Relationship between muscle strength and dyslipidemia, serum 25(OH)D, and weight status among diverse schoolchildren: a cross-sectional analysis

Sex-Specific Sarcopenia Prevalence and Risk Factors in the Korean Population: A Cross-Sectional Epidemiological Study

Background and Objective: This study aimed to identify the incidence of sarcopenia and disease risk factors in Korean adults and to provide data for sarcopenia prevention. Materials and Methods: Based on the Korea National Health and Nutrition Survey, 2008-2011, we selected 14,185 adults over the age of 20 who participated in sarcopenia diagnostic tests and health surveys. We analyzed sarcopenia risk factors using complex sample multi-logistic regression analysis. Results: The prevalence of sarcopenia in Korea was 31.3%, with 20.2% in men and 40.4% in women. In men, there was a higher risk of sarcopenia in those of older age, without a spouse, with a low body mass index (BMI), who never engage in resistance exercise, or who do mid-level intensity resistance exercises. In women, sarcopenia risk was higher in those in their 20s compared to those in their 60s, and risk factors included a low BMI, high-density lipoprotein cholesterol and waist circumference measurements, alcohol consumption, aerobic exercise, and resistance exercise. Conclusions: Interventions and lifestyle improvements will help prevent the onset of sarcopenia in elderly men and young women with risk factors such as a low BMI.

The association between serum vitamin D levels and abnormal lipid profile in pediatrics: A GRADE-assessed systematic review and dose-response meta-analysis of epidemiologic studies

CONTEXT

Several studies have investigated the relationship between serum vitamin D and dyslipidemia in children and adolescents, but the findings have been contradictory.

OBJECTIVE

The current systematic review and dose-response meta-analysis investigated the serum vitamin D - dyslipidemia relationship in children and adolescents.

DATA SOURCES

ISI Web of Science, Scopus, MEDLINE (PubMed), EMBASE databases, and Google Scholar, were searched up to December 2022.

DATA EXTRACTION

Observational studies that investigated the odds of dyslipidemia in categories of serum vitamin D levels in children were included, and their data were extracted.

DATA ANALYSIS

Pooling of 17 effect sizes from 15 studies (39 342 participants) showed that subjects with higher serum vitamin D had 27% lower odds of hypertriglyceridemia (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.60, 0.88). A meta-analysis of 18 effect sizes from 16 studies (39 718 participants) illustrated that highest vs lowest serum vitamin D was related to 22% lower odds of low high-density lipoprotein cholesterol (HDL-c) (OR = 0.78; 95% CI: 0.66, 0.91). Also, a nonlinear association between serum vitamin D and odds of abnormal lipid profile was found: elevating values of 25-hydroxyvitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in odds of hypertriglyceridemia, hyper low-density lipoprotein cholesterolemia, hypercholesterolemia, and hypo HDL-cholesterolemia. However, no significant linear association was observed. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the certainty of all evidence was rated as high.

CONCLUSION

This meta-analysis revealed that the level of 25-hydroxyvitamin D was inversely related to odds of abnormal serum triglycerides and HDL-c in children and adolescents. Increasing serum vitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in the odds of abnormal serum triglycerides, HDL-c, low-density lipoprotein cholesterol, and total cholesterol in children.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. 42023400787.

Causal relationship between lipid profile and muscle atrophy: A bi-directional Mendelian randomization study

BACKGROUND

The aim of this study was to analyze the bi-directional causal relationship between lipid profile and characteristics related to muscle atrophy by using a bi-directional Mendelian randomization (MR) analysis.

METHODS

The appendicular lean mass (ALM), whole body fat-free mass (WBFFM) and trunk fat-free mass (TFFM) were used as genome-wide association study (GWAS) data for evaluating muscle mass; the usual walking pace (UWP) and low grip strength (LGS) were used as GWAS data for evaluating muscle strength; and the triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), apolipoprotein A-1 (Apo A-1), and apolipoprotein B (Apo B) were used as GWAS data for evaluating lipid profile. For specific investigations, we mainly employed inverse variance weighting for causal estimation and MR-Egger for pleiotropy analysis.

RESULTS

MR results showed that the lipid profile predicted by genetic variants was negatively correlated with muscle mass, positively correlated with UWP, and was not causally correlated with LGS. On the other hand, the muscle mass predicted by genetic variants was negatively correlated with lipid profile, the UWP predicted by genetic variants was mainly positively correlated with lipid profile, while the LGS predicted by genetic variants had no relevant causal relationship with lipid profile.

CONCLUSIONS

Findings of this MR analysis suggest that hyperlipidemia may affect muscle mass and lead to muscle atrophy, but has no significant effect on muscle strength. On the other hand, increased muscle mass may reduce the incidence of dyslipidemia.

Eating Behavior and Factors of Metabolic Health in Primary Schoolchildren: A Cross-Sectional Study in Greek Children

Childhood obesity has been associated with altered blood lipids and bad eating habits. In this cross-sectional study, we assessed cardiorespiratory fitness and metabolic health markers in regard to weight status and dietary habits in schoolchildren. In 134 children (6-11 years), we conducted: (1) Anthropometry, namely z-score BMI (z-BMI), waist-to-height ratio (WHtR), and body composition analysis. (2) Measurements of handgrip strength (HGS), resting metabolic rate (RMR) and VO2max. (3) Quantification of blood lipids and antioxidant vitamins A, E, C. (4) Eating breakfast assessment. About 35% of children were overweight/obese. The z-BMI positively correlated with WHtR (r = 0.637, p < 0.001), and adversely correlated with fat-free mass (r = -0.728, p < 0.001) and vitamin E (r = -0.286, p < 0.001). RMR and VO2max were greater in normal weight children compared to those with overweight/obesity (p < 0.001). HGS did not differ between these groups, but was negatively correlated with dyslipidemia as shown by TG/HDL-C ratio (r = -0.224, p = 0.037). According to regression analysis, eating breakfast routinely at home was positively associated with RMR and adversely associated with z-BMI. Hence, regular breakfast consumption at home may improve RMR in kids. Cardiorespiratory fitness and physical strength are key modulators of metabolic health in Greek children added to a social determinant of health i.e., eating breakfast at home.

Targeting Sarcopenia as an Objective Clinical Outcome in the Care of Children with Spinal Cord-Related Paralysis: A Clinician's View

Muscle loss is consistently associated with immobility and paralysis and triggers significant metabolic and functional changes. The negative effects of sarcopenia are amplified in children who are in the process of building their muscle mass as part of development. Because muscle mass loss is consistently associated with increased morbidity and mortality throughout life, optimizing the size and health of muscles following a neurologic injury is an objective target for therapeutic interventions. This review hypothesizes that muscle mass correlates with functional outcomes in children with paralysis related to spinal cord-related neurologic deficits. We propose that the measurement of muscle mass in this population can be used as an objective outcome for clinical long-term care. Finally, some practical clinical approaches to improving muscle mass are presented.

Relationship between lipid profiles and reduced handgrip strength (dynapenia) in hospitalized patients with cirrhosis

BACKGROUND

Dynapenia embraces clinical significance and predictive value separated from skeletal muscle loss among cirrhosis. Moreover, alterations in lipid levels may impact muscle function. It has yet to elucidate the relationship between lipid profiles and muscle strength weakness. We sought to explore which lipid metabolism indicator could be useful to identify patients with dynapenia in daily practice.

METHODS

A retrospective observational cohort study enrolling 262 cirrhotic patients. Analysis of the receiver operating characteristic (ROC) curve was performed to determine the discriminatory cutoff for dynapenia. Multivariate logistic regression was conducted to assess the association between total cholesterol (TC) and dynapenia. Also, we established a model based on the classification and regression tree method.

RESULTS

ROC implicated a cutoff of TC ≤ 3.37 mmol/L to identify dynapenia. Patients with TC ≤ 3.37 mmol/L showed significantly lower handgrip strength (HGS; 20.0 vs. 24.7 kg, P  = 0.003), lower hemoglobin, lower platelet, lower white blood cell count, lower sodium and higher prothrombin-international normalized ratio. A positive correlation was found between TC and HGS values ( r  = 0.1860, P  = 0.003). TC remained a significant association with dynapenia after controlling for variables including age, sex, BMI, and the presence of ascites. The decision tree incorporating TC, BMI, and age had a sensitivity of 71.4%, specificity of 64.9%, and an area under ROC of 0.681.

CONCLUSION

TC ≤ 3.37 mmol/L was significantly associated with the presence of dynapenia. Assessing TC may be helpful for identifying dynapenic patients with cirrhosis in the health care or hospital setting.

Muscle Wasting among Hospitalized Children: A Narrative Review of the Feasibility and Accuracy of Diagnostic Methods

Muscle wasting is associated with a worse quality of life and increased morbidity and mortality among hospitalized children, especially those with chronic diseases. This review was conducted to summarize the data available on the most feasible and accurate diagnostic methods for detecting muscle wasting among hospitalized children, especially to review the evidence of the accuracy and feasibility of conducting assessments using handgrip strength (HGS). Many diagnostic methods are used in hospital settings to assess muscle wasting, by evaluating either muscle mass or strength, with evidentiary support for assessing muscle mass provided using ultrasonography, magnetic resonance imaging, computed tomography, dual-energy X-ray, bioelectrical impedance analysis, and anthropometry measurements. Currently, the most common diagnostic method used to detect muscle strength loss is the handheld dynamometer. Studies support using HGS among healthy and hospitalized children to assess the overall nutritional status and especially muscle function. However, almost all of these studies have been conducted in hospital settings and recruited children with different chronic diseases using a small sample size. More longitudinal cohort studies with large sample sizes are needed to assess the accuracy and feasibility of using HGS among hospitalized children.

Association of handgrip strength with anthropometry of a Brazilian healthy adolescent sample

The importance of dynamometric and anthropometric information for industry is known; however, few studies have investigated the relationship between anthropometry and handgrip strength (HGS) in adolescents. The aim of the present study was to investigate the association of anthropometric variables with the level of HGS production in adolescents. Participants were 541 adolescents aged 12-16 years from a public school in the city of Rio de Janeiro. The behavior of the following variables was examined: the ability to generate HGS, age, total body mass, height and hand dimensions (hand width, hand span, hand length). The results showed an increase in the ability to generate HGS in adolescence and a significant difference between the genders from 13 years old, where boys generated higher HGS values. Correlations between HGS and total body mass and the hand width stood out in both genders, indicating a greater association.

Obesity-Related Factors in Adult Women with Early Menarche

The average menarche age among South Korean women has decreased over time. Early menarche in women causes a higher incidence of obesity owing to the continuous fat accumulation induced by prolonged exposure to estrogen and adrenal steroids. Identifying the factors affecting obesity in women who experience early menarche is essential for managing obesity in adult women. This study aimed to analyze the factors associated with obesity in adult women who experienced early menarche and to provide basic data for obesity management. This study was a cross-sectional and descriptive survey from the seventh Korea National Health and Nutrition Examination. A total of 371 women aged ≥ 19 years experienced early menarche, and the propensity matching method was used to analyze the obesity-related factors identified in previous studies. The results showed that obesity in adult women with early menarche was negatively associated with the level of aerobic exercise (OR = 0.53, 95% CI = 0.30-0.93, p = 0.028) and muscle-strengthening exercise (OR = 0.33, 95% CI = 0.17-0.64, p = 0.001). Future longitudinal studies on girls who experience early menarche are needed to address female obesity prevention at every stage of life, and, based on these findings, obesity management programs can be developed and applied and their effectiveness determined.

Diazoxide improves muscle function in association with improved dyslipidemia and decreased muscle oxidative stress in streptozotocin-induced diabetic rats

AIM/INTRODUCTION

Diabetes Mellitus is a chronic degenerative disease, and its main biochemical characteristic is hyperglycemia due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. Hyperglycemia causes dyslipidemia and stimulates oxidative damage, leading to the main symptoms, such as fatigue and culminates in diabetic complications. Previous studies have shown that ATP-sensitive potassium channels counteract muscle fatigue and metabolic stress in healthy mouse models. To determine the effect of diazoxide on muscle strength development during diabetes, we tested the effect of diazoxide in streptozotocin-diabetic rats in muscle function, lipid profile and oxidative stress biomarkers.

MATERIALS AND METHODS

Wistar rats were divided into 4 groups of six animals each: (1) Control group, (2) diabetes group, (3) Control group + diazoxide, and (4) Diabetic + diazoxide (DB + DZX). 4 weeks after rats were sacrificed, soleus and extensor digitorum longus muscles (EDL) were extracted to prepare homogenates and serum was obtained for biochemical measurements. Oxidative damage was evaluated by the thiobarbituric acid method and the fluorescent for reactive oxygen species (ROS) probe 2,4-H₂DCFDA, respectively.

RESULTS

Diabetic rats with diazoxide administration showed an increase in the development of muscle strength in both muscles; in turn, the onset of fatigue was longer compared to the group of diabetic rats without treatment. Regarding the lipid profile, diazoxide decreased total cholesterol levels in the group of diabetic rats treated with diazoxide (x̅46.2 mg/dL) compared to the untreated diabetic group (x̅=104.4 mg/dL); secondly, diazoxide decreased triglyceride concentrations (x̅=105.3 mg/dL) compared to the untreated diabetic rats (x̅=412.2 mg/dL) as well as the levels of very low-density lipoproteins (x̅=20.4 mg/dL vs. x̅=82.44 mg/dL). Regarding the various markers of oxidative stress, the diabetic group treated with diazoxide was able to reduce the concentrations of TBARS and total reactive oxygen species as well as preserve the concentrations of reduced glutathione.

CONCLUSION

Diazoxide administration in diabetic rats increases muscle strength development in EDL and soleus muscle, decreases fatigue, reduces cholesterol and triglyceride concentrations and improves oxidative stress parameters such as TBARS, ROS, and glutathione status.

Handgrip Strength Cutoff Value Among Korean Adolescents with Metabolic Syndrome Components: Korean National Health and Nutrition Examination Survey Data 2014-2017

Abstract Objectives: To propose the cutoff value of handgrip strength (HGS) for each metabolic syndrome component in Korean adolescents. Methods: Total of 2303 adolescents (1226 boys and 1077 girls; age 10-18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2017. We used the International Diabetes Federation metabolic syndrome guideline for children to define metabolic syndrome. The highest HGS for both hands were recorded. The optimal HGS cutoff for predicting metabolic syndrome components was determined by receiver operating characteristic curve analysis. Results: Adolescents with metabolic syndrome components defined by each criterion had higher HGS, systolic blood pressure, waist circumference, body mass index, fasting glucose, cholesterol, triglyceride (TG), alanine aminotransferase, and aspartate aminotransferase compared with average participants' data. The cutoff value of HGS defining waist circumference, TG level, high-density lipoprotein, and blood pressure was 24, 21.5, 30.9, and 30.2, respectively. The cutoff value of HGS defining metabolic syndrome was 28.9. For HGS to body weight ratio, the cutoff value defining metabolic syndrome was 0.38. Conclusions: This study showed that cutoff values of HGS have relation with metabolic syndrome in adolescents. Although cutoff has been suggested, it may not be sufficient for clinical use. Additional data are need to be accumulated in actual clinical trials for more accurate cutoff HGS value.

Stroke-Related Sarcopenia among Two Different Developing Countries with Diverse Ethnic Backgrounds (Cross-National Study in Egypt and China)

The prevalence of stroke-related sarcopenia differs according to the diagnostic criteria, the cut-off point for assessment, and ethnicity. Egypt and China are developing countries with different races where no research concerning stroke-related sarcopenia has been performed yet. We aimed to evaluate the prevalence of possible sarcopenia and confirmed sarcopenia among Egyptian and Chinese stroke survivors using the Asian Working Group of Sarcopenia (AWGS-2019) criteria and to assess the variables associated with the prevalence rate. A prospective cross-sectional study was carried out among 200 Egyptian and 195 Chinese stroke survivors from 2019 to 2021 using a structural health questionnaire. A hand-held dynamometer was used to measure grip strength. Anthropometric measures were used to estimate muscle mass. Data were analyzed using SPSS statistics version 20. p-values < 0.05 were considered statistically significant. The prevalence of possible sarcopenia ranged from 20.0% to 34.4% among Egyptian and Chinese groups, except for the Egyptian females where it was 52.0%. The prevalence of sarcopenia in both populations ranged from 13.6% to 18.6%. Pre-stroke independent variables that accelerated possible sarcopenia were age, history of dyslipidemia, diabetes mellitus, and ischemic heart disease, but stroke severity was a post-stroke risk factor. Age was the only pre-stroke variable for sarcopenia, while quitting smoking and having good nutritional status were variables for the reduction of possible sarcopenia. Quitting smoking, having a good nutritional status, and early rehabilitation reduced sarcopenia development. Controlling vascular risk factors, enhancing rehabilitation, and nutritional therapy are protective measures against sarcopenia. Longitudinal studies are required to identify further risk factors.

Normative values for handgrip strength in Colombian children and adolescents from 6 to 17 years of age: estimation using quantile regression

OBJECTIVE

The objective of this study is twofold: i) to estimate the normative values for handgrip strength and relative handgrip strength, specific to sex and age, for Colombian children and adolescents from 6 to 17 years of age using quantile regression models and ii) to compare the normative values for handgrip strength and relative handgrip strength in Colombian children and adolescents with those in children and adolescents in different countries.

METHOD

This was a cross-sectional analysis of a sample of 2647 youngsters. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). The relative handgrip strength was estimated according to weight in kilograms. The normative values were estimated to handgrip strength and relative handgrip strength through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90, and P95 developed independently for each sex. All analyses were adjusted for the expansion factor.

RESULTS

The values for handgrip strength were considerably higher in males than in females in all age ranges. Additionally, as age increased for both sexes, the values for handgrip strength increased. The percentiles by sex and age for relative handgrip strength show for males a proportional increase according to age; for females, this did not occur.

CONCLUSIONS

When making comparisons with international studies, variability is observed in the methodologies used to evaluate handgrip strength and estimation methods, which could influence the discrepancies between the different reports.

Influences of Vitamin D and Iron Status on Skeletal Muscle Health: A Narrative Review

There is conflicting evidence of the roles vitamin D and iron have in isolation and combined in relation to muscle health. The purpose of this narrative review was to examine the current literature on the roles that vitamin D and iron have on skeletal muscle mass, strength, and function and how these nutrients are associated with skeletal muscle health in specific populations. Secondary purposes include exploring if low vitamin D and iron status are interrelated with skeletal muscle health and chronic inflammation and reviewing the influence of animal-source foods rich in these nutrients on health and performance. PubMed, Scopus, SPORT Discus, EMBAE, MEDLINE, and Google Scholar databases were searched to determine eligible studies. There was a positive effect of vitamin D on muscle mass, particularly in older adults. There was a positive effect of iron on aerobic and anaerobic performance. Studies reported mixed results for both vitamin D and iron on muscle strength and function. While vitamin D and iron deficiency commonly occur in combination, few studies examined effects on skeletal muscle health and inflammation. Isolated nutrients such as iron and vitamin D may have positive outcomes; however, nutrients within food sources may be most effective in improving skeletal muscle health.

Dietary Iron Restriction Improves Muscle Function, Dyslipidemia, and Decreased Muscle Oxidative Stress in Streptozotocin-Induced Diabetic Rats

Diabetes mellitus is a chronic degenerative disease characterized by hyperglycemia and oxidative stress. Iron catalyzes free radical overproduction. High iron concentrations have previously been reported to promote an increase in oxidative stress; however, the effect of iron restriction in diabetes has not yet been explored, so we tested to see if iron restriction in diabetic rats reduces oxidative damage and improved muscle function. Wistar rats were assigned to 4 groups: Control; Diabetic; Diabetic rats with a high iron diet, and Diabetic with dietary iron restriction. After 8 weeks the rats were sacrificed, the muscles were extracted to prepare homogenates, and serum was obtained for biochemical measurements. Low iron diabetic rats showed an increase in the development of muscle strength in both muscles. Dietary iron restriction decreased triglyceride concentrations compared to the untreated diabetic rats and the levels of extremely low-density lipoproteins. Aggravation of lipid peroxidation was observed in the diabetic group with a high iron diet, while these levels remained low with iron restriction. Iron restriction improved muscle strength development and reduced fatigue times; this was related to better lipid profile control and decreased oxidant stress markers.

Determinants of muscle power and force as assessed by Jumping Mechanography in rural Indian children

OBJECTIVES

To: 1. Assess muscle function (MF) of rural Indian children (6-11y, n=232), using Jumping Mechanography (JM) and hand dynamometer, 2. Investigate gender differences, 3. Identify determinants of MF.

METHODS

Data on anthropometry, muscle mass%, diet, physical activity, sunlight exposure, MF (maximum relative power Pmax/mass, maximum relative force Fmax/BW by JM; relative grip strength (RGS) by hand dynamometer) were collected. Pearson's correlation and hierarchical linear regression was performed.

RESULTS

Pmax/mass, Fmax/BW and RGS of the group were 31.7±5.0W/kg, 3.0±0.3 and 0.4±0.1 (mean±SD), respectively. The Pmax/mass Z-score was -1.1±0.9 and Fmax/BW Z-score was -0.9±1 (mean±SD) which was significantly lower than the machine reference data (p<0.05). Positive association of muscle mass% and protein intake was observed with all MF parameters and moderate+vigorous physical activity with Fmax/BW (p<0.05). Determinants of MF identified through regression for Pmax/mass were age (β=1.83,95% CI=0.973 - 2.686), muscle mass% (β=0.244,95% CI=0.131-0.358) and protein intake (β=3.211,95% CI=1.597-4.825) and for Fmax/BW was protein intake (β=0.130,95% CI=0.023-0.237) (p<0.05). Male gender was a positive predictor of having higher Pmax/mass (β=1.707,95% CI=0.040-3.373) (p<0.05).

CONCLUSION

MF was lower than in western counterparts. To optimize MF of rural Indian children, focus should be on improving muscle mass, ensuring adequate dietary protein, and increasing physical activity, especially in girls.

Muscular Fitness and Cardiometabolic Variables in Children and Adolescents: A Systematic Review

BACKGROUND

The importance of muscular fitness (MF) in the performance of activities of daily living is unequivocal. Additionally, emerging evidence has shown MF can reduce cardiometabolic risk in children and adolescents.

OBJECTIVES

The purpose of this study was to examine and summarize the evidence regarding the relationship between MF phenotypes (i.e., maximum muscular strength/power, muscular endurance, and maximum muscular strength/power/endurance) and cardiometabolic variables (obesity, blood pressure, lipids, glucose homeostasis, inflammatory markers, and clustered cardiometabolic variables) in children and adolescents.

DESIGN

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO, number CRD42020179273.

DATA SOURCES

A systematic review was performed on five databases (PubMed, EMBASE, SciELO, Scopus, and Web of Knowledge) from database inception to May 2020, with complementary searches in reference lists.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Eligibility criteria included (1) a study sample of youth aged ≤ 19 years, (2) an assessment of MF with individual or clustered cardiometabolic variables derived from adjusted models (regardless of test/measurement adopted or direction of reported association), and (3) a report of the association between both, using observational studies. Only original articles published in peer-reviewed journals in English, Portuguese, and Spanish languages were considered. The quality of the included studies was assessed by using the National Heart, Lung, and Blood Institute checklist. The percentage of results reporting a statistically significant inverse association between each MF phenotype and cardiometabolic variables was calculated.

RESULTS

Of the 23,686 articles initially identified, 96 were included (77 cross-sectional and 19 longitudinal), with data from children and adolescents from 35 countries. The score for the quality of evidence ranged from 0.33 to 0.92 (1.00 maximum). MF assessed by maximum muscular strength/power was inversely associated with lower obesity (64/113 total results (56.6%)) and reduction in clustered cardiometabolic risk (28/48 total results (58.3%)). When assessed by muscular endurance, an inverse association with obesity (30/44 total results (68.1%)) and cardiometabolic risk (5/8 total results (62.5%)) was identified. Most of the results for the relationship between MF phenotypes with blood pressure, lipids, glucose homeostasis, and inflammatory markers indicated a paucity of evidence for these interrelationships (percentage of results below 50.0%).

CONCLUSION

MF assessed by maximum muscular strength/power or muscular endurance is potentially associated with lower obesity and lower risk related to clustered cardiometabolic variables in children and adolescents. There is limited support for an inverse association between MF with blood pressure, lipids, glucose homeostasis biomarkers, and inflammatory markers in children and adolescents.

Relationship between vitamin D and physical activity: systematic review and meta-analysis

Abstract Vitamin D plays an important role in immune function and inflammation and the physical activity demonstrate relationship near to syntheses of vitamin D, considering to necessary to factors immunologics, environmental and physical. We searched five databases through February 20, 2021. Two reviewers screened the studies, collected data, assessed the risk of bias, and ranked the evidence for each outcome across the studies, independently and in duplicate. The prespecified endpoints of interest were Cardiorespiratory Fitness; Sunlight Exposure; Body Mass Index (BMI). We only included data from peer-reviewed articles in our primary analyses. In our primary analysis, there was a positive trend between serum 25(OH)D <20 ng/ml and body mass index, this result should be interpreted with caution, considering confidence intervals (RR 1.10 95% CI 0.37 to 1.83. We identified 4 high quality evidence that vitamin D levels and high physical activity required a direct relationship considering (four trials with 2,253) ; RR 0. (RR 0.0; 95% CI -0.15 to 0.15) (RR 0.59; 95% CI 0.43 to 0.75. Although the evidence available so far, from observational studies of medium quality, can be seen as showing a trend towards an association between sufficient serum levels of 25(OH)D and physical activity, this relationship has been shown. have a stimulating effect on vitamin D synthesis, the relationship of low body mass index with sufficient vitamin D levels is not based on solid evidence. We await results from ongoing studies to determine this effectiveness.

Using Body Composition Groups to Identify Children and Adolescents at Risk of Dyslipidemia

The impact of body composition on the early origin of chronic diseases is an increasingly appreciated phenomenon. Little is known about the characteristics of children with varying body composition. The aim of this study was to investigate serum lipid profiles and other characteristics in relation to body composition. The data of 1394 participants (aged 6 to <18 years) of the observational general population-based Austrian LEAD Study have been analyzed. Body composition groups were defined by appendicular lean mass (ALMI) and fat mass (FMI) indices assessed by DXA. Serum lipid profiles (triglycerides, LDL-c, HDL-c) and other characteristics (e.g., prematurity, smoke exposure, physical activity, nutrition) were investigated in these body composition groups. Different body composition groups, which are not distinguishable by BMI, exist. Children with high ALMI and high FMI showed higher triglycerides and LDL-c, but lower HDL-c levels. In contrast, levels did not differ between those with high FMI but low (or normal) ALMI, and other body composition groups. BMI should be interpreted cautiously, and body composition should be measured by more precise techniques. In particular, children and adolescents with high FMI who have concomitantly high ALMI should be followed closely in future studies to investigate whether they are at increased risk of cardiovascular problems.

Normalization of Muscle Strength Measurements in the Assessment of Cardiometabolic Risk Factors in Adolescents

Muscle strength (MS) has been associated with cardiometabolic risk factors (CMR) in adolescents, however, the impact attributed to body size in determining muscle strength or whether body size acts as a confounder in this relationship remains controversial. We investigated the association between absolute MS and MS normalized for body size with CMR in adolescents. This was a cross-sectional study comprising 351 adolescents (44.4% male; 16.6 ± 1.0 years) from Brazil. MS was assessed by handgrip and normalized for body weight, body mass index (BMI), height, and fat mass. CMR included obesity, high blood pressure, dyslipidemia, glucose imbalance, and high inflammation marker. When normalized for body weight, BMI, and fat mass, MS was inversely associated with the presence of two or more CMR among females. Absolute MS and MS normalized for height was directly associated with the presence of two or more CMR among males. This study suggests that MS normalized for body weight, BMI, and fat mass can be superior to absolute MS and MS normalized for height in representing lower CMR among females. Absolute MS and MS normalized for height were related to higher CMR among males.

Normative data for handgrip strength in Iranian healthy children and adolescents aged 7-18 years: comparison with international norms

BACKGROUND

Grip strength is an essential component of physical fitness. The objective of this study was to develop normative handgrip strength data for Iranian healthy boys and girls comparing their handgrip strength with international reference values.

METHODS

Handgrip strength was measured in 2637 healthy children/adolescents (1391 boys and 1246 girls), aged 7-18 years, using a standard adjustable Jamar hand dynamometer (Model 5030 J1, Sammons Preston Rolyan, Bolingbrook, IL, USA). Body mass (kg) and stature (cm) were measured and body mass index was computed in kg/m2. The sample was stratified by gender, age, and hand preference.

RESULTS

Handgrip strength increased with age and was considerably higher in boys than in girls for all age groups (p < 0.001). Grip strength had a parallel and linear growth for both genders until the age of about 11 years and showed a steeper upward slope in boys than in girls thereafter. The findings of the current investigation were significantly different from those of the previously published normative data, especially for boys over the age of 12 years and girls in the age range of 7-18 years (p < 0.001). This difference was mainly in such a way that the Iranians had lower handgrip strength.

CONCLUSIONS

The differences between present results and those of similar available in the literature in this field emphasize the significant role of using normative data specific to a particular population in research or clinical settings.

Relationships between Socioeconomic Status, Handgrip Strength, and Non-Alcoholic Fatty Liver Disease in Middle-Aged Adults

Although low socioeconomic status (SES) and decreased muscle strength have been found to be associated with the risk factors of non-alcoholic fatty liver disease (NAFLD), including insulin resistance, obesity, and metabolic syndrome, the associations among SES, muscle strength, and NAFLD are still unclear. We aimed to investigate the combined effect of SES and relative handgrip strength (HGS) on the risk of NAFLD in middle-aged adults. Data from 5272 middle-aged adults who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014–2018 were analyzed. NAFLD was defined using the hepatic steatosis index (HSI) > 36 and the comprehensive NAFLD score (CNS) ≥ 40 in the absence of other causes of liver disease. SES was based on a self-reported questionnaire. Overall, individuals with low SES (odds ratio (OR) = 1.703, 95% confidence interval (CI): 1.424–2.037, p < 0.001) or low HGS (OR = 12.161, 95% CI: 9.548–15.488, p < 0.001) had a significantly higher risk of NAFLD. The joint association analysis showed that a low SES combined with a low HGS (OR = 2.479, 95% CI: 1.351–4.549, p = 0.003) further significantly increased the risk of NAFLD when adjusted for all the covariates, compared with individuals with a high SES and a high HGS (OR = 1). The current findings suggest that both low SES and low HGS were independently and synergistically associated with an increased risk of NAFLD in middle-aged Korean adults.

Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach

Background

The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7–18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength.

Methods

Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7–18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure.

Results

No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance.

Conclusions

These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.

The role of serum levels of vitamin D in children's muscle strength: A systematic review

This review aims to investigate the different levels of vitamin D and its role in muscle strength in healthy children and non-athletes. A search conducted in three databases (PubMed, Scopus, and Psycinfo) resulted in 655 articles, which were systematically analyzed and selected based on the following criteria: (a) original cross-sectional studies and clinical trials; (b) healthy children aged 5-11 years; (c) no language restriction or year of publication; and (d) studies that assessed the possible relationship between vitamin D levels and muscle strength. Six studies were included because they met all the inclusion criteria. According to the findings of this review, factors such as sex, skin color, and vitamin D supplementation early in life modulate the levels of vitamin D in the body, and there is a relationship between muscle strength and vitamin D levels. Interestingly, vitamin D supplementation is not always significantly associated with increased muscle grip strength. However, there is a scarcity of studies that aim to analyze the possible effects of different levels of vitamin D on muscle function and neuromuscular variables in physically inactive children and non-athletes without previously diagnosed disease. Further studies are warranted in the future to address the gap in the literature.

The longitudinal relationship between dietary intake, physical activity and muscle strength among adolescents

The longitudinal relationship between muscle strength, dietary intake and physical activity among adolescents is not well understood. We investigated the trend and longitudinal effects of dietary intakes and physical activity scores on muscle strength in adolescents. This prospective cohort study consisted of 436 adolescents (134 males; 302 females) aged 13 years at baseline (2012) who were followed up at the ages of 15 (2014) and 17 (2016) years, respectively. We measured muscle strength using a calibrated hand dynamometer, estimated dietary intake with a 7-d dietary history and physical activity scores with a validated physical activity questionnaire for older children. A generalised estimating equation was used to examine the effect of dietary intakes and physical activity on muscle strength changes. The analysis was performed separately by sex. The muscle strength for males and females had increased within the 5-year period. The dietary intakes (energy and macronutrients) also increased initially but plateaued after the age of 15 years for both sexes. Females recorded a significant declining trend in physical activity scores compared with males as they grew older. A significant positive longitudinal relationship was found between protein (β = 0·035; P = 0·016), carbohydrate intake (β = 0·002; P = 0·013) and muscle strength among males. However, no longitudinal relationship was found between dietary intake, physical activity and muscle strength among females. Higher protein and carbohydrate intake among males was associated with higher muscle strength but was not observed in females. Nutrition and physical activity focusing on strength building are required in early adolescence and need to be tailored to males and females accordingly.

Relationship between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia occurrence rate in community-dwelling Chinese adults

Background

A study conducted on elderly Korean men showed that a high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio was associated with a high risk of developing sarcopenia. We aimed to determine such an association in community-dwelling Chinese adults.

Methods

From May 2016 to August 2017, we conducted a cross-sectional study on Chinese adults at the First Affiliated Hospital of Wenzhou Medical University. Univariate and multivariate logistic regression analyses were applied to evaluate a possible relationship between TG/HDL-C ratio and sarcopenia occurrence.

Results

We included 2613 adults in this study, with 13.85% presenting with sarcopenia. The odds ratios (ORs) for TG and HDL-C were 0.67 (95% confidence interval [CI]: 0.51–0.87), and 1.97 (95% CI: 1.49–2.61), respectively. Moreover, TG/HDL-C ratio was independently associated with sarcopenia status (OR: 0.63; 95% CI: 0.49–0.81).

Conclusions

We found that TG and HDL-C were, respectively, negatively and positively associated with sarcopenia occurrence rate in community-dwelling Chinese adults. However, a negative association was found between sarcopenia occurrence rate and TG/HDL-C ratio.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-020-01422-4.

Vitamin D status is associated with muscular strength in a nationally representative sample of US youth

AIM

To evaluate the association between serum 25-hydroxyvitamin D (25OHD) and muscular strength in a nationally representative sample of US youth.

METHODS

Participants (n = 3350) were 6- to 18-y-olds from 2011 to 2014 National Health and Nutrition Examination Survey. Relative handgrip strength was quantified using age- and sex-specific z-scores. Poor strength was defined as those <25th percentile. Multivariate general linear and logistic models were used to compare strength and poor strength status by clinically relevant groupings of 25OHD.

RESULTS

Approximately 20.2% of youth had 25OHD <50 nmol/L. Mean relative strength was highest for those at ≥75 nmol/L of 25OHD. The percentage of boys/girls with poor strength in the <50 nmol/L, 50-74.9 nmol/L and ≥75 nmol/L groups was 34.9%/32.3%, 25.8%/28.2% and 14.0%/15.8%, respectively. The odds of boys and girls with <50 nmol/L 25OHD having poor strength were 2.8 (95% CI: 1.4, 5.5) and 3.4 (1.7, 6.8) times higher compared to those with ≥75 nmol/L, respectively.

CONCLUSION

Higher levels of circulating vitamin D were associated with higher relative strength, and poor strength was more prevalent when 25OHD was <75 nmol/L. These findings highlight the value of vitamin D for the muscle-bone unit and potential extraskeletal ramifications.

Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014-2015 Korea National Health and Nutrition Examination Survey

BACKGROUND

Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia.

METHODS

We included 6,027 adults (2,934 men, 3,093 women) aged 30-69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia.

RESULTS

After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00-1.83), 1.29 (0.98-1.70), 1.23 (0.95- 1.60) in men and 1.81 (1.30-2.50), 1.81 (1.32-2.47), 1.39 (1.07-1.81) in women, respectively.

CONCLUSION

Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

Background: Recent studies in adult non-elderly and elderly individuals have reported a link between nonalcoholic fatty liver disease (NAFLD) and sarcopenia. Nonetheless, whether this relationship would be found outside these populations it is still unknown. Hence, we evaluated the relationship between NAFLD and skeletal muscle mass in children and adolescents with overweight/obesity. Methods: Two-hundred and thirty-four overweight/obese youths were enrolled. NAFLD was diagnosed by ultrasononography, after exclusion of infectious and metabolic disorders. Forty of the patients with NAFLD had also liver biopsy. Total and regional lean body mass and total fat mass measurements were obtained by dual-energy X-ray absorptiometry. The relative muscle mass (RMM) was defined as the percent of muscle mass (kg) relative to the sum of muscle and fat (kg) mass. Appendicular skeletal muscle mass (ASM) was calculated by the sum of muscle masses of the four limbs (kg), and expressed as percent of body weight. Results: Subjects were stratified according to tertiles of RMM. The prevalence of abdominal obesity, dyslipidemia, insulin resistance, metabolic syndrome, NAFLD as well as biopsy-proven nonalcoholic steatohepatitis (NASH) was significantly increased in the lowest tertile of RMM. After controlling for age, sex and Tanner stage, children in the lowest tertile of RMM had an increased risk for NAFLD (OR= 2.80, 95% CI=1.57-5.02) compared to those in the other two tertiles. This association persisted after additional adjustments for clinical and metabolic variables. Similarly, the risk of NAFLD in the lowest tertile of ASM/weight index was significantly higher compared to those in the other two tertiles after adjustment for the above confounders. Conclusions: This is the first study to establish an independent association between low muscle mass and NAFLD/NASH in overweight/obese youths. Considering the worldwide increase of pediatric obesity, measurements of muscle mass may serve as useful method of identifying among obese children those at high metabolic risk who may need intensive lifestyle interventions to prevent NAFLD and its progression.

Muscular Fitness Mediates the Association between 25-Hydroxyvitamin D and Areal Bone Mineral Density in Children with Overweight/Obesity

The association between vitamin D [25(OH)D] and bone health has been widely studied in children. Given that 25(OH)D and bone health are associated with muscular fitness, this could be the cornerstone to understand this relationship. Hence, the purpose of this work was to examine if the relation between 25(OH)D and areal bone mineral density (aBMD) was mediated by muscular fitness in children with overweight/obesity. Eighty-one children (8-11 years, 53 boys) with overweight/obesity were included. Body composition was measured with dual energy X-ray Absorptiometry (DXA), 25(OH)D was measured in plasma samples and muscular fitness was assessed by handgrip and standing long jump tests (averaged z-scores were used to represent overall muscular fitness). Simple mediation analyses controlling for sex, years from peak height velocity, lean mass and season were carried out. Our results showed that muscular fitness z-score, handgrip strength and standing long jump acted as mediators in the relationship between 25(OH)D and aBMD outcomes (percentages of mediation ranged from 49.6% to 68.3%). In conclusion, muscular fitness mediates the association of 25(OH)D with aBMD in children with overweight/obesity. Therefore, 25(OH)D benefits to bone health could be dependent on muscular fitness in young ages.

Dietary intake, physical activity and muscle strength among adolescents: the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study

OBJECTIVE

To examine the role of dietary intake and physical activity in muscle strength among adolescents.

DESIGN

Cross-sectional analysis.

SETTING

The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study.

PARTICIPANTS

Fifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014.

PRIMARY OUTCOME MEASURE

Muscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using a hand grip dynamometer.

RESULTS

Among the 1012 participants (395 male; 617 female), the hand grip strength of the males was higher than that of the females (27.08 kg vs 18.63 kg; p<0.001). Also, males were more active (2.43vs2.12; p<0.001) and consumed a higher amount of energy (2047 kcal vs 1738 kcal; p<0.001), carbohydrate (280.71 g vs 229.31 g; p<0.001) and protein (1.46 g/kg body weight (BW) vs 1.35 g/kg BW; p<0.168). After controlling for ethnicity, place of residency and body mass index, there was a positive relationship between hand grip strength and the intake of energy (r=0.14; p=0.006), carbohydrate (r=0.153; p=0.002) and fat (r=0.124; p=0.014) and the physical activity score (r=0.170; p=0.001) and a negative relationship between hand grip strength and the intake of protein (r=-0.134; p=0.008), for males. However, this was not observed among females.

CONCLUSIONS

Energy, carbohydrate and fat intakes and physical activity score were positively correlated with hand grip strength while protein intake was negatively correlated with hand grip strength in males but not in females.

Low muscle mass and strength in pediatrics patients: Why should we care?

Skeletal muscle plays major roles in metabolism and overall health across the lifecycle. Emerging evidence indicates that prenatal (maternal diet during pregnancy and genetic defects) and postnatal factors (physical activity, hormones, dietary protein, and obesity) influence muscle mass acquisition and strength early in life. As a consequence, low muscle mass and strength contributes to several adverse health outcomes during childhood. Specifically, studies demonstrated inverse associations of muscle mass and strength to single and clustered metabolic risk factors. The literature also consistently reports that low muscle mass and strength are associated with reduced bone parameters during growth, increasing the risk of osteoporosis in old age. Furthermore, muscle mass gains are associated with improved neurodevelopment in the first years of life. Given these negative implications of low muscle mass and strength on health, it is crucial to track muscle mass and strength development from childhood to adolescence. Several body composition techniques are currently available for estimation of muscle mass, all with unique advantages and disadvantages. The value of ultrasound as a technique to measure muscle mass is emerging in pediatric research with potential for translating the research findings to clinical settings. For the assessment of muscle strength, the handgrip strength test has been widely employed but without a standardized protocol. Although further research is needed to define normative data and cut points for the low muscle mass and strength phenotype, the use of such non-invasive medical monitoring is a promising strategy to identify early abnormalities and prevent low muscle mass in adulthood.