDonald
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Theo K. Bammler
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | | | - Jose M. Garcia
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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Ching P, Chang C, Pan C, Chiang Y, Kuo H, Hsu T, Chu C. Factors associated with cognitive function in patient with Alzheimer's disease with newly prescribed acetylcholinesterase inhibitors: A 1-year retrospective cohort study. Aging Med (Milton) 2024; 7:312-319. [PMID: 38975305 PMCID: PMC11222751 DOI: 10.1002/agm2.12324] [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: 02/21/2024] [Revised: 05/03/2024] [Accepted: 05/29/2024] [Indexed: 07/09/2024] Open
Abstract
Objective We aimed to examine the factors associated with treatment outcomes in patients with Alzheimer's disease (AD) after 1 year of acetylcholinesterase inhibitors (AChEI) treatment. Method We obtained electronic medical records from a medical center in Southern Taiwan between January 2015 and September 2021. Participants aged ≥60 who were newly diagnosed with AD and had been prescribed AChEIs were included. Cognitive assessments were performed before the AChEIs were prescribed and at the 1 year follow-up. Cognition progressors were defined as a Mini-Mental State Examination decline of >3 or a Clinical Dementia Rating decline of ≥1 after 1 year of AChEI treatment. The relationship between the baseline characteristics and cognitive status after follow-up was investigated using logistic regression analysis after adjusting for potential confounders. Results A total of 1370 patients were included in our study (mean age, 79.86 ± 8.14 years). After adjustment, the body mass index (BMI) was found to be significantly lower in the progressor group [adjusted odds ratio (AOR): 0.970, 95% confidence intervals (95% CIs): 0.943 to 0.997, P = 0.033]. The usage of antipsychotics was significantly higher in the progressor group (AOR: 1.599, 95% CIs: 1.202 to 2.202, P = 0.001). The usage of benzodiazepine receptor agonists also tended to be significantly higher in the progressor group (AOR: 1.290, 95% CIs: 0.996 to 1.697, p = 0.054). Conclusion These results suggest that patients with AD who receive 1 year of AChEI treatment and have a lower BMI or concurrent treatment with antipsychotics and benzodiazepine receptor agonists are more likely to suffer from cognitive decline.
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Affiliation(s)
- Pao‐Yuan Ching
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Cheng‐Ho Chang
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Chih‐Chuan Pan
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
- Center for Geriatric and GerontologyKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Yung‐Chih Chiang
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Hsin‐ya Kuo
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
- Center for Geriatric and GerontologyKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Tien‐Wei Hsu
- Department of Psychiatry, E‐DA Dachang HospitalI‐Shou UniversityKaohsiungTaiwan
- Department of Psychiatry, E‐DA HospitalI‐Shou UniversityKaohsiungTaiwan
- Graduate Institute of Clinical Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - Che‐Sheng Chu
- Department of PsychiatryKaohsiung Veterans General HospitalKaohsiungTaiwan
- Center for Geriatric and GerontologyKaohsiung Veterans General HospitalKaohsiungTaiwan
- Non‐invasive Neuromodulation Consortium for Mental DisordersSociety of PsychophysiologyTaipeiTaiwan
- Graduate Institute of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
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An SM, Chae JS, Lee HJ, Cho S, Im J. Association of Psoas: Lumbar Vertebral Index (PLVI) with Postherpetic Neuralgia in Patients Aged 60 and Older with Herpes Zoster. J Clin Med 2024; 13:3100. [PMID: 38892810 PMCID: PMC11172933 DOI: 10.3390/jcm13113100] [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: 04/18/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: The psoas: lumbar vertebral index (PLVI) is a simple and convenient measure to assess central sarcopenia. Recent studies have utilized the psoas area to indirectly assess sarcopenia and frailty, exploring their associations with various health outcomes. This study aims to investigate the relationship between the PLVI and postherpetic neuralgia (PHN) in patients aged 60 years and above following a herpes zoster (HZ) infection. Methods: We conducted a retrospective analysis of data from 351 patients (≥60 years) who developed HZ between January 2019 and December 2023; the patients were divided into two groups based on the presence or absence of PHN after HZ onset. Results: The analyses using receiver operating characteristic curves revealed a value for the area under the curve of 0.813 for PLVI and 0.769 for the modified frailty index (mFI). In a multivariate logistic regression analysis, numerical rating scale scoring, a low PLVI, and a greater number of categorical mFI variables (adjusted odds ratio: 1.30, 3.27, and 2.46, respectively) were found to be significant independent predictors of PHN. Conclusions: Our findings highlight the association between a low PLVI and PHN in an older population. The PLVI may have potential as a predictive tool for PHN in older patients with HZ, but further research is needed to confirm these results.
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Affiliation(s)
- Sang-Mee An
- Department of Anesthesiology and Pain Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea (H.J.L.)
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Ji Seon Chae
- Department of Anesthesiology and Pain Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea (H.J.L.)
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Hyun Jung Lee
- Department of Anesthesiology and Pain Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea (H.J.L.)
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Sooyoung Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea
| | - Jiwoong Im
- Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea
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28
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Guo B, Liu X, Si Q, Zhang D, Li M, Li X, Zhao Y, Hu F, Zhang M, Liu Y, Hu D. Associations of CBC-Derived inflammatory indicators with sarcopenia and mortality in adults: evidence from Nhanes 1999 ∼ 2006. BMC Geriatr 2024; 24:432. [PMID: 38755603 PMCID: PMC11100216 DOI: 10.1186/s12877-024-05012-2] [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: 02/14/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND It has been proposed that inflammation plays a role in the development of sarcopenia. This study aimed to investigate the links of complete blood cell count (CBC) parameters and CBC-derived inflammatory indicators with sarcopenia and mortality. METHODS Data pertaining to sarcopenia were extracted from the 1999-2006 National Health and Nutrition Examination Survey (NHANES), and mortality events were ascertained through the National Death Index up to December 31, 2019. The CBC-derived inflammatory indicators assessed in this study included the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII). The prognostic significance of these CBC-derived inflammatory indicators was evaluated using the random survival forests (RSF) analysis. RESULTS The study encompassed a cohort of 12,689 individuals, among whom 1,725 were diagnosed with sarcopenia. Among individuals with sarcopenia, 782 experienced all-cause mortality, and 195 succumbed to cardiovascular causes. Following adjustment for confounding variables, it was observed that elevated levels of NLR, dNLR, NMLR, SIRI, and SII were associated with an increased prevalence of sarcopenia. Among participants with sarcopenia, those in the highest quartile of NLR (HR = 1.336 [1.095-1.631]), dNLR (HR = 1.274 [1.046-1.550]), MLR (HR = 1.619 [1.290-2.032]), NMLR (HR = 1.390 [1.132-1.707]), and SIRI (HR = 1.501 [1.210-1.862]) exhibited an elevated risk of all-cause mortality compared to those in the lowest quartile of these inflammation-derived indicators. These associations were similarly observed in cardiovascular mortality (HR = 1.874 [1.169-3.003] for MLR, HR = 1.838 [1.175-2.878] for SIRI). The RSF analysis indicated that MLR exhibited the highest predictive power for both all-cause and cardiovascular mortality among individuals with sarcopenia. CONCLUSIONS Our findings underscore the association between CBC-derived inflammatory indicators and mortality in adults with sarcopenia. Of note, MLR emerged as the most robust predictor of all-cause and cardiovascular mortality in this population.
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Affiliation(s)
- Botang Guo
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xinqing Liu
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Qi Si
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Minyao Li
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China.
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Chiariello A, Conte G, Rossetti L, Trofarello L, Salvioli S, Conte M. Different roles of circulating and intramuscular GDF15 as markers of skeletal muscle health. Front Endocrinol (Lausanne) 2024; 15:1404047. [PMID: 38808117 PMCID: PMC11130406 DOI: 10.3389/fendo.2024.1404047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Growth Differentiation Factor 15 (GDF15) is a mitokine expressed in response to various stresses whose circulating levels increase with age and are associated with numerous pathological conditions, including muscle wasting and sarcopenia. However, the use of circulating GDF15 (c-GDF15) as a biomarker of sarcopenia is still debated. Moreover, the role of GDF15 intracellular precursor, pro-GDF15, in human skeletal muscle (SM-GDF15) is not totally understood. In order to clarify these points, the association of both forms of GDF15 with parameters of muscle strength, body composition, metabolism and inflammation was investigated. Methods the levels of c-GDF15 and SM-GDF15 were evaluated in plasma and muscle biopsies, respectively, of healthy subjects (HS) and patients with lower limb mobility impairment (LLMI), either young (<40 years-old) or old (>70 years-old). Other parameters included in the analysis were Isometric Quadriceps Strength (IQS), BMI, lean and fat mass percentage, Vastus lateralis thickness, as well as circulating levels of Adiponectin, Leptin, Resistin, IGF-1, Insulin, IL6, IL15 and c-PLIN2. Principal Component Analysis (PCA), Canonical Discriminant Analysis (CDA) and Receiving Operating Characteristics (ROC) analysis were performed. Results c-GDF15 but not SM-GDF15 levels resulted associated with decreased IQS and IGF-1 levels in both HS and LLMI, while only in LLMI associated with increased levels of Resistin. Moreover, in LLMI both c-GDF15 and SM-GDF15 levels were associated with IL-6 levels, but interestingly SM-GDF15 is lower in LLMI with respect to HS. Furthermore, a discrimination of the four groups of subjects based on these parameters was possible with PCA and CDA. In particular HS, LLMI over 70 years or under 40 years of age were discriminated based on SM-GDF15, c-GDF15 and Insulin levels, respectively. Conclusion our data support the idea that c-GDF15 level could be used as a biomarker of decreased muscle mass and strength. Moreover, it is suggested that c-GDF15 has a different diagnostic significance with respect to SM-GDF15, which is likely linked to a healthy and active state.
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Affiliation(s)
- Antonio Chiariello
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Giuseppe Conte
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
| | - Luca Rossetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Interdepartmental Centre “Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate)”, University of Bologna, Bologna, Italy
| | - Lorenzo Trofarello
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Stefano Salvioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Conte
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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Arsava EM, Gungor L, Sirin H, Sorgun MH, Aykac O, Batur Caglayan HZ, Kozak HH, Ozturk S, Topcuoglu MA. Muscle mass as a modifier of stress response in acute ischemic stroke patients. Sci Rep 2024; 14:10088. [PMID: 38698153 PMCID: PMC11066052 DOI: 10.1038/s41598-024-60829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/27/2024] [Indexed: 05/05/2024] Open
Abstract
Stroke triggers a systemic inflammatory response over the ensuing days after the cerebral insult. The age and comorbidities of the stroke population make them a vulnerable population for low muscle mass and sarcopenia, the latter being another clinical condition that is closely associated with inflammation, as shown by increased levels of pro-inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR). In this study, we evaluated the relationship between post-stroke NLR changes and muscle mass in a prospective cohort of acute ischemic stroke patients (n = 102) enrolled in the Muscle Assessment in Stroke Study Turkey (MASS-TR). Admission lumbar computed tomography images were used to determine the cross-sectional muscle area of skeletal muscles at L3 vertebra level and calculate the skeletal muscle index (SMI). The median (IQR) SMI was 44.7 (39.1-52.5) cm2/m2, and the NLR at admission and follow-up were 4.2 (3.0-10.5) and 9.4 (5.7-16.2), respectively. While there was no relationship between SMI and admission NLR, a significant inverse correlation was observed between SMI and follow-up NLR (r = - 0.26; P = 0.007). Lower SMI remained significantly associated (P = 0.036) with higher follow-up NLR levels in multivariate analysis. Our findings highlight the importance of muscle mass as a novel factor related to the level of post-stroke stress response.
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Affiliation(s)
- Ethem Murat Arsava
- Department of Neurology, Faculty of Medicine, Hacettepe University, 06230, Altindag, Ankara, Turkey.
| | - Levent Gungor
- Department of Neurology, Ondokuz Mayis University, Samsun, Turkey
| | - Hadiye Sirin
- Department of Neurology, Ege University, Izmir, Turkey
| | | | - Ozlem Aykac
- Department of Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Mehmet Akif Topcuoglu
- Department of Neurology, Faculty of Medicine, Hacettepe University, 06230, Altindag, Ankara, Turkey
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31
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Zhu Y, Mierau JO, Bakker SJL, Dekker LH, Navis GJ. Sarcopenia augments the risk of excess weight on COVID-19 hospitalization: A prospective study using the Lifelines COVID-19 cohort. Nutrition 2024; 121:112361. [PMID: 38367316 DOI: 10.1016/j.nut.2024.112361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE We investigated the associations of sarcopenia alone, overweight or obesity, and sarcopenic overweight or obesity with COVID-19 hospitalization. METHODS Participants from the Lifelines COVID-19 cohort who were infected with COVID-19 were included in this study. Sarcopenia was defined as a relative deviation of muscle mass of ≤ -1.0 SD from the sex-specific mean 24-h urinary creatinine excretion. Overweight or obesity was defined as a body mass index ≥ 25 kg/m2. Sarcopenic overweight or obesity was defined as the presence of overweight or obesity and low muscle mass. COVID-19 hospitalization was self-reported. Logistic regression models were used to analyze the associations of sarcopenia alone, overweight or obesity, and sarcopenic overweight or obesity with COVID-19 hospitalization. RESULTS Of the 3594 participants infected with COVID-19 and recruited in this study, 173 had been admitted to the hospital. Compared with the reference group, individuals with overweight or obesity and sarcopenic overweight or obesity were 1.78-times and 2.09-times more likely to have been hospitalized for COVID-19, respectively, whereas sarcopenia alone did not increase the risk of COVID-19 hospitalization. CONCLUSIONS In this middle-aged population, sarcopenic overweight or obesity elevated the risk of hospitalization for COVID-19 in those infected with COVID-19 more than overweight or obesity alone. These data support the relevance of sarcopenic overweight or obesity as a risk factor beyond the geriatric setting and should be considered in risk stratification in future public health and vaccination campaigns.
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Affiliation(s)
- Yinjie Zhu
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Jochen O Mierau
- Team Strategy and External Relations, University of Groningen, University Medical Center Groningen, The Netherlands; Lifelines Cohort Study and Biobank, Groningen, The Netherlands; Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Louise H Dekker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
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Kochlik B, Herpich C, Moreno-Villanueva M, Klaus S, Müller-Werdan U, Weinberger B, Fiegl S, Toussaint O, Debacq-Chainiaux F, Schön C, Bernhard J, Breusing N, Gonos ES, Franceschi C, Capri M, Sikora E, Hervonen A, Hurme M, Slagboom PE, Dollé MET, Jansen E, Grune T, Bürkle A, Norman K. Associations of circulating GDF15 with combined cognitive frailty and depression in older adults of the MARK-AGE study. GeroScience 2024; 46:1657-1669. [PMID: 37715843 PMCID: PMC10828354 DOI: 10.1007/s11357-023-00902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 09/18/2023] Open
Abstract
Growth differentiation factor-15 (GDF15) might be involved in the development of cognitive frailty and depression. Therefore, we evaluated cross-sectional associations of plasma GDF15 with combined cognitive-frailty-and-depression in older (i.e. ≥ 55 years) and younger adults of the MARK-AGE study. In the present work, samples and data of MARK-AGE ("European study to establish bioMARKers of human AGEing") participants (N = 2736) were analyzed. Cognitive frailty was determined by the global cognitive functioning score (GCF) and depression by the Self-Rating Depression Scale (SDS score). Adults were classified into three groups: (I) neither-cognitive-frailty-nor-depression, (II) either-cognitive-frailty-or-depression or (III) both-cognitive-frailty-and-depression. Cross-sectional associations were determined by unadjusted and by age, BMI, sex, comorbidities and hsCRP-adjusted linear and logistic regression analyses. Cognitive frailty, depression, age and GDF15 were significantly related within the whole study sample. High GDF15 levels were significantly associated with both-cognitive-frailty-and-depression (adjusted β = 0.177 [0.044 - 0.310], p = 0.009), and with low GCF scores and high SDS scores. High GDF15 concentrations and quartiles were significantly associated with higher odds to have both-cognitive-frailty-and-depression (adjusted odds ratio = 2.353 [1.267 - 4.372], p = 0.007; and adjusted odds ratio = 1.414 [1.025 - 1.951], p = 0.035, respectively) independent of age, BMI, sex, comorbidities and hsCRP. These associations remained significant when evaluating older adults. We conclude that plasma GDF15 concentrations are significantly associated with combined cognitive-frailty-and-depression status and, with cognitive frailty and depressive symptoms separately in old as well as young community-dwelling adults.
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Affiliation(s)
- Bastian Kochlik
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Food4Future (F4F), c/o Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Theodor-Echtermeyer-Weg 1, 14979, Grossbeeren, Germany
| | - Catrin Herpich
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - María Moreno-Villanueva
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Constance, Germany
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Constance, Germany
| | - Susanne Klaus
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Department of Physiology of Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Protestant Geriatric Center Berlin (EGZB), Berlin, Germany
| | - Birgit Weinberger
- Research Institute for Biomedical Aging Research, Universität Innsbruck, Rennweg 10, 6020, Innsbruck, Austria
| | - Simone Fiegl
- UMIT TIROL, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria
| | - Olivier Toussaint
- URBC-Narilis, University of Namur, Rue de Bruxelles 61, B-5000, Namur, Belgium
| | | | | | - Jürgen Bernhard
- BioTeSys GmbH, Schelztorstraße 54-56, 73728, Esslingen, Germany
| | - Nicolle Breusing
- Institute of Nutritional Medicine, Department of Applied Nutritional Science/Dietetics, University of Hohenheim, Stuttgart, Germany
| | - Efstathios S Gonos
- Institute of Biological Research and Biotechnology, National Hellenic Research Foundation (NHRF, 48 Vas. Constantinou Ave, 11635, Athens, Greece
| | - Claudio Franceschi
- Institute of Information Technology, Mathematics and Mechanics, Department of Applied Mathematics, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Miriam Capri
- Department of Medical and Surgical Sciences, University of Bologna-Alma Mater Studiorum, Bologna, Italy
- Alma Mater Research Institute On Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy
| | - Ewa Sikora
- Laboratory of the Molecular Bases of Ageing, Polish Academy of Sciences, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Antti Hervonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mikko Hurme
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - P Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn E T Dollé
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Eugene Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Faculty of Chemistry, Department of Physiological Chemistry, University of Vienna, Vienna, Austria
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Alexander Bürkle
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Constance, Germany
| | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany.
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
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Fan G, Zang B, Qiao Y, Shan T, Fu S, Xu W, Cai W, Jiang Y, Chao Y, Zhao W. Association of Sarcopenia, as Defined Based on the Skeletal Muscle Index, With Mortality and Morbidity After Cardiac Surgery: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth 2024; 38:982-991. [PMID: 38350741 DOI: 10.1053/j.jvca.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE To investigate whether "sarcopenia," defined based on the preoperative skeletal muscle index (SMI), can predict major postoperative morbidity and all-cause mortality. DESIGN A retrospective observational cohort study. SETTING At the authors' Department of Critical Care Medicine. PARTICIPANTS A total of 986 adult Chinese patients underwent cardiac surgery (coronary artery bypass graft, valve surgery, combined surgery, or aortic surgery) between January 2019 and August 2022. MEASUREMENTS AND MAIN RESULTS The skeletal muscle area at the third lumbar level (L3) was measured via preoperative computed tomography (up to 3 months from the date of imaging to the date of surgery) and normalized to patient height (skeletal muscle index). Sarcopenia was determined based on the skeletal muscle index being in the lowest sex-specific quartile. The primary outcome was all-cause mortality. The secondary outcome was major morbidity. A total of 968 patients were followed for a median of 2.00 years, ranging from 1.06 to 2.90 years. After the follow-up, 76 patients died during the follow-up period. Multivariate Cox proportional analysis showed a relationship between sarcopenia (adjusted hazard ratio 1.80, 95% CI 1.04-3.11; p = 0.034) and all-cause mortality. Kaplan-Meier curves revealed a significantly lower survival rate in the sarcopenia group than in the nonsarcopenia group. Overall, 199 (20.6%) patients had major morbidity. Multivariate analysis showed a significant relationship between sarcopenia (adjusted odds ratio = 2.21, 95% CI 1.52∼3.22, p < 0.001) and major morbidity. CONCLUSIONS Sarcopenia, defined by the skeletal muscle index, is associated with all-cause mortality and major morbidity after cardiac surgery, thereby suggesting the need for perioperative sarcopenia risk assessment for patients undergoing cardiac surgery to guide the prevention and management of adverse outcomes.
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Affiliation(s)
- Guanglei Fan
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Baohe Zang
- Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuhan Qiao
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Tianchi Shan
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Shuyang Fu
- Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Xu
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wen Cai
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yaning Jiang
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yali Chao
- Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wenjing Zhao
- Department of Intensive Care Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Xuekelati S, Maimaitiwusiman Z, Bai X, Xiang H, Li Y, Wang H. Sarcopenia is associated with hypomethylation of TWEAK and increased plasma levels of TWEAK and its downstream inflammatory factor TNF-α in older adults: A case-control study. Exp Gerontol 2024; 188:112390. [PMID: 38437928 DOI: 10.1016/j.exger.2024.112390] [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: 12/25/2023] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Sarcopenia is a harmful condition common among older adults for which no treatment is available. Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and its receptor fibroblast growth factor inducible 14 (FN14) are known to play important roles in the pathogenesis of sarcopenia. This study investigated alterations in methylation in TWEAK and Fn14 to identify potential targets for the managing sarcopenia. MATERIALS AND METHODS Through an epidemiological investigation, we detected methylation of CpG islands (CpGs) in TWEAK and Fn14 in community-dwelling older adult of Xinjiang by bisulfite sequencing. Significant CpGs associated with sarcopenia were selected for detection in 152 older individuals by pyrosequencing. Associations between CpG methylation, plasma inflammatory marker levels, and sarcopenia were analyzed. RESULTS Of 38 CpGs in TWEAK and 30 CpGs in Fn14 detected in 60 individuals, 6 CpGs showed lower methylation in sarcopenia patients compared with control individuals. In 152 older adults, covariance analysis with adjustment for age, gender, triglyceride level, obesity, diabetes, and hypertension showed that the methylation levels of 6 CpGs (CpG8, CpG12, CpG13, CpG20 and CpG21of TWEAK, and CpG24 of Fn14) were significantly lower in sarcopenia patients than in control individuals. With adjustment for additional confounding factors, covariate variance analysis showed that plasma TWEAK, TNF-α and IL-10 levels in the sarcopenia group were significant higher than those in the control group (P = 0.007, P < 0.001, P = 0.003). Multivariate logistic regression analysis showed that CpG8, CpG13, CpG21, and total methylation of TWEAK (OR = 0.767, 95 % CI = 0.622-0.947; OR = 0.740, 95 % CI = 0.583-0.941; OR = 0.734, 95 % CI = 0.561-0.958; OR = 0.883, 95 % CI = 0.795-0.980) as well as CpG22 and total methylation of Fn14 were significantly associated with sarcopenia (OR = 826, 95 % CI = 0.704-0.968; OR = 0.918, 95 % CI = 0.852-0.989). From partial correlation analysis, plasma TWEAK was correlated with plasma TNF-α (r = 0.172, P = 0.042). CONCLUSION Sarcopenia is associated with hypomethylation of TWEAK and increased plasma levels of TWEAK and its downstream inflammatory factor TNF-α in a community-dwelling population of older adults in Xinjiang.
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Affiliation(s)
- Saiyare Xuekelati
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
| | - Zhuoya Maimaitiwusiman
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
| | - Xue Bai
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
| | - Hong Xiang
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
| | - Yangjing Li
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
| | - Hongmei Wang
- Second Department of Comprehensive Internal Medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China.
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Balazs I, Stelzer M, Traub J, Horvath A, Feldbacher N, Stadlbauer V. Primary sarcopenia is associated with elevated spontaneous NET formation. Front Cell Dev Biol 2024; 12:1347495. [PMID: 38505257 PMCID: PMC10948394 DOI: 10.3389/fcell.2024.1347495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction: Sarcopenia is a frequent complication of liver cirrhosis, but it can also occur independently as a result of any underlying cause. The immune system plays an important role in the pathogenesis of both liver cirrhosis and sarcopenia. Neutrophil function, including neutrophil extracellular trap (NET) formation, is linked to chronic inflammation; however, it has not been extensively studied in patients with sarcopenia. Here, we aim to study if main neutrophil functions, such as phagocytosis, reactive oxygen species (ROS) production, and NET formation, are altered in patients with sarcopenia with or without liver cirrhosis. Methods: Neutrophils from 92 patients (52 patients with liver cirrhosis and sarcopenia, 25 patients with liver cirrhosis without sarcopenia, and 15 patients with sarcopenia without liver cirrhosis) and 10 healthy controls were isolated and stimulated with heat-inactivated E. coli (250 bacteria/cell), phorbol 12-myristate 13-acetate (PMA) (100 nM), or incubation medium in duplicates for 2 h at 37°C. Cells were fixed with paraformaldehyde and stained with 4',6-diamidino-2-phenylindole (DAPI). Pictures of 10 random fields of vision per slide were taken with an Olympus BX51 fluorescence microscope (Olympus, Shinjuku, Tokyo, Japan) at 600x total magnification. The DNA Area and NETosis Analysis (DANA) algorithm was used to quantify the percentage of NET formation per patient. Phagocytosis and ROS production were assessed with the PhagotestTM kit and PhagoburstTM kit (Glycotope, Heidelberg, Germany) in 92 patients and 21 healthy controls, respectively. Results: Spontaneous NET formation was significantly elevated in patients with only sarcopenia compared to patients with cirrhosis and sarcopenia (p = 0.008) and healthy controls (p = 0.039). NET formation in response to PMA was significantly decreased in patients with cirrhosis (p = 0.007), cirrhosis and sarcopenia (p < 0.001), and sarcopenia (p = 0.002) compared to healthy controls. There was no significant difference in NET formation in response to E. coli between the groups. The DANA algorithm was successfully optimized and validated for assessment of clinical samples. There were no significant changes in neutrophil phagocytosis between patients' groups compared to healthy controls. A significantly lower percentage of neutrophils produced ROS in response to N-formylmethionine-leucyl-phenylalanine (fMLF) in patients compared to healthy controls. Discussion: Spontaneous NET formation might contribute to chronic inflammation and sarcopenia pathogenesis. This, however, does not result in the impairment of the NET formation function of neutrophils in response to a bacterial stimulus and, therefore, cannot be not linked with the increased risk of bacterial infections neither in sarcopenia nor in cirrhosis. The semi-automated NET formation analysis can be successfully implemented to analyze the vast amount of data generated within clinical studies. This approach opens up the possibilities to develop an NET formation-based biomarker in different diseases including sarcopenia and implement NET formation analysis into clinical settings. Phagocytosis and ROS production were not affected in patients with sarcopenia. Further research is needed to explore the mechanism of NET formation in patients with sarcopenia and its potential as a biomarker in sarcopenia.
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Affiliation(s)
- Irina Balazs
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Manuel Stelzer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Julia Traub
- Department of Clinical Medical Nutrition, Medical University of Graz, Graz, Austria
| | - Angela Horvath
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Nicole Feldbacher
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Vanessa Stadlbauer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
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He D, Yan M, Zhou Y, Ge H, Zhang X, Xu Y, Liu C, Ying K, Zhu Y. Preserved Ratio Impaired Spirometry and COPD Accelerate Frailty Progression: Evidence From a Prospective Cohort Study. Chest 2024; 165:573-582. [PMID: 37499976 DOI: 10.1016/j.chest.2023.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND COPD has been found to be associated with frailty. However, longitudinal evidence for associations of COPD with frailty progression is inadequate. Furthermore, recent studies revealed a new phenotype of lung function impairment: preserved ratio impaired spirometry (PRISm) findings. Associations of PRISm findings and their transitions with frailty progression are unclear. RESEARCH QUESTION What are the associations of PRISm findings, transitions of PRISm findings, and COPD with frailty progression? STUDY DESIGN AND METHODS To analyze the associations of PRISm findings and COPD with frailty progression, 5,901 patients were included from the English Longitudinal Study of Ageing. Patients were classified into three lung function patterns of normal spirometry (NS) findings, PRISm findings, and COPD. Frailty progression was assessed by repeated measurements of the frailty index (FI) during follow-up. Among these 5,901 patients, 3,765 patients were included to analyze the associations of PRISm findings transitions with frailty progression. PRISm findings transitions were assessed based on the changes of lung function patterns after a 4-year interval. Linear mixed-effect models were used for statistical analyses. RESULTS The median follow-up periods were 9.5 years for the analyses of PRISm findings and COPD with frailty progression and 5.8 years for PRISm findings transitions with frailty progression. When compared with participants with NS findings, patients with PRISm findings and COPD demonstrated accelerated FI progression with additional annual increases of 0.301 (95% CI, 0.211-0.392; P < .001) and 0.172 (95% CI, 0.102-0.242; P < .001), respectively. Patients who transitioned from NS findings to PRISm findings also demonstrated accelerated FI progression when compared with those with stable NS findings (β = 0.242; 95% CI, 0.008-0.476; P = .042). However, no accelerated FI progression was found in patients with PRISm findings who transitioned to NS findings (β = 0.119; 95% CI, -0.181 to 0.418; P = .438). INTERPRETATION Our findings indicate that PRISm findings and COPD are associated with accelerated frailty progression. Further studies are needed to elucidate the causality of the association of PRISm findings and COPD with frailty.
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Affiliation(s)
- Di He
- Department of Epidemiology & Biostatistics, School of Public Health, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China; Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Mengsha Yan
- Department of Epidemiology & Biostatistics, School of Public Health, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China; Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yong Zhou
- Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Huiqing Ge
- Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Xuhui Zhang
- Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuying Xu
- Department of Epidemiology & Biostatistics, School of Public Health, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China; Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Chengguo Liu
- Putuo District People's Hospital, Zhoushan, Zhejiang, China
| | - Kejing Ying
- Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China; Department of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China; Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China.
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Lo Buglio A, Bellanti F, Carmignano DFP, Serviddio G, Vendemiale G. Association between Controlling Nutritional Status (CONUT) Score and Body Composition, Inflammation and Frailty in Hospitalized Elderly Patients. Nutrients 2024; 16:576. [PMID: 38474705 DOI: 10.3390/nu16050576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
The Controlling Nutritional Status (CONUT) score has demonstrated its ability to identify patients with poor nutritional status and predict various clinical outcomes. Our objective was to assess the association between the CONUT score, inflammatory status, and body composition, as well as its ability to identify patients at risk of frailty in hospitalized elderly patients. METHODS a total of 361 patients were retrospectively recruited and divided into three groups based on the CONUT score. RESULTS patients with a score ≥5 exhibited significantly higher levels of inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil/Lymphocytes ratio (NLR), main platelet volume (MPV), and ferritin, compared to those with a lower score. Furthermore, these patients showed unfavorable changes in body composition, including a lower percentage of skeletal muscle mass (MM) and fat-free mass (FFM) and a higher percentage of fatty mass (FM). A positive correlation was found between the CONUT score and inflammatory markers, Geriatric Depression Scale Short Form (GDS-SF), and FM. Conversely, the Mini Nutritional Assessment (MNA), Mini-Mental Status Examination, activity daily living (ADL), instrumental activity daily living (IADL), Barthel index, FFM, and MM showed a negative correlation. Frailty was highly prevalent among patients with a higher CONUT score. The receiver operating characteristic (ROC) curve demonstrated high accuracy in identifying frail patients (sensitivity). CONCLUSIONS a high CONUT score is associated with a pro-inflammatory status as well as with unfavorable body composition. Additionally, it is a good tool to identify frailty among hospitalized elderly patients.
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Affiliation(s)
- Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | | | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
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Wen Q, Chen X, Luo S, Hou L, Yue J, Liu X, Xia X, Liu F, Dong B, Ge N. Association between sarcopenia grade and fall history among older adults in West China: A retrospective study. BMJ Open 2024; 14:e080426. [PMID: 38382964 PMCID: PMC10882337 DOI: 10.1136/bmjopen-2023-080426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES The association between sarcopenia severity and fall history remains under-researched at present. Accordingly, this study was developed to evaluate the relationship between sarcopenic status and prior fall events in a multiethnic group of older community-dwelling adults in Western China. DESIGN A retrospective survey study, the data comes from the West China Health and Aging Trend study. SETTING The study was based in Western China. PARTICIPANTS In total, this retrospective analysis incorporated data from 2719 older adults (59.2% women). PRIMARY AND SECONDARY OUTCOME MEASURES Grip strength, gait speed and skeletal muscle mass index values were analysed for all participants, and the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 consensus criteria were leveraged to assess sarcopenia status in these individuals. Prior fall history was defined by any incidents in which an individual unintentionally came to rest on the floor within the past year. The association between sarcopenia status and fall history was examined through a binary logistic regression approach, with p<0.05 as the threshold for significance. RESULTS Using the AWGS2014 and AWGS2019 diagnostic criteria, of the individuals included in this study cohort 1851 (68.1%) were free of sarcopenia, 160 (5.9%) and 56 (2.1%) showed only muscle-mass loss, 322 (11.8%) and 267 (9.8%) exhibited non-severe sarcopenia and the remaining 386 (14.2%) and 545 (20.0%) exhibited severe sarcopenia, respectively. Previous fall events were reported for 14.8% of study cohort members. After full adjustment for potential confounders, a significant link between severe sarcopenia diagnosed by the AWGS2014 diagnostic criteria and fall history was observed (OR 1.397, 95% CI 1.029 to 1.896, p=0.032), while the AWGS2019 diagnostic criteria did not (OR 1.29, 95% CI 0.982 to 1.694, p=0.068). CONCLUSIONS Severe sarcopenia, as defined per the AWGS2014 criteria, was associated with a significantly higher risk of falls in this multiethnic cohort of older adults from Western China, while the AWGS2019 diagnostic criteria did not. However, this relationship was not observed for individuals who experienced muscle mass loss or had non-severe sarcopenia, according to both the AWGS2014 and AWGS2019 diagnostic criteria.
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Affiliation(s)
- Quan Wen
- Department of Traditional Chinese Medicine, Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan, China
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
| | - Xiaoyan Chen
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
- Zigong Mental Health Center, Zigong, China
| | - Shuyue Luo
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
- Sichuan University West China Hospital Center of Gerontology and Geriatrics, Chengdu, Sichuan, China
| | - Lisha Hou
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
| | - Jirong Yue
- Sichuan University West China Hospital Center of Gerontology and Geriatrics, Chengdu, Sichuan, China
- Department of Geriatrics, Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
| | - Xiaolei Liu
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
- Sichuan University West China Hospital Center of Gerontology and Geriatrics, Chengdu, Sichuan, China
| | - Xin Xia
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
| | - Fang Liu
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
- Center of Gerontology and Geriatrics, Chengdu Eighth People's Hospital, Chengdu, Sichuan, China
| | - Birong Dong
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
| | - Ning Ge
- Sichuan University West China Hospital National Clinical Research Center for Geriatrics, Chengdu, Sichuan, China
- Sichuan University West China Hospital Center of Gerontology and Geriatrics, Chengdu, Sichuan, China
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Albrecht R, Espejo T, Riedel HB, Nissen SK, Banerjee J, Conroy SP, Dreher-Hummel T, Brabrand M, Bingisser R, Nickel CH. Clinical Frailty Scale at presentation to the emergency department: interrater reliability and use of algorithm-assisted assessment. Eur Geriatr Med 2024; 15:105-113. [PMID: 37971677 PMCID: PMC10876739 DOI: 10.1007/s41999-023-00890-y] [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] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE The Clinical Frailty Scale (CFS) allows health care providers to quickly stratify older patients, to support clinical decision-making. However, few studies have evaluated the CFS interrater reliability (IRR) in Emergency Departments (EDs), and the freely available smartphone application for CFS assessment was never tested for reliability. This study aimed to evaluate the interrater reliability of the Clinical Frailty Scale (CFS) ratings between experienced and unexperienced staff (ED clinicians and a study team (ST) of medical students supported by a smartphone application to assess the CFS), and to determine the feasibility of CFS assignment in patients aged 65 or older at triage. METHODS Cross-sectional study using consecutive sampling of ED patients aged 65 or older. We compared assessments by ED clinicians (Triage Clinicians (TC) and geriatric ED trained nurses (geriED-TN)) and a study team (ST) of medical students using a smartphone application for CFS scoring. The study is registered on Clinicaltrials.gov (NCT05400707). RESULTS We included 1349 patients aged 65 and older. Quadratic-weighted kappa values for ordinal CFS levels showed a good IRR between TC and ST (ϰ = 0.73, 95% CI 0.69-0.76), similarly to that between TC and geriED-TN (ϰ = 0.75, 95% CI 0.66-0.82) and between the ST and geriED-TN (ϰ = 0.74, 95% CI 0.63-0.81). A CFS rating was assigned to 972 (70.2%) patients at triage. CONCLUSION We found good IRR in the assessment of frailty with the CFS in different ED providers and a team using a smartphone application to support rating. A CFS assessment occurred in more than two-thirds (70.2%) of patients at triage.
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Affiliation(s)
- Rainer Albrecht
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland
| | - Tanguy Espejo
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland
| | - Henk B Riedel
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland
| | - Søren K Nissen
- Research Unit for Emergency Medicine, Odense University Hospital, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Jay Banerjee
- University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Simon P Conroy
- St Pancras Hospital, Central and North West London NHS Foundation Trust, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, University College London Hospitals, London, UK
| | - Thomas Dreher-Hummel
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland
| | - Mikkel Brabrand
- Research Unit for Emergency Medicine, Odense University Hospital, Odense, Denmark
| | - Roland Bingisser
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland
| | - Christian H Nickel
- Emergency Department, University Hospital Basel, University of Basel, Petersgraben 2, 4031, Basel, Switzerland.
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Zhang F, Yan Y, Ge C. Prevalence and Impact of Frailty in Pancreatic Cancer: A Systematic Review and Meta-Analysis Based on 35,191 Patients. Ann Surg Oncol 2024; 31:535-544. [PMID: 37899415 DOI: 10.1245/s10434-023-14426-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Frailty has been associated with increased mortality among patients with pancreatic cancer. Nevertheless, several lines of evidence regarding the prevalence of frailty in patients with pancreatic cancer and mortality in patients with pancreatic cancer and frailty have not been thoroughly investigated and require clarification. METHODS A systematic review and meta-analysis of studies indexed in PubMed, Scopus, Web of Science, and Embase through March 2023 were conducted, and the pooled prevalence and relative risk (RR) estimate were calculated. RESULTS A total of 18 studies containing 35,191 patients with pancreatic cancer were included. The prevalence of frailty in pancreatic cancer was 45% (95% CI = 29-62; I2 = 99.9%; p = 0.000). In patients with pancreatic cancer, frailty was associated with increased relative risk for mortality (RR = 1.70; 95% CI = 1.30-2.22; I2 = 84.8%, p = 0.000). CONCLUSIONS Frailty prevalence in pancreatic cancer is common and exerts a significant negative impact on the survival of patients with pancreatic cancer. Our findings are characterized by significant heterogeneity, and caution is warranted in their interpretation. However, these findings highlight the importance of evaluating frailty, which may provide prognostic data and inform decision-making priorities.
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Affiliation(s)
- Fei Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Hunnan Division of the First Hospital of China Medical University, Shenyang, China.
| | - Ying Yan
- Department of Urinary Surgery, Northeast International Hospital, Shenyang, China
| | - Chunlin Ge
- Department of Hepatobiliary and Pancreatic Surgery, Hunnan Division of the First Hospital of China Medical University, Shenyang, China
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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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Aydin N, Gundogdu E. Evaluation of the relationship of the T and M stage with the erector spinae muscle area in male lung cancer patients. Aging Male 2023; 26:2154336. [PMID: 36869781 DOI: 10.1080/13685538.2022.2154336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES Sarcopenia is very common due to cachexia and presents with a decrease in skeletal muscle mass. In this study, we aimed to investigate the relationship between the T, M category and the erector spinae muscle area (ESMa). MATERIAL AND METHODS The initial first thorax and high-resolution computed tomography (CT) of patients with lung cancer between 2015 and 2019 were retrospectively screened. After exclusion criterias remaining 226 male patients constituted the study group. ESMa was measured manually in the section taken from the T12 vertebra spinous process level as previously described in the literature and its relationship with the T and M stage were evaluated. RESULTS The mean ages of patients were 70 ± 9.57 years. The T stage was T1 in 34 (15%) patients, T2 in 46 (20.4%), T3 in 59 (26.1%), and T4 in 87 (38.5%). Metastasis was detected in 83 (36.7%) patients. The mean ESMa of the patients was 34.15 ± 7.21 mm2 and did not differ according to the T stage (p = .39). ESMa was lower in the metastatic group (mean 30.42 ± 6.38 mm2) than the non-metastatic group (mean 36.32 ± 6.78 mm2) (p = .0001). CONCLUSIONS ESMa, one of the indicators of sarcopenia, is lower in patients with metastatic lung cancer than in nonmetastatic.
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Affiliation(s)
- Nevin Aydin
- Department of Radiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Elif Gundogdu
- Department of Radiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Ye L, Liang R, Liu X, Li J, Yue J, Zhang X. Frailty and sarcopenia: A bibliometric analysis of their association and potential targets for intervention. Ageing Res Rev 2023; 92:102111. [PMID: 38031836 DOI: 10.1016/j.arr.2023.102111] [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: 06/04/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
Frailty and sarcopenia are age-related diseases, and exhibit a concomitant relationship, as they share many common clinical features and etiological factors. Transitions within frailty status would be influenced by the presence of sarcopenia. Investigating their association to devise efficacious intervention and management strategies for geriatric patients is imperative, given their potentially unfavorable outcomes. In this study, the literature on sarcopenia and frailty was screened in the Web of Science core collection database over the past 30 years to ascertain the link between them through bibliometric analysis and the exploration of disease-related molecular pathways within the GeneCards and OMIM databases was conducted. Per inclusion and exclusion criteria, 3889 literature sources were selected for subsequent analysis. Keywords, including "cirrhosis" and "postoperative complications," represent the current and potential future research trends and focal points in this field. Moreover, 63 common potential targets between the two diseases were identified. Their pathogenesis involved cellular aging and endocrine metabolism regulation pathways, including AMPK, cell senescence, and the endocrine resistance pathway. This study identified an intimate correlation between frailty and sarcopenia in pathogenesis, prevention, and treatment measures, establishing a foundation for exploring shared prevention and treatment strategies for these two disorders.
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Affiliation(s)
- Lian Ye
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Liang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolei Liu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Li
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jirong Yue
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xinjun Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China; National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
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Marcozzi S, Bigossi G, Giuliani ME, Giacconi R, Piacenza F, Cardelli M, Brunetti D, Segala A, Valerio A, Nisoli E, Lattanzio F, Provinciali M, Malavolta M. Cellular senescence and frailty: a comprehensive insight into the causal links. GeroScience 2023; 45:3267-3305. [PMID: 37792158 PMCID: PMC10643740 DOI: 10.1007/s11357-023-00960-w] [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: 08/03/2023] [Accepted: 09/24/2023] [Indexed: 10/05/2023] Open
Abstract
Senescent cells may have a prominent role in driving inflammation and frailty. The impact of cellular senescence on frailty varies depending on the assessment tool used, as it is influenced by the criteria or items predominantly affected by senescent cells and the varying weights assigned to these items across different health domains. To address this challenge, we undertook a thorough review of all available studies involving gain- or loss-of-function experiments as well as interventions targeting senescent cells, focusing our attention on those studies that examined outcomes based on the individual frailty phenotype criteria or specific items used to calculate two humans (35 and 70 items) and one mouse (31 items) frailty indexes. Based on the calculation of a simple "evidence score," we found that the burden of senescent cells related to musculoskeletal and cerebral health has the strongest causal link to frailty. We deem that insight into these mechanisms may not only contribute to clarifying the role of cellular senescence in frailty but could additionally provide multiple therapeutic opportunities to help the future development of a desirable personalized therapy in these extremely heterogeneous patients.
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Affiliation(s)
- Serena Marcozzi
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
- Scientific Direction, IRCCS INRCA, 60124, Ancona, Italy
| | - Giorgia Bigossi
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Maria Elisa Giuliani
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Robertina Giacconi
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Francesco Piacenza
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Maurizio Cardelli
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Dario Brunetti
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20126, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20129, Milan, Italy
| | - Agnese Segala
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
| | - Alessandra Valerio
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa, 11, 25123, Brescia, Italy
| | - Enzo Nisoli
- Center for Study and Research On Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129, Milan, Italy
| | | | - Mauro Provinciali
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy
| | - Marco Malavolta
- Advanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121, Ancona, Italy.
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Luo YX, Zhu YH, Yao XQ. Knowledge mapping of exercise and physical activity research in older adults: Hotspots, bursts, and trends of the last decade. Heliyon 2023; 9:e23181. [PMID: 38149200 PMCID: PMC10750044 DOI: 10.1016/j.heliyon.2023.e23181] [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: 09/20/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023] Open
Abstract
Background and objectives Global aging has increased the importance of health management in older adults. Exercise is a crucial strategy for healthy aging and has led to numerous scientific advancements due to its impact on age-related illnesses. We aim to investigate the research hotspots, bursts of knowledge base, and trends in the field of exercise and physical activity in older adults over the past decade and present them in a visual manner. Methods We searched and retrieved data from the Web of Science database, and performed a bibliometric analysis of publications on exercise and physical activity research in older adults from 2013 to 2022. We evaluated the current status and hotspots through co-occurrence analysis using VOSviewer. The evolution and bursts of knowledge base were assessed through co-citation analysis using CiteSpace. Thematic evolution was analyzed using the bibliometrix package to discover keyword trends. The attribution and collaboration of countries/regions, institutions and authors were also analyzed. Results A total of 27,820 publications were included. Publications on exercise and physical activity in older adults increased from 1755 records in 2013-3737 records in 2022 annually. In co-occurrence analysis of keywords, 5 major clusters were revealed: sarcopenia, cognition, frailty, mental health, and rehabilitation. Co-citation analysis reveals that the knowledge base has evolved from references focused on frailty, dementia, and physical activity before 2016 to references focus on sarcopenia, cognition and sedentary behavior after 2020. Among the top 10 high-frequency keywords, sarcopenia demonstrated a consistent and significant upward trend, with its percentage increasing from 8.7 % (82 times) in 2016 to 12.2 % (236 times) in the most recent year, making it the most frequently used keyword. Frailty ranked second, starting at 5.6 % (41 times) in 2013 and gradually rising to 11.7 % (225 times) in 2022. The most productive country, institution and author were the USA (8212 publications), the University of Pittsburgh(501 publications), and Brendon Stubbs(94 publications), respectively. Discussion Publications on exercise and physical activity for older adults have surged in the last decade, accompanied by a shift in the knowledge base. Regional disparities in the academic output in this field need to be addressed in the future to promote healthy aging.
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Affiliation(s)
- Ya-Xi Luo
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying-Hai Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiu-Qing Yao
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Municipality Clinical Research Center for Geriatric Medicine, Chongqing, China
- Department of Rehabilitation Therapy, Chongqing Medical University, Chongqing, China
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Marco-Bonilla M, Fresnadillo M, Largo R, Herrero-Beaumont G, Mediero A. Energy Regulation in Inflammatory Sarcopenia by the Purinergic System. Int J Mol Sci 2023; 24:16904. [PMID: 38069224 PMCID: PMC10706580 DOI: 10.3390/ijms242316904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
The purinergic system has a dual role: the maintenance of energy balance and signaling within cells. Adenosine and adenosine triphosphate (ATP) are essential for maintaining these functions. Sarcopenia is characterized by alterations in the control of energy and signaling in favor of catabolic pathways. This review details the association between the purinergic system and muscle and adipose tissue homeostasis, discussing recent findings in the involvement of purinergic receptors in muscle wasting and advances in the use of the purinergic system as a novel therapeutic target in the management of sarcopenia.
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Affiliation(s)
| | | | | | | | - Aránzazu Mediero
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040 Madrid, Spain; (M.M.-B.); (M.F.); (R.L.); (G.H.-B.)
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Bellanti F, Lo Buglio A, Quiete S, Dobrakowski M, Kasperczyk A, Kasperczyk S, Vendemiale G. Sarcopenia Is Associated with Changes in Circulating Markers of Antioxidant/Oxidant Balance and Innate Immune Response. Antioxidants (Basel) 2023; 12:1992. [PMID: 38001845 PMCID: PMC10669556 DOI: 10.3390/antiox12111992] [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: 09/27/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The involvement of redox balance alterations and innate immunity is suggested to play a key role in the pathogenesis of sarcopenia. This investigation aimed to define and relate modifications in circulating markers of redox homeostasis and the innate immune response in human sarcopenia. (2) Methods: A total of 32 subjects aged >65 years old and affected by sarcopenia according to the second "European Working Group on sarcopenia in older people" guidelines were compared with 40 non-sarcopenic age-matched controls. To assess systemic redox homeostasis, reduced (GSH) and oxidized (GSSG) blood glutathione and plasma malondialdehyde (MDA)- and 4-hydroxy-2,3-nonenal (HNE)-protein adducts were measured. Immune cells and circulating interleukins were determined to compare the innate immune response between both groups. (3) Results: Impaired redox balance in sarcopenic patients, characterized by a high blood GSSG/GSH ratio and plasma MDA/HNE-protein adducts, was sustained by reduced antioxidants in peripheral blood mononuclear cells. Furthermore, sarcopenic patients showed higher neutrophil-to-lymphocyte ratios and interleukin (IL)-4, IL-6, IL-10, and tumor necrosis factor (TNF) with respect to non-sarcopenic patients. Linear regression analysis resulted in a strong association between redox balance and immune response markers in the sarcopenic group. (4) Conclusions: These results support the interplay between redox homeostasis alteration and disruption of the innate immune response in the pathogenesis of sarcopenia.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Stefano Quiete
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Michał Dobrakowski
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Aleksandra Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Sławomir Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
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Schilling R, Schmidt SCE, Fiedler J, Woll A. Associations between physical activity, physical fitness, and body composition in adults living in Germany: A cross-sectional study. PLoS One 2023; 18:e0293555. [PMID: 37883524 PMCID: PMC10602354 DOI: 10.1371/journal.pone.0293555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND & AIMS Body composition (BC) changes with age and is associated with morbidity and mortality. A physically active lifestyle influences BC and represents an important predictor of successful aging. To emphasize this, the World Health Organization established activity recommendations for all age groups. We describe BC during adulthood using a cross-sectional sample from a German community and investigate the associations between physical activity (PA), physical fitness (PF), and BC. METHODS Data from 329 men and women aged 35 to 86 years were analyzed. PA was measured by questionnaire and classified into sport activity and habitual activity. PF was measured through physical performance tests and BC by bioelectrical impedance analysis. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated to represent height-adjusted BC. Associations between PA, PF, and BC were analyzed using linear regression models. RESULTS For both sexes, strength was positively associated with FFMI (♂: ß = 0.313; ♀: ß = 0.213) and phase angle (♂: ß = 0.357; ♀: ß = 0.409). For FMI, a significant negative association with strength was found only in women (ß = -0.189). Cardiorespiratory fitness showed a negative association with FMI (ß = -0.312) and FFMI (ß = -0.201) for men, while in women a positive association was found for FFMI (ß = 0.186). For coordination, a significant association with FMI was observed only in women (ß = -0.190). Regarding PA only one significant relationship between sport activity and FMI among women (ß = -0.170) was found. CONCLUSIONS In our sample, PF was closer related to BC than PA. Strength and cardiorespiratory fitness were the strongest predictors for BC. This supports the World Health Organization's activity recommendations to include both resistance and endurance training in the weekly sports program to maintain a healthy BC.
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Affiliation(s)
- Raphael Schilling
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen C. E. Schmidt
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janis Fiedler
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Lin Y, Wang X, Yao W, Sun Y, Zhou J, Feng F. Causality between urate levels with sarcopenia-related traits: a bi-directional Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1252968. [PMID: 37955003 PMCID: PMC10637380 DOI: 10.3389/fendo.2023.1252968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background Observational studies have suggested associations between serum urate levels and sarcopenia, but the causality underlying this correlation remains uncertain. The principal objective of this study is to investigate a causal relationship of serum urate levels with sarcopenia-related traits (hand grip strength, lean mass, walking pace) using bidirectional two-sample Mendelian randomization (MR) approach. The utilization of MR methodology serves to minimize bias caused by reverse causality and confounding factors from observational studies. Methods The summary statistics of serum urate levels were derived from a cohort consisting of 288,659 individuals participating in CKDGen study. The parameters of right-hand grip strength (N=461,089), left-hand grip strength (N=461,026), appendicular lean mass (ALM) (N=450,243), whole-body lean mass(N=454,850),right-leg fat-free mass(FFM;N=454,835),left-leg FFM(N=454,805), right-arm FFM(N=454,753),left-arm FFM(N=454,672) and walking pace (N=459,915)were sourced from the UK Biobank. MR analysis was conducted utilizing inverse variance weighted (IVW), weighted median, and MR-Egger to evaluate causality. Sensitivity analysis was performed using Cochran's Q test, MR-Egger intercept test, leave-one-out analysis and the funnel plot. Results IVW estimates demonstrated that serum urate levels exhibited no causal association with sarcopenia-related traits. In the inverse MR investigation, we had exclusively discerned an inverse correlation between walking pace and serum urate levels. No compelling evidence had surfaced to substantiate any association of other sarcopenia-related traits with serum urate. Supplemental MR methods consistently validated the findings obtained from the primary analysis. Sensitivity analysis demonstrated the robustness of findings. Conclusion Our MR study revealed the absence of the bidirectional causal relationship between serum urate levels and sarcopenia. It is imperative to acknowledge that advanced age and an individual's health status are pivotal determinants influencing urate level and the initiation and advancement of sarcopenia. However, it is worth underscoring that these aspects remain unexamined within the purview of this study. Thus, future investigations should delve deeper into these intricate facets.
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Affiliation(s)
- Yanze Lin
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xun Wang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenchao Yao
- Department of Orthopaedics, the First People’s Hospital of Chun’an County, Hangzhou, Zhejiang, China
| | - Yuanting Sun
- Graduate School, Hunan University of Chinese Medicine, Changsha, China
| | - Jinlei Zhou
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fabo Feng
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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Cho KH, Paek JM, Ko KM. Long-Term Survival Prediction Model for Elderly Community Members Using a Deep Learning Method. Geriatrics (Basel) 2023; 8:105. [PMID: 37887978 PMCID: PMC10606576 DOI: 10.3390/geriatrics8050105] [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: 09/06/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
In an aging society, maintaining healthy aging, preventing death, and enabling a continuation of economic activities are crucial. This study sought to develop a model for predicting survival times among community-dwelling older individuals using a deep learning method, and to identify the level of influence of various risk factors on the survival period, so that older individuals can manage their own health. This study used the Korean National Health Insurance Service claims data. We observed community-dwelling older people, aged 66 years, for 11 years and developed a survival time prediction model. Of the 189,697 individuals enrolled at baseline, 180,235 (95.0%) survived from 2009 to 2019, while 9462 (5.0%) died. Using deep-learning-based models (C statistics = 0.7011), we identified various factors impacting survival: Charlson's comorbidity index; the frailty index; long-term care benefit grade; disability grade; income level; a combination of diabetes mellitus, hypertension, and dyslipidemia; sex; smoking status; and alcohol consumption habits. In particular, Charlson's comorbidity index (SHAP value: 0.0445) and frailty index (SHAP value: 0.0443) were strong predictors of survival time. Prediction models may help researchers to identify potentially modifiable risk factors that may affect survival.
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Affiliation(s)
- Kyoung Hee Cho
- Department of Health Policy and Management, SangJi University, Wonju-si 26339, Republic of Korea;
| | - Jong-Min Paek
- Department of Computer Engineering, SangJi University, Kwang-Man Ko. 83 Sangjidae-gil, Wonju-si 26339, Republic of Korea;
| | - Kwang-Man Ko
- Department of Computer Engineering, SangJi University, Kwang-Man Ko. 83 Sangjidae-gil, Wonju-si 26339, Republic of Korea;
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