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Ramoo K, Hairi NN, Yahya A, Choo WY, Hairi FM, Ismail N, Peramalah D, Kandiben S, Ali ZM, Ahmad N, Abdul Razak I, Bulgiba A. Sarcopenia and All-Cause Mortality Risk in Community-Dwelling Rural Malaysian Older Adults. Asia Pac J Public Health 2024; 36:225-231. [PMID: 38482589 DOI: 10.1177/10105395241237811] [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: 04/05/2024]
Abstract
Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
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Affiliation(s)
- Karthikeyanathan Ramoo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Public Health, Universitas Airlangga, Surabaya City, Indonesia
| | - Abqariyah Yahya
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Devi Peramalah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shathanapriya Kandiben
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - NurSakinah Ahmad
- Mental Health, Injury Prevention, Violence and Substance Abuse Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Awang Bulgiba
- Academy of Sciences Malaysia, Kuala Lumpur, Malaysia
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2
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Ladang A, Kovacs S, Lengelé L, Locquet M, Beaudart C, Reginster JY, Bruyère O, Cavalier E. Neurofilament-light chains (NF-L), a biomarker of neuronal damage, is increased in patients with severe sarcopenia: results of the SarcoPhAge study. Aging Clin Exp Res 2023; 35:2029-2037. [PMID: 37581861 PMCID: PMC10520189 DOI: 10.1007/s40520-023-02521-9] [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: 06/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND As clinical tests, such as gait speed, require nervous system integrity to be performed properly, sarcopenia shares features with neurological diseases. Neurofilament light chains (NF-L) are now used as a blood-biomarker of neuronal damage, and its expression might be altered in sarcopenia. We aimed to assess NF-L concentrations in a large cohort of older individuals screened for sarcopenia. METHODS The SarcoPhAge cohort is a Belgian cohort of 534 community-dwelling older adults with an ongoing 10-year follow-up. Sarcopenia diagnosis was established at inclusion according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was evaluated with a hydraulic hand dynamometer, appendicular lean mass by Dual-Energy X-ray Absorptiometry (DXA) and physical performance by the Short Physical Performance Battery (SPPB). NF-L was measured on all available sera collected at the time of inclusion (n = 409) using SiMoA technology (Quanterix°). RESULTS In the multivariate model, NF-L was associated with performance tests such as gait speed (p < 0.0001) and SPPB scores (p = 0.0004). An association was also observed with muscle strength (p = 0.0123) and lean mass (p = 0.0279). In the logistic regression model, NF-L was an independent predictor of severe sarcopenia (p = 0.0338; OR = 20.0; 95% CI 1.39-287.7) with satisfactory diagnostic accuracy (AUC: 0.828) and subjects with an SPPB score ≤ 8 had higher odds of having increased NF-L (p < 0.0001; OR = 23.9; 95% CI 5.5-104). CONCLUSIONS These data highlight the potential for using NF-L to investigate the pathophysiology of sarcopenia severity and the neurological features associated with performance tests. However, these results need to be confirmed with other cohorts in different settings.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium.
| | - Stéphanie Kovacs
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium
| | - Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, CHU de Liège, University of Liège, 4000, Liège, Belgium
| | - Etienne Cavalier
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium
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Shimada H, Suzuki T, Doi T, Lee S, Nakakubo S, Makino K, Arai H. Impact of osteosarcopenia on disability and mortality among Japanese older adults. J Cachexia Sarcopenia Muscle 2023; 14:1107-1116. [PMID: 36858820 PMCID: PMC10067490 DOI: 10.1002/jcsm.13209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND In clinical settings, muscle mass and bone mineral density assessments are usually performed using dual-energy X-ray absorptiometry (DXA), the clinical standard technique. However, DXA is often unavailable in community settings. This study aimed to determine whether osteoporosis, osteopenia (OP) and sarcopenia (SP) identified by simplified instruments are associated with the future incidence of disability and mortality and evaluate the validity of these instruments as community screening tools. We also examined osteosarcopenia (OS), defined as the coexistence of OP and SP, as a new indicator of geriatric syndromes to determine whether it has an additive effect on adverse outcome incidence compared with OP and SP alone. METHODS In total, 8995 older adults participated in the study (women: 51.7%, average age: 73.5 ± 5.4 years). Data were extracted from the Japanese national cohort study, National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. We determined OP based on T-scores generated based on the speed of sound, which is the time taken for ultrasound waves to go through a determined distance in the calcaneus bone. Skeletal muscle mass was evaluated using a bioimpedance analysis device. Handgrip strength and walking speed were measured as physical performance indicators. Incidences of disability and mortality were prospectively determined for 5 years. RESULTS The prevalence of OP, SP and OS was 45.5%, 3.9% and 7.4%, respectively. The incidence of disability in the nonOP/nonSP, OP, SP and OS groups was 6.5%, 14.9%, 20.5% and 33.5%, respectively. The incidence of mortality in the nonOP/nonSP, OP, SP and OS groups was 4.0%, 4.9%, 10.3% and 10.2%, respectively. Participants with OP (hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.25-1.68), SP (HR: 1.38, 95% CI: 1.08-1.76) and OS (HR: 1.73, 95% CI: 1.43-2.09) had a higher risk of disability than nonOP/nonSP participants. Participants with OP (HR: 1.31, 95% CI: 1.04-1.64) and OS (HR: 1.45, 95% CI: 1.05-2.00) had a higher risk of mortality than nonOP/nonSP participants. SP was not significantly related to mortality (HR: 1.14, 95% CI: 0.90-1.45). There was no statistical interaction between OP and SP in incident disability and mortality. CONCLUSIONS Among older adults, OS identified by bioimpedance and quantitative ultrasound assessments was associated with an increased risk of disability and mortality. Further research is needed to implement these findings in community health activities, such as setting precise cut-off values and constructing accurate disability and mortality prediction models.
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Affiliation(s)
- Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takao Suzuki
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,J. F. Oberlin University Graduate Division, Tokyo, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Stuck AK, Basile G, Freystaetter G, de Godoi Rezende Costa Molino C, Lang W, Bischoff-Ferrari HA. Predictive validity of current sarcopenia definitions (EWGSOP2, SDOC, and AWGS2) for clinical outcomes: A scoping review. J Cachexia Sarcopenia Muscle 2023; 14:71-83. [PMID: 36564353 PMCID: PMC9891988 DOI: 10.1002/jcsm.13161] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/25/2022] [Indexed: 12/25/2022] Open
Abstract
Over the last 3 years new definitions of sarcopenia by the Sarcopenia Definition and Outcome Consortium (2020, SDOC), European Working Group on Sarcopenia in Older People (2019, EWGSOP2) and Asian Working Group on Sarcopenia (2019, AWGS2) have been proposed. The objective of this scoping review was to explore predictive validity of these current sarcopenia definitions for clinical outcomes. We followed the PRISMA checklist for scoping reviews. Based on a systematic search performed by two independent reviewers of databases (Pubmed and Embase) articles comparing predictive validity of two or more sarcopenia definitions on prospective clinical outcomes published since January 2019 (the year these definitions were introduced) were included. Data were extracted and results collated by clinical outcomes and by sarcopenia definitions, respectively. Of 4493 articles screened, 11 studies (mean age of participants 77.6 (SD 5.7) years and 50.0% female) comprising 82 validity tests were included. Overall, validity tests on the following categories of clinical outcomes were performed: fracture (n = 40, assessed in one study), mortality (n = 18), function (n = 11), institutionalization (n = 7), falls (n = 4), and hospitalization (n = 2). Thereby, EWGSOP2 was investigated in 15 validity tests (18.3%) on all categories of clinical outcomes, whereas SDOC was investigated in four validity tests (4.9%) in one study on fractures in men only, and none of the validity tests investigated predictive validity by the AWGS2. However, we were not able to pool the data using a meta-analytic approach due to important methodological heterogeneity between the studies. We identified various definitions of clinical outcomes that were used to test predictive validity of sarcopenia definitions suggesting that an agreement on an operational definition of a clinical outcome is key to advance in the field of sarcopenia. Moreover, data on predictive validity using the sarcopenia definitions by the SDOC and AWGS2 are still scarce and lacking, respectively. In a next step, prospective studies including both women and men are needed to compare predictive validity of current sarcopenia definitions on defined key clinical outcomes.
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Affiliation(s)
- Anna K Stuck
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Giacomo Basile
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gregor Freystaetter
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Aging Medicine, University Hospital Zurich, Zurich, Switzerland
| | | | - Wei Lang
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Aging Medicine, University Hospital Zurich, Zurich, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
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Spexoto MCB, Ramírez PC, de Oliveira Máximo R, Steptoe A, de Oliveira C, Alexandre TDS. European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) criteria or slowness: which is the best predictor of mortality risk in older adults? Age Ageing 2022; 51:6649128. [PMID: 35906934 PMCID: PMC9338689 DOI: 10.1093/ageing/afac164] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 01/11/2023] Open
Abstract
Objectives to analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults. Methods a longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up. Results compared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16–1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24–1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49–2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off. Conclusions using LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults.
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Affiliation(s)
- Maria Claudia Bernardes Spexoto
- Food, Nutrition and Health Postgraduate Program, Federal University of Grande Dourados, Dourados, Brazil.,Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Paula Camila Ramírez
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Department of Epidemiology and Public Health, University College London, London, UK.,Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil
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Sanchez-Sanchez JL, He L, Virecoulon Giudici K, Guyonnet S, Parini A, Dray C, Valet P, Pereira O, Vellas B, Rolland Y, de Souto Barreto P. Circulating Levels of Apelin, GDF-15 and Sarcopenia: Lack of Association in the MAPT Study. J Nutr Health Aging 2022; 26:564-570. [PMID: 35718864 DOI: 10.1007/s12603-022-1800-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Apelin and GDF-15 have been proposed as biomarkers of age-related sarcopenia but evidence in human models is scarce. This study aimed to explore the associations between blood apelin and GDF-15 with sarcopenia incidence and the evolution of sarcopenia components over two years in older adults >70 years. DESIGN Secondary longitudinal analysis of the Multidomain Alzheimer Preventive Trial. PARTICIPANTS Older adults (>70 years) attending primary care centers in France and Monaco. SETTING Community. MEASUREMENTS Serum Apelin (pg/mL) and plasma GDF-15 (pg/mL) were measured. Outcomes included sarcopenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP) and its determinants (appendicular lean mass [ALM] evaluated through a Dual-energy X-ray Absorptiometry (DXA) scan, handgrip strength (HGS) and the 4-meter gait speed) measured over 2 years. Linear mixed models and logistic regression were used to explore the longitudinal associations. RESULTS We included 168 subjects from MAPT (median age=76y, IQR=73-79; 78% women). Serum apelin was not significantly associated with sarcopenia incidence (OR=1.001;95%CI=1.000,1.001;p-value>0.05 in full-adjusted models) nor with ALM (β=-5.8E-05;95%CI=-1.0E-04,2.12E-04;p>0.05), HGS (β=-1.1E-04;95%CI=-5.0E-04,2.8E-04;p>0.05), and GS (β=-5.1E-06;95%CI=-1.0E-05,2.0E-05;p>0.05) in fully adjusted models. Similarly, plasma GDF-15 was not associated with both the incidence of sarcopenia (OR=1.001,95%CI=1.000,1.002,p>0.05) and the evolution of its determinants ([ALM, β=2.1E-05;95%CI=-2.6E-04,3.03E-04;p>0.05], HGS [β=-5.9E-04;95%CI=-1.26E-03,8.1E-05; p>0.05] nor GS [β=-2.6E-06;95%CI=-3.0E-05, 2.3E-05;p>0.05]) in fully adjusted models. CONCLUSIONS Blood apelin and GDF-15 were not associated with sarcopenia incidence or with the evolution of sarcopenia components over a 2-year follow-up in community-dwelling older adults. Well-powered longitudinal studies are needed to confirm or refute our findings.
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Affiliation(s)
- J L Sanchez-Sanchez
- Juan Luis Sánchez, Gérontopôle de Toulouse, Institut du Vieillissement, 37 Allées Jules Guesde, 31000 Toulouse, France, +34662309412,
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Burian E, Becherucci EA, Junker D, Sollmann N, Greve T, Hauner H, Zimmer C, Kirschke JS, Karampinos DC, Subburaj K, Baum T, Dieckmeyer M. Association of Cervical and Lumbar Paraspinal Muscle Composition Using Texture Analysis of MR-Based Proton Density Fat Fraction Maps. Diagnostics (Basel) 2021; 11:diagnostics11101929. [PMID: 34679627 PMCID: PMC8534863 DOI: 10.3390/diagnostics11101929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
In this study, the associations of cervical and lumbar paraspinal musculature based on a texture analysis of proton density fat fraction (PDFF) maps were investigated to identify gender- and anatomical location-specific structural patterns. Seventy-nine volunteers (25 men, 54 women) participated in the present study (mean age ± standard deviation: men: 43.7 ± 24.6 years; women: 37.1 ± 14.0 years). Using manual segmentations of the PDFF maps, texture analysis was performed and texture features were extracted. A significant difference in the mean PDFF between men and women was observed in the erector spinae muscle (p < 0.0001), whereas the mean PDFF did not significantly differ in the cervical musculature and the psoas muscle (p > 0.05 each). Among others, Variance(global) and Kurtosis(global) showed significantly higher values in men than in women in all included muscle groups (p < 0.001). Not only the mean PDFF values (p < 0.001) but also Variance(global) (p < 0.001), Energy (p < 0.001), Entropy (p = 0.01), Homogeneity (p < 0.001), and Correlation (p = 0.037) differed significantly between the three muscle compartments. The cervical and lumbar paraspinal musculature composition seems to be gender-specific and has anatomical location-specific structural patterns.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (D.J.); (D.C.K.)
- Correspondence:
| | - Edoardo A. Becherucci
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
| | - Daniela Junker
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (D.J.); (D.C.K.)
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, 81377 Munich, Germany;
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 80992 Munich, Germany;
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (D.J.); (D.C.K.)
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore 487372, Singapore;
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.A.B.); (N.S.); (C.Z.); (J.S.K.); (T.B.); (M.D.)
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8
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Geerinck A, Beaudart C, Reginster JY, Locquet M, Monseur C, Gillain S, Bruyère O. Development and validation of a short version of the Sarcopenia Quality of Life questionnaire: the SF-SarQoL. Qual Life Res 2021; 30:2349-2362. [PMID: 33782793 PMCID: PMC8298237 DOI: 10.1007/s11136-021-02823-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form. METHODS The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test-retest reliability, structural validity and examined item parameters with a graded response model (IRT). RESULTS The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59-43.45) vs. 42.86 (26.56-63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847-0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094-0.123; SRMR = 0.055) with no misfitting items and good response category separation. CONCLUSIONS A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.
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Affiliation(s)
- A Geerinck
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - C Beaudart
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - J-Y Reginster
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Locquet
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - C Monseur
- Department of Education Sciences, University of Liège, Liège, Belgium
| | - S Gillain
- Geriatrics Department, University Hospital of Liège, Liège, Belgium
| | - O Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
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9
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Xu J, Wan CS, Ktoris K, Reijnierse EM, Maier AB. Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis. Gerontology 2021; 68:361-376. [PMID: 34315158 DOI: 10.1159/000517099] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis. OBJECTIVE This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. METHODS A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria - cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. RESULTS Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. CONCLUSIONS Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.
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Affiliation(s)
- Jane Xu
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Ching S Wan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Melbourne, Victoria, Australia
| | - Kiriakos Ktoris
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
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10
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Mitani A, Iwai T, Shichinohe T, Takeda H, Kumagai S, Nishida M, Sugita J, Teshima T. The Combined Usage of the Global Leadership Initiative on Malnutrition Criteria and Controlling Nutrition Status Score in Acute Care Hospitals. ANNALS OF NUTRITION AND METABOLISM 2021; 77:178-184. [PMID: 34274929 DOI: 10.1159/000516994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The Global Leadership Initiative on Malnutrition (GLIM) lacks reliable blood tests for evaluating the nutrition status. We retrospectively compared the GLIM criteria, Controlling Nutrition Status (CONUT) score, and Subjective Global Assessment (SGA) to establish effective malnutrition screening and provide appropriate nutritional interventions according to severity. METHODS We classified 177 patients into 3 malnutrition categories (normal/mild, moderate, and severe) according to the GLIM criteria, CONUT score, and SGA. We investigated the malnutrition prevalence, concordance of malnutrition severity, predictability of clinical outcome, concordance by etiology, and clinical outcome by inflammation. RESULTS The highest prevalence of malnutrition was found using the GLIM criteria (87.6%). Concordance of malnutrition severity was low between the GLIM criteria and CONUT score. Concordance by etiology was low in all groups but was the highest in the "acute disease" group. The area under the curve of clinical outcome and that of the "with inflammation group" were significantly higher when using the CONUT score versus using the other tools (0.679 and 0.683, respectively). CONCLUSION The GLIM criteria have high sensitivity, while the CONUT score can effectively predict the clinical outcome of malnutrition. Their combined use can efficiently screen for malnutrition and patient severity in acute care hospitals.
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Affiliation(s)
- Asako Mitani
- Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan.,Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Takahito Iwai
- Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan, .,Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan,
| | - Toshiaki Shichinohe
- Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan.,Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Hiroshi Takeda
- Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan.,Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Satomi Kumagai
- Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan.,Department of Nutrition, Hokkaido University Hospital, Sapporo, Japan
| | - Mutsumi Nishida
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Junichi Sugita
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.,Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Takanori Teshima
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.,Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
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11
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Tan LJ, Li XH, Li GG, Hu Y, Chen XD, Deng HW. Identification of novel pleiotropic gene for bone mineral density and lean mass using the cFDR method. Ann Hum Genet 2021; 85:201-212. [PMID: 34115876 DOI: 10.1111/ahg.12438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
Bone mineral density (BMD) and whole-body lean mass (WBLM) are two important phenotypes of osteoporosis and sarcopenia. Previous studies have shown that BMD and lean mass were phenotypically and genetically correlated. To identify the novel common genetic factors shared between BMD and WBLM, we performed the conditional false discovery rate (cFDR) analysis using summary data of the genome-wide association study of femoral neck BMD (n = 53,236) and WBLM (n = 38,292) from the Genetic Factors for Osteoporosis Consortium (GEFOS). We identified eight pleiotropic Single Nucleotide Polymorphism (SNPs) (PLCL1 rs11684176 and rs2880389, JAZF1 rs198, ADAMTSL3 rs10906982, RFTN2/MARS2 rs7340470, SH3GL3 rs1896797, ST7L rs10776755, ANKRD44/SF3B1 rs11888760) significantly associated with femoral neck BMD and WBLM (ccFDR < 0.05). Bayesian fine-mapping analysis showed that rs11888760, rs198, and rs1896797 were the possible functional variants in the ANKRD44/SF3B1, JAZF1i, and SH3GL3 loci, respectively. Functional annotation suggested that rs11888760 was likely to comprise a DNA regulatory element and linked to the expression of RFTN2 and PLCL1. PLCL1 showed differential expression in laryngeal posterior cricoarytenoid muscle between rats of 6 months and 30 months of age. Our findings, together with PLCL1's potential functional relevance to bone and skeletal muscle function, suggested that rs11888760 was the possible pleiotropic functional variants appearing to coregulate both bone and muscle metabolism through regulating the expression of PLCL1. The findings enhanced our knowledge of genetic associations between BMD and lean mass and provide a rationale for subsequent functional studies of the implicated genes in the pathophysiology of diseases, such as osteoporosis and sarcopenia.
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Affiliation(s)
- Li-Jun Tan
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China
| | - Xiao-Hua Li
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China
| | - Gai-Gai Li
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China
| | - Yuan Hu
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China
| | - Xiang-Ding Chen
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China
| | - Hong-Wen Deng
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, China.,Center of Bioinformatics and Genomics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
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12
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Geerinck A, Locquet M, Bruyère O, Reginster J, Beaudart C. Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL ® questionnaire. J Cachexia Sarcopenia Muscle 2021; 12:319-330. [PMID: 33644998 PMCID: PMC8061363 DOI: 10.1002/jcsm.12687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/18/2020] [Accepted: 01/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The SarQoL® questionnaire was specifically designed to measure quality of life (QoL) in sarcopenia. Frailty and sarcopenia have areas of overlap, notably weak muscle strength and slow gait speed, which may mean that the SarQoL could provide a measure of QoL in frailty. This study aimed to evaluate the clinimetric properties of the SarQoL questionnaire in physical frailty using the Fried criteria. METHODS Analyses were carried out on data from the Sarcopenia and Physical impairment with advancing Age study. Frailty was assessed with the Fried criteria and QoL with the SarQoL, the Short-Form 36-Item, and the EuroQoL 5-Dimension (EQ-5D) questionnaires. We evaluated discriminative power (with the Kruskal-Wallis analysis of variance test), internal consistency (with Cronbach's alpha), construct validity (through hypotheses testing), test-retest reliability (with the intraclass correlation coefficient), measurement error (calculating standard error of measurement and smallest detectable change), and responsiveness (through hypotheses testing and standardized response mean). RESULTS In total, 382 participants were included for the validation and 117 for the responsiveness evaluation. They had a median age of 73 (69-79) years, took 5 (3-8) drugs, and had 4 (3-5) co-morbidities. There were more women (n = 223; 58.4%) than men and, in total, 172 (45%) robust, 167 (44%) pre-frail, and 43 (11%) frail participants. Discriminative power was confirmed when significantly lower (P < 0.001) overall SarQoL scores, and thus also worse QoL, were observed between robust [77.1 (64.35-85.90)], pre-frail [62.54 (53.33-69.57)], and frail [49.99 (40.45-56.06)] participants. Six of the SarQoL domains performed likewise, with significantly lower scores according to frailty status with Domain 7 (fears) being the exception. Internal consistency was good (α = 0.866). Convergent (using Short-Form 36-Item and EQ-5D) and divergent construct validity (using EQ-5D) was confirmed. Test-retest reliability was excellent [intraclass correlation coefficient = 0.918 (0.834-0.961)], with a standard error of measurement of 3.88 and a smallest detectable change of 10.76 points. We found moderate responsiveness when five of the nine hypotheses were confirmed, coupled with a large effect size for the overall SarQoL score (corrected standardized response mean of -1.44). CONCLUSIONS The SarQoL questionnaire has adequate clinimetric properties for use with frail patients in clinical practice and trials and could provide data that are more appropriate and detailed than the generic questionnaires currently used.
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Affiliation(s)
- Anton Geerinck
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Médéa Locquet
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
| | - Jean‐Yves Reginster
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
- Biochemistry Department, College of ScienceKing Saud UniversityRiyadhSaudi Arabia
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health EconomicsUniversity of Liège, World Health Organization Collaborating Centre for Public Health aspects of musculo‐skeletal health and ageingLiègeBelgium
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13
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Dai M, Lin T, Yue J, Dai L. Signatures and Clinical Significance of Amino Acid Flux in Sarcopenia: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:725518. [PMID: 34589057 PMCID: PMC8473793 DOI: 10.3389/fendo.2021.725518] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/24/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dysregulation of amino acids is closely linked to the initiation and progression of sarcopenia. We summarized recent advancements in the studies of amino acid profiles in sarcopenia and systematically presented the clinical significance of amino acid flux in sarcopenia. METHODS We systematically searched in MEDLINE, EMBASE, and Cochrane library from inception to June 1, 2021 to capture all studies examining metabolomics of sarcopenia. We used the following keywords: sarcopenia, metabonomics, metabolomics, amino acid profile, and mass spectrometry. Original articles comparing amino acid patterns between persons with and without sarcopenia were included. Two independent investigators independently completed title and abstract screening, data extraction, and quality evaluation. We used a random effects model to examine the association between amino acids levels and sarcopenia. Sensitivity analyses restricted the analyses to studies in which muscle mass was measured by bioelectrical impedance analysis. Study quality was evaluated according to the Agency for Healthcare Research and Quality (AHRQ) checklist. RESULTS The systematic research yielded six eligible articles, comprising 1,120 participants. Five studies used muscle mass in combination with physical performance and/or muscle strength as the criteria to diagnose sarcopenia, while one study used muscle mass as a diagnostic criterion alone. We found that the concentrations of branched-chain amino acids leucine (standardized mean difference [SMD] -1.249; 95% confidence interval [CI]: -2.275, -0.223, P = 0.02, I2 = 97.7%), isoleucine (SMD -1.077; 95% CI: -2.106, -0.049, P = 0.04, I2 = 97.8%), and aromatic amino acid tryptophan (SMD -0.923; 95% CI: -1.580, -0.265, P = 0.01, I2 = 89.9%) were significantly reduced in individuals with sarcopenia. Study results were robust in sensitivity analysis. CONCLUSIONS The homeostasis of amino acids is critical to maintaining muscle health. The profiles of amino acids might be useful biomarkers for the characterization of sarcopenia. Future studies are warranted to study the clinical significance of amino acids in the diagnosis and treatment of sarcopenia.
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Affiliation(s)
- Miao Dai
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Jirong Yue, ; Lunzhi Dai,
| | - Lunzhi Dai
- Department of State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu, China
- *Correspondence: Jirong Yue, ; Lunzhi Dai,
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14
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Skeletal Muscle Health and Cognitive Function: A Narrative Review. Int J Mol Sci 2020; 22:ijms22010255. [PMID: 33383820 PMCID: PMC7795998 DOI: 10.3390/ijms22010255] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022] Open
Abstract
Sarcopenia is the loss of skeletal muscle mass and function with advancing age. It involves both complex genetic and modifiable risk factors, such as lack of exercise, malnutrition and reduced neurological drive. Cognitive decline refers to diminished or impaired mental and/or intellectual functioning. Contracting skeletal muscle is a major source of neurotrophic factors, including brain-derived neurotrophic factor, which regulate synapses in the brain. Furthermore, skeletal muscle activity has important immune and redox effects that modify brain function and reduce muscle catabolism. The identification of common risk factors and underlying mechanisms for sarcopenia and cognition may allow the development of targeted interventions that slow or reverse sarcopenia and also certain forms of cognitive decline. However, the links between cognition and skeletal muscle have not been elucidated fully. This review provides a critical appraisal of the literature on the relationship between skeletal muscle health and cognition. The literature suggests that sarcopenia and cognitive decline share pathophysiological pathways. Ageing plays a role in both skeletal muscle deterioration and cognitive decline. Furthermore, lifestyle risk factors, such as physical inactivity, poor diet and smoking, are common to both disorders, so their potential role in the muscle-brain relationship warrants investigation.
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15
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Sanchez-Rodriguez D, Locquet M, Bruyère O, Lengelé L, Cavalier E, Reginster JY, Beaudart C. Prediction of 5-year mortality risk by malnutrition according to the GLIM format using seven pragmatic approaches to define the criterion of loss of muscle mass. Clin Nutr 2020; 40:2188-2199. [PMID: 33069510 DOI: 10.1016/j.clnu.2020.09.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To assess the association between baseline malnutrition according to the GLIM format, using seven pragmatic approaches to define the criterion of loss of muscle mass, with mortality in the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study during a 5-year follow-up. Secondarily, to calculate diagnostic performance indicators, concordance, and feasibility of these 7 pragmatic approaches compared to the original GLIM criteria. METHODS Post-hoc analysis of the SarcoPhAge cohort, which included 534 community-dwelling volunteers ≥65-year-old, followed-up from 2013 to 2019. Baseline malnutrition was defined by GLIM criteria and 7 approaches: 1) Omission of a reduced muscle mass as a criterion; 2) Substitution for handgrip strength, 3) Calf-circumference, 4) Mid-arm circumference, 5) Goodman's grid, 6) Ishii's score chart, and 7) Yu's formula. The association between malnutrition (according to GLIM criteria and the 7 approaches) and mortality was assessed by Cox-regressions. Sensitivity, Specificity, Positive (PPV), Negative (NPV) predictive values, area under the curve (AUC), Cohen-kappa coefficient, and TELOS-feasibility score were calculated. RESULTS Data to calculate GLIM criteria were available for 373 subjects (73.07 ± 5.96 years, 56% women). Prevalence of malnutrition with GLIM criteria was 24.4% (ranged from 13.9% to 20.9% with the 7 approaches). GLIM criteria showed a HR = 3.38 (1.89-6.09) to predict mortality during the 5-year follow-up, which ranged from HR = 2.72 (1.51-4.91) to 3.94 (2.14-7.24) with the 7 approaches. All 7 approaches were feasible (TELOS ≥ 3), showed sensitivity ≥ 65%, specificity ≥ 95.4%, PPV ≥ 85%, NPV ≥ 88%, AUC ≥ 0.7 and had almost-perfect/strong concordance (k ≥ 0.7) with the original GLIM criteria. CONCLUSIONS GLIM criteria and the 7 approaches predicted three-to four-fold mortality, all ensured an accurate diagnosis, and were feasible in clinical settings.
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Affiliation(s)
- Dolores Sanchez-Rodriguez
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Geriatrics Department, Rehabilitation Research Group, Hospital Del Mar Medical, Research Institute (IMIM), Universitat Pompeu Fabra, Barcelona, Spain.
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU - Sart Tilman, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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16
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Sanchez-Rodriguez D, Locquet M, Reginster JY, Cavalier E, Bruyère O, Beaudart C. Mortality in malnourished older adults diagnosed by ESPEN and GLIM criteria in the SarcoPhAge study. J Cachexia Sarcopenia Muscle 2020; 11:1200-1211. [PMID: 32657045 PMCID: PMC7567139 DOI: 10.1002/jcsm.12574] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Global Leadership Initiative on Malnutrition (GLIM) criteria have been recently launched by consensus of the major nutrition societies. GLIM criteria are partly constructed on the previous definition of malnutrition developed by the European Society of Clinical Nutrition and Metabolism (ESPEN). We aimed to assess malnutrition according to the ESPEN and GLIM criteria at baseline and to determine the corresponding risk of mortality during a 4-year follow-up in community-dwelling older adults from the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study. The relationship between malnutrition and incidence of 4-year adverse health consequences (institutionalization, hospitalization, falls, and fractures) was assessed. METHODS This prospective population-based cohort was part of SarcoPhAge, which included 534 older adults in Belgium, followed up from 2013 to 2019. Community-dwelling healthy volunteers ≥65 years old were recruited. Mortality and adverse health consequences were collected annually by interview or phone call. Baseline malnutrition was defined according to the GLIM and ESPEN criteria. Agreement between the two definitions was reported by Cohen's kappa coefficient. Adjusted Cox regression and Kaplan-Meier survival curves were performed for malnutrition. Logistic regression was used for the other outcomes. RESULTS From 534 subjects in SarcoPhAge, the records for 411 participants (73.2 ± 6.05 years old; 55.7% women) had all the variables needed to apply the GLIM criteria. Prevalence of baseline malnutrition was 23.4% for GLIM and 7% for ESPEN criteria (k = 0.30, low agreement). The adjusted Cox regression showed a significant increased mortality risk according to malnutrition status as defined by the GLIM [adjusted hazard ratio = 4.41 (95% confidence interval: 2.17-8.97)] and ESPEN [adjusted hazard ratio = 2.76 (95% confidence interval: 1.16-6.58)] criteria. Survival curves differed significantly between malnourished and non-malnourished groups, regardless of the definition used (log rank P < 0.001 for both). No association was found between baseline malnutrition according to these two criteria and 4-year risk of institutionalization, hospitalization, falls, or fractures (all P > 0.05). CONCLUSIONS Malnutrition according to the GLIM criteria was associated with a 4.4-fold higher mortality risk, double that of the ESPEN criteria, during a 4-year follow-up. No association was found between malnutrition according to these two criteria and incidence of other health adverse consequences. GLIM criteria anticipate mortality and might guide interventions, with important implications for clinical practice and research.
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Affiliation(s)
- Dolores Sanchez-Rodriguez
- WHO Collaborating Centre for Public Health aspects of musculo-skeletal health and aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,Geriatrics Department, Parc de Salut Mar, Barcelona, Spain.,Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.,School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health aspects of musculo-skeletal health and aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health aspects of musculo-skeletal health and aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, KSA
| | - Etienne Cavalier
- Royal Belgian Society of Laboratory Medicine, Verviers, Belgium.,Department of Clinical Chemistry, University of Liège, CHU-Sart Tilman, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health aspects of musculo-skeletal health and aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health aspects of musculo-skeletal health and aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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17
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Muscle Wasting and Sarcopenia in Heart Failure-The Current State of Science. Int J Mol Sci 2020; 21:ijms21186549. [PMID: 32911600 PMCID: PMC7555939 DOI: 10.3390/ijms21186549] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is primarily characterized by skeletal muscle disturbances such as loss of muscle mass, quality, strength, and physical performance. It is commonly seen in elderly patients with chronic diseases. The prevalence of sarcopenia in chronic heart failure (HF) patients amounts to up to 20% and may progress into cardiac cachexia. Muscle wasting is a strong predictor of frailty and reduced survival in HF patients. Despite many different techniques and clinical tests, there is still no broadly available gold standard for the diagnosis of sarcopenia. Resistance exercise and nutritional supplementation represent the currently most used strategies against wasting disorders. Ongoing research is investigating skeletal muscle mitochondrial dysfunction as a new possible target for pharmacological compounds. Novel agents such as synthetic ghrelin and selective androgen receptor modulators (SARMs) seem promising in counteracting muscle abnormalities but their effectiveness in HF patients has not been assessed yet. In the last decades, many advances have been accomplished but sarcopenia remains an underdiagnosed pathology and more efforts are needed to find an efficacious therapeutic plan. The purpose of this review is to illustrate the current knowledge in terms of pathogenesis, diagnosis, and treatment of sarcopenia in order to provide a better understanding of wasting disorders occurring in chronic heart failure.
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18
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Sui SX, Holloway‐Kew KL, Hyde NK, Williams LJ, Tembo MC, Leach S, Pasco JA. Definition‐specific prevalence estimates for sarcopenia in an Australian population: the Geelong Osteoporosis Study. JCSM CLINICAL REPORTS 2020. [DOI: 10.1002/crt2.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
| | | | | | | | | | | | - Julie A. Pasco
- Deakin University Geelong Victoria Australia
- Department of Medicine—Western Campus The University of Melbourne St Albans Victoria Australia
- Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia
- University Hospital Geelong Geelong Victoria Australia
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19
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Martone AM, Marzetti E, Salini S, Zazzara MB, Santoro L, Tosato M, Picca A, Calvani R, Landi F. Sarcopenia Identified According to the EWGSOP2 Definition in Community-Living People: Prevalence and Clinical Features. J Am Med Dir Assoc 2020; 21:1470-1474. [PMID: 32359893 DOI: 10.1016/j.jamda.2020.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People (EWGSOP2) recently updated the definition of sarcopenia in order to reflect scientific and clinical evidences. OBJECTIVE The aim is to explore the prevalence of sarcopenia (according to the new EWGSOP2 definition) and related risk factors among an unselected sample of subjects living in community. SETTING AND PARTICIPANTS The Longevity Check-up 7+ project is an ongoing cross-sectional study started in June 2015 and conducted in unconventional settings (ie, exhibitions, malls, and health promotion campaigns). Candidate participants are eligible for enrollment if they are at least 18 years of age. METHODS Muscle strength was assessed by handgrip strength and physical performance was evaluated by chair stand test. RESULTS The mean age of 11,253 subjects was 55.6 (standard deviation 11.5, from 18 to 98 years) years, and 6356 (56%) were women. Using the EWGSOP2 algorithm, 973 participants (8.6%) were identified as affected by sarcopenia, and the prevalence of sarcopenia significantly increased with age. Sarcopenia was associated with diabetes prevalence ratio (PR) 1.42, 95% confidence interval (CI) 1.06-1.89, impairment in 400-m walking performance (PR 2.16, 95% CI 1.74-2.17), and self-reported unhealthy status (PR 1.77, 95% CI 1.45-2.17). Conversely, a decreased probability of being sarcopenic was detected among subjects following a healthy diet (PR 0.79, 95% CI 0.63-0.98) and involved in regular physical activity (PR 0.79, 95% CI 0.64-0.99). CONCLUSIONS AND IMPLICATIONS Muscle strength and physical performance assessment should be considered as the recommended methods for the early detection of individuals at risk of probable sarcopenia.
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Affiliation(s)
- Anna Maria Martone
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Sara Salini
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Maria Beatrice Zazzara
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Luca Santoro
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Matteo Tosato
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Riccardo Calvani
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Landi
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
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20
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Understanding and Addressing Muscle Strength, Mass, and Function in Older Persons. J Am Med Dir Assoc 2020; 20:1-4. [PMID: 30580818 DOI: 10.1016/j.jamda.2018.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 11/18/2018] [Indexed: 01/06/2023]
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21
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Abstract
PURPOSE OF REVIEW To summarize the latest advances and caveats in defining sarcopenia and discuss the implications of the most recent worldwide initiatives which are trying to harmonize the definition. RECENT FINDINGS The evolution over time of the definitions of sarcopenia is discussed, with a focus on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) definition and the Sarcopenia Definitions and Outcomes Consortium (SDOC) conference. The EWGSOP2 and the SDOC agree on the overall concept of sarcopenia, which involves both impaired function (low muscle strength) and structural damage (low muscle mass/quality). However, physical performance is considered as a diagnostic criterion (EWGSOP), a severity grading assessment (EWGSOP2) or an outcome (SDOC) pending on the definition used. Muscle strength has been recognized as the best predictor of health outcomes. Muscle mass alone, as part of the definition of cachexia, sarcopenia and malnutrition, is a nondefining parameter. Furthermore, there is a lack of precision in measurement techniques and variability of the cut-off points in defining it. SUMMARY We discuss the relationship of sarcopenia with cachexia, malnutrition and frailty, and the areas that are hampering agreement. We summarize key scientific evidence, consider future study of this nutrition-related disease and raise concern about the need for a universal definition of sarcopenia.
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Affiliation(s)
- Dolores Sanchez-Rodriguez
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Geriatrics Department, Parc Salut Mar
- Department of Health Sciences, Universitat Pompeu Fabra
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM)
- School of Medicine, Universitat Autònoma de Barcelona
| | - Ester Marco
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM)
- School of Medicine, Universitat Autònoma de Barcelona
- Physical Medicine and Rehabilitation Department, Parc Salut Mar
- Universitat Internacional de Catalunya, Barcelona
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22
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Bachettini NP, Bielemann RM, Barbosa-Silva TG, Menezes AMB, Tomasi E, Gonzalez MC. Sarcopenia as a mortality predictor in community-dwelling older adults: a comparison of the diagnostic criteria of the European Working Group on Sarcopenia in Older People. Eur J Clin Nutr 2019; 74:573-580. [PMID: 31586126 DOI: 10.1038/s41430-019-0508-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES The definition of sarcopenia remains a matter of discussion and there is no globally accepted consensus for its diagnosis. The aim of this study was to assess the effect of sarcopenia diagnostic components on mortality, as well as to compare the associations between sarcopenia diagnosed via the 2010 and 2018 Consensuses of the European Working Group on Sarcopenia in Older People (EWGSOP) and mortality. METHODS Prospective cohort study involving noninstitutionalized older adults aged ≥ 60 years. For the diagnosis of sarcopenia, the definitions proposed by the 2010 (EWGSOP) and 2018 (EWGSOP2) Consensuses were used. The diagnostic components corresponded to muscle mass, muscular strength, and physical performance. The associations of sarcopenia and its components with mortality were investigated using Cox proportional hazard regression models. RESULTS The sample consisted of 1291 older adults. After an average of 2.6 years of follow-up, 88 (6.8%) participants had died. The diagnosis of severe sarcopenia by both Consensuses was associated with an increased risk of mortality. Severe sarcopenia was associated with an increased risk of death compared with that in people without sarcopenia when using EWGSOP (hazard ratio (HR) 3.15, 95% confidence interval (CI) 1.44-6.90) and EWGSOP2 (HR 4.11, 95% CI 1.88-9.00). Older adults with decreased gait speed had a 76% higher risk of dying (p = 0.033). There was no statistically significant association between the other sarcopenia components and mortality risk. CONCLUSIONS Older adults with severe sarcopenia and those with changes in physical performance had an increased risk of death in the short term.
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Affiliation(s)
| | - Renata Moraes Bielemann
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Thiago Gonzalez Barbosa-Silva
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Surgery, School of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | | | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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23
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Relationship between the changes over time of bone mass and muscle health in children and adults: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:429. [PMID: 31521141 PMCID: PMC6745072 DOI: 10.1186/s12891-019-2752-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813). Methods We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI). Results Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23–0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004). Conclusion Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.
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Automatic Classification of Sarcopenia Level in Older Adults: A Case Study at Tijuana General Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183275. [PMID: 31489909 PMCID: PMC6765933 DOI: 10.3390/ijerph16183275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 01/10/2023]
Abstract
This paper presents a study based on data analysis of the sarcopenia level in older adults. Sarcopenia is a prevalent pathology in adults of around 50 years of age, whereby the muscle mass decreases by 1 to 2% a year, and muscle strength experiences an annual decrease of 1.5% between 50 and 60 years of age, subsequently increasing by 3% each year. The World Health Organisation estimates that 5–13% of individuals of between 60 and 70 years of age and 11–50% of persons of 80 years of age or over have sarcopenia. This study was conducted with 166 patients and 99 variables. Demographic data was compiled including age, gender, place of residence, schooling, marital status, level of education, income, profession, and financial support from the State of Baja California, and biochemical parameters such as glycemia, cholesterolemia, and triglyceridemia were determined. A total of 166 patients took part in the study, with an average age of 77.24 years. The purpose of the study was to provide an automatic classifier of sarcopenia level in older adults using artificial intelligence in addition to identifying the weight of each variable used in the study. We used machine learning techniques in this work, in which 10 classifiers were employed to assess the variables and determine which would provide the best results, namely, Nearest Neighbors (3), Linear SVM (Support Vector Machines) (C = 0.025), RBF (Radial Basis Function) SVM (gamma = 2, C = 1), Gaussian Process (RBF (1.0)), Decision Tree (max_depth = 3), Random Forest (max_depth=3, n_estimators = 10), MPL (Multilayer Perceptron) (alpha = 1), AdaBoost, Gaussian Naive Bayes, and QDA (Quadratic Discriminant Analysis). Feature selection determined by the mean for the variable ranking suggests that Age, Systolic Arterial Hypertension (HAS), Mini Nutritional Assessment (MNA), Number of chronic diseases (ECNumber), and Sodium are the five most important variables in determining the sarcopenia level, and are thus of great importance prior to establishing any treatment or preventive measure. Analysis of the relationships existing between the presence of the variables and classifiers used in moderate and severe sarcopenia revealed that the sarcopenia level using the RBF SVM classifier with Age, HAS, MNA, ECNumber, and Sodium variables has 82′5 accuracy, a 90′2 F1, and 82′8 precision.
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25
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Yang LJ, Wu GH, Yang YL, Wu YH, Zhang L, Wang MH, Mo LY, Xue G, Wang CZ, Weng XF. Nutrition, Physical Exercise, and the Prevalence of Sarcopenia in Elderly Residents in Nursing Homes in China. Med Sci Monit 2019; 25:4390-4399. [PMID: 31189870 PMCID: PMC6587647 DOI: 10.12659/msm.914031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background This study aimed to investigate the factors associated with sarcopenia in elderly residents in three nursing homes in Suzhou City, East China including the association with nutrition and physical exercise. Material/Methods Elderly residents (n=316) from three nursing homes included 112 men and 204 women. The appendicular skeletal muscle index (ASMI), grip strength, and movements were measured to diagnose sarcopenia. The correlation between sarcopenia with age, sex, body mass index (BMI), ASMI, upper arm circumference, calf circumference, muscle content, grip strength, dietary intake, degree and duration of movement were also assessed. Results The prevalence of sarcopenia was 28.8% (30.4% for men and 27.9% for women). Patients with sarcopenia were older compared with controls. Height, BMI, upper arm circumference, calf circumference and arm muscle mass, lower limb muscle mass, limb skeletal muscle index and ASMI, grip strength, and pace of movement were lower than controls. The prevalence of sarcopenia correlated with the intake of meat, fish, eggs, and milk, and duration of weekly aerobic and resistance exercise. Logistic regression analysis showed a positive correlation between the prevalence of sarcopenia and age, and a negative correlation between BMI and consumption of meat, eggs, and milk. Conclusions The prevalence of sarcopenia in elderly residents in three nursing homes in Suzhou City was 28.8%. Increasing age was a risk factor for sarcopenia. Increased BMI and a diet containing meat, eggs, and milk were protective factors. The findings from this study provide support that adequate dietary protein can prevent sarcopenia in the elderly.
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Affiliation(s)
- Li-Jun Yang
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Guan-Hui Wu
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Yun-Long Yang
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Yong-Hua Wu
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Li Zhang
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Min-Hong Wang
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Li-Ya Mo
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Gang Xue
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Chuan-Zhi Wang
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
| | - Xiao-Fen Weng
- Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland)
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26
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Borba VZC, Costa TL, Moreira CA, Boguszewski CL. MECHANISMS OF ENDOCRINE DISEASE: Sarcopenia in endocrine and non-endocrine disorders. Eur J Endocrinol 2019; 180:R185-R199. [PMID: 30913536 DOI: 10.1530/eje-18-0937] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/26/2019] [Indexed: 12/11/2022]
Abstract
Objective This paper reviews the main mechanisms, diagnostic criteria, treatment options and available data on sarcopenia in endocrine and non-endocrine disorders. The literature notes the presence of sarcopenia as a comorbid condition or a complication of another clinical situation and not a disease that only affects elderly patients. Method We performed a literature review, focusing on the following: mechanisms related to sarcopenia in elderly patients, and sarcopenia as it presents in the context of chronic and endocrine diseases; diagnostic tools and methods; aspects of sarcopenia and treatment options specific to chronic diseases and endocrine disorders respectively. Results Sarcopenia in chronic and endocrine disorders shares many mechanisms with sarcopenia affecting elderly patients, but certain diseases can have a predominant aspect that leads to sarcopenia. The prevalence of sarcopenia varies, depending on different diagnostic criteria, from around 12 to 60% in chronic illnesses and 15 to 90% in endocrine disorders. The interplay between sarcopenia, chronic diseases and elderly patients requires further study, to clarify the impact of each, in terms of prognosis and mortality. Conclusion Awareness of the presentation of sarcopenia in the context of other diseases and ages (and not just the elderly) is fundamental to ensure that preventive measures can be deployed.
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Affiliation(s)
| | - Tatiana Lemos Costa
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
| | - Carolina Aguiar Moreira
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
- Pro-Renal Brasil, Lab PRO, Bone Histomorphometry Section, Curitiba, Brazil
| | - Cesar Luiz Boguszewski
- Endocrine Division (SEMPR), Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil
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Locquet M, Beaudart C, Petermans J, Reginster JY, Bruyère O. EWGSOP2 Versus EWGSOP1: Impact on the Prevalence of Sarcopenia and Its Major Health Consequences. J Am Med Dir Assoc 2019; 20:384-385. [PMID: 30661861 DOI: 10.1016/j.jamda.2018.11.027] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 11/20/2018] [Accepted: 11/23/2018] [Indexed: 01/24/2023]
Affiliation(s)
| | - Charlotte Beaudart
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | | | | | - Olivier Bruyère
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
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28
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Zhang X, Huang P, Dou Q, Wang C, Zhang W, Yang Y, Wang J, Xie X, Zhou J, Zeng Y. Falls among older adults with sarcopenia dwelling in nursing home or community: A meta-analysis. Clin Nutr 2019; 39:33-39. [PMID: 30665817 DOI: 10.1016/j.clnu.2019.01.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/20/2018] [Accepted: 01/02/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To assess and quantify sarcopenia as a risk for falls among community-dwelling older people and nursing home older persons. METHODS Prospective cohort studies that evaluated the association between sarcopenia and falls in older adults were identified via a systematic literature search of Medline (via Ovid), PubMed, EMBASE, and the Cochrane CENTRAL Library from database inception until October 15, 2018, in English and Chinese. RESULTS 10 studies (10,073 participants) were included in the meta-analysis. Among older adults, having sarcopenia was significantly associated with a higher risk of falls, compared to older adults without sarcopenia (pooled OR-odds ratio = 1.52, 95% CI-confidence interval: 1.32-1.77, I2 = 39.1%). In addition, the results of subgroup analysis indicated that male participants with sarcopenia had a higher risk of falls than mixed gender participants with sarcopenia (pooled OR = 1.72, 95% CI: 1.36-2.18 versus pooled OR = 1.41, 95% CI: 1.16-1.70). Other subgroup analyses were conducted using different study follow-up periods (>1 year versus ≤ 1 year) (pooled OR 1.63, 95% CI: 1.38-1.92 versus 1.20, 95% CI: 0.87-1.65). In addition, community-dwelling older people with sarcopenia was significantly increase risk of fall, compared with non-sarcopenia (pooled OR = 1.69, 95% CI: 1.43-2.00), whereas it was not found among nursing home residents (pooled OR = 1.12, 95% CI: 0.84-1.51). Furthermore, sarcopenia definition subgroup analysis found that older adults with sarcopenia increase the risk of falls when using EWGSOP (pooled OR = 1.43, 95% CI: 1.19-1.72), FNIH (pooled OR = 1.82, 95% CI: 1.39-2.37), AWGS (pooled OR = 7.68, 95% CI: 1.41-41.80), respectively. CONCLUSION The present study found that sarcopenia is a risk factor for falls among community-dwelling older people, but not among nursing home older persons. Future research is needed to provide evidence for specific interventions aimed at treating sarcopenia and preventing falls among older adults dwelling in the community.
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Affiliation(s)
- Xiaoming Zhang
- The Affiliated Baoan Hospital of Southern Medical University, The People's Hospital of Baoan Shenzhen, Shenzhen, China.
| | - Pan Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Qingli Dou
- The Affiliated Baoan Hospital of Southern Medical University, The People's Hospital of Baoan Shenzhen, Shenzhen, China
| | - Conghua Wang
- West China Hospital, Sichuan University, Chengdu, China
| | - Wenwu Zhang
- The Affiliated Baoan Hospital of Southern Medical University, The People's Hospital of Baoan Shenzhen, Shenzhen, China
| | - Yongxue Yang
- Geriatrics Department, Chengdu Fifth People's Hospital; Chengdu-Montpellier Geriatric Research Center, Chengdu, China
| | - Jiang Wang
- College of Nursing, Jing Gang Shan University, Jian, China
| | - Xiaohua Xie
- Department of Nursing, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
| | - Jianghua Zhou
- Geriatrics Department, Chengdu Fifth People's Hospital; Chengdu-Montpellier Geriatric Research Center, Chengdu, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yingchun Zeng
- The Third Affiliated Hospital of Guangzhou Medical University, Research Institute of Gynecology & Obstetrics, Guangzhou, China
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