1
|
Ilyas Z, Perna S, A. Alalwan T, Zahid MN, Spadaccini D, Gasparri C, Peroni G, Faragli A, Alogna A, La Porta E, Ali Redha A, Negro M, Cerullo G, D’Antona G, Rondanelli M. The Ketogenic Diet: Is It an Answer for Sarcopenic Obesity? Nutrients 2022; 14:620. [PMID: 35276979 PMCID: PMC8838342 DOI: 10.3390/nu14030620] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
This review aims to define the effectiveness of the ketogenic diet (KD) for the management of sarcopenic obesity. As the combination of sarcopenia and obesity appears to have multiple negative metabolic effects, this narrative review discusses the effects of the ketogenic diet as a possible synergic intervention to decrease visceral adipose tissue (VAT) and fatty infiltration of the liver as well as modulate and improve the gut microbiota, inflammation and body composition. The results of this review support the evidence that the KD improves metabolic health and expands adipose tissue γδ T cells that are important for glycaemia control during obesity. The KD is also a therapeutic option for individuals with sarcopenic obesity due to its positive effect on VAT, adipose tissue, cytokines such as blood biochemistry, gut microbiota, and body composition. However, the long-term effect of a KD on these outcomes requires further investigations before general recommendations can be made.
Collapse
Affiliation(s)
- Zahra Ilyas
- Department of Laboratory, Bahrain Specialist Hospital, Juffair P.O. Box 10588, Bahrain
- Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq P.O. Box 32038, Bahrain; (S.P.); (T.A.A.); (M.N.Z.)
| | - Simone Perna
- Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq P.O. Box 32038, Bahrain; (S.P.); (T.A.A.); (M.N.Z.)
| | - Tariq A. Alalwan
- Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq P.O. Box 32038, Bahrain; (S.P.); (T.A.A.); (M.N.Z.)
| | - Muhammad Nauman Zahid
- Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq P.O. Box 32038, Bahrain; (S.P.); (T.A.A.); (M.N.Z.)
| | - Daniele Spadaccini
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (D.S.); (C.G.); (G.P.)
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (D.S.); (C.G.); (G.P.)
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (D.S.); (C.G.); (G.P.)
| | - Alessandro Faragli
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, 13353 Berlin, Germany;
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
| | - Alessio Alogna
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
| | - Edoardo La Porta
- Department of Cardionephrology, Istituto Clinico Ligure Di Alta Specialità (ICLAS), GVM Care and Research, 16035 Rapallo, Italy;
- Department of Internal Medicine (DiMi), University of Genova, 16121 Genova, Italy
| | - Ali Ali Redha
- Department of Chemistry, College of Science, Sakhir Campus, University of Bahrain, Zallaq P.O. Box 32038, Bahrain;
- Chemistry Department, School of Science, Loughborough University, Loughborough LE11 3TU, UK
| | - Massimo Negro
- CRIAMS-Sport Medicine Centre, 27058 Voghera, Italy; (M.N.); (G.D.)
| | - Giuseppe Cerullo
- Department of Movement and Wellbeing Sciences, University of Naples “Parthenope”, 80133 Napoli, Italy;
| | - Giuseppe D’Antona
- CRIAMS-Sport Medicine Centre, 27058 Voghera, Italy; (M.N.); (G.D.)
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- IRCCS Mondino Foundation, 27100 Pavia, Italy
| |
Collapse
|
2
|
Pierard M, Tassin A, Legrand A, Legrand A. Chronic hypoxaemia and gender status modulate adiponectin plasmatic level and its multimer proportion in severe COPD patients: new endotypic presentation? BMC Pulm Med 2020; 20:255. [PMID: 32998721 PMCID: PMC7528580 DOI: 10.1186/s12890-020-01288-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/15/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Disease progression in COPD patient is associated to lung function decline, leading to a higher risk of hypoxaemia and associated comorbidities, notably cardiovascular diseases (CVD). Adiponectin (Ad) is an adipokine with cardio-protective properties. In COPD patients, conflicting results were previously reported regarding Ad plasmatic (Adpl) level, probably because COPD is a heterogeneous disease with multifactorial influence. Among these factors, gender and hypoxaemia could interact in a variety of ways with Ad pathway. Therefore, we postulated that these components could influence Adpl level and its multimers in COPD patients and contribute to the appearance of a distinct endotype associated to an altered CVD risk. METHODS One hundred COPD patients were recruited: 61 were men and 39 were women. Patients who were not severely hypoxemic were allocated to non-hypoxemic group which included 46 patients: 27 men and 19 women. Hypoxemic group included 54 patients: 34 men and 20 women. For all patients, Adpl level and proportion of its different forms were measured. Differences between groups were evaluated by Rank-Sum tests. The relationship between these measures and BMI, blood gas analysis (PaO2, PaCO2), or lung function (FEV1, FEV1/FVC, TLCO, TLC, RV) were evaluated by Pearson correlation analysis. RESULTS Despite similar age, BMI and obstruction severity, women had a higher TLC and RV (median: TLC = 105%; RV = 166%) than men (median: TLC = 87%; RV = 132%). Adpl level was higher in women (median = 11,152 ng/ml) than in men (median = 10,239 ng/ml) and was negatively associated with hyperinflation (R = - 0,43) and hypercapnia (R = - 0,42). The proportion of the most active forms of Ad (HMW) was increased in hypoxemic women (median = 10%) compared with non-hypoxemic women (median = 8%) but was not modulated in men. CONCLUSION COPD pathophysiology seemed to be different in hypoxemic women and was associated to Ad modulations. Hyperinflation and air-trapping in association with hypercapnia and hypoxaemia, could contribute to a modulation of Adpl level and of its HMW forms. These results suggest the development of a distinct endotypic presentation, based on gender.
Collapse
Affiliation(s)
- Mélany Pierard
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, Avenue du Champ de Mars, 6, B-7000, Mons, Belgium
| | - Alexandra Tassin
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, Avenue du Champ de Mars, 6, B-7000, Mons, Belgium
| | - Antoine Legrand
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, Avenue du Champ de Mars, 6, B-7000, Mons, Belgium
| | - Alexandre Legrand
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, Avenue du Champ de Mars, 6, B-7000, Mons, Belgium.
- Department of Pneumology, Erasme Hospital, Brussels, Belgium.
| |
Collapse
|
3
|
Feng H, Wang X, Zhao T, Mao L, Hui Y, Fan X, Lin L, Zhao W, Jiang K, Wang B, Yu Q, Zhang J, Sun C. Myopenic obesity determined by visceral fat area strongly predicts long-term mortality in cirrhosis. Clin Nutr 2020; 40:1983-1989. [PMID: 32977996 DOI: 10.1016/j.clnu.2020.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/06/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The impact of changes in body composition has proved to correlate with outcomes in cirrhosis, however, numerous issues remain elusive. The present study aimed to investigate the prognostic value of myopenic obesity (MO) on long-term mortality in cirrhosis. METHODS We retrospectively analyzed 200 patients with cirrhosis. Body composition parameters including skeletal muscle index (SMI) and visceral fat area (VFA) were estimated by computed tomography images at the third lumbar vertebra level. We defined MO as a low SMI (male: SMI < 46.96 cm2/m2 and female: SMI < 32.46 cm2/m2) with BMI ≥ 25 kg/m2 or VFA ≥ 100 cm2 according to our previous publication. Patients were categorized into one of four body composition groups in terms of the presence or absence of myopenia and obesity. RESULTS On the basis of VFA or BMI, the four group comparison demonstrated the prognosis was poor in MO, followed by myopenic/nonobesity (MN), nonmyopenic/obesity and nonmyopenic/nonobesity, in that order (log-rank test). Multivariate Cox analysis identified that MO (HR 2.498; 95% CI, 1.214-5.140; P = 0.013), MN (HR 2.763; 95% CI, 1.244-6.134; P = 0.013), age (HR 3.035; 95% CI, 1.904-4.839; P < 0.001), neutrophil-to-lymphocyte ratio (HR 1.142; 95% CI, 1.082-1.207; P < 0.001) and MELD (HR 1.140; 95% CI, 1.066-1.219; P = 0.001) were independently associated with 2-year mortality according to VFA classification. CONCLUSIONS MO was an independent predictor of higher long-term mortality in cirrhosis. Prevention strategies by reducing visceral fat obesity rather than BMI should be the optimal target for MO management.
Collapse
Affiliation(s)
- Hongjuan Feng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Department of Nutriology, Tianjin Third Central Hospital, Jintang Road 83, Hedong District, Tianjin, 300170, China
| | - Xiaoyu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Tianming Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Lihong Mao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Yangyang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Lin Lin
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China
| | - Wei Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China
| | - Qingxiang Yu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China.
| | - Jie Zhang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China.
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China; Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154,Heping District, Tianjin, 300052, China; Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China.
| |
Collapse
|
4
|
Benz E, Trajanoska K, Lahousse L, Schoufour JD, Terzikhan N, De Roos E, de Jonge GB, Williams R, Franco OH, Brusselle G, Rivadeneira F. Sarcopenia in COPD: a systematic review and meta-analysis. Eur Respir Rev 2019; 28:28/154/190049. [PMID: 31722892 PMCID: PMC9488535 DOI: 10.1183/16000617.0049-2019] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/05/2019] [Indexed: 12/28/2022] Open
Abstract
COPD is associated with a progressive loss of muscle mass and function. However, there is an unmet need to define and standardise methods to estimate the prevalence of sarcopenia in COPD patients. We performed a systematic review and meta-analysis of the prevalence of this extrapulmonary manifestation in COPD patients. We searched Embase, Medline (Ovid), CINAHL (EBSCO), Web of Science, Scopus and Google Scholar for studies published up to January 17, 2019, assessing sarcopenia in COPD patients based on low muscle mass and decreased muscle function. Interventional studies, in vitro experiments, protocols or reviews and meta-analyses were excluded. We estimated heterogeneity (I2) and assessed significance (Q) using a Chi-squared test for estimates obtained from random-effects models. 4465 articles were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 62 full-text articles. Finally, 10 articles (n=2565 COPD patients) were included in this systematic review and meta-analyses. Overall, the prevalence of sarcopenia in patients with COPD was 21.6% (95% CI 14.6–30.9%, I2=94%), ranging from 8% in population-based to 21% in clinic-based studies, and 63% in COPD patients residing in nursing homes. Sarcopenia is frequently observed in COPD patients, with varying prevalence across population settings. Sarcopenia in COPD should be assessed using standardised tests and cut-off points from sarcopenia consensus criteria for clinical practice and international comparisons. We confirmed a high prevalence of sarcopenia in COPD patients, with varying prevalence across population settings. We recommend adhering to the sarcopenia consensus criteria to systematically evaluate the muscle health of COPD patients.http://bit.ly/2KA6weh
Collapse
Affiliation(s)
- Elizabeth Benz
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Both authors contributed equally
| | - Katerina Trajanoska
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Both authors contributed equally
| | - Lies Lahousse
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Bioanalysis, FFW, Ghent University, Ghent, Belgium
| | - Josje D Schoufour
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Natalie Terzikhan
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Emmely De Roos
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Gerdien B de Jonge
- Medical Library, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ross Williams
- Dept of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Guy Brusselle
- Dept of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands .,Dept of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium.,Dept of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Dept of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
5
|
Gut-Gobert C, Cavaillès A, Dixmier A, Guillot S, Jouneau S, Leroyer C, Marchand-Adam S, Marquette D, Meurice JC, Desvigne N, Morel H, Person-Tacnet C, Raherison C. Women and COPD: do we need more evidence? Eur Respir Rev 2019; 28:28/151/180055. [PMID: 30814138 PMCID: PMC9488562 DOI: 10.1183/16000617.0055-2018] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/21/2018] [Indexed: 01/20/2023] Open
Abstract
The increasingly female face of chronic obstructive pulmonary disease (COPD) prevalence among women has equalled that of men since 2008, due in part to increased tobacco use among women worldwide and exposure to biomass fuels. This finding is supported by a number of characteristics. There is evidence of susceptibility to smoking and other airborne contaminants, along with epidemiological and phenotypic manifestations. COPD has thus become the leading cause of death in women in the USA. The clinical presentation is characterised by increasingly pronounced dyspnoea with a marked tendency towards anxiety and depression, undernutrition, nonsmall cell lung cancer (especially adenocarcinoma) and osteoporosis. Quality of life is also more significantly impacted. The theories advanced to explain these differences involve the role played by oestrogens, impaired gas exchange in the lungs and smoking habits. While these differences require appropriate therapeutic responses (smoking cessation, pulmonary rehabilitation, long-term oxygen therapy), barriers to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. Faced with this serious public health problem, we need to update and adapt our knowledge to the epidemiological changes. The face of COPD is increasingly female. We need more evidence and a change in how the disease is managed. http://ow.ly/zueL30mWqlS
Collapse
Affiliation(s)
- Christophe Gut-Gobert
- G.E.T.B.O. (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie, Brest, France
| | - Arnaud Cavaillès
- Institut du Thorax, CHU de Nantes, Dept of Pulmonology, Nantes, France
| | - Adrien Dixmier
- Dept of Pulmonology, Orléans Regional Hospital, Orléans, France
| | - Stéphanie Guillot
- Unité d'Explorations Fonctionnelles Respiratoires, CHRU Rennes, Rennes, France
| | - Stéphane Jouneau
- Service de Pneumologie, Hôpital Pontchaillou, Rennes, France.,IRSET UMR 1085, Université de Rennes 1, Rennes, France
| | - Christophe Leroyer
- G.E.T.B.O. (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie, Brest, France
| | - Sylvain Marchand-Adam
- Université François Rabelais Faculté de Médecine de Tours, Inserm 1100, CHRU de Tours Service de Pneumologie, Tours, France
| | - David Marquette
- Dept of Pulmonary Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Jean-Claude Meurice
- Dept of Pulmonology Centre Hospitalier de l'Université de Poitiers, Poitiers, France
| | | | - Hugues Morel
- Dept of Pulmonology, Orléans Regional Hospital, Orléans, France
| | | | - Chantal Raherison
- Service des Maladies Respiratoires, CHU Bordeaux, Epicene U1219 Université de Bordeaux, Bordeaux, France
| |
Collapse
|
6
|
Nicolini A, Barbagelata E, Tagliabue E, Colombo D, Monacelli F, Braido F. Gender differences in chronic obstructive pulmonary diseases: a narrative review. Panminerva Med 2018; 60:192-199. [DOI: 10.23736/s0031-0808.18.03463-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
7
|
Hara N, Iwasa M, Sugimoto R, Mifuji-Moroka R, Yoshikawa K, Terasaka E, Hattori A, Ishidome M, Kobayashi Y, Hasegawa H, Iwata K, Takei Y. Sarcopenia and Sarcopenic Obesity Are Prognostic Factors for Overall Survival in Patients with Cirrhosis. Intern Med 2016; 55:863-70. [PMID: 27086797 DOI: 10.2169/internalmedicine.55.5676] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Although the prognosis is known to be poor in cirrhosis patients associated with sarcopenia, the relationships among skeletal muscle, visceral fat, and the liver have not yet been thoroughly investigated. Therefore, the prognosis and its associations with body composition and the severity of liver disease were examined in patients with cirrhosis. METHODS The skeletal muscle mass and visceral fat area were measured in 161 patients with cirrhosis, the effects of body composition on the prognosis were analyzed, and any factors that contribute to changes in body composition were assessed. RESULTS During the mean observation period of 1,005 days, 73 patients died. Patients with sarcopenia or sarcopenic obesity had a poor prognosis, and this difference was pronounced in the subset of patients classified as Child-Pugh class A. A decreased skeletal muscle mass was strongly correlated with decreased serum albumin levels. Sarcopenia is a common feature of advanced cirrhosis, and transitions were observed from normal body composition to sarcopenia and from obese to sarcopenic obesity. CONCLUSION The body composition is a prognostic factor for cirrhosis, and a better body composition may be advantageous for obtaining a long-term survival in patients with cirrhosis.
Collapse
Affiliation(s)
- Nagisa Hara
- Nutrition Unit, Mie University Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Costa TMDRL, Costa FM, Moreira CA, Rabelo LM, Boguszewski CL, Borba VZC. Sarcopenia in COPD: relationship with COPD severity and prognosis. J Bras Pneumol 2015; 41:415-21. [PMID: 26578132 PMCID: PMC4635087 DOI: 10.1590/s1806-37132015000000040] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/14/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. METHODS A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index. RESULTS We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. CONCLUSIONS In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis.
Collapse
Affiliation(s)
- Tatiana Munhoz da Rocha Lemos Costa
- Serviço de Endocrinologia e Metabologia - SEMPR - Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
- Programa de Pós-Graduação em Medicina Interna, Departamento de Medicina Interna, Universidade Federal do Paraná, Curitiba, Brasil
| | - Fabio Marcelo Costa
- Serviço de Pneumologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
| | - Carolina Aguiar Moreira
- Serviço de Endocrinologia e Metabologia - SEMPR - Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
- Programa de Pós-Graduação em Medicina Interna, Departamento de Medicina Interna, Universidade Federal do Paraná, Curitiba, Brasil
| | - Leda Maria Rabelo
- Serviço de Pneumologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
| | - César Luiz Boguszewski
- Serviço de Endocrinologia e Metabologia - SEMPR - Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
| | - Victória Zeghbi Cochenski Borba
- Serviço de Endocrinologia e Metabologia - SEMPR - Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil
- Programa de Pós-Graduação em Medicina Interna, Departamento de Medicina Interna, Universidade Federal do Paraná, Curitiba, Brasil
| |
Collapse
|
9
|
Aryal S, Diaz-Guzman E, Mannino DM. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. Int J Chron Obstruct Pulmon Dis 2014; 9:1145-54. [PMID: 25342899 PMCID: PMC4206206 DOI: 10.2147/copd.s54476] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD), one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research.
Collapse
Affiliation(s)
- Shambhu Aryal
- Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, USA
| | - Enrique Diaz-Guzman
- Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, USA
| | - David M Mannino
- Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
10
|
Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: From sarcopenic obesity to cachexia. Clin Nutr 2014; 33:737-48. [DOI: 10.1016/j.clnu.2014.03.007] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/17/2014] [Accepted: 03/24/2014] [Indexed: 12/18/2022]
|
11
|
Holm SM, Rodgers W, Haennel RG, MacDonald GF, Bryan TL, Bhutani M, Wong E, Stickland MK. Effect of modality on cardiopulmonary exercise testing in male and female COPD patients. Respir Physiol Neurobiol 2014; 192:30-8. [DOI: 10.1016/j.resp.2013.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 11/06/2013] [Accepted: 11/22/2013] [Indexed: 10/25/2022]
|
12
|
Dasarathy S. Posttransplant sarcopenia: an underrecognized early consequence of liver transplantation. Dig Dis Sci 2013; 58:3103-11. [PMID: 23912247 PMCID: PMC4066193 DOI: 10.1007/s10620-013-2791-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 07/02/2013] [Indexed: 02/06/2023]
Abstract
Liver transplantation is believed to reverse the clinical and metabolic abnormalities of cirrhosis. Reduced skeletal muscle mass or sarcopenia contributes to increased mortality and adverse consequences of cirrhosis. Failure of reversal of sarcopenia of cirrhosis after liver transplantation is not well recognized. Six temporally, geographically, and methodologically distinct follow-up studies in 304 cirrhotics reported conflicting data on changes in indirect measures of skeletal muscle mass after transplantation. Distinct measures of body composition but not skeletal muscle mass were used and did not focus on the clinical consequences of sarcopenia after transplantation. A number of studies reported an initial rapid postoperative loss of lean mass followed by incomplete recovery with a maximum follow-up of 2 years. Posttransplant sarcopenia may be responsible for metabolic syndrome and impaired quality of life after liver transplantation. Potential reasons for failure to reverse sarcopenia after liver transplantation include use of immunosuppressive agents [mammalian target of rapamycin (mTOR) and calcineurin inhibitors] that impair skeletal muscle growth and protein accretion. Repeated hospitalizations, posttransplant infections, and renal failure also contribute to posttransplant sarcopenia. Finally, recovery from muscle deconditioning is limited by lack of systematic nutritional and physical-activity-based interventions to improve muscle mass. Despite the compelling data on sarcopenia before liver transplantation, the impact of posttransplant sarcopenia on clinical outcomes is not known. There is a compelling need for studies to examine the mechanisms and consequences of sarcopenia post liver transplantation to permit development of therapies to prevent and reverse this disorder.
Collapse
Affiliation(s)
- Srinivasan Dasarathy
- Department of Gastroenterology, Hepatology and Pathobiology, Cleveland Clinic, Lerner Research Institute, NE4 208, 9500 Euclid Avenue, Cleveland, OH, 44195, USA,
| |
Collapse
|
13
|
Abstract
Chronic obstructive pulmonary disease (COPD) is quickly becoming one of the leading causes of morbidity and mortality. The purpose of this article is to review the clinical presentation, spirometry, and pharmacologic management of COPD, as well as the results of a survey examining nurse practitioners' (NPs) knowledge about COPD and its management.
Collapse
|
14
|
Kohler M, Sandberg A, Kjellqvist S, Thomas A, Karimi R, Nyrén S, Eklund A, Thevis M, Sköld CM, Wheelock ÅM. Gender differences in the bronchoalveolar lavage cell proteome of patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol 2013; 131:743-51. [DOI: 10.1016/j.jaci.2012.09.024] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/20/2012] [Accepted: 09/24/2012] [Indexed: 11/25/2022]
|
15
|
Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G. Sarcopenia as a risk factor for falls in elderly individuals: Results from the ilSIRENTE study. Clin Nutr 2012; 31:652-8. [DOI: 10.1016/j.clnu.2012.02.007] [Citation(s) in RCA: 580] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 02/17/2012] [Indexed: 12/31/2022]
|