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Wang XP, Yan D, Jin XP, Zhang WY, Shi T, Wang X, Song W, Xiong X, Guo D, Chen S. The role of amino acid metabolism alterations in acute ischemic stroke: From mechanism to application. Pharmacol Res 2024; 207:107313. [PMID: 39025169 DOI: 10.1016/j.phrs.2024.107313] [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: 06/01/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024]
Abstract
Acute ischemic stroke (AIS) is the most prevalent type of stroke, and due to its high incidence, disability rate, and mortality rate, it imposes a significant burden on the health care system. Amino acids constitute one of the most crucial metabolic products within the human body, and alterations in their metabolic pathways have been identified in the microenvironment of AIS, thereby influencing the pathogenesis, severity, and prognosis of AIS. The amino acid metabolism characteristics in AIS are complex. On one hand, the dynamic progression of AIS continuously reshapes the amino acid metabolism pattern. Conversely, changes in the amino acid metabolism pattern also exert a double-edged effect on AIS. This interaction is bidirectional, dynamic, heterogeneous, and dose-specific. Therefore, the distinctive metabolic reprogramming features surrounding amino acids during the AIS process are systematically summarized in this paper, aiming to provide potential investigative strategies for the early diagnosis, treatment approaches, and prognostic enhancement of AIS.
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Affiliation(s)
- Xiang-Ping Wang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Dan Yan
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311202, China.
| | - Xia-Ping Jin
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Wen-Yan Zhang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Tao Shi
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Xiang Wang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Wenjuan Song
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China.
| | - Xing Xiong
- Traditional Chinese Medical Hospital of Xiaoshan,The Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 311200, Zhejiang Province, China.
| | - Duancheng Guo
- Cancer Institute, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
| | - Sheng Chen
- First People's Hospital of Xiaoshan District,Hangzhou 311200, Zhejiang Province, China.
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Miura K, Matsushita T, Nishioka S, Nakashima R, Onizuka S. Association between sarcopenia at discharge and functional outcomes 1 month and 6 months after discharge in patients in convalescent rehabilitation wards. Geriatr Gerontol Int 2024; 24:715-721. [PMID: 38860531 DOI: 10.1111/ggi.14921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/15/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024]
Abstract
AIM This retrospective cohort study investigated the relationship between sarcopenia and Activities of Daily Living capacity after discharge from convalescent rehabilitation wards. METHODS We included consecutive patients discharged from three convalescent rehabilitation wards in a hospital in Japan between December 2018 and October 2020. Sarcopenia was diagnosed based on the criteria of the 2019 Asian Working Group for Sarcopenia, utilizing skeletal muscle mass index and handgrip strength. Statistical analyses were carried out separately for men and women. The primary outcome was a higher motor domain (motor Functional Independence Measure [mFIM]) and a higher cognitive domain (cognitive Functional Independence Measure [cFIM]) of the FIM score 1 month after discharge. The secondary outcomes were higher mFIM and cFIM scores 6 months after discharge, analyzed using binary logistic regression. RESULTS Among 305 participants (mean age 70.0 years, 148 men), 93 were identified as having sarcopenia. The prevalence of sarcopenia was 16% for outpatient rehabilitation services, 59% for home-visit rehabilitation services and 50% for older adult day care. Logistic regression analyses showed that sarcopenia at discharge was not an independent variable for mFIM at 1 month (odds ratio [OR] 20, 95% confidence interval [CI] 0.31-1300 for men, OR 0.51, 95% CI 0.11-2.4 for women) and cFIM (OR 0.63, 95% CI 0.10-3.8 for men, OR 5.3, 95% CI 0.81-34 for women). At 6 months, sarcopenia at discharge was not an independent variable for mFIM (OR 0.30, 95% CI 0.02-3.6 for men, OR 0.40, 95% CI 0.06-2.5 for women) and cFIM (OR 0.16, 95% CI 0.01-2.4 for men, OR 0.00, 95% CI 0.00-1.1 for women). CONCLUSIONS Sarcopenia at the time of discharge from convalescent rehabilitation wards does not independently predict FIM 1 month or 6 months after discharge. Geriatr Gerontol Int 2024; 24: 715-721.
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Affiliation(s)
- Kyohei Miura
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Tatsuya Matsushita
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Ryusei Nakashima
- Department of Clinical Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Shinya Onizuka
- Department of Rehabilitation Medicine, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
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Hou Q, Yao L, Ou J. Research hotspot and frontiers in post-stroke dysphagia: A bibliometric study and visualisation analysis. J Eval Clin Pract 2024; 30:703-715. [PMID: 38652528 DOI: 10.1111/jep.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Dysphagia, a common complication after stroke, significantly hampers the recovery process of patients, both due to dysphagia itself and the additional complications it causes. Although a large number of articles have been published on post-stroke dysphagia (PSD), bibliometric analysis in this field is still lacking. This study aimed to provide a comprehensive understanding of the research hotspots and trends in PSD, thereby guiding future research efforts. METHODS The Web of Science Core Collection (WoSCC) database was searched for articles related to PSD from 2003 to 2022. Data were visualised and analysed using CiteSpace and VOSviewer. RESULTS A total of 3102 publications were included in the scientometric analysis, with a gradual increase in the number of papers published each year. The United States emerged as the country with the highest number of publications (625 articles), while the University of Manchester led with the most publications among institutions (67 articles). Notably, Dysphagia was both the most published (254 articles) and the most cited journal (11,141 citations). Among authors, Hamdy S emerged as the most prolific (52 articles), with Martino R being the most cited (1042 citations). CONCLUSION Based on our findings, we anticipate that research hotspots in PSD will mainly focus on complications due to PSD such as stroke-associated pneumonia, stroke-related sarcopenia. Additionally, exploration into the mechanisms and parameters of noninvasive brain stimulation techniques for the treatment of PSD, as well as the rehabilitation needs of patients with PSD, are expected to be key focal points in future research endeavours.
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Affiliation(s)
- Qinzhi Hou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jibing Ou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Liu D, Wang S, Liu S, Wang Q, Che X, Wu G. Frontiers in sarcopenia: Advancements in diagnostics, molecular mechanisms, and therapeutic strategies. Mol Aspects Med 2024; 97:101270. [PMID: 38583268 DOI: 10.1016/j.mam.2024.101270] [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: 10/28/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
The onset of sarcopenia is intimately linked with aging, posing significant implications not only for individual patient quality of life but also for the broader societal healthcare framework. Early and accurate identification of sarcopenia and a comprehensive understanding of its mechanistic underpinnings and therapeutic targets paramount to addressing this condition effectively. This review endeavors to present a cohesive overview of recent advancements in sarcopenia research and diagnosis. We initially delve into the contemporary diagnostic criteria, specifically referencing the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group on Sarcopenia (AWGS) 2019 benchmarks. Additionally, we elucidate comprehensive assessment techniques for muscle strength, quantity, and physical performance, highlighting tools such as grip strength, chair stand test, dual-energy X-ray Absorptiometry (DEXA), bioelectrical impedance analysis (BIA), gait speed, and short physical performance battery (SPPB), while also discussing their inherent advantages and limitations. Such diagnostic advancements pave the way for early identification and unequivocal diagnosis of sarcopenia. Proceeding further, we provide a deep-dive into sarcopenia's pathogenesis, offering a thorough examination of associated signaling pathways like the Myostatin, AMP-activated protein kinase (AMPK), insulin/IGF-1 Signaling (IIS), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways. Each pathway's role in sarcopenia mediation is detailed, underscoring potential therapeutic target avenues. From a mechanistic perspective, the review also underscores the pivotal role of mitochondrial dysfunction in sarcopenia, emphasizing elements such as mitochondrial oxidative overload, mitochondrial biogenesis, and mitophagy, and highlighting their therapeutic significance. At last, we capture recent strides made in sarcopenia treatment, ranging from nutritional and exercise interventions to potential pharmacological and supplementation strategies. In sum, this review meticulously synthesizes the latest scientific developments in sarcopenia, aiming to enhance diagnostic precision in clinical practice and provide comprehensive insights into refined mechanistic targets and innovative therapeutic interventions, ultimately contributing to optimized patient care and advancements in the field.
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Affiliation(s)
- Dequan Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shijin Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shuang Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Qifei Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Xiangyu Che
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
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Mat Nawi NF, Simok AA, Hanafi MH, Mohd Ismail ZI. Improvements of mid-thigh circumferences following robotic rehabilitation in hemiparetic stroke patients. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2091. [PMID: 38642068 DOI: 10.1002/pri.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 08/22/2023] [Accepted: 03/31/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Stroke has emerged as the leading cause of disability globally. The provision of long-term rehabilitation to stroke survivors poses a health care burden to many countries. Robotic devices have created a major turning point in stroke rehabilitation program. Currently, the anthropometric evidence to support the benefit of robotic rehabilitation (RR) among stroke patients is scarce. Therefore, the aim of this study was to evaluate the impact of RR on the mid-thigh circumferences of the paretic limbs in stroke patients. METHODS Twenty stroke patients from conventional rehabilitation (CR) (n = 10) and RR (n = 10) groups were recruited through a purposive sampling method. Patients in the CR group received a two-hour session of a five-day-a-week home-based CR program for 4 weeks. Patients in the RR group received a five-day-a-week of an hour combined physiotherapy and occupational therapy session and a one-hour robotic therapy session using the HAL® Cyberdyne lower-limb, for 4 weeks. The mid-thigh circumferences of both limbs were measured on day 1 (baseline), week 2 and week 4 of rehabilitation program. RESULTS The results revealed no statistically significant difference in the mid-thigh circumferences between the paretic (F1.05,9.44 = 1.96, p = 0.20), and the normal (F1.05,9.44 = 1.96, p = 0.20) sides in the CR group (n = 10). For the comparison between the paretic and normal sides in the RR group (n = 10), the paretic mid-thigh circumferences revealed significant time effect results (F2,18 = 11.91, p = 0.001), which were due to changes between baseline and week 2, and baseline and week 4 measurements. Interestingly, the normal mid-thigh circumferences also revealed a significant time effect (F2,18 = 6.56, p = 0.007), which is due to changes between baseline and week 4. One-way analysis of variance was employed to compare the mean average between groups due to the difference in the baseline measurements of the mid-thigh circumferences between the paretic side of the CR and the RR groups. With this adjustment, the average means mid-thigh circumferences after 4 weeks of therapy were shown to be significantly different between the CR and RR groups (F1,18 = 12.49, p = 0.02). CONCLUSION Significant increments in the mid-thigh circumferences following RR were seen in the paretic limbs of stroke patients. Hence, this study may provide some insights into further potential research related to the benefits of RR in stroke patients.
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Affiliation(s)
- Nur Fasihah Mat Nawi
- Department of Anatomy, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Anna Alicia Simok
- Department of Anatomy, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neuroscience, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia
- Rehabilitation Medicine Unit, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Zul Izhar Mohd Ismail
- Department of Anatomy, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia
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Tanaka S, Yamauchi K, Hayashi Y, Kumagae K, Goto K, Harayama E, Arakawa S. Factors influencing the reduction in quadriceps muscle thickness in the paretic limbs of patients with acute stroke. Clin Nutr ESPEN 2024; 60:173-178. [PMID: 38479907 DOI: 10.1016/j.clnesp.2024.01.019] [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: 08/21/2023] [Revised: 12/08/2023] [Accepted: 01/16/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Muscle atrophy is an early event that occurs after stroke, but there are few reports on the changes in skeletal muscle thickness in acute stroke. This study investigated the factors contributing to reduced muscle thickness in patients with acute stroke. METHODS In total, 51 patients with stroke and the National Institute of the Health Stroke Scale (NIHSS) > 3 were included in our study. They were admitted to our hospital between July 2017 and May 2020. The quadriceps muscle thickness was measured with an ultrasound device within 2 days after admission and 14 days later. The collected data included age, sex, body mass index, stroke type, neuromuscular electrical stimulation, NIHSS, serum albumin at admission, start of enteral nutrition, Functional Oral Intake Scale (FOIS), start of mobilization and ambulation, number of physical and occupational therapy units, C-reactive protein at admission and whether surgery had been performed. These data were retrospectively retrieved from medical documents. A dietician calculated energy intake, protein intake, and energy adequacy. Multiple regression analysis was used to identify the factors associated with reduced quadriceps muscle thickness. The independent variables were NIHSS, date of start of enteral feeding, protein intake, FOIS, date of mobilization, and date of start of ambulation training. RESULTS The rate of change in quadriceps muscle thickness of the paretic limb was -15.3 % (interquartile range, -46.1-14.8 %). Multiple regression analysis showed that the factors responsible for the decrease in muscle thickness on the paretic side were FOIS (β: 0.376; 95 % Cl, 0.999 to 4.541) and the start date of ambulation (β: -0.378; 95 % Cl, -2.575 to -0.543), with a multiple correlation coefficient of 0.456. CONCLUSION The FOIS and the start date of ambulation after acute stroke were related to the rate of reduction in muscle thickness on the paretic side.
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Affiliation(s)
- Shota Tanaka
- Department of Rehabilitation, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
| | - Kota Yamauchi
- Department of Rehabilitation, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
| | - Yuri Hayashi
- Department of Rehabilitation, Kyushu University Hospital, 3-1-1, Maidashi, Higashi Ward, Fukuoka City, Fukuoka, Japan.
| | - Kenichi Kumagae
- Department of Rehabilitation, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
| | - Kei Goto
- Department of Rehabilitation, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
| | - Eisei Harayama
- Department of Rehabilitation, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
| | - Shuji Arakawa
- Department of Cerebrovascular Medicine, Stroke Center, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahata Higashi Ward, Kitakyushu City, Fukuoka, Japan.
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Zheng Y, Feng J, Yu Y, Ling M, Wang X. Advances in sarcopenia: mechanisms, therapeutic targets, and intervention strategies. Arch Pharm Res 2024; 47:301-324. [PMID: 38592582 DOI: 10.1007/s12272-024-01493-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
Sarcopenia is a multifactorial condition characterized by loss of muscle mass. It poses significant health risks in older adults worldwide. Both pharmacological and non-pharmacological approaches are reported to address this disease. Certain dietary patterns, such as adequate energy intake and essential amino acids, have shown positive outcomes in preserving muscle function. Various medications, including myostatin inhibitors, growth hormones, and activin type II receptor inhibitors, have been evaluated for their effectiveness in managing sarcopenia. However, it is important to consider the variable efficacy and potential side effects associated with these treatments. There are currently no drugs approved by the Food and Drug Administration for sarcopenia. The ongoing research aims to develop more effective strategies in the future. Our review of research on disease mechanisms and drug development will be a valuable contribution to future research endeavors.
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Affiliation(s)
- Youle Zheng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Jin Feng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Yixin Yu
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Min Ling
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
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Ballesteros-Torres JM, Escalante-Aburto A, Villarreal-Arce ME, Caballero-Prado CJ. Exploring the Impact of Protein Supplement Source on Body Composition in Women Practicing Anaerobic Resistance Exercise: A Pilot Study. Nutrients 2024; 16:321. [PMID: 38276559 PMCID: PMC10820452 DOI: 10.3390/nu16020321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Supplements based on protein hydrolysates have been used as an effective source to access amino acids with greater bioavailability, promoting absorption to improve body composition. Five groups of young women were randomly selected. They followed a personalized eating plan that included different protein supplements (meat, vegan, branched-chain amino acids [BCAAs], whey, and control group), combined with an exercise plan, for eight weeks, aiming to assess their consumption effects combined with resistance exercise on body composition. Bioelectrical impedance before and after the treatment was conducted. The results showed that the supplementation with BCAAs presented a significant decrease (p < 0.05) on the BMI in this group (initial BMI = 19.7 kg/m2; final BMI = 19.4 kg/m2). When comparing the final measures among the groups, the BCAAs and vegan supplements caused a significant decrease in body weight (50.24 kg and 51.34 kg, respectively). The BMI of the group supplemented with meat proteins was statistically higher (22.06 kg/m2) than that the group supplemented with BCAAs (19.4 kg/m2) (p < 0.05). No significant changes were observed in the type of protein consumed to produce muscle mass in the participants after eight weeks of study under a controlled diet and anaerobic resistance exercise. Participants exhibited energy deficiencies, but their macronutrient distribution appeared normal. Following an 8-week intervention, meat and BCAAs reduced weight and BMI, although no statistical differences were observed. It is recommended to extend the treatment for a more comprehensive understanding.
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Affiliation(s)
- Juan Manuel Ballesteros-Torres
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas (FCB), Universidad Autónoma de Nuevo León (UANL), Ave. Universidad s/n, Cd. Universitaria, San Nicolás de los Garza 66450, Mexico;
| | - Anayansi Escalante-Aburto
- Tecnologico de Monterrey, Institute for Obesity Research, Eugenio Garza Sada 2501, Monterrey 64849, Mexico
- Departamento de Nutrición, Universidad de Monterrey (UDEM), Escuela de Ciencias Aliadas a la Salud, Ave. Ignacio Morones Prieto, 4500 Pte., San Pedro Garza García 66238, Mexico;
| | - María Elena Villarreal-Arce
- Departamento de Nutrición, Universidad de Monterrey (UDEM), Escuela de Ciencias Aliadas a la Salud, Ave. Ignacio Morones Prieto, 4500 Pte., San Pedro Garza García 66238, Mexico;
| | - Cindy Joanna Caballero-Prado
- Departamento de Nutrición, Universidad de Monterrey (UDEM), Escuela de Ciencias Aliadas a la Salud, Ave. Ignacio Morones Prieto, 4500 Pte., San Pedro Garza García 66238, Mexico;
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Cong WJ, Liu ZP, Liang YX, Ye SL, Cai ZM, Chen HM, Liao CW, Lin QL, Feng RQ, Zhou XD, Wu YZ, Sun LQ, Huang XR, Zhang MM, Huang GQ, Zhu BL. Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study. Clin Interv Aging 2024; 19:109-118. [PMID: 38250175 PMCID: PMC10800106 DOI: 10.2147/cia.s447038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Purpose To explore the predictive value of nutritional risk for all-cause death and functional outcomes among elderly acute stroke patients. Patients and Methods A total of 479 elderly acute stroke patients were enrolled in this study. The nutritional risk of patients was screened by the GNRI and NRS-2002. The primary outcome was all-cause death, and the secondary outcome was poor prognosis defined as a modified Rankin Scale (mRS) score ≥3. Results Based on the NRS-2002, patients with nutritional risk had a higher risk of all-cause death at 3 months (adjusted OR: 3.642, 95% CI 1.046~12.689) and at 3 years (adjusted OR: 2.266, 95% CI 1.259~4.076) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.748, 95% CI 1.518~4.972. Based on the GNRI, compared to those without nutritional risk, patients with mild malnutrition also had a higher risk of all-cause death at 3 months (adjusted OR: 7.186, 95% CI 1.550~33.315) and at 3 years (adjusted OR: 2.255, 95% CI 1.211~4.199) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 1.947, 95% CI 1.030~3.680), so patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months (adjusted OR: 6.535, 95% CI 1.380~30.945) and at 3 years (adjusted OR: 2.498, 95% CI 1.301~4.799) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.213, 95% CI 1.144~4.279). Conclusion Nutritional risk increases the risk of poor short-term and long-term outcomes in elderly patients with acute stroke. For elderly stroke patients, we should pay attention to early nutritional risk screening, and effective intervention should be provided to improve the prognosis of such patients.
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Affiliation(s)
- Wen-Jie Cong
- Department of Acupuncture and Physiotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Zhi-Peng Liu
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Yi-Xin Liang
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Sheng-Lie Ye
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Zhong-Ming Cai
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Hao-Man Chen
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Cheng-Wei Liao
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Qun-Li Lin
- Department of Neurology, Yongjia People's Hospital, Wenzhou, Zhejiang, People's Republic of China
| | - Ren-Qian Feng
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xu-Dong Zhou
- Department of Neurology, Pingyang People's Hospital, Wenzhou, Zhejiang, People's Republic of China
| | - Yan-Zhi Wu
- The First Clinical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Le-Qiu Sun
- Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xue-Rong Huang
- Department of Neurology, Ruian People's Hospital, Wenzhou, Zhejiang, People's Republic of China
| | - Man-Man Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang People's Republic of China
| | - Gui-Qian Huang
- School of Mental Health, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Bei-Lei Zhu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang People's Republic of China
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Hou Y, Xiang J, Wang B, Duan S, Song R, Zhou W, Tan S, He B. Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 14:1263650. [PMID: 38260146 PMCID: PMC10801049 DOI: 10.3389/fendo.2023.1263650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Sarcopenia and diabetes are two age-related diseases that are common in the elderly population, and have a serious effect on their general health and quality of life. Sarcopenia refers to the progressive loss of muscle mass, strength and function, whereas diabetes is a chronic disease characterized by elevated blood sugar levels. The comorbidity of sarcopenia and diabetes is particularly concerning, as people with diabetes have a higher risk of developing sarcopenia due to the combination of insulin resistance, chronic inflammation and reduced physical activity. In contrast, sarcopenia destroyed blood sugar control and exacerbated the development of people with diabetes, leading to the occurrence of a variety of complications. Fortunately, there are a number of effective treatment strategies for sarcopenia in people with diabetes. Physical exercise and a balanced diet with enough protein and nutrients have been proved to enhance the muscular quality and strength of this population. Additionally, pharmacological therapies and lifestyle changes can optimize blood sugar control, which can prevent further muscle loss and improve overall health outcomes. This review aims to summarize the pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes, which help healthcare professionals recognize their intimate connection and provide a new vision for the treatment of diabetes and its complications in this population. Through early identification and comprehensive treatment, it is possible to improve the muscle function and general quality of life of elderly with diabetes and sarcopenia.
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Affiliation(s)
- Yang Hou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Jia Xiang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Bo Wang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Shoufeng Duan
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Rouxuan Song
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Wenhu Zhou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Songwen Tan
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Binsheng He
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
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KAWAKUBO SAKI, FUKAO KOSUKE, SOMEYA YUKI, NISHIMURA JUNYA, DOI MAYUMI, SATO YUSEI, YOKOYAMA MIHO, TABATA MINORU, MINAMINO TOHRU, NAITO HISASHI. Effectiveness of Nutritional Guidance Focusing on Leucine Intake During Cardiac Rehabilitation Maintenance. JUNTENDO IJI ZASSHI = JUNTENDO MEDICAL JOURNAL 2023; 70:29-43. [PMID: 38854810 PMCID: PMC11154643 DOI: 10.14789/jmj.jmj23-0008-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/16/2023] [Indexed: 06/11/2024]
Abstract
Objective Due to the lack of information on the effects of nutritional guidance focused on leucine intake in patients undergoing maintenance cardiac rehabilitation, this study investigated on plasma leucine concentrations, lean body mass, and muscle strength. Methods Nutritional guidance, focused on leucine (intervention group) or general nutritional guidance (control group), was provided for six months to patients participating in cardiac rehabilitation. Body composition, grip strength, hematological test results, and diet of both groups were compared before and after the intervention. Results Seven patients in the intervention group (53.2 ± 18.2 years) and 7 patients in the control group (58.6 ± 15.3 years) were included. Dietary survey results showed that the six-month intervention significantly (p < 0.05) increased protein intake and estimated leucine intake only in the intervention group. There was no significant difference in the rate of change in plasma leucine concentration between the two groups. The rate of change in lean body mass was significantly higher in the intervention group compared to the control group (p = 0.035). The rate of change in plasma leucine concentration and that in lean body mass was positively correlated only in the intervention group (r = 0.777, p = 0.040), and the rate of change in plasma leucine concentration was also positively correlated with the rate of change in grip strength (ρ = 0.857, p = 0.014). Conclusions In the patients undergoing maintenance cardiac rehabilitation, increased plasma leucine concentration by nutritional guidance focused on leucine increased lean body mass without any increasing the training load.
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Affiliation(s)
| | - KOSUKE FUKAO
- Corresponding author: Kosuke Fukao, Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai-city, Chiba 270-1695, Japan, TEL: +81-476-98-1001 FAX: +81-476-98-1001 E-mail:
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Dora K, Tsukamoto H, Suga T, Tomoo K, Suzuki A, Adachi Y, Takeshita M, Kato Y, Kawasaki M, Sato W, Imaizumi A, Karakawa S, Uchida H, Hashimoto T. Essential amino acid supplements ingestion has a positive effect on executive function after moderate-intensity aerobic exercise. Sci Rep 2023; 13:22644. [PMID: 38114553 PMCID: PMC10730626 DOI: 10.1038/s41598-023-49781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
Aerobic exercise acutely improves cognitive function (e.g., executive function (EF); memory recognition (MR)) and increases circulating brain-derived neurotrophic factor (BDNF). In addition, branched-chain amino acids (BCAA) ingestion acutely shortens the choice reaction time and increases brain BDNF. We examined whether the ingestion of essential amino acid (EAA) supplements (mainly composed of BCAA) would positively impact on cognitive function and circulating BDNF after moderate-intensity aerobic exercise. Twenty-two healthy young men received either an EAA supplements or the placebo (PL) 30 min before undergoing aerobic exercise. The participants performed a cycling exercise at 60% of peak oxygen uptake for 30 min. EF after aerobic exercise was better after the EAA treatment than after the PL treatment (P = 0.02). MR (P = 0.38 for response accuracy; P = 0.15 for reaction time) and circulating BDNF (P = 0.59) were not altered by EAA supplements. EF improvement was correlated with increases in some amino acids (leucine, isoleucine, valine, lysine, phenylalanine; all Ps < 0.05) that are potential substrates for synthesizing neurotransmitters in the brain. These results suggest that EAA supplements ingestion had a positive effect on EF after moderate-intensity aerobic exercise, while MR and BDNF were not altered.
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Affiliation(s)
- Kento Dora
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
- Department of Biomedical Engineering, Toyo University, Kawagoe, Saitama, Japan
| | - Hayato Tsukamoto
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Tadashi Suga
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
| | - Keigo Tomoo
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Asuka Suzuki
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
| | - Yusuke Adachi
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Masamichi Takeshita
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Yumiko Kato
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Mika Kawasaki
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Wataru Sato
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Akira Imaizumi
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Sachise Karakawa
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Hirohisa Uchida
- Sports Nutrition Department, Ajinomoto Co., Inc., Chuo-ku, Tokyo, Japan
| | - Takeshi Hashimoto
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan.
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Sato Y, Yoshimura Y, Abe T, Nagano F, Matsumoto A, Wakabayashi H. Change in phase angle is associated with improvement in activities of daily living and muscle function in patients with acute stroke. Eur Geriatr Med 2023; 14:1333-1341. [PMID: 37603189 DOI: 10.1007/s41999-023-00853-3] [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: 06/05/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE The phase angle (PhA) is a simple index that reflects nutritional status and muscle quality. This study aimed to investigate the association between PhA changes and activities of daily living (ADL), muscle strength, and muscle mass in patients with acute stroke. METHODS This retrospective, observational, cross-sectional study included patients hospitalized for acute stroke. The primary outcome was functional independence measure (FIM) of motor gain. The secondary outcomes were changes in handgrip strength and skeletal muscle mass index (SMI) during hospitalization. Multivariate analysis was used to examine whether PhA changes were associated with outcomes, after adjusting for potential confounders. RESULTS Hundred and sixty one subjects (mean age 74.6 years, 92 men) were included in the study. Multivariate analysis showed that PhA change was significantly and positively correlated with the gain in FIM motor scores, both for men (β = 0.634, p < 0.001) and women (β = 0.660, p < 0.001). Furthermore, there were significant associations between PhA change and changes in handgrip strength for men (β = 0.222, p = 0.030) and women (β = 0.491, p < 0.001), as well as SMI for men (β = 0.556, p < 0.001) and women (β = 0.290, p = 0.025). CONCLUSIONS An increased phase angle was positively associated with ADL, muscle strength, and muscle mass at discharge in patients with acute stroke.
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Affiliation(s)
- Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Machi, Kikuchi-Gun, Kumamoto, 869-1106, Japan.
| | - Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Machi, Kikuchi-Gun, Kumamoto, 869-1106, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Machi, Kikuchi-Gun, Kumamoto, 869-1106, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
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Sato Y, Yoshimura Y, Abe T, Nagano F, Matsumoto A. Hospital-associated sarcopenia and the preventive effect of high energy intake along with intensive rehabilitation in patients with acute stroke. Nutrition 2023; 116:112181. [PMID: 37678013 DOI: 10.1016/j.nut.2023.112181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Hospital-associated sarcopenia is prevalent and associated with poor outcomes in acutely admitted patients. Prevention of developing sarcopenia during hospitalization is an important factor in stroke management. Therefore, this study aimed to investigate whether energy intake and rehabilitation duration contribute to the prevention of hospital-associated sarcopenia in patients with acute stroke. METHODS Patients with acute stroke were included in this study. Energy intake during the first week of hospitalization was classified as "high" or "low" based on the reported cutoff value. Rehabilitation time during hospitalization was classified as "intense" or "mild" based on the median. The four groups were compared based on the combinations of high or low energy intake and intense or mild rehabilitation. The primary outcome was the development of sarcopenia during hospitalization. The secondary outcome was the Functional Independence Measure motor item gain during hospitalization. Multivariate analysis was performed with the primary or secondary outcome as the dependent variable and the effect of each group on the outcome was examined. RESULTS A total of 112 participants (mean age = 70.6 y; 63 men) were included in the study. Multivariate analysis found that high × intense (odds ratio = 0.113; P = 0.041) was independently associated with the development of sarcopenia during hospitalization (i.e., hospital-related sarcopenia). High × intense (β = 0.395; P < 0.001) was independently associated with the gain of Functional Independence Measure motor items. CONCLUSIONS In patients with acute stroke, the combination of high energy intake and adequate rehabilitation time is associated with prevention of hospital-associated sarcopenia.
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Affiliation(s)
- Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, Niigata, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Rehman SU, Ali R, Zhang H, Zafar MH, Wang M. Research progress in the role and mechanism of Leucine in regulating animal growth and development. Front Physiol 2023; 14:1252089. [PMID: 38046946 PMCID: PMC10691278 DOI: 10.3389/fphys.2023.1252089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
Leucine, a branched-chain amino acid, is essential in regulating animal growth and development. Recent research has uncovered the mechanisms underlying Leucine's anabolic effects on muscle and other tissues, including its ability to stimulate protein synthesis by activating the mTORC1 signaling pathway. The co-ingestion of carbohydrates and essential amino acids enhances Leucine's anabolic effects. Moreover, Leucine has been shown to benefit lipid metabolism, and insulin sensitivity, making it a promising strategy for preventing and treating metabolic diseases, including type 2 diabetes and obesity. While emerging evidence indicates that epigenetic mechanisms may mediate Leucine's effects on growth and development, more research is needed to elucidate its mechanisms of action fully. Specific studies have demonstrated that Leucine promotes muscle growth and metabolic health in animals and humans, making it a promising therapeutic agent. However, it is essential to note that Leucine supplementation may cause digestive issues or interact with certain medications, and More study is required to determine definitively optimal dosages. Therefore, it is important to understand how Leucine interacts with other nutrients, dietary factors, and lifestyle habits to maximize its benefits. Overall, Leucine's importance in human nutrition is far-reaching, and its potential to prevent muscle loss and enhance athletic performance warrants further investigation.
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Affiliation(s)
| | | | | | | | - Mengzhi Wang
- Laboratory of Metabolic Manipulation of Herbivorous Animal Nutrition, College of Animal Science and Technology, Yangzhou University, Yangzhou, China
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Zhang L, Yao L, Zhao F, Yu A, Zhou Y, Wen Q, Wang J, Zheng T, Chen P. Protein and Peptide-Based Nanotechnology for Enhancing Stability, Bioactivity, and Delivery of Anthocyanins. Adv Healthc Mater 2023; 12:e2300473. [PMID: 37537383 DOI: 10.1002/adhm.202300473] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/18/2023] [Indexed: 08/05/2023]
Abstract
Anthocyanin, a unique natural polyphenol, is abundant in plants and widely utilized in biomedicine, cosmetics, and the food industry due to its excellent antioxidant, anticancer, antiaging, antimicrobial, and anti-inflammatory properties. However, the degradation of anthocyanin in an extreme environment, such as alkali pH, high temperatures, and metal ions, limits its physiochemical stabilities and bioavailabilities. Encapsulation and combining anthocyanin with biomaterials could efficiently stabilize anthocyanin for protection. Promisingly, natural or artificially designed proteins and peptides with favorable stabilities, excellent biocapacity, and wide sources are potential candidates to stabilize anthocyanin. This review focuses on recent progress, strategies, and perspectives on protein and peptide for anthocyanin functionalization and delivery, i.e., formulation technologies, physicochemical stability enhancement, cellular uptake, bioavailabilities, and biological activities development. Interestingly, due to the simplicity and diversity of peptide structure, the interaction mechanisms between peptide and anthocyanin could be illustrated. This work sheds light on the mechanism of protein/peptide-anthocyanin nanoparticle construction and expands on potential applications of anthocyanin in nutrition and biomedicine.
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Affiliation(s)
- Lei Zhang
- Department of Chemical Engineering and Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L3G1, Canada
| | - Liang Yao
- College of Biotechnology, Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu, 212018, China
| | - Feng Zhao
- Department of Chemical Engineering and Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L3G1, Canada
| | - Alice Yu
- Schulich School of Medicine and Dentistry, Western University, Ontario, N6A 3K7, Canada
| | - Yueru Zhou
- Department of Chemical Engineering and Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L3G1, Canada
| | - Qingmei Wen
- Guangzhou Institute of Energy Conversion, Chinese Academy of Sciences, Guangzhou, 510640, China
| | - Jun Wang
- College of Biotechnology, Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu, 212018, China
| | - Tao Zheng
- Guangzhou Institute of Energy Conversion, Chinese Academy of Sciences, Guangzhou, 510640, China
| | - Pu Chen
- Department of Chemical Engineering and Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L3G1, Canada
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Arnal-Gómez A, Cortés-Amador S, Ruescas-Nicolau MA, Carrasco JJ, Pérez-Alenda S, Santamaría-Balfagón A, Sánchez-Sánchez ML. Assessing Stroke-Related Sarcopenia in Chronic Stroke: Identification of Clinical Assessment Tools-A Pilot Study. Biomedicines 2023; 11:2601. [PMID: 37892976 PMCID: PMC10604487 DOI: 10.3390/biomedicines11102601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/14/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Stroke-related sarcopenia has recently been defined as the muscle atrophy consequent to stroke and assessing it following the guidelines with simple clinical tools is crucial in chronic stroke survivors. The aim of this study was to determine the characteristics of patient-friendly instruments sarcopenia in a chronic stroke sample (SG) compared to non-stroke counterparts (CG). Each participant underwent a single assessment which consisted of: SARC-F questionnaire, assessment of muscle strength (hand grip and five-times sit-to-stand test, 5STS), the calf circumference (CC) of both legs, the short physical performance battery (SPPB), and the 10 m walk test. A total of 68 participants were included (SG, n = 34 and CG, n = 34). All variables showed statistical differences (p < 0.05) between the SG and the CG, except handgrip although it showed lower values for SG. The values of the 5STS (16.26 s) and the SPPB (7 points) were below to the cutoff values for the SG. The five-times sit-to-stand test, SPPB, and gait speed can lead clinicians to detect stroke-related sarcopenia. Maximum handgrip shows a trend of low values for men and women in the SG, however, CC did not detect sarcopenia in our sample.
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Affiliation(s)
- Anna Arnal-Gómez
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
| | - Sara Cortés-Amador
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
| | - Maria-Arantzazu Ruescas-Nicolau
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
| | - Juan J. Carrasco
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
| | | | - M. Luz Sánchez-Sánchez
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010 Valencia, Spain; (A.A.-G.); (M.-A.R.-N.); (J.J.C.); (S.P.-A.); (M.L.S.-S.)
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Lu W, Feng W, Lai J, Yuan D, Xiao W, Li Y. Role of adipokines in sarcopenia. Chin Med J (Engl) 2023; 136:1794-1804. [PMID: 37442757 PMCID: PMC10406092 DOI: 10.1097/cm9.0000000000002255] [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: 10/05/2022] [Indexed: 07/15/2023] Open
Abstract
ABSTRACT Sarcopenia is an age-related disease that mainly involves decreases in muscle mass, muscle strength and muscle function. At the same time, the body fat content increases with aging, especially the visceral fat content. Adipose tissue is an endocrine organ that secretes biologically active factors called adipokines, which act on local and distant tissues. Studies have revealed that some adipokines exert regulatory effects on muscle, such as higher serum leptin levels causing a decrease in muscle function and adiponectin inhibits the transcriptional activity of Forkhead box O3 (FoxO3) by activating peroxisome proliferators-activated receptor-γ coactivator -1α (PGC-1α) and sensitizing cells to insulin, thereby repressing atrophy-related genes (atrogin-1 and muscle RING finger 1 [MuRF1]) to prevent the loss of muscle mass. Here, we describe the effects on muscle of adipokines produced by adipose tissue, such as leptin, adiponectin, resistin, mucin and lipocalin-2, and discuss the importance of these adipokines for understanding the development of sarcopenia.
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Affiliation(s)
- Wenhao Lu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Wenjie Feng
- Department of Burns and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jieyu Lai
- Xiangya School of Medicine, Central South University, Changsha, Hunan 410083, China
| | - Dongliang Yuan
- Xiangya School of Medicine, Central South University, Changsha, Hunan 410083, China
| | - Wenfeng Xiao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yusheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
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Lee SH, Choi H, Kim KY, Lee HS, Jung JM. Appendicular Skeletal Muscle Mass Associated with Sarcopenia as a Predictor of Poor Functional Outcomes in Ischemic Stroke. Clin Interv Aging 2023; 18:1009-1020. [PMID: 37427011 PMCID: PMC10329446 DOI: 10.2147/cia.s402548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/17/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose Several studies have examined the clinical impact of poststroke and stroke-related sarcopenia on stroke recovery. However, few studies have investigated the effect of sarcopenia detected shortly after stroke on functional prognosis. We predicted functional outcomes using early screening for sarcopenia in patients with acute ischemic stroke. We also examined the effect of sarcopenia detected shortly after stroke on functional prognosis. Patients and Methods Patients diagnosed with acute ischemic stroke within 2 days of symptom onset were consecutively enrolled at a tertiary university hospital. Appendicular skeletal muscle mass (ASM) was measured using dual-energy X-ray absorptiometry during early hospitalization. Sarcopenia was diagnosed based on low ASM and strength criteria of the Asian Working Group for Sarcopenia (AWGS) and European Working Group on Sarcopenia in Older People (EWGSOP2). The primary outcome was poor functional outcome, defined as a modified Rankin score of 4-6 and all-cause mortality at 3 months. Results Of the 653 patients, 214 (32.8%) and 174 (26.6%) had sarcopenia according to the AWGS and EWGSOP2 criteria, respectively. Irrespective of the definition, the sarcopenia group had a significantly higher proportion of patients with poor functional outcomes and all-cause mortality. Multivariate logistic regression analysis revealed that height-adjusted ASM was independently associated with poor functional outcomes (odds ratio: 0.61; 95% confidence interval: 0.40-0.91; P <0.005), and they were negatively correlated. However, the association between 3-month mortality, skeletal muscle mass, and sarcopenia was not sustained in multivariate analyses. Conclusion Height-adjusted ASM associated with sarcopenia is a potential predictor of poor functional outcomes at 3 months in patients with acute stroke. However, owing to the limitations of this study, further research is required to confirm these findings.
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Affiliation(s)
- Sang-Hun Lee
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Hangseok Choi
- Medical Science Research Center, Korea University College of Medicine, Seoul, South Korea
| | - Keon-Yeup Kim
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Hyung-Soo Lee
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jin-Man Jung
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
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20
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Mendes J, Simões CD, Martins JO, Sousa AS. INFLAMMATORY BOWEL DISEASE AND SARCOPENIA: A FOCUS ON MUSCLE STRENGTH - NARRATIVE REVIEW. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:373-382. [PMID: 37792768 DOI: 10.1590/s0004-2803.230302023-45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/26/2023] [Indexed: 10/06/2023]
Abstract
•Muscle strength decline is a crucial factor for the course of sarcopenia in inflammatory bowel disease (IBD) patients. •There is a need to discuss the association between IBD and sarcopenia focusing not only on changes of muscle mass, but also on muscle strength. •A narrative review was conducted in order to present the set of factors with impact in both muscle strength and IBD. •Inflammation, reduced nutrient intake and malabsorption, changes in body composition and gut microbiota dysbiosis are most likely the main factors with impact on muscle strength in IBD patients. Inflammation, changes in nutrient absorption and gut dysbiosis are common conditions in patients with inflammatory bowel disease. These factors may lead to variations in macro- and micronutrients and, particularly, to an imbalance of protein metabolism, loss of muscle mass and development of sarcopenia. This narrative review aims to present the set of factors with impact in muscle strength and physical performance that may potentially mediate the relation between inflammatory bowel disease and sarcopenia. Studies that associated changes in muscle strength, sarcopenia and inflammatory bowel disease were selected through a literature search in databases Medline, Pubmed and Scielo using relevant keywords: muscle strength, physical performance, sarcopenia and inflammatory bowel disease. Chronic inflammation is currently reported as a determinant factor in the development of muscle atrophy in inflammatory bowel disease. In addition, strength decline in inflammatory bowel disease patients may be also influenced by changes in body composition and by gut dysbiosis. Measures of muscle strength and physical performance should be considered in the initial identification of sarcopenia, particularly in patients with inflammatory bowel disease, for a timely intervention can be provided. Presence of proinflammatory cytokines, high adiposity, malabsorption and consequent deficits of macro and micronutrients, loss of muscle mass, and gut dysbiosis may be the main factors with impact in muscle strength, that probably mediate the relation between inflammatory bowel disease and sarcopenia.
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Affiliation(s)
- Joana Mendes
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde (FCS), Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Catarina D Simões
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde (FCS), Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- CIBIO-InBIO Research Centre in Biodiversity and Genetic Resources, University of Porto, 4485-661, Vairão, Portugal
| | - Joana O Martins
- Faculdade de Ciências da Saúde (FCS), Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Ana S Sousa
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde (FCS), Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
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21
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Chen M, Cao Y, Ji G, Zhang L. Lean nonalcoholic fatty liver disease and sarcopenia. Front Endocrinol (Lausanne) 2023; 14:1217249. [PMID: 37424859 PMCID: PMC10327437 DOI: 10.3389/fendo.2023.1217249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases in the world. The risk factor for NAFLD is often considered to be obesity, but it can also occur in people with lean type, which is defined as lean NAFLD. Lean NAFLD is commonly associated with sarcopenia, a progressive loss of muscle quantity and quality. The pathological features of lean NAFLD such as visceral obesity, insulin resistance, and metabolic inflammation are inducers of sarcopenia, whereas loss of muscle mass and function further exacerbates ectopic fat accumulation and lean NAFLD. Therefore, we discussed the association of sarcopenia and lean NAFLD, summarized the underlying pathological mechanisms, and proposed potential strategies to reduce the risks of lean NAFLD and sarcopenia in this review.
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22
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Kokura Y, Momosaki R. Rehabilitation Nutrition in Older People. Nutrients 2023; 15:nu15081893. [PMID: 37111112 PMCID: PMC10143752 DOI: 10.3390/nu15081893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Rehabilitation nutrition is expected to help treat frailty, undernutrition, and sarcopenia [...].
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Affiliation(s)
- Yoji Kokura
- Department of Nutritional Management, Keiju Hatogaoka Integrated Facility for Medical and Long-Term Care, Hosu 927-0023, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
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23
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Tokuda Y, Mori H. Essential Amino Acid and Tea Catechin Supplementation after Resistance Exercise Improves Skeletal Muscle Mass in Older Adults with Sarcopenia: An Open-Label, Pilot, Randomized Controlled Trial. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:255-262. [PMID: 35512762 DOI: 10.1080/07315724.2022.2025546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tea catechins (TCCs) have gained significant attention owing to their health effects. However, evidence is limited regarding the benefit of TCC and essential amino acids (EAAs) ingestion plus that of TCC ingestion after resistance exercise (RE) among older individuals with sarcopenia. We aimed to evaluate whether a 24-week nutritional program involving EAA and TCC supplementation after RE improved skeletal muscle mass (SMM) among older adults with sarcopenia. METHODS We conducted an open-label, pilot, randomized controlled trial among older adults with sarcopenia at the Harima Care Center or community in Hyogo, Japan. Participants were allocated to RE (n = 18), RE with EAA supplementation (RE + EAA, n = 18), or RE with EAA and TCC supplementation (RE + EAA + TCC, n = 18) groups. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria. A 24-week resistance exercise program was carried out twice weekly, with an intake of 3,000 mg and 540 mg of EAA and TCC supplements, respectively. SMM was the primary outcome parameter. The mean adherence rate to exercise and supplementation intake over the 24-week intervention period was 86.8% in the RE + EAA + TCC group, 86.4% in the RE + EAA group, and 85.4% in the RE group. A significant group-by-time interaction was identified for SMM (p = 0.010). The pre- to post-intervention increase in SMM was significantly higher in the RE + EAA + TCC group than in the RE group (p = 0.010). These results suggest that supplementation with EAA and TCC after RE, compared to RE only, improves SMM in older people with sarcopenia. To the best of our knowledge, our study is the first pilot randomized controlled trial to evaluate the effect of TCC supplementation on SMM in older people with sarcopenia. Supplemental data for this article is available online at http://dx.doi.org/10.1080/07315724.2022.2025546.
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Affiliation(s)
- Yasunobu Tokuda
- Hyogo Locomotion-senior-tera-koya, General Incorporated Association, Akashi-City, Hyogo-Prefecture, Japan.,Department of Health Science, Hyogo University, Kakogawa-City, Hyogo-Prefecture, Japan
| | - Hiroyasu Mori
- Institute of Advanced Medical Sciences, Tokushima University, Tokushima-City, Tokushima-Prefecture, Japan
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24
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Szklarzewska S, Mottale R, Engelman E, De Breucker S, Preiser JC. Nutritional rehabilitation after acute illness among older patients: A systematic review and meta-analysis. Clin Nutr 2023; 42:309-336. [PMID: 36731161 DOI: 10.1016/j.clnu.2023.01.013] [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: 08/10/2022] [Revised: 12/18/2022] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Acute illness can lead to disability and reduced quality of life in older patients. The aim of this systematic review was to evaluate the effect of nutritional rehabilitation provided during and after hospitalisation for an acute event on functional status, muscle mass, discharge destination and quality of life of older patients. METHODS The protocol for this systematic review was registered in PROSPERO (CRD42021264971). Articles were searched using Scopus, Medline, Google Scholar and Clinical. TRIALS gov. For studies included in the meta-analysis, Hedges'g standardized mean difference effect size was calculated and transformed in odds ratios. RESULTS We identified 7383 articles, of which 45 publications (41 trials, n = 8538 participants, mean age 80.35 ± 7.01 years.) were eligible for the systematic review. Patients were hospitalized for acute medical diseases (n = 6925) and fractures (n = 1063). The interventions included supplementation with a fixed amount of oral nutritional supplements (ONS, n = 17 trials), individualized diet plan (n = 3), combination of physical exercise with nutrition therapy (n = 14 trials), combination of anabolic agents with nutrition therapy (n = 5 trials). Overall nutritional rehabilitation improved functional status (Odds ratio 1.63 [1.15; 2.3], p = 0.003) and muscle mass (Odds ratio 2.61 [1.22; 5.5], p = 0.01), but not the quality of life or the discharge destination. CONCLUSION Nutritional rehabilitation was found to improve functional status and muscle mass. There is a need for larger studies involving older hospitalized patients.
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Affiliation(s)
- Sylwia Szklarzewska
- Department of Geriatric Medicine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
| | - Raphael Mottale
- Department of Internal Medicine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Sandra De Breucker
- Department of Geriatric Medicine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Charles Preiser
- Medical Direction, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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25
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Zhang K, Zhang K, Liu Q, Wu J. The Relationship Between Sarcopenia, Cognitive Impairment, and Cerebral White Matter Hyperintensity in the Elderly. Clin Interv Aging 2023; 18:547-555. [PMID: 37026080 PMCID: PMC10072150 DOI: 10.2147/cia.s404734] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose To explore the relationship between sarcopenia-related indices, cognitive impairment and cerebral white matter hyperintensities. Patients and methods Ninety-five hospitalized older adults aged 60 years and older were used in this study. Three sarcopenia-related indicators were measured: hand grip strength (Measured with a spring-type dynamometer), gait speed (6m step speed method), and appendicular skeletal muscle mass (ASM, bioelectrical impedance). Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was assessed using Montreal Cognitive Assessment (MoCA). Cerebral white matter hyperintensity was assessed using 3.0T superconducting magnetic resonance imaging. Results In both men and women, these three indices of sarcopenia were significantly and negatively correlated with WMH grades, except for appendicular skeletal muscle mass and WMH grades in women. Scores on the MoCA scale were significantly positive correlated with grip strength, and ASM, both in men and women. After adjusting for confounders and WMHs, regression analyses showed an increased incidence of cognitive impairment in patients with sarcopenia relative to those without sarcopenia. Conclusion Lower sarcopenia-related indices were significantly associated with cognitive impairment. WMHs may be one of the factors linking sarcopenia and cognitive function.
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Affiliation(s)
- Kangrui Zhang
- Graduate School, Bengbu Medical College, Bengbu, 233000, People’s Republic of China
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
| | - Kangdi Zhang
- Graduate School, Anhui Medical University, Hefei, 230000, People’s Republic of China
| | - Qiuwan Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
| | - Juncang Wu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
- Correspondence: Juncang Wu, Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China, Email
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26
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Lu HY, Ho UC, Kuo LT. Impact of Nutritional Status on Outcomes of Stroke Survivors: A Post Hoc Analysis of the NHANES. Nutrients 2023; 15:nu15020294. [PMID: 36678164 PMCID: PMC9864300 DOI: 10.3390/nu15020294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Stroke, a neurological emergency, is a leading cause of death and disability in adults worldwide. In acute or rehabilitative stages, stroke survivors sustain variable neurological recovery with long-term disabilities. The influence of post-stroke nutritional status on long-term survival has not been confirmed. Using the United States National Health and Nutrition Examination Survey data (2001−2010), we conducted a matched-cohort analysis (929 and 1858 participants in stroke and non-stroke groups, respectively) to investigate the influence of nutritional elements on post-stroke survival. With significantly lower nutrient consumption, the mortality risk was 2.2 times higher in stroke patients compared to non-stroke patients (Kaplan−Meier method with Cox proportional hazards model: adjusted hazard ratio, 2.208; 95% confidence interval: 1.887−2.583; p < 0.001). For several nutritional elements, the lower consumption group had significantly shorter survival than the higher consumption stroke subgroup; moreover, stroke patients with the highest 25% nutritional intake for each nutritional element, except moisture and total fat, had significantly shorter survival than non-stroke patients with the lowest 25% nutrition. Malnutrition is highly prevalent in stroke patients and is associated with high mortality rates. The dynamic change in energy requirements throughout the disease course necessitates dietary adjustment to ensure adequate nutritional intake.
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Affiliation(s)
- Hsueh-Yi Lu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin 640, Taiwan
| | - Ue-Cheung Ho
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456
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27
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Xing L, Bao Y, Wang B, Shi M, Wei Y, Huang X, Dai Y, Shi H, Gai X, Luo Q, Yin Y, Qin D. Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Front Neurol 2023; 14:1128092. [PMID: 36908603 PMCID: PMC9996061 DOI: 10.3389/fneur.2023.1128092] [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: 12/20/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.
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Affiliation(s)
- Liwei Xing
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China.,The First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yi Bao
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Binyang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Hongling Shi
- Department of Rehabilitation Medicine, The Third People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Xuesong Gai
- Department of Rehabilitation Medicine, The First People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Qiu Luo
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Yong Yin
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
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28
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吉村 芳. [Nutritional management of older inpatients - undernutrition, frailty, and sarcopenia]. Nihon Ronen Igakkai Zasshi 2023; 60:214-230. [PMID: 37730320 DOI: 10.3143/geriatrics.60.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- 芳弘 吉村
- 熊本リハビリテーション病院サルコペニア・低栄養研究センター
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29
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Inoue T, Ueshima J, Kawase F, Kobayashi H, Nagano A, Murotani K, Saino Y, Maeda K. Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review. Nutrients 2022; 15:113. [PMID: 36615772 PMCID: PMC9824538 DOI: 10.3390/nu15010113] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to identify trajectories of the prevalence of sarcopenia in the pre- and post-stroke periods and to determine the diagnostic criteria used in patients with stroke. We searched for literature in six databases: MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Ichushi-web (in Japanese). We included 1627 studies in the primary screening, and 35 studies were finally included. Of the 35 studies, 32 (91.4%) included Asian patients, and the criteria of the Asian Working Group for Sarcopenia was mainly used as the diagnostic criteria. Nineteen studies used muscle strength and muscle mass to diagnose sarcopenia, whereas a full assessment, including physical performance, was performed in five studies. The estimated prevalences of sarcopenia in pre-stroke, within 10 days of stroke, and from 10 days to 1 month after stroke were 15.8%, 29.5%, and 51.6%, respectively. Sarcopenia increased by approximately 15% from pre-stroke to 10 days, and increased by approximately 20% from 10 days to 1 month. Healthcare providers should note that the prevalence of sarcopenia increases during the acute phase in patients with stroke.
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Affiliation(s)
- Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata 950-3198, Japan
| | - Junko Ueshima
- Department of Nutrition Service, NTT Medical Center Tokyo, Tokyo 141-8625, Japan
| | - Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi 444-2351, Japan
| | - Haruko Kobayashi
- General Incorporated Association Manabi Public Library, Aichi 465-0015, Japan
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo 663-8211, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Fukuoka 830-0011, Japan
| | - Yoko Saino
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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30
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Influence of Oxidative Stress and Inflammation on Nutritional Status and Neural Plasticity: New Perspectives on Post-Stroke Neurorehabilitative Outcome. Nutrients 2022; 15:nu15010108. [PMID: 36615766 PMCID: PMC9823808 DOI: 10.3390/nu15010108] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/13/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
Beyond brain deficits caused by strokes, the effectiveness of neurorehabilitation is strongly influenced by the baseline clinical features of stroke patients, including a patient's current nutritional status. Malnutrition, either as a pre-stroke existing condition or occurring because of ischemic injury, predisposes patients to poor rehabilitation outcomes. On the other hand, a proper nutritional status compliant with the specific needs required by the process of brain recovery plays a key role in post-stroke rehabilitative outcome favoring neuroplasticity mechanisms. Oxidative stress and inflammation play a role in stroke-associated malnutrition, as well as in the cascade of ischemic events in the brain area, where ischemic damage leads to neuronal death and brain infarction, and, via cell-to-cell signaling, the alteration of neuroplasticity processes underlying functional recovery induced by multidisciplinary rehabilitative treatment. Nutrition strategies based on food components with oxidative and anti-inflammatory properties may help to reverse or stop malnutrition and may be a prerequisite for supporting the ability of neuronal plasticity to result in satisfactory rehabilitative outcome in stroke patients. To expand nutritional recommendations for functional rehabilitation recovery, studies considering the evolution of nutritional status changes in post-stroke patients over time are required. The assessment of nutritional status must be included as a routine tool in rehabilitation settings for the integrated care of stroke-patients.
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31
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Nutrition in the prevention and management of sarcopenia - A special focus on Asian Indians. Osteoporos Sarcopenia 2022; 8:135-144. [PMID: 36605171 PMCID: PMC9805983 DOI: 10.1016/j.afos.2022.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia, characterized by loss of muscle mass and strength, is common in advanced old age but can be accelerated by chronic disease, malnutrition and physical inactivity. Early initiation of intervention to achieve and maintain a higher peak muscle mass and strength may allow for prevention or delay of sarcopenia and facilitate independent living even in old age. In this context, malnutrition, a significant contributor to sarcopenia, is often overlooked among the Indian population. Maintenance of an optimal energy and protein balance with adequate physical activity level is essential to preserve physical function in the aging population. However, research on the role of micronutrients in muscle maintenance, is still in its infancy. This narrative review, therefore, aims to explore the current status of International and Indian research on the role of nutrition in sarcopenia mitigation and the way forward.
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32
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Igarashi M, Nakagawa-Nagahama Y, Miura M, Kashiwabara K, Yaku K, Sawada M, Sekine R, Fukamizu Y, Sato T, Sakurai T, Sato J, Ino K, Kubota N, Nakagawa T, Kadowaki T, Yamauchi T. Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men. NPJ AGING 2022; 8:5. [PMID: 35927255 PMCID: PMC9158788 DOI: 10.1038/s41514-022-00084-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/17/2022] [Indexed: 12/15/2022]
Abstract
AbstractPreclinical studies have revealed that the elevation of nicotinamide adenine dinucleotide (NAD + ) upon the administration of nicotinamide mononucleotide (NMN), an NAD + precursor, can mitigate aging-related disorders; however, human data on this are limited. We investigated whether the chronic oral supplementation of NMN can elevate blood NAD + levels and alter physiological dysfunctions in healthy older participants. We administered 250 mg NMN per day to aged men for 6 or 12 weeks in a placebo-controlled, randomized, double-blind, parallel-group trial. Chronic NMN supplementation was well tolerated and caused no significant deleterious effect. Metabolomic analysis of whole blood samples demonstrated that oral NMN supplementation significantly increased the NAD + and NAD + metabolite concentrations. There were nominally significant improvements in gait speed and performance in the left grip test, which should be validated in larger studies; however, NMN exerted no significant effect on body composition. Therefore, chronic oral NMN supplementation can be an efficient NAD + booster for preventing aging-related muscle dysfunctions in humans.
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33
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Combination of High Energy Intake and Intensive Rehabilitation Is Associated with the Most Favorable Functional Recovery in Acute Stroke Patients with Sarcopenia. Nutrients 2022; 14:nu14224740. [PMID: 36432427 PMCID: PMC9694182 DOI: 10.3390/nu14224740] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Energy intake and rehabilitation time individually contribute to the improvement of activities of daily living (ADL). This study aimed to investigate the additive effect of energy intake and rehabilitation time on ADL improvement in acute stroke patients with sarcopenia. The study included 140 patients (mean age 82.6 years, 67 men) with stroke. Energy intake during the first week of hospitalization was classified as “Sufficiency” or “Shortage” based on the reported cutoff value and rehabilitation time was classified as “Long” or “Short” based on the median. The study participants were categorized into four groups based on the combination of energy intake and rehabilitation time. The primary outcome was the gain of functional independence measure (FIM) motor during hospitalization. The secondary outcomes were length of stay and home discharge rates. Multivariate analysis was performed with primary/secondary outcomes as the dependent variable, and the effect of each group on the outcome was examined. Multivariate analysis showed that “long rehabilitation time and sufficient energy intake” (β = 0.391, p < 0.001) was independently associated with the gain of FIM motor items. The combination of high energy intake and sufficient rehabilitation time was associated with ADL improvement in acute stroke patients with sarcopenia.
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Liao M, Mu Y, Su X, Zheng L, Zhang S, Chen H, Xu S, Ma J, Ouyang R, Li W, Cheng C, Cai J, Chen Y, Wang C, Zeng F. Association between Branched-Chain Amino Acid Intake and Physical Function among Chinese Community-Dwelling Elderly Residents. Nutrients 2022; 14:nu14204367. [PMID: 36297051 PMCID: PMC9611152 DOI: 10.3390/nu14204367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the potential associations of dietary BCAAs (isoleucine, leucine, and valine) with physical function in the elderly Chinese population. A validated semiquantitative food frequency questionnaire and anthropometric and physical function measurements were used to collect data. We modeled trends in physical function indicators for BCAA quartiles using multivariate linear regression models. Among 4336 (43.97% men) participants aged 72.73 ± 5.48 years, a higher dietary intake of BCAAs was positively associated with increased handgrip strength (all p trends < 0.001), shorter times for 4-m fast walking (all p trends < 0.001) and repeated chair rises (all p trends < 0.001). No linear association was found between subtypes of amino acids and any physical functions (all p trends > 0.05). Individuals in the highest quartiles of BCAA intake had a reduced risk of developing low muscle strength, and the multiadjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for women and men were 0.50 (0.38−0.65) and 0.67 (0.50−0.91), respectively. Similarly, higher BCAA consumption was associated with a lower risk of developing low physical performance (4-m walking speed: OR = 0.68 [0.50−0.93]; repeated chair rises: OR = 0.66 [0.54−0.81]). Higher dietary BCAA intake might be beneficial for physical function in the elderly population.
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Affiliation(s)
- Minqi Liao
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Institute of Epidemiology, Helmholtz Munich-German Research Center for Environmental Health, D-85764 Munich, Germany
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Yingjun Mu
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Xin Su
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Lu Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Shiwen Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Hongen Chen
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - Shan Xu
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - Junrong Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Ruiqing Ouyang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Wanlin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Chen Cheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Jun Cai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Yuming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Changyi Wang
- Department of Non-Communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
- Correspondence: (C.W.); (F.Z.); Tel.: +86-075526640203 (C.W.); +86-2085226335 (F.Z.); Fax: +86-075526403044 (C.W.); +86-2085221343 (F.Z.)
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510630, China
- Disease Control and Prevention Institute, Jinan University, Guangzhou 510630, China
- Jinan University-BioKangtai Vaccine Institute, School of Medicine, Jinan University, Guangzhou 510630, China
- Correspondence: (C.W.); (F.Z.); Tel.: +86-075526640203 (C.W.); +86-2085226335 (F.Z.); Fax: +86-075526403044 (C.W.); +86-2085221343 (F.Z.)
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Wu L, He K, Fang D, Qiu X, Xiao W, Lou S, Yong R. Trends in Nutrition Research for Sarcopenia: A Bibliometric Analysis. Nutrients 2022; 14:nu14204262. [PMID: 36296946 PMCID: PMC9612349 DOI: 10.3390/nu14204262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Sarcopenia is age-related, pathophysiological muscle atrophy. Research regarding nutrition treatment of sarcopenia has developed rapidly, particularly as populations age. We evaluated the development of trends in this field using a bibliometric analysis. Articles up to July 2022 were searched in the Scopus database. Bibliographic information from the selected publications, such as countries, citations, world maps, institutions, authors, journals, and keywords, were converted and analyzed automatically using the “bibliometrix” package in R environment (version 4.2.0). We identified 368 Scopus articles from 1998–2021. According to citation analyses, 27 documents received more than 100 citations. Bibliometric analysis based on the literature included in this study revealed that South Korea (61 publications), United States (50), Japan (35), China (30), and Italy (20) contributed the most publications. Tehran University of Medical Science (19 records, 2.55% of articles) contributed the most publications. The most productive author was Landi, with eight articles (2.17% of articles). The publications were located in 196 journals, with Nutrients having the most publications (30, 8.15% of articles). The curves representing keywords “sarcopenia” and “aged” were the most apparent. Our analysis suggested that global nutrition and sarcopenia-related research increased rapidly from 2001 to 2021, demonstrating that this was a promising area of future research that could benefit from continued advances. Future research may focus on the effects of age and sex as well as intervention effectiveness, particularly exercise and nutrition supplementation.
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Affiliation(s)
- Lei Wu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou 310053, China
| | - Kelin He
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou 310053, China
| | - Dandan Fang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Xiuyue Qiu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Wenhui Xiao
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Shuhui Lou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Rulin Yong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Correspondence:
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Fang WJ, Zheng F, Zhang LZ, Wang WH, Yu CC, Shao J, Wu YJ. Research progress of clinical intervention and nursing for patients with post-stroke dysphagia. Neurol Sci 2022; 43:5875-5884. [PMID: 35661279 PMCID: PMC9166186 DOI: 10.1007/s10072-022-06191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Post-stroke dysphagia (PSD) is a common and costly complication of stroke and is associated with increased mortality, morbidity, and hospitalization. Although most patients can spontaneously resume swallowing, there are still many patients who do not recover and even die. Despite multiple advances in the acute treatment and secondary prevention of stroke, the effective treatment of PSD remains a neglected area. Studies have shown that repair mechanisms of neurostimulation techniques and increased cortical activity play an important role in the treatment of PSD. In addition, nutritional interventions are also crucial for the treatment of malnutrition in PSD patients. Therefore, this article reviews the effects of the current main clinical treatment methods and nutritional interventions on the treatment and rehabilitation of PSD patients. It also emphasized the necessity of developing an individualized care plan for PSD patients, which is of great significance to promote the clinical treatment, nutritional status, prognosis, and quality of life of PSD patients.
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Affiliation(s)
- Wen-Juan Fang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Fei Zheng
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Lin-Zhi Zhang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Wen-Hui Wang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Cheng-Chen Yu
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Juan Shao
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Yi-Jin Wu
- The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, Anhui, China.
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Conde Maldonado E, Marqués-Jiménez D, Casas-Agustench P, Bach-Faig A. Effect of supplementation with leucine alone, with other nutrients or with physical exercise in older people with sarcopenia: a systematic review. ENDOCRINOL DIAB NUTR 2022; 69:601-613. [PMID: 36396594 DOI: 10.1016/j.endien.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/01/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Older adults are at a greater risk of developing sarcopenia as a result of reduced mobility, malnutrition, dietary changes and certain diseases. There are no systematic reviews in the literature analysing the effects of supplementation with leucine alone or as part of a supplement, and with or without physical exercise in older people with sarcopenia. We aimed to systematically review the evidence in intervention studies on the effects of supplementation with leucine, either alone, combined with other supplements, or combined with other supplements and physical exercise in older people with sarcopenia. MATERIALS AND METHODS Literature searches related to the topic were conducted in three databases (Pubmed/Medline, Cochrane and SciELO) looking for articles published prior to December 2020. This review includes intervention studies in older adults over 60 years of age with a history of sarcopenia where researchers reported on the effects of leucine supplementation, with or without physical exercise, related to the disease's treatments or outcomes. RESULTS The systematic review identified three intervention studies examining the effect of leucine without physical exercise, one on leucine with physical exercise, seven on leucine paired with another nutrient and without physical exercise, and twelve on leucine paired with another nutrient and physical exercise. The results revealed that leucine supplementation alone and without physical exercise did not improve markers of sarcopenia, whereas interventions pairing leucine with supplements, particularly leucine-enriched protein supplements, are a promising treatment for the improvement of sarcopenic markers, whether with or without physical exercise. CONCLUSIONS Leucine supplementation, specifically paired with protein supplements, both with and without physical exercise, was found to be an effective dietary intervention for the improvement of sarcopenia. Further dietary interventions are necessary to calculate effective dosage quantities for both leucine and nutrient supplementation as an integral part of the treatment.
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Affiliation(s)
| | - Diego Marqués-Jiménez
- Facultad de Ciencias de la Salud, Universitat Oberta de Catalunya (UOC), Barcelona, Spain; Deportivo Alavés (SAD) (Academia), Vitoria-Gasteiz, Spain
| | - Patricia Casas-Agustench
- Facultad de Ciencias de la Salud, Universitat Oberta de Catalunya (UOC), Barcelona, Spain; School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK.
| | - Anna Bach-Faig
- Grupo de Investigación FoodLab (2017SGR 83), Facultad de Ciencias de la Salud, Universitat Oberta de Catalunya, Barcelona, Spain; Vocalía de Alimentación y Nutrición, Colegio Oficial de Farmacéuticos de Barcelona, Barcelona, Spain.
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Akazawa N, Kishi M, Hino T, Tsuji R, Tamura K, Hioka A, Moriyama H. Increase in muscle mass of the quadriceps is related to decrease in intramuscular adipose tissue in convalescent stroke patients: A longitudinal study. Clin Nutr ESPEN 2022; 51:199-206. [DOI: 10.1016/j.clnesp.2022.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/09/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
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Conde Maldonado E, Marqués-Jiménez D, Casas-Agustench P, Bach-Faig A. Efecto de la suplementación con leucina sola, junto con otro nutriente o con ejercicio físico en personas adultas mayores con sarcopenia: una revisión sistemática. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Liu J, Dong J, Guo J. The effects of nutrition supplement on rehabilitation for patients with stroke: Analysis based on 16 randomized controlled trials. Medicine (Baltimore) 2022; 101:e29651. [PMID: 36123946 PMCID: PMC9478301 DOI: 10.1097/md.0000000000029651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Malnutrition is a relatively common and often unrecognized condition in stroke survivors, which may negatively affect functional recovery and survival. Though previous studies have indicated significant role of nutrition supplement for rehabilitation of patients with stroke, the results still remain controversy. OBJECTIVE The present analysis was designed to systematically review effective evidence of nutrition supplement on rehabilitation for patients with stroke. METHODS A systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science up to August 1, 2021 was performed to find relevant studies that analyzed the effect of nutrition supplement on rehabilitation of patients with stroke. The primary outcome was functional outcomes and activities of daily living (ADL). The secondary outcomes included disability, all-cause mortality, infections, pneumonia, walking ability, stroke recurrence, and laboratory results indicating nutrition status of patients. All statistical analyses were performed using standard statistical procedures with Review Manager 5.2. RESULTS Ultimately, 16 studies including 7547 patients were identified. Our pooled results found no significant difference in total, cognitive and motor FIM score between nutrition supplement and placebo groups, with pooled MDs of 7.64 (95% CI - 1.67 to 16.94; P = .11), 0.74 (95% CI - 1.33 to 2.81; P = .48), 1.11 (95% CI - 1.68 to 3.90; P = .44), respectively. However, our result showed that nutritional interventions had significant effect on ADL for patients with stroke (MD 3.26; 95% CI 0.59 to 5.93; P = .02). In addition, nutrition supplement reduced the incidence of infections for patients with stroke, with a pooled RR of 0.65 (95% CI 0.51 to 0.84; P = .0008). No significant results were found in disabilities, complication and laboratory outcomes. CONCLUSIONS The present meta-analysis indicated no statistically significant effect of nutrition supplement on functional outcomes as well as disabilities, complication and laboratory outcomes for patients with stroke. However, it increased ADL and reduced the incidence of infections.
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Affiliation(s)
- Jianhua Liu
- Department of Physical Therapy, Beijing Bo’ai Hospital, Chinese Rehabilitation Research Centre, Beijing, China
| | - Jige Dong
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China
| | - Jiangzhou Guo
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China
- *Correspondence: Jiangzhou Guo, Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Huajiadi Street, Chaoyang District, Beijing 100102, China (e-mail: )
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Dietary Essential Amino Acid Intake Is Associated with High Muscle Strength in Korean Older Adults. Nutrients 2022; 14:nu14153104. [PMID: 35956282 PMCID: PMC9370335 DOI: 10.3390/nu14153104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 01/30/2023] Open
Abstract
The relationship between daily dietary intake of an individual or all essential amino acids (EAAs) and muscle strength in older adults is still inadequately characterized. This population-based cross-sectional study included 5971 participants aged ≥65 years from the 2014–2019 Korea National Health and Nutrition Examination Survey. Dietary information was derived from the 24 h recall data. Total essential amino acid score (EAAS) was calculated with an intake that satisfied the recommended nutrient intake (RNI) in each essential amino acid (EAA). The mean handgrip strength was estimated from triplicate measurements obtained using the dominant hand, and high muscle strength was defined as handgrip strength ≥28 kg for men and ≥18 kg for women. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. After multivariable adjustment, we found that a high total EAAS was associated with high muscle strength in Korean older adults (OR: 1.38, 95% CI: 1.07–1.79). High muscle strength was significantly enhanced with increased total EAA intake from animal sources (OR: 1.27, 95% CI: 1.02–1.58), but there was no significant association with total EAA intake from non-animal sources. EAA intake and high muscle strength are associated based on a positive dose-response relationship in which high muscle strength is further increased when the overall EAA intake meets the RNI. Thus, Korean older adults should ensure an adequate intake of all EAAs from various food sources (especially animal sources) to meet the RNI as a prerequisite for achieving high muscle strength.
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Bertschi D, Kiss CM, Beerli N, Mauthner O, Kressig RW. Impact of sarcopenia on daily functioning: a cross-sectional study among older inpatients. Aging Clin Exp Res 2022; 34:2041-2046. [PMID: 35794312 PMCID: PMC9464162 DOI: 10.1007/s40520-022-02175-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Geriatric patients with sarcopenia are at increased risk for functional decline with loss of independence in daily living. This cross-sectional study aims to investigate the impact of sarcopenia on different domains of functional status in hospitalized geriatric patients. METHODS Sarcopenia was assessed at hospital admission using the recommendations of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Body impedance analysis (BIA) was performed to determine muscle mass, and a pneumatic hand dynamometer was used to assess muscle strength. The functional independence measure (FIM) score, an 18-item tool exploring an individual's physical, cognitive and social functions, was used to measure functional status. RESULTS In 305 included inpatients with a median age of 84.0 years (65.6% female), prevalence of sarcopenia was 22.6%. Overall, sarcopenic patients had significant lower FIM scores compared to non-sarcopenic patients (p = 0.006). An association with sarcopenia was found for the FIM items bed/chair/wheelchair transfer (p = 0.047), transfer to toilet (p = 0.048), locomotion (p = 0.001), climbing stairs (p = 0.012), comprehension (p = 0.029), and social interaction (p = 0.028). CONCLUSION In hospitalized geriatric patients, sarcopenia was found to be associated with both cognitive and mobility domains, but not with self-care domains of the FIM score. Therefore, when addressing sarcopenia in inpatients, tailored and multi-dimensional training interventions mainly should focus on motor-cognitive abilities.
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Affiliation(s)
- Dominic Bertschi
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Caroline M Kiss
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Nadine Beerli
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Oliver Mauthner
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
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Kose E, Yoshimura Y, Wakabayashi H, Matsumoto A. Use of antipsychotics is negatively associated with muscle strength in older adults with sarcopenia after stroke. J Stroke Cerebrovasc Dis 2022; 31:106587. [PMID: 35793581 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106587] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/29/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The use of antipsychotics has been shown to affect activities of daily living during rehabilitation but reports regarding their effects on older patients with sarcopenia are insufficient. We aimed to examine the effect of the use of antipsychotics on muscle strength and muscle mass in older patients with sarcopenia undergoing convalescent rehabilitation after stroke. METHODS This retrospective cohort study was conducted at a rehabilitation hospital between 2015 and 2020. The study outcomes included skeletal muscle mass index and hand grip strength at discharge. Multivariate analyses were used to determine whether the use of antipsychotics at admission and at 4 weeks after admission were independently associated with the study outcomes, after adjusting for potential confounders. RESULTS Of the 619 stroke patients admitted, 196 (mean age 81 years; 44.4% men) had sarcopenia at admission and were included in the final analysis. The median hand grip strength and median skeletal muscle mass index values were 12.5 (5.9-17.9) kg and 5.1 (4.5-6.0) kg/m2, respectively. In the multivariate analyses, the use of antipsychotics at 4 weeks post-admission was independently associated with hand grip strength at discharge (β = -0.125, p = 0.008), which was not the case when used at admission. Furthermore, the use of antipsychotics at admission and at 4 weeks after admission were not significantly associated with the skeletal muscle mass index at discharge. CONCLUSIONS The use of antipsychotics in older patients with sarcopenia after stroke was negatively associated with handgrip strength at discharge.
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Affiliation(s)
- Eiji Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Tokyo, Japan
| | - Yoshihiro Yoshimura
- Department of Rehabilitation Medicine, Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto 869-1106, Japan.
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan
| | - Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Lee SY, Lee HJ, Lim JY. Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr 2022; 102:104758. [DOI: 10.1016/j.archger.2022.104758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/02/2022]
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Honaga K, Otaka Y, Kaji K, Sakata Y, Hamano H, Nakamura H, Kondo K. Effects of Citrus depressa Hayata Fruit Extract on Thigh Muscles Mass and Composition in Subacute Stroke Patients: A Double-Blind, Randomized, Controlled Pilot Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:391-398. [PMID: 35100035 PMCID: PMC9127834 DOI: 10.1089/jicm.2021.0299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: This pilot study evaluated the effects of Citrus depressa Hayata fruit extract (CFEx) on thigh muscle cross-sectional area (CSA) and composition in subacute stroke patients with hemiparesis who were undergoing rehabilitation. Design and Intervention: This double-blinded, placebo-controlled, randomized pilot trial included 40 subacute stroke patients with moderate-to-severe hemiparesis, and they were randomly assigned to receive CFEx or placebo supplements for 12 weeks. The thigh muscle CSA was measured by computed tomography as total muscle area defined by Hounsfield units (HU) values of -29 to 150 HU. The total muscle area was divided into muscle area with fat infiltration and normal muscle area to evaluate muscle composition (-29 to 29 and 30 to 150 HU, respectively). Results: At baseline, the total muscle area and normal muscle area in the paretic thigh were lower than those in the nonparetic thigh. The nonparetic normal muscle area was significantly higher in the CFEx group than in the placebo group at 12 weeks, whereas the total muscle area was not different. Conclusions: The thigh muscle CSA and composition in the paretic side have already deteriorated in patients with moderate-to-severe hemiparesis at the subacute stroke stage. CFEx supplementation during rehabilitation might improve the nonparetic thigh muscle composition in subacute stroke patients. Findings of this study are needed to be verified by a large-scale randomized trial since this study was a pilot study with a small sample size. Trial registration: UMIN Clinical Trial Registry (UMIN ID: UMIN000012902).
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Affiliation(s)
- Kaoru Honaga
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Kentaro Kaji
- Department of Rehabilitation Medicine, National Higashisaitama Hospital, Saitama, Japan
| | - Yasuyuki Sakata
- Health Care and Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Hirokazu Hamano
- Health Care and Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Hirohiko Nakamura
- Health Care and Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Whey Protein, L-Leucine and Vitamin D Supplementation for Preserving Lean Mass during a Low-Calorie Diet in Sarcopenic Obese Women. Nutrients 2022; 14:nu14091884. [PMID: 35565851 PMCID: PMC9099886 DOI: 10.3390/nu14091884] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
In sarcopenic obese subjects it is essential to reduce body weight and preserve lean mass, in order to avoid a worsening of muscle function. Several studies have shown that leucine supplementation can be useful to improve skeletal muscle mass in sarcopenic patients. The aim of our study was to evaluate the effectiveness of a short-term low-calorie diet (LCD) combined with supplementation with whey protein and leucine on weight loss, lean mass and muscle strength in sarcopenic, obese, hyperinsulinemic and post-menopausal women. Sixteen females with a mean age of 60 years (range: 50–70 years), BMI 37.6 kg/m2 (range: 31.7–44.1 Kg/m2), HOMA-index ≥ 2.5 (range: 2.9–12) were assigned to an LCD regimen (1000 kcal/day) with supplementation of 18 g whey proteins which 4.1 g of leucine for 45 days. Anthropometric indexes, blood and urine chemistry, body composition by DEXA, muscle strength by handgrip test and Short Physical Performance Battery (SPPB) were assessed at baseline and at the end of the treatment. A significant reduction in BMI (37.6 vs. 35.7 Kg/m2), waist circumference (107 vs. 102.4 cm), HOMA index (4.8 vs. 2.3) and fasting insulin (17.4 vs. 10.4 μIU/mL) was observed in all patients. Women preserved total lean body mass (55 vs. 5%) and significantly improved their muscle strength, as measured by handgrip (15.3 vs. 20.1 Kg), and their muscle function, as measured by SPPB (7.5 vs. 8.9). A significant increase in BUN was also observed (36.1 vs. 46.3). We conclude that LCD with adequate protein intake and supplementation with whey protein and leucine should be promoted to maintain muscle mass and improve muscle strength in post-menopausal women with sarcopenic obesity.
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Pradines M, Ghédira M, Bignami B, Vielotte J, Bayle N, Marciniak C, Burke D, Hutin E, Gracies JM. Do Muscle Changes Contribute to the Neurological Disorder in Spastic Paresis? Front Neurol 2022; 13:817229. [PMID: 35370894 PMCID: PMC8964436 DOI: 10.3389/fneur.2022.817229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background At the onset of stroke-induced hemiparesis, muscle tissue is normal and motoneurones are not overactive. Muscle contracture and motoneuronal overactivity then develop. Motor command impairments are classically attributed to the neurological lesion, but the role played by muscle changes has not been investigated. Methods Interaction between muscle and command disorders was explored using quantified clinical methodology-the Five Step Assessment. Six key muscles of each of the lower and upper limbs in adults with chronic poststroke hemiparesis were examined by a single investigator, measuring the angle of arrest with slow muscle stretch (XV1) and the maximal active range of motion against the resistance of the tested muscle (XA). The coefficient of shortening CSH = (XN-XV1)/XN (XN, normally expected amplitude) and of weakness CW = (XV1-XA)/XV1) were calculated to estimate the muscle and command disorders, respectively. Composite CSH (CCSH) and CW (CCW) were then derived for each limb by averaging the six corresponding coefficients. For the shortened muscles of each limb (mean CSH > 0.10), linear regressions explored the relationships between coefficients of shortening and weakness below and above their median coefficient of shortening. Results A total of 80 persons with chronic hemiparesis with complete lower limb assessments [27 women, mean age 47 (SD 17), time since lesion 8.8 (7.2) years], and 32 with upper limb assessments [18 women, age 32 (15), time since lesion 6.4 (9.3) years] were identified. The composite coefficient of shortening was greater in the lower than in the upper limb (0.12 ± 0.04 vs. 0.08 ± 0.04; p = 0.0002, while the composite coefficient of weakness was greater in the upper limb (0.28 ± 0.12 vs. 0.15 ± 0.06, lower limb; p < 0.0001). In the lower limb shortened muscles, the coefficient of weakness correlated with the composite coefficient of shortening above the 0.15 median CSH (R = 0.43, p = 0.004) but not below (R = 0.14, p = 0.40). Conclusion In chronic hemiparesis, muscle shortening affects the lower limb particularly, and, beyond a threshold of severity, may alter descending commands. The latter might occur through chronically increased intramuscular tension, and thereby increased muscle afferent firing and activity-dependent synaptic sensitization at the spinal level.
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Affiliation(s)
- Maud Pradines
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Mouna Ghédira
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Blaise Bignami
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Jordan Vielotte
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Nicolas Bayle
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Christina Marciniak
- Department of Physical Medicine and Rehabilitation, Northwestern University and the Shirley Ryan AbilityLab, Chicago, IL, United States.,Department of Neurology, Northwestern University and the Shirley Ryan AbilityLab, Chicago, IL, United States
| | - David Burke
- Department of Neurology, Royal Prince Alfred Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Emilie Hutin
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Jean-Michel Gracies
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
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Ko SH, Shin YI. Nutritional Supplementation in Stroke Rehabilitation: A Narrative Review. BRAIN & NEUROREHABILITATION 2022; 15:e3. [PMID: 36743847 PMCID: PMC9833461 DOI: 10.12786/bn.2022.15.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/08/2022] Open
Abstract
Malnutrition is associated with increased mortality and poor functional recovery after stroke. Most guidelines for stroke rehabilitation strongly recommend nutritional screening for malnutrition. Nutritional status after stroke is related to long-term outcomes, and nutritional supplementation is recommended for stroke patients with malnutrition and those at risk of malnutrition. However, routine nutritional supplementation in stroke patients, regardless of nutritional status, is not correlated with improved functional outcomes, and nutritional supplementation is not recommended if the nutritional status is adequate. Nutritional supplementation with protein, amino acids, vitamins, and minerals positively affects recovery after stroke, with improvements seen in motor function, cognition, activities of living, and mood. However, the evidence is insufficient due to the small number of studies and the lack of well-designed randomized controlled studies. Therefore, nutritional supplementation for stroke patients in rehabilitation should not be uniform, and individual nutritional interventions based on an assessment of the patient's nutritional status should be provided.
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Affiliation(s)
- Sung-Hwa Ko
- Department of Rehabilitation Medicine, Rehabilitation Hospital and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Rehabilitation Hospital and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea
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Investigation of the Effect of Nutritional Supplementation with Whey Protein and Vitamin D on Muscle Mass and Muscle Quality in Subacute Post-Stroke Rehabilitation Patients: A Randomized, Single-Blinded, Placebo-Controlled Trial. Nutrients 2022; 14:nu14030685. [PMID: 35277045 PMCID: PMC8838798 DOI: 10.3390/nu14030685] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/05/2023] Open
Abstract
In post-stroke hemiparesis patients, the skeletal muscle mass decrease rapidly with the histological degradation. We investigated the effect of nutritional supplementation with whey protein and vitamin D on the muscle mass and muscle quality, in post-stroke convalescent rehabilitation patients in a randomized, single-blinded, placebo-controlled trial. Fifty patients were randomly assigned to two groups; HP group received supplemental jelly (100 kcal; whey protein 10 g; vitamin D 20 μg) twice a day throughout up to 16-week period, the control group received placebo jelly. Cross-sectional area (CSA) of thigh muscle, skeletal muscle index (SMI), muscle strength, activity of daily living (ADL), and some nutritional indicators in blood were measured. Although no significant difference was observed in CSA and SMI between the groups, fat infiltration into the thighs muscle was singnificantly lower in the HP group. There were no significant difference in muscle strength and ADL between the groups. Blood urea nitrogen and serum 25(OH)D at endpoint were significantly higher in the HP group but physiological normal ranges. Supplementation with whey protein and vitamin D in post-stroke patients led to suppression of fat infiltration into the muscle. Long-term follow-up studies are needed to verify whether this nutritional intervention provides substantial benefits for the prognosis of stroke survivors.
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50
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Negm AM, Lee J, Hamidian R, Jones CA, Khadaroo RG. Management of Sarcopenia: A Network Meta-analysis of Randomized Controlled Trials. J Am Med Dir Assoc 2022; 23:707-714. [DOI: 10.1016/j.jamda.2022.01.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
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