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Najm A, Niculescu AG, Grumezescu AM, Beuran M. Emerging Therapeutic Strategies in Sarcopenia: An Updated Review on Pathogenesis and Treatment Advances. Int J Mol Sci 2024; 25:4300. [PMID: 38673885 PMCID: PMC11050002 DOI: 10.3390/ijms25084300] [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: 03/17/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Sarcopenia is a prevalent degenerative skeletal muscle condition in the elderly population, posing a tremendous burden on diseased individuals and healthcare systems worldwide. Conventionally, sarcopenia is currently managed through nutritional interventions, physical therapy, and lifestyle modification, with no pharmaceutical agents being approved for specific use in this disease. As the pathogenesis of sarcopenia is still poorly understood and there is no treatment recognized as universally effective, recent research efforts have been directed at better comprehending this illness and diversifying treatment strategies. In this respect, this paper overviews the new advances in sarcopenia treatment in correlation with its underlying mechanisms. Specifically, this review creates an updated framework for sarcopenia, describing its etiology, pathogenesis, risk factors, and conventional treatments, further discussing emerging therapeutic approaches like new drug formulations, drug delivery systems, stem cell therapies, and tissue-engineered scaffolds in more detail.
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Affiliation(s)
- Alfred Najm
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari, Sector 5, 050474 Bucharest, Romania; (A.N.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania
| | - Adelina-Gabriela Niculescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 011061 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 011061 Bucharest, Romania
| | - Mircea Beuran
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari, Sector 5, 050474 Bucharest, Romania; (A.N.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania
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Wu Y, Wang Z, Fang Y. Association of Performance on Multiple Cognitive Domains with Sarcopenia among Middle-Aged and Older Adults. Dement Geriatr Cogn Disord 2024; 53:162-167. [PMID: 38593753 DOI: 10.1159/000538751] [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: 01/24/2024] [Accepted: 04/05/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION The relationship between cognitive function and subsequent sarcopenia remains unclear. Therefore, this study aimed to examine the associations of performance on multiple cognitive domains with sarcopenia in the middle-aged and older adults. METHODS This longitudinal analysis (wave 2011-2013) included 2,934 participants from the CHARLS study. Sarcopenia was defined by the Asian Sarcopenia Working Group 2019 criteria. Cognitive function was measured by the Chinese version of the Mini-Mental State Examination (MMSE). Three interpretable techniques, namely SHapley Additive exPlanations (SHAP) and two built-in methods (coefficients of logistic regression and Gini importance of random forest), were used to assess the relationship between MMSE, its components (orientation, attention, episodic memory, and visuospatial ability) and sarcopenia. In addition, the association of MMSE score and its components with sarcopenia was further validated using stepwise regression. RESULTS All interpretable methods showed that MMSE score was important predictors of sarcopenia, especially the SHAP (MMSE score ranked top one). For its components, episodic memory, visuospatial ability, and attention showed high predictive value compared with orientation. Stepwise regression analyses showed that MMSE score and its components of episodic memory and visuospatial ability were correlated with sarcopenia, with their odds ratios of 0.93 (95% CI: 0.91-0.96, p < 0.001), 0.87 (95% CI: 0.82-0.93, p < 0.001), and 1.32 (95% CI: 1.05-1.65, p = 0.016), respectively. CONCLUSIONS Better cognitive function especially episodic memory and visuospatial ability was negatively associated with incident sarcopenia among community middle-aged and older adults.
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Affiliation(s)
- Yafei Wu
- School of Public Health, Xiamen University, Xiamen, China,
| | - Zongjie Wang
- School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, China
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Lu CF, Liu WS, Cang XM, Sun X, Wang XQ, Wang CH, Xu F. The bidirectional associations between sarcopenia-related traits and cognitive performance. Sci Rep 2024; 14:7591. [PMID: 38555389 PMCID: PMC10981681 DOI: 10.1038/s41598-024-58416-w] [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: 09/09/2023] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
While many studies have sought to explore the degree to which sarcopenia-related traits are associated with cognitive performance, these studies have yielded contradictory results without any clear indication of the causality of such relationships. In efforts to better understand associations between sarcopenia-related traits and cognitive ability, a series of multivariate linear regression assessments were carried out upon datasets derived through the National Health and Nutrition Examination Survey (NHANES). Of these, cognitive performance was assessed by the Digit Symbol Substitution Test (DDST), the Consortium to Establish a Registry for Alzheimer's Disease Immediate Recall Test (CERAD-IR), Delayed Recall Test (CERAD-DR) and Animal Fluency Test (AFT). Causal relationships between the two were further inferred via a two-sample Mendelian randomization (MR) analysis approach. Sarcopenia-related traits considered in these assessments included walking speed, appendicular skeletal muscle mass (ASM), and hand grip strength (HGS). Walking speed, ASM, and HGS were all significantly independently related to cognitive scores following adjustment for covariates. MR assessments also identified that each 1-SD higher walking speed and appendicular lean mass were causally and respectively associated with a 0.34 [standard error (SE) = 0.09; p < 0.001)] standardized score higher and a 0.07 (SE = 0.01; p < 0.001) standardized score higher cognitive score, whereas a higher hand grip strength was positively associated with a better cognitive performance. Reverse MR assessments also yielded similar findings. These data suggest that lower walking speed, muscle strength, and muscle mass were all closely related to lower cognitive performance irrespective of gender, and that there may be a mutually reinforcing relationship among these variables.
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Grants
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- MB2020012, QNZ2022019, MS2022018, MB2021012, JCZ21099, MS2022027 Medical Research Project of Health Commission of Nantong
- HS2020005, JC202111 Science and Technology Support Program of Nantong
- HS2020005, JC202111 Science and Technology Support Program of Nantong
- MS22022001 Social and People's Livelihood Project of Nantong
- 2022LZ005 Clinical Research Program of Nantong University
- Social and People’s Livelihood Project of Nantong
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Affiliation(s)
- Chun-Feng Lu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Wang-Shu Liu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xiao-Min Cang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xin Sun
- Department of Anesthesiology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China
| | - Xue-Qin Wang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
| | - Chun-Hua Wang
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
| | - Feng Xu
- Department of Endocrinology, Nantong City No 1 People's Hospital and Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, 226001, China.
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Schütze K, Schopp M, Fairchild TJ, Needham M. Old muscle, new tricks: a clinician perspective on sarcopenia and where to next. Curr Opin Neurol 2023; 36:441-449. [PMID: 37501556 PMCID: PMC10487352 DOI: 10.1097/wco.0000000000001185] [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] [Indexed: 07/29/2023]
Abstract
PURPOSE OF REVIEW This review offers a contemporary clinical approach to the recognition, prevention and management of sarcopenia, and discusses recent clinically relevant advances in the aetiopathogenesis of muscle ageing that may lead to future therapeutic targets. RECENT FINDINGS The key recent directions for sarcopenia are in the diagnosis, understanding molecular mechanisms and management. Regarding the recognition of the condition, it has become increasingly clear that different definitions hamper progress in understanding. Therefore, the Global Leadership in Sarcopenia has been established in 2022 to develop a universally accepted definition. Moreover, substantial work is occurring to understand the various roles and contribution of inflammation, oxidative stress, mitochondrial dysfunction and metabolic dysregulation on skeletal muscle function and ageing. Finally, the role of resistance-based exercise regimes has been continually emphasised. However, the role of protein supplementation and hormone replacement therapy (HRT) are still under debate, and current clinical trials are underway. SUMMARY With the global ageing of our population, there is increasing emphasis on maintaining good health. Maintenance of skeletal muscle strength and function are key to preventing frailty, morbidity and death.
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Affiliation(s)
- Katie Schütze
- School of Medicine, The University of Notre Dame Australia, Fremantle
| | - Madeline Schopp
- School of Medicine, The University of Notre Dame Australia, Fremantle
| | - Timothy J. Fairchild
- Centre for Molecular Medicine & Innovative Therapeutics
- School of Allied Health, Murdoch University
| | - Merrilee Needham
- School of Medicine, The University of Notre Dame Australia, Fremantle
- Centre for Molecular Medicine & Innovative Therapeutics
- Perron Institute of Neurological and Translational Sciences, Nedlands
- Department of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Jang JY, Kim D, Kim ND. Pathogenesis, Intervention, and Current Status of Drug Development for Sarcopenia: A Review. Biomedicines 2023; 11:1635. [PMID: 37371730 DOI: 10.3390/biomedicines11061635] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Sarcopenia refers to the loss of muscle strength and mass in older individuals and is a major determinant of fall risk and impaired ability to perform activities of daily living, often leading to disability, loss of independence, and death. Owing to its impact on morbidity, mortality, and healthcare expenditure, sarcopenia in the elderly has become a major focus of research and public policy debates worldwide. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice, partly owing to the lack of available diagnostic testing and uniform diagnostic criteria. Since the World Health Organization and the United States assigned a disease code for sarcopenia in 2016, countries worldwide have assigned their own disease codes for sarcopenia. However, there are currently no approved pharmacological agents for the treatment of sarcopenia; therefore, interventions for sarcopenia primarily focus on physical therapy for muscle strengthening and gait training as well as adequate protein intake. In this review, we aimed to examine the latest information on the epidemiology, molecular mechanisms, interventions, and possible treatments with new drugs for sarcopenia.
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Affiliation(s)
- Jung Yoon Jang
- Department of Pharmacy, College of Pharmacy, Research Institute for Drug Development, Pusan National University, Busan 46241, Republic of Korea
| | - Donghwan Kim
- Functional Food Materials Research Group, Korea Food Research Institute, Wanju-gun 55365, Jeollabuk-do, Republic of Korea
| | - Nam Deuk Kim
- Department of Pharmacy, College of Pharmacy, Research Institute for Drug Development, Pusan National University, Busan 46241, Republic of Korea
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Du H, Yu M, Xue H, Lu X, Chang Y, Li Z. Association between sarcopenia and cognitive function in older Chinese adults: Evidence from the China health and retirement longitudinal study. Front Public Health 2023; 10:1078304. [PMID: 36703834 PMCID: PMC9871477 DOI: 10.3389/fpubh.2022.1078304] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background Sarcopenia and cognitive impairment are the most common causes of disability in the aging population. The potential role of sarcopenia in the development of cognitive impairment remains poorly understood. A cross-sectional analysis was performed using nationally representative data to evaluate associations between sarcopenia and cognition in China. Methods We included 2,391 participants (35.63% female) who were at least 60 years of age in 2015 from the China Health and Retirement Longitudinal Study (CHARLS). Muscle strength, appendicular skeletal mass (ASM), and physical performance measurements, were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia 2019 (AWGS2019). Cognitive function was assessed by 10 items in the Telephone Interview for Cognitive Status (TICS-10), delayed word recall, and graph drawing. Based on cognitive score tertiles, data were divided into three groups. Multiple linear and logistic regression models were used to assess the relationship between sarcopenia and cognition. Results The prevalence of possible sarcopenia was 27.16% for men and 27.46% for women. Cognitive decline was significantly associated with sarcopenia status (β = -0.88, p < 0.001) and negatively associated with components of sarcopenia in male group. The results remained consistent in male after further adjusting for creatinine, uric acid, blood sugar, etc. Low cognitive function in female was only associated with low muscle strength (β = -0.85, p = 0.02). In addition, participants with possible sarcopenia had greater risk of cognitive decline than those without sarcopenia (OR = 1.41; 95% CI: 1.06-1.87). However, the same association was not significant in female group. Conclusion We suggest that sarcopenia might be associated with cognition function, with possible sarcopenia being significantly associated with higher cognition risk in China population, which providing a further rationale for timely recognition and management of sarcopenia.
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Affiliation(s)
- Hongzhen Du
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Miao Yu
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongmei Xue
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Xuning Lu
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Yaping Chang
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Zengning Li
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China,*Correspondence: Zengning Li ✉
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7
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Portable Digital Monitoring System for Sarcopenia Screening and Diagnosis. Geriatrics (Basel) 2022; 7:geriatrics7060121. [PMID: 36412610 PMCID: PMC9680425 DOI: 10.3390/geriatrics7060121] [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: 08/31/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022] Open
Abstract
Sarcopenia is a well-known highly prevalent muscle disease that severely impairs overall physical performance in elders, inducing a massive health-related economic burden. The widespread screening, diagnosis and treatment of sarcopenia are pivotal to restrain the disease progression and constrain its societal impact. Simple-to-use, portable, and reliable methods to evaluate sarcopenia are scarce, and sarcopenia-related assessments are typically done in several time-consuming stages. This study presents a portable digital system that enables a simple and intuitive method to evaluate sarcopenia-based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm-including the four Find-Assess-Confirm-Severity (FACS) steps. The system comprises a mobile application (app); two wireless devices: a dynamometer (Gripwise) and a skinfold caliper (Lipowise); and a back-end website. To find cases, the SARC-F questionnaire is applied. To assess sarcopenia, the handgrip strength and the sit-to-stand tests are performed with the Gripwise and an application-embedded stopwatch, respectively. To confirm cases, anthropometric measures are performed, and muscle quantity is estimated with Lipowise. Finally, to assess severity, the app stopwatch grants the gait speed test application, evaluating physical performance. This step-by-step sarcopenia assessment results in a final grading according to the cut-off points of the EWGSOP2 criteria. All data is automatically encrypted and exported into a GDPR-compliant cloud platform, in which healthcare professionals can access and monitor their patients through the internet.
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Ikegami T, Nishikawa H, Goto M, Shimamoto F, Terazawa T, Yamaguchi T, Yamasaki E, Asaishi K, Nakamura S, Higuchi K. Prognostic Impact of Ectopic Fat Deposition within Psoas Muscle in Stage IV Gastric Cancer Patients Undergoing Systemic Chemotherapy. J Cancer 2022; 13:3477-3484. [PMID: 36313034 PMCID: PMC9608208 DOI: 10.7150/jca.78407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022] Open
Abstract
Aims: In this study, we focused on the fat ratio within psoas muscle (FRPM) and sought to clarify the impact of FRPM on overall survival (OS) in stage IV gastric cancer (GC) patients undergoing systemic chemotherapy (n = 79, median age = 69 years, 59 males). Methods: The median FRPM was 1.67 %. Forty patients with FRPM ≥1.67 % were defined as the FRPM-high group, and the remaining 39 patients was defined as the FRPM-low group. The median PMI in male and female patients was 4.35 cm2/m2 and 2.88 cm2/m2. Thirty male patients with PMI ≥4.35 cm2/m2 and 10 female patients with PMI ≥2.88 cm2/m2 was defined as the PMI-high group, and the remaining 39 patients was defined as the PMI-low group. Results: The 1-, 2- and 3- year cumulative OS rate for all cases was 70.8%, 24.3% and 14.6%. The proportion of ECOG-PS 2 or 3 in patients with FRPM-high and FRPM-low was 17.5% (7/40) and 2.6% (1/39). The 1-, 2- and 3- year cumulative OS rate in patients with FRPM-high and FRPM-low was 67.3%, 14.3% and 7.6% in the FRPM-high group and 74.8%, 40.5% and 32.4% in the FRPM-low group (P = 0.0341). The 1-, 2- and 3- year cumulative OS rate in patients with PMI-high and PMI-low was 86.7%, 40.4% and 30.0% in the PMI-high group and 55.8%, 12.8% and 6.4% in the PMI-low group (P < 0.0001). In the multivariate analysis of factors associated with OS, PMI (P = 0.0047) and FRPM (P = 0.0019) were independent predictors for the OS. Conclusion: Higher FRPM can be associated with decreased physical activity, and not only skeletal muscle mass but also skeletal muscle function can be an essential prognostic factor in stage IV GC patients undergoing systemic chemotherapy.
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Affiliation(s)
- Takako Ikegami
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan.,Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Hiroki Nishikawa
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan.,The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan.,✉ Corresponding author: ; Tel.: +81-726-83-1221
| | - Masahiro Goto
- Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Fukutaro Shimamoto
- Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Tetsuji Terazawa
- Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Toshifumi Yamaguchi
- Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Eiki Yamasaki
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Ken Asaishi
- Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Shiro Nakamura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
| | - Kazuhide Higuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-8686, Japan
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Mirzai S, Eck BL, Chen PH, Estep JD, Tang WHW. Current Approach to the Diagnosis of Sarcopenia in Heart Failure: A Narrative Review on the Role of Clinical and Imaging Assessments. Circ Heart Fail 2022; 15:e009322. [PMID: 35924562 PMCID: PMC9588634 DOI: 10.1161/circheartfailure.121.009322] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Sarcopenia has been established as a predictor of poor outcomes in various clinical settings. It is particularly prevalent in heart failure, a clinical syndrome that poses significant challenges to health care worldwide. Despite this, sarcopenia remains overlooked and undertreated in cardiology practice. Understanding the currently proposed diagnostic process is paramount for the early detection and treatment of sarcopenia to mitigate downstream adverse health outcomes.
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Affiliation(s)
- Saeid Mirzai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
| | - Brendan L. Eck
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Po-Hao Chen
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH
| | - Jerry D. Estep
- Department of Cardiology, Cleveland Clinic Florida, Weston, FL
| | - W. H. Wilson Tang
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
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Asaishi K, Matsui M, Nishikawa H, Goto M, Asai A, Ushiro K, Ogura T, Takeuchi T, Nakamura S, Kakimoto K, Miyazaki T, Fukunishi S, Ohama H, Yokohama K, Yasuoka H, Higuchi K. Grip Strength in Patients with Gastrointestinal Diseases. J Clin Med 2022; 11:jcm11082079. [PMID: 35456173 PMCID: PMC9025528 DOI: 10.3390/jcm11082079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
We sought to elucidate factors contributing to the grip strength (GS) decline in patients with gastrointestinal diseases (Ga-Ds, n = 602, 379 males, median age = 72 years). The GS decline in males and females was defined as <28 kg and <18 kg, respectively, following the current Asian guidelines. The median GS (male) was 28.8 kg, and GS decline (male) was found in 169 patients (44.6%). The median GS (female) was 17.5 kg, and GS decline (female) was found in 122 patients (54.7%). Advanced cancer was identified in 145 patients (24.1%). In terms of the univariate analysis of parameters of the GS decline, age (p < 0.0001), gender (p = 0.0181), body mass index (BMI, p = 0.0002), ECOG-PS (p < 0.0001), SARC-F score (p < 0.0001), hemoglobin value (p < 0.0001), total lymphocyte count (p < 0.0001), serum albumin value (p < 0.0001), C reactive protein (CRP) value (p < 0.0001), and estimated glomerular filtration rate were statistically significant. In terms of the multivariate analysis, age (p < 0.0001), BMI (p = 0.0223), hemoglobin value (p = 0.0186), serum albumin value (p = 0.0284), the SARC-F score (p = 0.0003), and CRP value (p < 0.0001) were independent parameters. In conclusion, the GS decline in patients with Ga-Ds is closely associated with not only the primary factor (i.e., aging) but also secondary factors such as inflammatory factors and nutritional factors.
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Affiliation(s)
- Ken Asaishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Masahiro Matsui
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hiroki Nishikawa
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
- Correspondence: ; Tel.: +81-726-83-1221
| | - Masahiro Goto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Akira Asai
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kosuke Ushiro
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takeshi Ogura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Toshihisa Takeuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Shiro Nakamura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuki Kakimoto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takako Miyazaki
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Shinya Fukunishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Hideko Ohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Keisuke Yokohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hidetaka Yasuoka
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuhide Higuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (K.A.); (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
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Matsui M, Nishikawa H, Goto M, Asai A, Ushiro K, Ogura T, Takeuchi T, Nakamura S, Kakimoto K, Miyazaki T, Fukunishi S, Ohama H, Yokohama K, Yasuoka H, Higuchi K. Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers. Cancers (Basel) 2021; 14:cancers14010010. [PMID: 35008175 PMCID: PMC8749778 DOI: 10.3390/cancers14010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary There have been few reports with regard to the relevance between the SARC-F score and the prognosis in patients with gastrointestinal advanced cancers, and we aimed to elucidate these issues (n = 421, median age = 73 years). During the follow-up period, 145 patients (34.4%) died. The 1-year cumulative overall survival rate in patients with SARC-F ≥ 4 (recommended cutoff point, n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the overall survival, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score 1 (p = 0.0147) and 2 (p < 0.0001), ECOG-PS 2 (p < 0.0001), and 3 (p < 0.0001) and 4 (p < 0.0001) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and the best cutoff point of the SARC-F score was two. The SARC-F score appears to be useful in patients with gastrointestinal advanced malignancies. Abstract We sought to elucidate the prognostic impact of the SARC-F score among patients with gastrointestinal advanced malignancies (n = 421). A SARC-F score ≥ 4 was judged to have a strong suspicion for sarcopenia. In patients with ECOG-PS 4 (n = 43), 3 (n = 61), and 0–2 (n = 317), 42 (97.7%), 53 (86.9%) and 8 (2.5%) had the SARC-F score ≥ 4. During the follow-up period, 145 patients (34.4%) died. All deaths were cancer-related. The 1-year cumulative overall survival (OS) rate in patients with SARC-F ≥ 4 (n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the OS, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score (GPS) 1 (p = 0.0147, GPS 0 as a standard), GPS 2 (p < 0.0001, GPS 0 as a standard), ECOG-PS 2 (p < 0.0001, ECOG-PS 0 as a standard), ECOG-PS 3 (p < 0.0001, ECOG-PS 0 as a standard), and ECOG-PS 4 (p < 0.0001, ECOG-PS 0 as a standard) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and best cutoff point of the SARC-F score was two. In conclusion, the SARC-F score is useful in patients with gastrointestinal advanced malignancies.
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Affiliation(s)
- Masahiro Matsui
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hiroki Nishikawa
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
- Correspondence: ; Tel.: +81-726-831-221
| | - Masahiro Goto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Akira Asai
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kosuke Ushiro
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takeshi Ogura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Toshihisa Takeuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Shiro Nakamura
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuki Kakimoto
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Takako Miyazaki
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Shinya Fukunishi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
- The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan
| | - Hideko Ohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Keisuke Yokohama
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Hidetaka Yasuoka
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
| | - Kazuhide Higuchi
- The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (M.G.); (A.A.); (K.U.); (T.O.); (T.T.); (S.N.); (K.K.); (T.M.); (S.F.); (H.O.); (K.Y.); (H.Y.); (K.H.)
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Hypoalbuminemia Predicts Serious Complications Following Elective Bariatric Surgery. Obes Surg 2021; 31:4519-4527. [PMID: 34378157 DOI: 10.1007/s11695-021-05641-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The aims of this study were to (1) characterize the prevalence of hypoalbuminemia (HA), (2) compare complication rates among HA and non-HA patients, and (3) determine the influence of HA on postoperative complications and 30-day mortality among bariatric surgery patients. MATERIALS AND METHODS Data was extracted from the MBSAQIP registry from 2015 to 2018. A presurgical serum albumin level of [Formula: see text] 3.5 g/dL was used to organize the patient population into HA and non-HA cohorts. Bivariate analysis and multivariable logistic regression modeling were used. RESULTS Of 590,971 patients, 42,618 (7.2%) were identified as having serum albumin levels [Formula: see text] 3.5 g/dL. HA patients were younger (44.0 + / - 11.9 vs. 44.5 + / - 12.0 years; p < 0.0001), were of increased BMI (48.5 + / - 9.0 kg/m2 vs. 45.1 + / - 7.7 kg/m2; p < 0.0001), and had a lower baseline functional status (1.6% vs. 1.0% dependent or partially dependent; p < 0.0001). HA patients had more anastomotic leaks (0.46% vs. 0.38%; p = 0.02), deep surgical site infections (0.37% vs. 0.24%; p < 0.0001), and composite serious complications (4.4% vs. 3.3%; p < 0.0001). At 30-day post-operation, complications including need for reintervention (1.6% vs. 1.2%; p < 0.0001), readmission (4.8% vs. 3.7%; p < 0.0001), and mortality (0.14% vs. 0.086%; p = 0.001) were all more prevalent among HA patients. After functional status, HA was the strongest modifiable predictor of serious complications but was not predictive of 30-day mortality. CONCLUSION We identified HA as one of the greatest modifiable factors predictive of serious complications. Adoption of strategies to identify and improve preoperative serum albumin levels may reduce overall serious complications among elective bariatric surgery patients.
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Chiu E, Oleynick C, Raman M, Bielawska B. Optimizing Inpatient Nutrition Care of Adult Patients with Inflammatory Bowel Disease in the 21st Century. Nutrients 2021; 13:1581. [PMID: 34065070 PMCID: PMC8151132 DOI: 10.3390/nu13051581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022] Open
Abstract
Malnutrition is highly prevalent in inflammatory bowel disease (IBD) patients and disproportionately affects those admitted to hospital. Malnutrition is a risk factor for many complications in IBD, including prolonged hospitalization, infection, greater need for surgery, development of venous thromboembolism, post-operative complications, and mortality. Early screening for malnutrition and prompt nutrition intervention if indicated has been shown to prevent or mitigate many of these outlined risk factors. There are many causes of malnutrition in IBD including reduced oral food intake, medications, active inflammation, and prior surgical resections. Hospitalization can further compound pre-existing malnutrition through inappropriate diet restrictions, nil per os (NPO) for endoscopy and imaging, or partial bowel obstruction, resulting in "post-hospital syndrome" after discharge and readmission. The aim of this article is to inform clinicians of the prevalence and consequences of malnutrition in IBD, as well as available screening and assessment tools for diagnosis, and to offer an organized approach to the nutritional care of hospitalized adult IBD patients.
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Affiliation(s)
- Elaine Chiu
- Division of Gastroenterology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Chris Oleynick
- Division of Internal Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Maitreyi Raman
- Division of Gastroenterology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Barbara Bielawska
- Department of Medicine, Division of Gastroenterology, University of Ottawa, Ottawa, ON K1H 8L6, Canada;
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