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He S, Meng D, Wei M, Guo H, Yang G, Wang Z. Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia. BMC Geriatr 2024; 24:586. [PMID: 38977995 PMCID: PMC11232209 DOI: 10.1186/s12877-024-05188-7] [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: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (NCT05767710).
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Affiliation(s)
- Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Hongzhi Guo
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA
- Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA.
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan.
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Qorolli M, Beqaj S, Ibrahimi‐Kaçuri D, Murtezani A, Krasniqi V, Mačak Hadžiomerović A. Functional status and quality of life in post-COVID-19 patients two to three weeks after hospitalization: A cross-sectional study. Health Sci Rep 2023; 6:e1510. [PMID: 37621387 PMCID: PMC10444983 DOI: 10.1002/hsr2.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Background and Aims Extended hospitalization due to coronavirus disease 2019 (COVID-19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post-hospitalized patients are promptly assessed. The aim of this study was to identify post-COVID-19 patients' functional status and quality of life, as well as to investigate their inter-relatedness 2-3 weeks after hospital discharge. Methods The study included 39 post-COVID-19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio-demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6-min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5-Dimension 5-Level (EQ-5D-5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing. Results The median (interquartile range [IQR]) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0-3), 3 (1-6), 9 (8-10), 30.5 (23.2-43.5) kg, 344.5 (312.7-381.7) m respectively, while the mean (SD) for EQ-5D-5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ-5D-5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = -0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = -0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg-CR10, and 6MWT were found to be strongly predictive of SPPB total score. Conclusion In post-COVID-19 patients' functional status and quality of life were impaired 2-3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.
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Affiliation(s)
- Merita Qorolli
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Samire Beqaj
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
| | | | - Ardiana Murtezani
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Valon Krasniqi
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
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He J, Li H, Yao J, Wang Y. Prevalence of sarcopenia in patients with COPD through different musculature measurements: An updated meta-analysis and meta-regression. Front Nutr 2023; 10:1137371. [PMID: 36875833 PMCID: PMC9978530 DOI: 10.3389/fnut.2023.1137371] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Aim Chronic obstructive pulmonary disease (COPD) patients vary widely in terms of the prevalence of sarcopenia, which is partially attributed to differences in diagnostic criteria and disease severity. There are several different musculature measurements that are used to quantify sarcopenia. This study included published literature for meta-analysis to assess the sarcopenia prevalence in COPD patients and correlate the disease with the clinical characteristics of such patients. Methods A comprehensive review of the English and Chinese literature on sarcopenia prevalence in COPD patients was conducted using electronic databases such as China National Knowledge Infrastructure (CNKI), Web of Science, Cochrane Library, EMBASE, PubMed, and Wanfang. Two researchers analyzed the studies for Newcastle-Ottawa Scale. The software Stata 11.0 was employed for the analysis of the acquired data. The standard mean differences method was utilized for the estimation and quantification of the effect size. Furthermore, a fixed- or random-effects model was employed for conducting a combined analysis. Results In total, 56 studies were included as per the specific inclusion criteria. The resulting data of the assessed COPD patients in this research indicated a 27% prevalence of sarcopenia. Further analysis of subgroups was executed per disease severity, ethnicity, diagnostic criteria, gender, and age. Per these findings, increased disease severity elevated the prevalence of sarcopenia. The Latin American and Caucasian populations indicated an increased prevalence of sarcopenia. In addition, the prevalence of sarcopenia was related to diagnostic criteria and definition. Male COPD patients had a higher prevalence of sarcopenia than female COPD patients. COPD patients with an average age greater than 65 had a slightly higher prevalence of sarcopenia. COPD patients with comorbid sarcopenia had poorer pulmonary function, activity tolerance, and clinical symptoms than patients with COPD alone. Conclusion Sarcopenia prevalence is high (27%) in COPD patients. In addition, these patients had worse pulmonary function and activity tolerance compared to patients without sarcopenia. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367422, identifier CRD42022367422.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Hezhi Li
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jun Yao
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Yan Wang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.,Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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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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Lippi L, Folli A, Curci C, D’Abrosca F, Moalli S, Mezian K, de Sire A, Invernizzi M. Osteosarcopenia in Patients with Chronic Obstructive Pulmonary Diseases: Which Pathophysiologic Implications for Rehabilitation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114314. [PMID: 36361194 PMCID: PMC9657186 DOI: 10.3390/ijerph192114314] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 05/10/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a burdensome condition affecting a growing number of people worldwide, frequently related to major comorbidities and functional impairment. In these patients, several factors might have a role in promoting both bone and muscle loss, including systemic inflammation, corticosteroid therapies, sedentary behaviours, deconditioning, malnutrition, smoking habits, and alcohol consumption. On the other hand, bone and muscle tissues share several linkages from functional, embryological, and biochemical points of view. Osteosarcopenia has been recently defined by the coexistence of osteoporosis and sarcopenia, but the precise mechanisms underpinning osteosarcopenia in patients with COPD are still unknown. In this scenario, a deeper understanding of the molecular basis of osteosarcopenia might guide clinicians in a personalized approach integrating skeletal muscle health with the pulmonary rehabilitation framework in COPD. Taken together, our results summarized the currently available evidence about the multilevel interactions between osteosarcopenia and COPD to pave the way for a comprehensive approach targeting the most common risk factors of these pathological conditions. Further studies are needed to clarify the role of modern clinical strategies and telemedicine solutions to optimize healthcare delivery in patients with COPD, including osteopenia, osteoporosis, and sarcopenia screening in these subjects.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, 12800 Prague, Czech Republic
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 15006 Prague, Czech Republic
- Correspondence: ; Tel.: +390961369768
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Gao H, Wang J, Zou X, Zhang K, Zhou J, Chen M. High blood urea nitrogen to creatinine ratio is associated with increased risk of sarcopenia in patients with chronic obstructive pulmonary disease. Exp Gerontol 2022; 169:111960. [PMID: 36152777 DOI: 10.1016/j.exger.2022.111960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Sarcopenia has been reported to be a prognostic factor for chronic obstructive pulmonary disease (COPD). However, the relationship between the ratio of blood urea nitrogen to creatinine (BUN/Cr) and sarcopenia in patients with COPD remain unclear. Therefore, the purpose of this study is to explore whether the ratio can be used as a predictor of sarcopenia in hospitalized COPD patients. METHODS The skeletal muscle area index (SMI) at the level of the 12th thoracic vertebra (T12) was used to assess the risk of sarcopenia in patients. This single center cross-sectional study was conducted by analyzing the clinical parameters and identifying the T12 skeletal muscle area (SMA) and density (SMD) on chest CT images of COPD hospitalized patients admitted to the respiratory department of our hospital from March 2018 to August 2021. The study enrolled 265 hospitalized patients. Based on the different statistical properties of the above variables, differences between groups were measured by independent sample Student t-tests, Mann-Whitney U tests, or Chi-Square tests. Multivariable linear regression analysis was used to evaluate the relationship between the value of BUN/Cr and the risk of sarcopenia. RESULTS The serum BUN/Cr ratio was negatively correlated with SMI (r = -0.201, p = 0.001) in COPD patients, and multivariate linear regression analysis showed that this ratio was associated with the risk of sarcopenia (β = -0.109, p = 0.041). The optimal cut-off value of BUN/Cr ratio for identifying COPD patients with sarcopenia was 97.893. There was also a significant negative correlation between serum BUN/Cr ratio and forced vital capacity (FVC; r = -0.235, p < 0.001) and forced expiratory volume in the first second (FEV1; r = -0.219, p < 0.001). CONCLUSION The BUN/Cr ratio can be used to predict sarcopenia and evaluate pulmonary function in hospitalized COPD patients.
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Affiliation(s)
- Hengxing Gao
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, 277#, Yanta West Road, Xi'an, Shaanxi Province 710061, China
| | - Jing Wang
- Department of Pulmonary and Critical Care Medicine, Shaanxi Provincial Second People's Hospital, No. 3 Shangqin Road, Xi'an, Shaanxi Province 710005, China
| | - Xuexue Zou
- Department of Radiology, Binzhou Medical University Hospital, 661 Yellow River Road, Binzhou, Shandong Province 256600, China
| | - Kun Zhang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, 277#, Yanta West Road, Xi'an, Shaanxi Province 710061, China
| | - Jiejun Zhou
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, 277#, Yanta West Road, Xi'an, Shaanxi Province 710061, China
| | - Mingwei Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, 277#, Yanta West Road, Xi'an, Shaanxi Province 710061, China; Department of Pulmonary and Critical Care Medicine, Shaanxi Provincial Second People's Hospital, No. 3 Shangqin Road, Xi'an, Shaanxi Province 710005, China.
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Pichon R, Van Hove O, Ménard M, Hearing D, Crétual A. Impairment and characteristics of postural control sub-components in people with COPD: a scoping review. Disabil Rehabil 2022:1-16. [PMID: 36000464 DOI: 10.1080/09638288.2022.2107083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Impairment of postural control is common in people with COPD. However, the precise characteristics of this alteration are not clearly known. The "Systems Framework for Postural Control" which define postural control sub-components, represents an interesting tool to explore this field. The main aim of this review was to identify which postural control sub-components are impaired in people with COPD and to summarise characteristics for each sub-component. A secondary aim was to precise the relation between postural control and activities of daily living (ADL).Materials and methods: A scoping review was conducted, according to the JBI methodology. Medline, Cochrane Library, Scielo, Google Scholar, OpenGrey, and HAL were searched from inception to May 2022. The search was performed in English and French.Results: Eighty-nine articles were included. There was evidence of a potential impairment for most of the postural control sub-components. Characteristics of every sub-component alteration were heterogeneous. Reduced postural control could be associated with difficulties in ADL.Conclusions: People with COPD may have impairment in a wide range of postural control sub-components. Further research is needed to clarify if a common pattern of modification exits for this alteration and to precise the link with ADL.Implications for rehabilitationImpairment of postural control is a common extra-respiratory manifestation in people with COPD and so clinicians must include it in their clinical reasoning.Numerous postural control sub-components could be altered in people with COPD, suggesting that postural control assessment must be holistic.This scoping review shows that characteristics of postural control impairment are varied and that there may be no common pattern at the COPD population level.The relationship between impaired postural control and activities of daily living remains unclear, but clinicians should be alert to potential negative interactions between these two areas.
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Affiliation(s)
- Romain Pichon
- Institut de Formation en Pédicurie-Podologie, Ergothérapie et Kinésithérapie (IFPEK), Rennes, France.,M2S Laboratory - EA 7470, University Rennes 2, Rennes, France
| | | | - Mathieu Ménard
- M2S Laboratory - EA 7470, University Rennes 2, Rennes, France.,Institut d'Ostéopathie de Rennes - Bretagne (IO-RB), Bruz, France
| | - Diane Hearing
- M2S Laboratory - EA 7470, University Rennes 2, Rennes, France
| | - Armel Crétual
- M2S Laboratory - EA 7470, University Rennes 2, Rennes, France
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Gao J, Deng M, Li Y, Yin Y, Zhou X, Zhang Q, Hou G. Resistin as a Systemic Inflammation-Related Biomarker for Sarcopenia in Patients With Chronic Obstructive Pulmonary Disease. Front Nutr 2022; 9:921399. [PMID: 35903456 PMCID: PMC9315354 DOI: 10.3389/fnut.2022.921399] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/03/2022] [Indexed: 12/16/2022] Open
Abstract
Background Sarcopenia is common in patients with chronic obstructive pulmonary disease (COPD) and is mainly caused by systemic inflammation. Resistin acts as a proinflammatory cytokine and is involved in the activation of multiple inflammatory signaling pathways. The aim of this study was to determine the relationship between resistin levels and systemic inflammation and to assess the clinical value of circulating resistin for sarcopenia in patients with COPD. Methods In this prospective observational study, we enrolled 235 patients with COPD who were divided into development and validation sets. The definition of sarcopenia followed the guidelines from the Asian Working Group for Sarcopenia. Serum concentrations of resistin and TNF-α were measured using an enzyme-linked immunosorbent assay (ELISA). Results In this study, higher serum resistin levels were significantly associated with lower skeletal muscle mass and muscular strength. The serum resistin levels in patients with sarcopenia were significantly higher than those in patients without sarcopenia. The serum resistin level had positive correlations with the serum TNF-α level (r = 0.250, p = 0.007). The predictive efficacy of the serum resistin level (AUC: 0.828) for sarcopenia was superior to that of the serum TNF-α level (AUC: 0.621). The cutoff point (7.138 ng/ml) for the serum resistin level was validated in the validation set (AUC: 0.818). Conclusions Serum resistin levels were associated with systemic inflammation and can be used accurately and easily to predict sarcopenia in patients with COPD.
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Affiliation(s)
- Jinghan Gao
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Mingming Deng
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yanxia Li
- Respiratory Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yan Yin
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Xiaoming Zhou
- Department of Pulmonary and Critical Care Medicine, Disease, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Qin Zhang
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Gang Hou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- *Correspondence: Gang Hou
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Deng M, Bian Y, Zhang Q, Zhou X, Hou G. Growth Differentiation Factor-15 as a Biomarker for Sarcopenia in Patients With Chronic Obstructive Pulmonary Disease. Front Nutr 2022; 9:897097. [PMID: 35845807 PMCID: PMC9282868 DOI: 10.3389/fnut.2022.897097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/19/2022] [Indexed: 12/18/2022] Open
Abstract
Purpose Sarcopenia is an important factor contributing to comorbidities in patients with chronic obstructive pulmonary disease (COPD) and is an independent risk factor for increased mortality. The diagnostic process for sarcopenia requires specific equipment and specialized training and is difficult procedurally. A previous study found that GDF15 levels are associated with skeletal muscle mass and function in patients with COPD. However, whether circulating GDF15 levels can be used for the prediction of sarcopenia in patients with COPD is unknown. Methods This study included 235 patients with stable COPD who were divided into a development set (n = 117) and a validation set (n = 118), and we followed the definition of sarcopenia as defined by the guidelines from the Asian Working Group for Sarcopenia. Serum concentrations of GDF15 were measured using an enzyme-linked immunosorbent assay (ELISA), and construction of a nomogram and decision curve analysis were performed using the R package “rms.” Results In this study, serum GDF15 levels were negatively associated with skeletal muscle mass (r = –0.204, p = 0.031), handgrip strength (r = –0.274, p = 0.004), quadriceps strength (r = –0.269, p = 0.029), and the thickness (r = –0.338, p < 0.001) and area (r = –0.335, p < 0.001) of the rectus femoris muscle in patients with COPD. Furthermore, the serum levels of GDF15 in patients with sarcopenia were significantly higher than those in controls. Importantly, serum levels of GDF15 could effectively predict sarcopenia in patients with COPD based on the development set (AUC = 0.827) and validation set (AUC = 0.801). Finally, a nomogram model based on serum GDF15 levels and clinical features showed good predictive ability (AUC > 0.89) in the development and validation sets. Conclusion Serum GDF15 levels could be used to accurately and easily evaluate sarcopenia in patients with COPD.
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Affiliation(s)
- Mingming Deng
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yiding Bian
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Qin Zhang
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Xiaoming Zhou
- Respiratory Department, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Gang Hou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- *Correspondence: Gang Hou,
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Cardoso RF, Lacerda ACR, Lima VP, de Oliveira LFF, de Oliveira SFF, Araújo RP, Castro CLFE, da Silva FP, de Paiva LV, Dietrich L, Figueiredo PHS, Costa HS, Bernardo-Filho M, da Cunha de Sá-Caputo D, Mendonça VA, Taiar R. Efficacy of Acupuncture on Quality of Life, Functional Performance, Dyspnea, and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Clinical Trial. J Clin Med 2022; 11:jcm11113048. [PMID: 35683437 PMCID: PMC9181529 DOI: 10.3390/jcm11113048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by the presence of chronic airflow obstruction. Previous studies have evaluated the effect of acupuncture treatment (AT) in patients with COPD. Nevertheless, these studies show a great deal of heterogeneity in treatment protocols, having sample sizes that are too small to estimate and clarify effect size and heterogeneity in patients’ baseline. The aim of this study is to evaluate the effectiveness of acupuncture on quality of life, functional performance, dyspnea, and pulmonary function in patients with COPD. As such, patients will go through the following three phases: Phase I–pretreatment: period of subject selection and inclusion in the protocol, with an interview and performance of exams and tests as follows: Mini-Cog, dual-energy X-ray absorptiometry, spirometry, the Patient-Generated Index, Saint George’s Respiratory Questionnaire, the six-minute walk test, the London Chest Activity of Daily Living, and the COPD Assessment Test. Phase II–8 weeks of treatment, with AT 3 times a week, with two parallel groups: Group I–with 50 subjects–AT according to the recommended technical standards; Group II–with 50 subjects–Control, without acupuncture. Phase III–Continuation of AT for 8 weeks, maintaining the subjects in the previously allocated groups and following the same methodology.
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Affiliation(s)
- Renato Fleury Cardoso
- Postgraduate Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina 39803-371, Brazil; (R.F.C.); (A.C.R.L.); (V.A.M.)
| | - Ana Cristina Rodrigues Lacerda
- Postgraduate Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina 39803-371, Brazil; (R.F.C.); (A.C.R.L.); (V.A.M.)
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Vanessa Pereira Lima
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Lucas Fróis Fernandes de Oliveira
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Sofia Fróis Fernandes de Oliveira
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Rafaela Paula Araújo
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Cecylia Leiber Fernandes e Castro
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Flávia Pereira da Silva
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Lizânia Vieira de Paiva
- Postgraduate Program in Health, Society and Environment (PPGSASA), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina 39803-371, Brazil;
| | - Lia Dietrich
- Dentistry Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil;
| | - Pedro Henrique Scheidt Figueiredo
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Henrique Silveira Costa
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Mario Bernardo-Filho
- Laboratory of Mechanical Vibrations and Integrative Practices, State University of Rio de Janeiro, Rio de Janeiro 20550-013, Brazil; (M.B.-F.); (D.d.C.d.S.-C.)
| | - Danúbia da Cunha de Sá-Caputo
- Laboratory of Mechanical Vibrations and Integrative Practices, State University of Rio de Janeiro, Rio de Janeiro 20550-013, Brazil; (M.B.-F.); (D.d.C.d.S.-C.)
| | - Vanessa Amaral Mendonça
- Postgraduate Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina 39803-371, Brazil; (R.F.C.); (A.C.R.L.); (V.A.M.)
- Physiotherapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina 39803-371, Brazil; (V.P.L.); (L.F.F.d.O.); (S.F.F.d.O.); (R.P.A.); (C.L.F.e.C.); (F.P.d.S.); (P.H.S.F.), (H.S.C.)
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims Champagne-Ardenne, 51100 Reims, France
- Correspondence:
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11
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Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia. Exp Gerontol 2022; 164:111834. [PMID: 35588999 DOI: 10.1016/j.exger.2022.111834] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022]
Abstract
This study investigated whether blood-based biomarkers were related to functional test performance and respiratory muscle strength in older adults with COPD and sarcopenia. The participants included in this cross-sectional study were from both sexes and sixty years or older. Based on clinical assessment, participants were categorized in COPD (n = 43) and non-COPD (NCOPD) (n = 43) groups. They were also assessed for body composition and muscular mass by dual-energy X-ray absorptiometry, using the relative skeletal muscle index for the diagnosis of sarcopenia. A series of functional tests, including short physical performance battery (SPPB), 6-minute walking test (6MWT), maximal inspiratory and expiratory pressures (MIP and MEP), were carried out. Plasma levels of myokines (Irisin and BDNF), and soluble TNF receptors (sTNFR1 and sTNFR2) were determined by ELISA. In the multivariate analysis, 6MWD was associated with age, COPD-related sarcopenia and BDNF (R2 = 0.29; f2 = 0.41). SPPB score was associated with COPD-related sarcopenia and sTNFR1 (R2 = 0.25; f2 = 0.33). MIP value was associated with sex, COPD-related sarcopenia, sTNFR2 and Irisin (R2 = 0.24; f2 = 0.31). Finally, MEP value was associated with sex COPD-related sarcopenia (R2 = 0.18; f2 = 0.22). Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia.
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Gaynor-Sodeifi K, Lewthwaite H, Jenkins AR, Fernandes Belo L, Koch E, Mujaddid A, Raffoul D, Tracey L, Jensen D. The Association between Fat-Free Mass and Exercise Test Outcomes in People with Chronic Obstructive Pulmonary Disease: A Systematic Review. COPD 2022; 19:182-205. [PMID: 35410561 DOI: 10.1080/15412555.2022.2049737] [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] [Indexed: 10/18/2022]
Abstract
People with chronic obstructive pulmonary disease (COPD) tend to have abnormally low levels of fat-free mass (FFM), which includes skeletal muscle mass as a central component. The purpose of this systematic review was to synthesise available evidence on the association between FFM and exercise test outcomes in COPD. MEDLINE, Cochrane Library, EMBASE, Web of Science, and Scopus were searched. Studies that evaluated exercise-related outcomes in relation to measures of FFM in COPD were included. Eighty-three studies, containing 18,770 (39% female) COPD participants, were included. Considerable heterogeneity was identified in the ways that FFM and exercise test outcomes were assessed; however, higher levels of FFM were generally associated with greater peak exercise capacity. This association was stronger for some exercise test outcomes (e.g. peak rate of oxygen consumption during incremental cycle exercise testing) than others (e.g. six-minute walking distance). This review identified heterogeneity in the methods used for measuring FFM and exercise capacity. There was, in general, a positive association between FFM and exercise capacity in COPD. There was also an identified lack of studies investigating associations between FFM and temporal physiological and perceptual responses to exercise. This review highlights the significance of FFM as a determinant of exercise capacity in COPD.
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Affiliation(s)
- Kaveh Gaynor-Sodeifi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Hayley Lewthwaite
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,College of Engineering, Science and Environment, School of Environmental & Life Sciences, University of Newcastle, Ourimbah, New South Wales, Australia
| | - Alex Robert Jenkins
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Letícia Fernandes Belo
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Emily Koch
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Ahzum Mujaddid
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Dana Raffoul
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Lauren Tracey
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Dennis Jensen
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Translational Research in Respiratory Diseases Program, Montreal, Quebec, Canada
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13
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van Bakel SIJ, Gosker HR, Langen RC, Schols AMWJ. Towards Personalized Management of Sarcopenia in COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:25-40. [PMID: 33442246 PMCID: PMC7800429 DOI: 10.2147/copd.s280540] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
The awareness of the presence and consequences of sarcopenia has significantly increased over the past decade. Sarcopenia is defined as gradual loss of muscle mass and strength and ultimately loss of physical performance associated with aging and chronic disease. The prevalence of sarcopenia is higher in chronic obstructive pulmonary disease (COPD) compared to age-matched controls. Current literature suggests that next to physical inactivity, COPD-specific alterations in physiological processes contribute to accelerated development of sarcopenia. Sarcopenia in COPD can be assessed according to current guidelines, but during physical performance testing, ventilatory limitation should be considered. Treatment of muscle impairment can halt or even reverse sarcopenia, despite respiratory impairment. Exercise training and protein supplementation are currently at the basis of sarcopenia treatment. Furthermore, effective current and new interventions targeting the pulmonary system (eg, smoking cessation, bronchodilators and lung volume reduction surgery) may also facilitate muscle maintenance. Better understanding of disease-specific pathophysiological mechanisms involved in the accelerated development of sarcopenia in COPD will provide new leads to refine nutritional, exercise and physical activity interventions and develop pharmacological co-interventions.
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Affiliation(s)
- Sophie I J van Bakel
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Harry R Gosker
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Ramon C Langen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
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