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Neelamegam M, Ahmad A, Meng Li C, Pui Li W, Zulhaimi NS, Cysique L, Earnshaw V, Omar SFS, Kamarulzaman A, Kamaruzzaman SB, Rajasuriar R. Psychosocial risk factors and cognitive decline in people living with HIV: results from the Malaysian HIV and aging (MHIVA) study. AIDS Care 2024; 36:1041-1049. [PMID: 37666210 PMCID: PMC10909927 DOI: 10.1080/09540121.2023.2254543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/25/2023] [Indexed: 09/06/2023]
Abstract
HIV-associated mortality has improved with the advent of antiretroviral therapy, yet neurocognitive decline persists. We assessed the association between psychosocial risk factors and cognitive function among Malaysian PLWH. Data of virally suppressed PLWH (n = 331) on stable ART, from the Malaysian HIV and Aging study was assessed. Psychosocial factors were assessed using the Lubben Social Network Scale-6 (social isolation) and Depression Anxiety Stress Scale-21 (DASS-21). The Montreal Cognitive Assessment (MoCA) with normative standards for the Malaysian population was used to determine cognitive function. Linear and logistic regression were used to assess the associations between cognition, and psychosocial risk factors. Median age of participants was 43.8 years (IQR 37.7-51.0). Participants were predominantly male (82.8%), with secondary education or higher (85.2%). Participants were on ART for 5.7 years (IQR 3.0-9.7), with a mean MoCA score of 24.6 (±3.7). Social isolation was found in 34.6% of participants, and severe depression, severe stress, and severe anxiety in 10.6%, 15.4%, and 6.0% respectively. After adjusting for demographic, clinical, and HIV parameters, MoCA scores were significantly associated with severe stress (β = -0.11, p = 0.02) and having marginal friendship ties (β = -0.13, p = 0.03). Social isolation and severe stress are associated with neurocognitive impairment in PLWH.
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Affiliation(s)
- Malinee Neelamegam
- Department of Biostatistics and Epidemiology, School of Public Health, The University of North Texas Health Science Center, TX, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
| | - Ahsan Ahmad
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- School of Medicine, Yale University, New Haven, CT, USA
| | - Chong Meng Li
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wong Pui Li
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurul Syuhada Zulhaimi
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lucette Cysique
- School of Psychology, Faculty of Science, The University of New South Wales, Sydney, Australia
| | - Valerie Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, DE, United States
| | - Sharifah Faridah Syed Omar
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adeeba Kamarulzaman
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Reena Rajasuriar
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Xu Y, Wang D, Chen P, Qi B, Li X, Xie C, Wu J, Li L, Gao G, Geng S, Yang D. Factors associated with skeletal muscle mass in middle-aged men living with HIV. J Cachexia Sarcopenia Muscle 2024. [PMID: 39015948 DOI: 10.1002/jcsm.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/19/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Despite extensive research on muscle loss in people living with HIV (PLWH), the prevalence and contributing factors specifically among middle-aged men remain unclear. This study aimed to determine the prevalence of low muscle mass within this demographic and to identify associated factors. METHODS A total of 378 men living with HIV were enrolled in the study. They were classified into low muscle mass group if they displayed a skeletal muscle index (SMI) <7.00 kg/m2 or fell within the lowest quintile of SMI based on the criteria established by the Asian Working Group for Sarcopenia 2019. RESULTS Out of the 378 men living with HIV enrolled, 351 had normal muscle mass, while 27 (7.1%) had low muscle mass. Antiretroviral drugs Zidovudine (AZT) (OR = 0.246, P = 0.022) and higher serum albumin levels (OR = 0.899, P = 0.026) were found to be protective factors against low muscle mass according to quintile grouping. Strong positive associations between SMI and body mass index (BMI), nutritional risk index (NRI), oedema index and fat-free mass index (FFMI) (R > 0.5, P < 0.001) were observed. In addition, both BMI (sensitivity = 0.741, specificity = 0.906) and NRI (sensitivity = 0.963, specificity = 0.601) had high sensitivity and specificity in diagnosing low muscle mass, with critical values of 19.85 and 114.177 for BMI and NRI, respectively. The oedema index was the most effective measure of body composition in detecting abnormal fluid retention with high sensitivity (92.6%) and moderate specificity (71.8%) in identifying individuals with low muscle mass. Notably, PLWH with low muscle mass participants had a significantly higher prevalence (92.6%) of a high oedema index compared with those with normal muscle mass (28.2%). This observation indicates that individuals with HIV who experience reduced muscle mass is commonly accompanied with abnormal fluid retention within the body. CONCLUSIONS Antiretroviral medication types, specifically Zidovudine, BMI and NRI can be independent risk factors for low muscle mass in men with HIV. These factors, along with BMI, could be used conveniently to predict low muscle mass. Furthermore, the association between the oedema index and muscle mass suggests that observing signs of oedema may indicate a risk of low muscle mass in PLWH.
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Affiliation(s)
- Yide Xu
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dongdong Wang
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Pei Chen
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Clinical Nutrition, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Bufeng Qi
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaoting Li
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chunfeng Xie
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jieshu Wu
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lin Li
- Department of Health Management Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Gu Gao
- Department of Health Management Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shanshan Geng
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dandan Yang
- Department of Sexually Transmitted Diseases and AIDS, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China
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Quaresma MVLDS, Vicente BM, Balchiunas RE, Ribeiro SML. Sarcopenia risk, sarcopenia-related quality of life, and associated factors in people living with human immunodeficiency virus (HIV): A web-based survey. Nutrition 2024; 120:112352. [PMID: 38306734 DOI: 10.1016/j.nut.2024.112352] [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: 06/16/2023] [Revised: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES We aimed to screen for the risk of sarcopenia and sarcopenia-related quality of life and associated factors of people living with HIV (PLWH). RESEARCH METHODS AND PROCEDURES This nonprobabilistic web-based survey evaluated PLWH. The participants were invited directly from a university-based inpatient clinic and responded to a web questionnaire that included the SARC-F and SarQoL to screen people at risk of sarcopenia and their quality of life. People at risk of sarcopenia were defined by the proposed cutoff points for SARC-F (≥ 4 points), and SarQoL overall score was categorized according to the median. Moreover, we performed a logistic regression to investigate associations between HIV-, lifestyle-, and health-associated factors (i.e., physical activity, dietary pattern, sleep quality, gastrointestinal symptoms, HIV diagnosis, type, combinations, and duration of ART, smoking, drinking, BMI, and weight loss), and outcomes (SARC-F and SarQoL). RESULTS The sample comprised 202 PLWH, mainly middle-aged (50.6-60.5 y; n = 101). Only 5.9% (n = 12) are at risk of sarcopenia according to SARC-F, and only 17.3% (n = 35) exhibited lower sarcopenia-related quality of life according to SarQoL. In the multiple models, only the gastrointestinal symptoms increased the odds of sarcopenia risk (OR: 1.058; P = 0.01) and poor sarcopenia-associated quality of life (OR: 1.041; P = 0.013). CONCLUSIONS We verified that only 5.9% and 17.3% of PLWH are at risk of sarcopenia and presented lower sarcopenia-related quality of life, respectively. Only the gastrointestinal symptoms were associated with a risk of sarcopenia and lower sarcopenia-related quality of life, without significant differences between age groups.
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Affiliation(s)
- Marcus V L Dos Santos Quaresma
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Roseli Espindola Balchiunas
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | - Sandra M L Ribeiro
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, Brazil.
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Cabrera DM, Cornejo MP, Pinedo Y, Garcia PJ, Hsieh E. Assessment of regional body composition, physical function and sarcopenia among peruvian women aging with HIV: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000814. [PMID: 37594923 PMCID: PMC10437949 DOI: 10.1371/journal.pgph.0000814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/11/2023] [Indexed: 08/20/2023]
Abstract
Management of chronic conditions and optimization of overall health has become a primary global health concern in the care of people living with HIV in the era of highly active antiretroviral therapy (ART), particularly in lower-and-middle income countries where infrastructure for chronic disease management may be fragmented. Alterations in body composition can reflect important changes in musculoskeletal health, particularly among populations at risk for developing fat and muscle redistribution syndromes, such as women with HIV on ART. Given the lack of data on this topic in Latin America and the Caribbean, we designed an exploratory study to measure these outcomes in a population of women aging with HIV in Peru. We conducted a cross-sectional study among Peruvian women with and without HIV aged ≥40 years. Dual X-ray absorptiometry was used to measure trunk and limb lean mass (LM) and fat mass (FM). Physical performance was assessed with the Short Physical Performance Battery (SPPB) and physical strength with a dynamometer. Sarcopenia was assessed based upon EWGSOP criteria. We used linear regression to model associations between body composition, sarcopenia and physical performance scores. 104 women with HIV and 212 women without HIV were enrolled (mean age 52.4±8.2 vs. 56.4±8.8 years, p≤0.001). Among women with HIV, mean years since diagnosis was 11.8±6 and all were on ART. Mean SPPB score was 9.9 vs 10.8 (p<0.001) between both groups. Sarcopenia spectrum was found in 25.9% and 23.1%, respectively. In the multivariable regression analysis, trunk FM and older age were negatively correlated with physical performance among women with HIV. Severe sarcopenia was found among a greater proportion of those with HIV (3.8% vs. 0.9%, p = 0.84), however this finding was not statistically significant. Women with HIV had significantly lower SPPB scores compared to women without HIV, and trunk FM and upper limb LM were independent predictors for the SPPB and Grip Strength tests, respectively. Larger, prospective studies are needed in Latin America & the Caribbean to identify individuals at high risk for sarcopenia and declines in physical function, and to inform prevention guidelines.
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Affiliation(s)
- Diego M. Cabrera
- Department of Internal Medicine, Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Epidemiology, STD, and HIV, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mijahil P. Cornejo
- Department of Rheumatology, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Yvett Pinedo
- Department of Infectious Diseases, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Patricia J. Garcia
- Department of Epidemiology, STD, and HIV, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Evelyn Hsieh
- Department of Internal Medicine, Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Rheumatology, VA Connecticut Healthcare System, West Haven, Connecticut, United States of America
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Zhang Z, Lin Q, Xu Y, Guan W, Song X, Li Y, Zhang Y, Li T, Yu W. Effect of different antiretroviral therapy on muscle mass, bone mineral density, and trabecular bone score in Chinese HIV-infected males. Arch Osteoporos 2023; 18:48. [PMID: 37041320 DOI: 10.1007/s11657-023-01238-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/21/2023] [Indexed: 04/13/2023]
Abstract
This is the first study to report both greater BMD loss and muscle loss in Chinese HIV-infected males with lamivudine (3TC)-tenofovir disoproxil fumarate (TDF)-efavirenz (EFV) regimen, which highlights the importance of closely monitoring muscle mass and bone mineral density in patients treated with 3TC-TDF-EFV regimen and provides a foundation for the clinical intervention of sarcopenia and osteoporosis. PURPOSE To compare the effect initiating different antiretroviral therapy (ART) regimens have on muscle mass, bone mineral density (BMD), and trabecular bone score (TBS). METHODS We designed a retrospective study of ART-naive Chinese males with HIV (MWH) undergoing two different regimens at 1-year follow-up. All subjects underwent dual-energy absorptiometry (DXA) for BMD and muscle mass prior to ART initiation, and again 1 year later. TBS iNsight software was used for TBS. We analyzed differences in muscle mass, BMD, and TBS after different treatment arms and associations between ART regimens and changes in them. RESULTS A total of 76 men were included (mean age 31.83 ± 8.75 years). Mean absolute muscle mass decreased significantly from baseline to follow-up after initiation of lamivudine (3TC)-tenofovir disoproxil fumarate (TDF)-efavirenz (EFV), whereas increased significantly after initiation of 3TC-zidovudine(AZT)/Stavudine(d4T)-Nevirapine(NVP). Assignment to 3TC-TDF-EFV resulted in greater percentage loss in BMD at lumbar spine (LS) and total hip (TH) compared to 3TC-AZT/d4T-NVP, but this difference was not statistically significant at the femoral neck BMD and TBS. In the multivariable logistic regression model adjusted for covariates, the 3TC-TDF-EFV regimen was associated with higher odds of decreased appendicular and total muscle mass, LS and TH BMD. CONCLUSIONS This is the first study to report not only greater BMD loss but also muscle loss in Chinese MWH with 3TC-TDF-EFV regimen. Our work highlights the importance of closely monitoring muscle mass and BMD in patients treated with 3TC-TDF-EFV regimen and provides a foundation for the clinical intervention of sarcopenia and osteoporosis in them.
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Affiliation(s)
- Zaizhu Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Qiang Lin
- Department of Radiology, Beijing Arion Cancer Center, Beijing, China
| | - Ying Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wenmin Guan
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaojing Song
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, China
| | - Yanling Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, China
| | - Yi Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, China.
| | - Wei Yu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
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SeyedAlinaghi S, Ghayomzadeh M, Mirzapour P, Maroufi SF, Pashaei Z, Ali Z, Tantuoyir MM, Aghaie N, Vahedi F, Salmani R, MohsseniPour M, Qaderi K, Shahidi R, Peyman A, Varshochi S, Afzalian A, Maroufi SP, Mehraeen E, Dadras O, Hackett D. A systematic review of sarcopenia prevalence and associated factors in people living with human immunodeficiency virus. J Cachexia Sarcopenia Muscle 2023. [PMID: 36929581 DOI: 10.1002/jcsm.13212] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/15/2023] [Accepted: 02/06/2023] [Indexed: 03/18/2023] Open
Abstract
People living with human immunodeficiency virus (HIV) (PLWH) appear to be at an increased risk of sarcopenia, which can have a devastating effect on their life due to consequences such as physical disability, poor quality of life, and finally death. This systematic review examined sarcopenia prevalence and its associated factors in PLWH. A systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, Embase and Cochrane databases from the dates of inception up to May 2022. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. Data relating to the study population, purpose of study, gender, age, race, body mass index, medical history, paraclinical results and antiretroviral therapy as associated factors of sarcopenia were extracted. In addition, the prevalence of sarcopenia in PLWH and its promoting and reducing factors were also extracted. We reviewed the 14 related studies for identifying of sarcopenia prevalence and its associated factors in PLWH. The total number of PLWH in all the reviewed studies was 2592. There was no criterion for the minimum number of people with HIV and the lowest number of PLWH was 27, and the highest number was 860. Some studies reported a significantly higher prevalence of sarcopenia in HIV-infected individuals compared with HIV-negative controls as follows: 24.2-6.7%, 15-4% and 10-6%, respectively. We showed that, age (30-50 years), being female, >5 years post-HIV diagnosis, multiple vertebral fractures, cocaine/heroin use and lower gamma-glutamyl transferase level were the main promoting factors of sarcopenia. Higher educational level, employment, physical exercise, calf circumference >31 cm, and gait speed >0.8 m/s were also factors to reduce sarcopenia. Sarcopenia prevalence in PLWH is higher than HIV-negative population. Given the importance and prevalence of sarcopenia among PLWH and its associated consequences (i.e., mortality and disability), determining its risk factors is of great importance.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Ghayomzadeh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zoha Ali
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Marcarious M Tantuoyir
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran.,Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana
| | - Narjes Aghaie
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Vahedi
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Salmani
- Department of Midwifery, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Kowsar Qaderi
- Department of Midwifery, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Akram Peyman
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sanaz Varshochi
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Luk FWL, Li T, Ho HY, Chan YY, Cheung SK, Wong V, Kwok TCY, Lui G. Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes? J Int AIDS Soc 2022; 25 Suppl 4:e25988. [PMID: 36176015 PMCID: PMC9522638 DOI: 10.1002/jia2.25988] [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: 01/20/2022] [Accepted: 08/01/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Sarcopenia is an important clinical syndrome in older people living with HIV (PLWH). With a change to the Asia sarcopenia definition in 2019, we aimed to determine whether health outcomes were associated with different definitions of sarcopenia among Asian PLWH. Methods We performed a prospective cross‐sectional study enrolling PLWH aged ≥35 years from January 2018 to November 2021. We defined sarcopenia by the Asia Working Group of Sarcopenia (AWGS) criteria in 2014 and 2019. AWGS‐2014 included low muscle mass plus weak handgrip strength and/or slow gait speed. AWGS‐2019 included low muscle mass plus low muscle strength or physical performance, while the presence of all defines severe sarcopenia. We measured appendicular skeletal muscle mass using dual‐energy X‐ray absorptiometry, handgrip strength, usual gait speed, five‐time chair stand test and Short Physical Performance Battery. Correlations between each sarcopenia definition and health‐related quality of life (using EQ‐5D‐5L and SF‐36) and functional disability were determined. Results One hundred and fifty Asian PLWH were enrolled, 132 (88%) were male, mean age was 60±10 years, duration of HIV diagnosis was 13 (IQR 8–18) years and current CD4 count was 574 (IQR 362–762) cells/mm3, 67 (45%) had multimorbidity, 64 (43%) had polypharmacy. Prevalence of sarcopenia by AWGS‐2014, AWGS‐2019 and severe sarcopenia was 17.3%, 27.3% and 18.0%, respectively. Age, education and polypharmacy were associated with sarcopenia. Sarcopenia (AWGS‐2014) and severe sarcopenia were associated with mobility, physical functioning and physical component score (SF‐36). All three criteria were associated with impaired instrumental activities of daily living (IADL). After age and sex adjustment, sarcopenia (AWGS‐2014) (adjusted odds ratio/aOR 5.4, 95% confidence interval/CI 2.0–15.1) and severe sarcopenia (aOR 5.1, 95% CI 1.9–14.0) were associated with mobility and physical component score (SF‐36) (β coefficients –5.3342, p = 0.022 and –5.412, p = 0.019). Sarcopenia (AWGS 2014) (aOR 5.2, 95% CI 1.7–16.2), sarcopenia (AWGS‐2019) (aOR 4.5, 95% CI 1.5–13.1) and severe sarcopenia (aOR 3.5, 95% CI 1.1–10.9) were associated with impaired IADL in fully adjusted models. Conclusions In a sample of Asian PLWH, 17.3%, 27.3% and 18.0% had sarcopenia as defined by AWGS‐2014, AWGS‐2019 and severe sarcopenia, respectively. Sarcopenia by AWGS‐2014 and severe sarcopenia correlated with parameters of poor health outcomes, while sarcopenia by AWGS‐2019 correlated with functional disability.
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Affiliation(s)
- Fion Wing Lam Luk
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Timothy Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Hang Yee Ho
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Yin Yan Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Siu King Cheung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Vickie Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Timothy Chi Yui Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Grace Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
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Shared and Divergent Epigenetic Mechanisms in Cachexia and Sarcopenia. Cells 2022; 11:cells11152293. [PMID: 35892590 PMCID: PMC9332174 DOI: 10.3390/cells11152293] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023] Open
Abstract
Significant loss of muscle mass may occur in cachexia and sarcopenia, which are major causes of mortality and disability. Cachexia represents a complex multi-organ syndrome associated with cancer and chronic diseases. It is often characterized by body weight loss, inflammation, and muscle and adipose wasting. Progressive muscle loss is also a hallmark of healthy aging, which is emerging worldwide as a main demographic trend. A great challenge for the health care systems is the age-related decline in functionality which threatens the independence and quality of life of elderly people. This biological decline can also be associated with functional muscle loss, known as sarcopenia. Previous studies have shown that microRNAs (miRNAs) play pivotal roles in the development and progression of muscle wasting in both cachexia and sarcopenia. These small non-coding RNAs, often carried in extracellular vesicles, inhibit translation by targeting messenger RNAs, therefore representing potent epigenetic modulators. The molecular mechanisms behind cachexia and sarcopenia, including the expression of specific miRNAs, share common and distinctive trends. The aim of the present review is to compile recent evidence about shared and divergent epigenetic mechanisms, particularly focusing on miRNAs, between cachexia and sarcopenia to understand a facet in the underlying muscle wasting associated with these morbidities and disclose potential therapeutic interventions.
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Agus A, Agus S, Suka A. Interleukin-15 is a significant predictor of sarcopenia in human immunodeficiency virus infected patients on antiretroviral therapy: A cross-sectional study. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.354418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Sarcopenia predicts adverse outcomes in an elderly population with coronary artery disease: a systematic review and meta-analysis. BMC Geriatr 2021; 21:493. [PMID: 34521369 PMCID: PMC8439080 DOI: 10.1186/s12877-021-02438-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/26/2021] [Indexed: 01/07/2023] Open
Abstract
Background The development of sarcopenia is attributed to normal aging and factors like type 2 diabetes, obesity, inactivity, reduced testosterone levels, and malnutrition, which are factors of poor prognosis in patients with coronary artery disease (CAD). This study aimed to perform a meta-analysis to assess whether preoperative sarcopenia can be used to predict the outcomes after cardiac surgery in elderly patients with CAD. Methods PubMed, Embase, the Cochrane library, and Web of Science were searched for available papers published up to December 2020. The primary outcome was major adverse cardiovascular outcomes (MACE). The secondary outcomes were mortality and heart failure (HF)-related hospitalization. The random-effects model was used. Hazard ratios (HRs) with 95% confidence intervals (95%CIs) were estimated. Results Ten studies were included, with 3707 patients followed for 6 months to 4.5 ± 2.3 years. The sarcopenia population had a higher rate of MACE compared to the non-sarcopenia population (HR = 2.27, 95%CI: 1.58–3.27, P < 0.001; I2 = 60.0%, Pheterogeneity = 0.02). The association between sarcopenia and MACE was significant when using the psoas muscle area index (PMI) to define sarcopenia (HR = 2.86, 95%CI: 1.84–4.46, P < 0.001; I2 = 0%, Pheterogeneity = 0.604). Sarcopenia was not associated with higher late mortality (HR = 2.15, 95%CI: 0.89–5.22, P = 0.090; I2 = 91.0%, Pheterogeneity < 0.001), all-cause mortality (HR = 1.35, 95%CI: 0.14–12.84, P = 0.792; I2 = 90.5%, Pheterogeneity = 0.001), and death, HF-related hospitalization (HR = 1.37, 95%CI: 0.59–3.16, P = 0.459; I2 = 62.0%, Pheterogeneity = 0.105). The sensitivity analysis revealed no outlying study in the analysis of the association between sarcopenia and MACE after coronary intervention. Conclusion Sarcopenia is associated with poor MACE outcomes in patients with CAD. The results could help determine subpopulations of patients needing special monitoring after CAD surgery. The present study included several kinds of participants; although non-heterogeneity was found, interpretation should be cautious. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02438-w.
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11
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Almeida TSD, Cortez AF, Cruz MRD, Almeida VPD. Predictors of sarcopenia in young hospitalized patients living with HIV. Braz J Infect Dis 2021; 25:101574. [PMID: 33861970 PMCID: PMC9392175 DOI: 10.1016/j.bjid.2021.101574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/08/2021] [Accepted: 03/27/2021] [Indexed: 11/20/2022] Open
Abstract
The prevalence of sarcopenia in hospitalized people living with HIV is underdiagnosed, as assessment instruments are not always available. This study aimed to identify factors related to sarcopenia, correlating their anthropometric and clinical markers in hospitalized people living with HIV. This was an observational cross-sectional clinical study, carried out from September 2018 through October 2019. Handgrip strength, muscle mass index, calf circumference and gait speed test were evaluated in recruited patients within three days of hospital admission. The sample consisted in 44 patients, mostly men (66%), black (68%), young adults (41.65 ± 12.18 years) and immunodeficient (CD4 cell count 165 cells/mm3 [34.25–295.5]). Sarcopenia was present in 25% of the sample. Calf circumference showed a significant correlation with CD4 cell count and viral load (p < 0.05) while handgrip strength and gait speed test did not. Calf circumference > 31 cm and gait speed test > 0.8 m/s reduced the chance of sarcopenia by 60% (OR = 0.396 [−1.67 to −0.18]; p < 0.05) and 98% (OR = 0.02 [−8.16 to 0.13]; p < 0.05) respectively. Calf circumference > 31 cm and gait speed test > 0.8 m/s are associated with a reduced chance of sarcopenia in hospitalized HIV patients.
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Affiliation(s)
| | | | - Mônica Rodrigues da Cruz
- Oswaldo Cruz Foundation (Fiocruz), Pedro Ernesto University Hospital, (UERJ), Evandro Chagas National Institute of Infectious Diseases, Rio de Janeiro, RJ, Brazil.
| | - Vívian Pinto de Almeida
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Hospital Universitário Gaffrée e Guinle, Department of Physical Therapy, Rio de Janeiro, RJ, Brazil.
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12
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Oliveira VHF, Borsari AL, Cárdenas JDG, Alves Junior CM, Castro NF, Marinello PC, Padilha CS, Webel AR, Erlandson KM, Deminice R. Low Agreement Between Initial and Revised European Consensus on Definition and Diagnosis of Sarcopenia Applied to People Living With HIV. J Acquir Immune Defic Syndr 2021; 86:e106-e113. [PMID: 33230028 DOI: 10.1097/qai.0000000000002576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND In 2019, the European Working Group on Sarcopenia in Older People (EWGSOP2) proposed low muscle strength as the primary outcome for sarcopenia diagnosis instead of low muscle mass, as proposed in 2010 (EWGSOP1). Therefore, the aim of this study was to compare the prevalence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions in people living with HIV (PLHIV) and to determine the agreement and correlation between different tests proposed by EWGSOP2. SETTING Cross-sectional study, where 302 PLHIV (151 men), 51.7 ± 9.0 years old were evaluated for the presence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions. METHODS Appendicular skeletal muscle was estimated using bioimpedance analysis. Handgrip strength, chair stand, gait speed, and static balance were used as muscle function measures. Agreement was determined using Cohen kappa and Pearson correlation coefficient was calculated. RESULTS Sarcopenia prevalence was 4.3% using EWGSOP1 and 1.0% using EWGSOP2. Agreement for sarcopenia diagnosis between EWGSOP1 and EWGSOP2 was fair (k = 0.37, P < 0.01). From the 13 cases of sarcopenia diagnosed using EWGSOP1, only 3 cases (23.1%) were also diagnosed using EWGSOP2. A medium correlation (r = -0.32, P < 0.01) and poor agreement (k = 0.14, P < 0.01) between muscle strength tests (handgrip strength and chair stand) were observed. Concordance between handgrip and chair stand was observed in 11 participants only, whereas 65 participants were considered to have low muscle strength using chair stand but not using handgrip. CONCLUSIONS Lower sarcopenia prevalence using EWGSOP2 and low agreement between EWGSOP1 and EWGSOP2 operational definitions in diagnosing sarcopenia were observed in PLHIV.
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Affiliation(s)
- Vitor H F Oliveira
- Department of Physical Education, Londrina State University, Londrina, Paraná, Brazil.,Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Ana L Borsari
- Department of Physical Education, Londrina State University, Londrina, Paraná, Brazil
| | | | | | - Noemy F Castro
- Salgado Institute of Integral Health, Londrina, Paraná, Brazil
| | - Poliana C Marinello
- Biological Sciences Center, Londrina State University, Londrina, Paraná, Brazil
| | - Camila S Padilha
- Department of Physical Education, State University of São Paulo, Presidente Prudente, São Paulo, Brazil; and
| | - Allison R Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | | | - Rafael Deminice
- Department of Physical Education, Londrina State University, Londrina, Paraná, Brazil
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13
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de Almeida LL, Ilha TASH, de Carvalho JAM, Stein C, Caeran G, Comim FV, Moresco RN, Haygert CJP, Compston JE, Premaor MO. Sarcopenia and Its Association with Vertebral Fractures in People Living with HIV. Calcif Tissue Int 2020; 107:249-256. [PMID: 32683475 DOI: 10.1007/s00223-020-00718-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/29/2020] [Indexed: 01/23/2023]
Abstract
The prevalence of chronic diseases is increasing in people living with HIV (PLHIV) in the post ART era. Sarcopenia is prevalent in the elderly and is associated with many chronic diseases. Our study aimed to evaluate the frequency of sarcopenia in PLHIV and its association with bone mineral density and fracture. A cross-sectional study was carried out at Santa Maria, South Brazil. It included PLHV age ≥ 50 years and registered to receive antiretroviral therapy. A structured questionnaire was applied, blood samples collected, muscle strength evaluated, body composition measured, and vertebral morphometry performed. Sarcopenia and presarcopenia were defined according to the European Working Group on Sarcopenia in Older People. Of the 101 patients recruited, 83 underwent DXA and muscle strength measurements. The prevalence of sarcopenia and presarcopenia in the individuals studied was 12% and 16.9%, respectively. 66.7% of sarcopenic individuals had morphometric vertebral fractures and there was a tendency towards a higher frequency of multiple vertebral fractures when compared with non-sarcopenic subjects (44.4% vs. 16.2%, p = 0.066). BMI and total hip BMD were significantly lower in sarcopenic than non-sarcopenic individuals (p ≥ 0.035 and 0.032 respectively). In multiple regression analysis, sarcopenia was associated with age and multiple vertebral fractures. Sarcopenia was present in 12% of this population of PLHIV age ≥ 50 years and was associated with lower hip BMD and a high prevalence of vertebral fractures.
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Affiliation(s)
| | | | | | | | | | - Fabio V Comim
- Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Melissa O Premaor
- Federal University of Minas Gerais, Belo Horizonte, Brazil.
- Departamento de Clínica Médica, Universidade Federal de Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190 - sala 246, Belo Horizonte, MG, Brazil.
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14
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Abstract
PLHIV have an increased risk of osteoporosis and fractures when compared with people of the same age and sex. In this review, we address the epidemiology and the pathophysiology of bone disease and fractures in PLHIV. The assessment of fracture risk and fracture prevention in these subjects is also discussed. The spectrum of HIV-associated disease has changed dramatically since the introduction of potent antiretroviral drugs. Today, the survival of people living with HIV (PLHIV) is close to that of the general population. However, the longer life-span in PLHIV is accompanied by an increased prevalence of chronic diseases. Detrimental effects on bone health are well recognised, with an increased risk of osteoporosis and fractures, including vertebral fractures, compared to the general population. The causes of bone disease in PLHIV are not fully understood, but include HIV-specific risk factors such as use of antiretrovirals and the presence of chronic inflammation, as well as traditional risk factors for fracture. Current guidelines recommend the use of FRAX to assess fracture probability in PLHIV age ≥ 40 years and measurement of bone mineral density in those at increased fracture risk. Vitamin D deficiency, if present, should be treated. Bisphosphonates have been shown to increase bone density in PLHIV although fracture outcomes are not available.
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Affiliation(s)
- M O Premaor
- Department of Clinical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - J E Compston
- Department of Medicine, Cambridge Biomedical Campus, Cambridge, UK
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15
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Yamanashi H, Nobusue K, Nonaka F, Honda Y, Shimizu Y, Kawashiri SY, Izumida M, Kubo Y, Tamai M, Nagata Y, Yanagihara K, Kulkarni B, Kinra S, Kawakami A, Maeda T. Human T-cell lymphotropic virus type-1 infection associated with sarcopenia: community-based cross-sectional study in Goto, Japan. Aging (Albany NY) 2020; 12:15504-15513. [PMID: 32706758 PMCID: PMC7467371 DOI: 10.18632/aging.103736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/07/2020] [Indexed: 11/25/2022]
Abstract
Sarcopenia is characterized by a progressive skeletal muscle disorder that involves the loss of muscle mass and low muscle strength, which contributes to increased adverse outcomes. Few studies have investigated the association between chronic infection and sarcopenia. This study aimed to examine the association between human T-cell lymphotropic virus type-1 (HTLV-1) and sarcopenia. We conducted a cross-sectional study and enrolled 2,811 participants aged ≥ 40 years from a prospective cohort study in Japanese community dwellers during 2017-2019. Sarcopenia was defined as low appendicular skeletal muscle mass and low handgrip strength. The association between HTLV-1 seropositivity and sarcopenia was assessed using multivariable logistic regression. Odds ratio (OR) and 95% confidence interval (CI) of sarcopenia were analysed using HTLV-1 seropositivity. We adjusted for age, sex, body mass index, physical activity, systolic blood pressure, glycated haemoglobin, low-density lipoprotein cholesterol, and smoking and drinking status. Of 2,811 participants, 484 (17.2%) HTLV-1 infected participants were detected. HTLV-1 infection was significantly associated with sarcopenia (adjusted OR 1.46, 95% CI 1.03-2.07, P = 0.034). HTLV-1 was associated with sarcopenia among community-dwelling adults. Active surveillance and early detection of asymptomatic HTLV-1 infection might be beneficial to reinforce countermeasures to inhibit the progress of HTLV infection-associated sarcopenia.
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Affiliation(s)
- Hirotomo Yamanashi
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8501, Japan.,Department of Infectious Diseases, Nagasaki University Hospital, Sakamoto, Nagasaki 852-8501, Japan.,Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki 852-8523, Japan
| | - Kenichi Nobusue
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki 852-8523, Japan.,Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Nagasaki 853-8691, Japan
| | - Fumiaki Nonaka
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Nagasaki 853-8691, Japan
| | - Yukiko Honda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Yuji Shimizu
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan.,Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Mai Izumida
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8501, Japan.,Department of Infectious Diseases, Nagasaki University Hospital, Sakamoto, Nagasaki 852-8501, Japan.,Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki 852-8523, Japan
| | - Yoshinao Kubo
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki 852-8523, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Yasuhiro Nagata
- Department of Innovative Development of Human Resources for Comprehensive Community Care, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Bharati Kulkarni
- Clinical Division, National Institute of Nutrition, Hyderabad 500007, India
| | - Sanjay Kinra
- Clinical Division, National Institute of Nutrition, Hyderabad 500007, India.,Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8501, Japan.,Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Nagasaki 853-8691, Japan.,Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki 852-8523, Japan
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16
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Oliveira VHF, Borsari AL, Webel AR, Erlandson KM, Deminice R. Sarcopenia in people living with the Human Immunodeficiency Virus: a systematic review and meta-analysis. Eur J Clin Nutr 2020; 74:1009-1021. [PMID: 32341489 DOI: 10.1038/s41430-020-0637-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 01/05/2023]
Abstract
People living with HIV (PLHIV) experience greater loss of muscle mass and function than people without HIV. However, HIV is not routinely recognized as a sarcopenia risk factor outside of HIV literature. The purposes of this study were to establish the prevalence and predictors of sarcopenia among PLHIV, and to compare the prevalence of sarcopenia among PLHIV and people without HIV. A systematic literature search of the PubMed, Embase, Cinahl, and Scielo databases was performed following PRISMA and MOOSE guidelines. Identified articles were included if they evaluated sarcopenia among PLHIV using either the presence of low muscle mass only or low muscle mass in association with low muscle function. The pooled prevalence of sarcopenia among PLHIV and the odds ratio for sarcopenia in PLHIV compared with controls were calculated. From 13 studies and 2267 participants, the prevalence of sarcopenia among PLHIV was 24.1% (95% CI = 17.8-31.0%). PLHIV presented 6.1 greater odds (95% CI = 1.1-33.5) of sarcopenia compared with people without HIV, matched by age, sex, BMI, and ethnicity. Longer exposure to specific HIV drugs, tobacco and alcohol, lower education and employment rates, and greater HIV duration were associated with sarcopenia. In conclusion, PLHIV had a high prevalence of sarcopenia, related to both HIV and non-HIV risk factors. HIV should be considered a risk factor for sarcopenia in the general population. CRD42019131449.
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Affiliation(s)
- Vitor H F Oliveira
- Department of Physical Education, State University of Londrina, Londrina, Paraná, Brazil.
| | - Ana L Borsari
- Department of Physical Education, State University of Londrina, Londrina, Paraná, Brazil
| | - Allison R Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | | | - Rafael Deminice
- Department of Physical Education, State University of Londrina, Londrina, Paraná, Brazil
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17
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Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020; 21:300-307.e2. [PMID: 32033882 DOI: 10.1016/j.jamda.2019.12.012] [Citation(s) in RCA: 2683] [Impact Index Per Article: 670.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022]
Abstract
Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong S.A.R., China.
| | - Prasert Assantachai
- Division of Geriatric Medicine, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tung-Wai Auyeung
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Ming-Yueh Chou
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Jenny S W Lee
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Chih-Kuang Liang
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wee Shiong Lim
- Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ken Sugimoto
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoki Tanaka
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Teimei Zhang
- Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Health, Beijing, China
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
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18
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Bonato M, Turrini F, Galli L, Banfi G, Cinque P. The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1283. [PMID: 32079244 PMCID: PMC7068546 DOI: 10.3390/ijerph17041283] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/15/2022]
Abstract
Sarcopenia is a physiopathological process associated with aging, caused by reduction of muscle strength, muscle quality and physical performance, and associated with an increased risk of falls, physical disability and premature death. There is no effective treatment for sarcopenia, but physical exercise seems to be highly effective at counteracting the decline in muscle mass and strength associated with aging. Recently, sarcopenia has been recognized as an emerging issue in people living with HIV (PLWH). Despite adequate treatment with combination antiretroviral therapy (cART), PLWH may exhibit an early occurrence of some aging-related conditions, including sarcopenia, frailty and falls, and this is likely resulting from high rates of comorbidities, high-risk behaviours, chronic immune activation and cART-specific factors. In this review, we discuss the potential mechanisms and the clinical relevance of sarcopenia in PLWH, and present data from longitudinal studies of physical activity in this population. Despite none of these studies having specifically addressed the benefits of physical exercise on sarcopenia, there is evidence that exercise is effective to increase aerobic capacity and muscle strength, and to improve body composition and inflammatory outcomes in PLWH. Therefore, the expected benefits of physical exercise are likely to translate into a successful and specific intervention for prevention and treatment of sarcopenia in this population.
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Affiliation(s)
- Matteo Bonato
- IRCSS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy;
| | - Filippo Turrini
- IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (F.T.); (L.G.); (P.C.)
- Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Laura Galli
- IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (F.T.); (L.G.); (P.C.)
| | - Giuseppe Banfi
- IRCSS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy;
- Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Paola Cinque
- IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (F.T.); (L.G.); (P.C.)
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19
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Assessment of sarcopenia in virally suppressed HIV-infected Asians receiving treatment: Erratum. AIDS 2019; 33:769. [PMID: 30829751 DOI: 10.1097/01.aids.0000554204.38139.5a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Falutz J, Kirkland S, Guaraldi G. Geriatric Syndromes in People Living with HIV Associated with Ageing and Increasing Comorbidities: Implications for Neurocognitive Complications of HIV Infection. Curr Top Behav Neurosci 2019; 50:301-327. [PMID: 31907879 DOI: 10.1007/7854_2019_119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Long-term survival of treated people living with HIV (PLWH) currently approaches that of the general population. The average age of PLWH is currently in the mid-50s in resource-rich countries and is predicted that over 40% of PLWH will be older than 60 within a decade. Similar trends have been confirmed in all communities of PLWH with access to antiretroviral therapies. However, the positive impact on survival has been challenged by several developments. Ageing PLWH have clinical features similar to the general population about 5-10 years older. In addition to the earlier occurrence of common age-related conditions common geriatric syndromes have also impacted this population prematurely. These are often difficult to evaluate and manage conditions usually of multifactorial aetiology. They include polypharmacy, frailty, impaired mobility and falls, sarcopenia, sensory impairment, and increasingly, non-dementing cognitive decline. Cognitive decline is of particular concern to PLWH and their care providers. In the general geriatric population cognitive impairment increases with age and occurs in all populations with a prevalence of over 25% in people over 80. Effective treatments are lacking and therefore minimizing risk factors plays an important role in maintaining healthspan. In the general population geriatric syndromes may increase the risk of cognitive decline. The corollary is that decreasing the risk of their development may limit cognitive impairment. Whether a similar status holds in PLWH is uncertain. This chapter will address the question of whether common geriatric syndromes in PLWH contribute to cognitive impairment. Common risk factors may provide clues to limit or delay cognitive decline.
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Affiliation(s)
- Julian Falutz
- McGill University Health Centre, Montreal, QC, Canada.
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