Elevated serum adiponectin and tumor necrosis factor-α and decreased transthyretin in Japanese elderly women with low grip strength and preserved muscle mass and insulin sensitivity

Association of anemia with hyperadiponectinemia in oldest-old Japanese women who resided at home alone without wheelchair use

The association of anemia with hyperadiponectinemia (HAN) (≥ 20 μg/mL) was studied in 95 Japanese women aged 65-74 (young-old), 175 women aged 75-84 (old-old), and 51 women aged over 85 (oldest-old) who resided at home alone without wheelchair use. The prevalence of anemia was 21.5% overall and increased with aging stepwise (9.5, 22.9, and 39.2% in young-olds, old-olds, and oldest-olds, respectively, p < 0.001). Most of the anemia was normocytic and only one woman had hemoglobin < 10 g/dL. Old-olds with anemia had low serum iron, albumin, and cholesterol and a higher prevalence of renal insufficiency (30.0 versus 5.2%, p < 0.001). In contrast, these variables did not differ between anemic and non-anemic young-olds. oldest-olds with anemia had low serum iron and higher adiponectin concentrations (22.8 ± 9.8 vs. 16.0 ± 6.7 μg/mL, p = 0.005) and prevalence of HAN (60.0 vs. 19.4%, p = 0.006) and renal insufficiency (50.0 vs. 0%, p < 0.001). However, inflammatory markers did not differ between anemic and non-anemic oldest-olds. The prevalence of anemia was higher in oldest-olds with versus without HAN (66.7 vs. 24.2%, p = 0.006). In multivariable logistic regression analysis, anemia was associated with HAN (OR: 15.7, 95% CI 1.2-207, p = 0.03) in oldest-olds and with renal insufficiency (OR: 7.1, 95% CI 2.4-21.0, p < 0.001) in old-olds. In conclusion, the association of anemia with HAN was evident in oldest-old Japanese women, suggesting the anti-inflammatory properties of circulating adiponectin.

The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review

BACKGROUND

Zinc (Zn) deficiency, malnutrition, sarcopenia, and frailty are prevalent among older adults and are prominent factors contributing to disability and mortality.

OBJECTIVE

This scoping review was conducted to aid understanding of the extent and types of research addressing the role of Zn in nutritional status, sarcopenia, and frailty, among older individuals.

METHOD

A systematic search was performed in August 2022 of 3 electronic databases (PubMed, Web of Science, and ProQuest) using predefined search terms. The review was conducted referring to the Arksey and O'Malley framework and PRISMA-ScR.

RESULTS

The search retrieved 16 018 records, and a total of 49 studies were included in this review after the screening. Of those, 30 were based on dietary Zn intake, 18 on tissue Zn levels, and 1 on both. Most studies were based on cross-sectional data from community-dwelling older adults. Studies addressing the associations between Zn status and individual anthropometric and sarcopenia-related variables reported inconsistent results. However, most studies reported inverse associations between malnutrition, frailty, and Zn status.

CONCLUSION

There was more consistent evidence of the relationship of Zn status with malnutrition, sarcopenia, and frailty rather than with individual nutritional parameters. Validated screening and assessment tools and criteria and prospective studies are required to elucidate the relationship of Zn with sarcopenia and frailty in the older population.

Low handgrip strength is associated with diabetic foot disease in geriatric patients with type 2 diabetes

BACKGROUND

This study aims to reveal the prevalence of low handgrip strength in older patients with type 2 diabetes who have diabetic foot disease and to assess the association of handgrip strength with diabetic foot disease in older patients with type 2 diabetes.

METHODS

Eighty-nine geriatric patients with diabetic foot ulcers and 69 patients without diabetic foot ulcers who presented to the endocrinology outpatient clinic between August 2020 and November 2021 were included in the study. The exclusion criteria were the usage of steroids, stroke-induced quadriplegia, myopathy, disability, hemodialysis treatment, type 1 diabetes, patients under 65 years of age, and history of malignancy. The information of drugs administered, demographic and clinical data were obtained from the patient files. The Wagner score was used to evaluate the severity of ulcers. A handgrip strength test was performed with a handheld digital dynamometer. For females <16 kg (kilograms), for males <27 kg was accepted as low handgrip strength.

RESULTS

Forty-nine patients (55.1%) with diabetic foot ulcers and 25 (36.2%) patients without diabetic foot ulcers had low handgrip strength. There was a significant difference between two groups (p = 0.019). The patients with diabetic foot ulcers who had lower handgrip strength had higher rates of peripheral artery disease than patients with diabetic foot ulcers who had normal handgrip strength (p = 0.02 and p = 0.009, respectively). The patients with diabetic foot ulcers who had lower handgrip strength, had significantly higher rates of Wagner scores 4 and 5 and lower rates of Wagner scores 1 and 3 (p = 0.039).

DISCUSSION

Older patients with type 2 diabetes and diabetic foot disease had a higher rate of low handgrip strength. Low handgrip strength was significantly associated with the occurrence of diabetic foot ulcers and directly correlated with Wagner score in geriatric patients with type 2 diabetes.

Changes and Risk Factors of Skeletal Muscle Mass and Strength in Patients with Type 2 Diabetes over 60 Years Old: A Cross-Sectional Study from China

OBJECTIVE

The accelerate loss of skeletal muscle mass, strength, and function, named sarcopenia, is a progressive and generalised skeletal muscle disorder, and it is always associated with increased outcomes including falls, frailty, and disability. Diabetes mellitus is associated with significant muscle and physical complications. We aimed at clarifying the changes and risk factors of skeletal muscle mass and strength in elderly with type 2 diabetes.

METHODS

The study consisted of patients with type 2 diabetes (n = 120) and an older general population (n = 126). The skeletal muscle mass and muscle strength, as well as the serum levels of chronic inflammation, oxidative stress, homocysteine, and insulin-like factor-1 were assessed, and the correlation and regression analysis were conducted to evaluate outcomes.

RESULTS

T2DM patients exhibited lower muscle strength compared with the non-T2DM subjects (P < 0.01). Among T2DM patients, serum IGF-1 levels were positively correlated with muscle strength (r = 0.255, P < 0.01) and muscle mass (r = 0.209, P < 0.05), levels of 8-OHdG were inversely correlated with muscle strength (r = -0.252, P < 0.01), and there was a negative association between HCY and muscle mass (r = -0.185, P < 0.05). Muscle mass and strength of patients with higher education level were significantly higher than those with lower education level (P < 0.05), in male patients, muscle mass and muscle strength were significantly lower in smokers (P < 0.01), and muscle mass was lower in chronic drinkers (P < 0.05).

CONCLUSIONS

These findings suggest that diabetic patients may be more susceptible to sarcopenia at an older age. And it also provides evidences that among elderly with diabetes mellitus, oxidative damage and HCY as well as IGF-1 are important predictors of age-dependent sarcopenia.