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Bellos I, Marinaki S, Lagiou P, Boletis IN, Koster A, van Greevenbroek MMJ, Eussen SJPM, Savelberg HHCM, Wesselius A, Benetou V. Association of kidney function with physical performance: the Maastricht study. J Nephrol 2024:10.1007/s40620-024-01933-8. [PMID: 38594601 DOI: 10.1007/s40620-024-01933-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Kidney failure has been associated with decreased physical capacity, although evidence regarding the physical performance of individuals with earlier stages of chronic kidney disease (CKD) remains limited. METHODS Cross-sectional data were derived from the prospective, population-based Maastricht Study. Multivariate linear regression models were fitted to assess the association of estimated glomerular filtration rate (eGFR) and albuminuria categories with physical performance test outcomes. RESULTS Overall, 7396 participants were included. Compared to eGFR 60-90 ml/min/1.73 m2, values < 60 ml/min/1.73 m2 were associated with significantly shorter 6-min walk distance (β: - 13.04 m, 95% confidence intervals-CI - 19.95; - 6.13), worse timed chair rise stand test time (β: 0.91 s, 95% CI 0.36; 1.47), lower maximal grip (β: - 0.83 kg, 95% CI - 1.50; - 0.15) and elbow flexion (β: - 3.64 Nm, 95% CI - 7.11; - 0.16) strength. Additionally, eGFR > 90 ml/min/1.73 m2 was linked to significantly shorter 6-min walk distance (β: - 6.13 m, 95% CI - 9.44; - 2.82). Urinary albumin excretion > 30 mg/24 h was associated with shorter 6-min walk distance (β: - 12.48 m, 95% CI - 18.28; - 6.68), worse timed chair rise stand test time (β: 0.51 s, 95% CI 0.11; 1.06), lower maximal grip (β: - 1.34 kg, 95% CI - 1.91; - 0.76) and elbow flexion strength (β: - 3.31 Nm, 95% CI - 5.80; - 0.82). CONCLUSIONS Reduced eGFR and higher albuminuria levels were associated with worse physical performance, especially shorter 6-min walk distance and lower muscle strength. The relationship between eGFR and physical function was non-linear, with also high eGFR values being associated with worse performance, especially in the six-minute walk test.
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Affiliation(s)
- Ioannis Bellos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
- Department of Nephrology and Renal Transplantation, Laiko General Hospital, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527, Athens, Greece.
| | - Smaragdi Marinaki
- Department of Nephrology and Renal Transplantation, Laiko General Hospital, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis N Boletis
- Department of Nephrology and Renal Transplantation, Laiko General Hospital, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 11527, Athens, Greece
| | - Annemarie Koster
- CAPRHI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Marleen M J van Greevenbroek
- CAPRHI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Human Biology and Movement Science, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Simone J P M Eussen
- CAPRHI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, 6229ER, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, 6229ER, The Netherlands
| | - Hans H C M Savelberg
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Anke Wesselius
- Department of Epidemiology, Maastricht University, Maastricht, 6229ER, The Netherlands
- School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, 6229ER, The Netherlands
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Liu Y, Chai S, Zhang X. Effect of sarcopenia, osteoporosis, and osteosarcopenia on spine fracture in American adults with prediabetes. Front Endocrinol (Lausanne) 2023; 14:1163029. [PMID: 37152953 PMCID: PMC10154554 DOI: 10.3389/fendo.2023.1163029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Objective This study aimed to investigate the effect of sarcopenia, osteoporosis, and osteosarcopenia on spine fracture in patients with prediabetes. Methods We collected and analyzed the data from the U.S. National Health and Nutrition Examination Surveys during the period from 2009 to 2018. Bone mineral density and the skeletal muscle mass index (SMI) were measured with dual-energy X-ray absorptiometry (DXA). The diagnosis of spine fracture was based on DXA and history. Results People with prediabetes were more likely to develop sarcopenia than normal glucose tolerance subjects (OR 1.33, 95% CI 1.07-1.66), while there was no significant increase of osteoporosis in prediabetes (OR 0.91, 95% CI 0.78-1.05). The SMI was independently associated with osteoporosis in prediabetes adults (OR 0.65, 95% CI 0.50-0.85). Both sarcopenia and osteoporosis were positively associated with spine fracture in prediabetes (OR 4.44, 95% CI 1.76-11.21, and OR 2.90, 95% CI 1.85-4.56, respectively). The risk of spine fracture was substantially higher in the presence of osteosarcopenia (OR 6.63; 95% CI, 1.34-32.94) than in the presence of sarcopenia or osteoporosis alone in prediabetes. Conclusion In adults with prediabetes, both sarcopenia and osteoporosis are risk factors for spine fracture, and the combination of sarcopenia and osteoporosis further increases the prevalence of spine fracture.
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Kaga H, Tamura Y, Someya Y, Naito H, Tabata H, Kakehi S, Yamasaki N, Sato M, Kadowaki S, Suzuki R, Sugimoto D, Kawamori R, Watada H. Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study. J Cachexia Sarcopenia Muscle 2022; 13:2835-2842. [PMID: 36052707 PMCID: PMC9745500 DOI: 10.1002/jcsm.13074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/16/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sarcopenia is a major cause of disability in the elderly. Although type 2 diabetes is a risk factor for increased sarcopenia, the relationship between prediabetes and sarcopenia has not been elucidated. We aimed to examine the relationship between sarcopenia and prediabetes. METHODS The design of this study is a cross-sectional study. We evaluated glucose metabolism using the 75-g oral glucose tolerance test and glycated haemoglobin, appendicular skeletal muscle mass, and hand grip strength in 1629 older adults living in an urban area of Tokyo, Japan. We investigated the frequency of sarcopenia in participants with normal glucose tolerance (NGT), prediabetes and diabetes. A multivariable logistic regression model was used to analyse the association between glucose tolerance and the prevalence of sarcopenia. RESULTS The mean age of participants was 73.1 ± 5.4 years. In men, 44.3% had NGT, 26.6% had prediabetes, and 29.1% had diabetes. In women, the distribution was 56.1%, 28.8% and 15.2%. The prevalence of sarcopenia was 12.7% in men and 11.9% in women. Logistic regression revealed that prediabetes and diabetes are independent risk factors for sarcopenia in men (prediabetes, odds ratio [OR] = 2.081 [95% confidence interval {CI}: 1.031-4.199]; diabetes, OR = 2.614 [95% CI: 1.362-5.018]) and diabetes, but not prediabetes, is an independent risk factor for sarcopenia in women (prediabetes, OR = 1.036 [95% CI: 0.611-1.757]; diabetes, OR = 2.099 [95% CI: 1.146-3.844]). In both sexes, higher age (men, OR = 1.086 [95% CI: 1.028-1.146]; women, OR = 1.195 [95% CI: 1.142-1.251]), higher body fat percentage (men, OR = 1.346 [95% CI: 1.240-1.461]; women, OR = 1.218 [95% CI: 1.138-1.303]) and lower body mass index (men, OR = 0.371 [95% CI: 0.299-0.461]; women, OR = 0.498 [95% CI: 0.419-0.593]) were independent risk factors for sarcopenia. CONCLUSIONS Although we confirmed that diabetes mellitus is associated with sarcopenia in both sexes, prediabetes is associated with sarcopenia in men, but not in women.
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Affiliation(s)
- Hideyoshi Kaga
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshifumi Tamura
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hitoshi Naito
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroki Tabata
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Saori Kakehi
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nozomu Yamasaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Motonori Sato
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Satoshi Kadowaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ruriko Suzuki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Daisuke Sugimoto
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryuzo Kawamori
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Wen C, Lien AS, Jiang Y. Sarcopenia in Elderly Diabetes. J Diabetes Investig 2022; 13:944-946. [PMID: 35048543 PMCID: PMC9153845 DOI: 10.1111/jdi.13752] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Chen‐Yu Wen
- Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
| | - Angela Shin‐Yu Lien
- School of nursing college of medicine and Healthy Aging Research Center Chang Gung University Taoyuan Taiwan
- Division of Endocrinology and Metabolism Department of Internal Medicine Chang Gung Memorial Hospital‐Linko Taoyuan Taiwan
| | - Yi‐Der Jiang
- Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
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