Associations between the quality of life in sarcopenia measured with the SarQoL® and nutritional status

Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis

BACKGROUND

Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors.

METHODS

Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis.

RESULTS

Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia.

CONCLUSIONS

Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.

Myosteatosis is associated with poor survival after kidney transplantation: a large retrospective cohort validation

PURPOSE

We aim to establish diagnostic thresholds of sarcopenia and myosteatosis based on CT measurements, and to validate their prognostic value in a large cohort of kidney transplant recipients.

METHODS

Local healthy population with abdominal CT between 2010 and 2022, and patients underwent kidney transplantation between 2015 and 2019 at our center were retrospectively included. The skeletal muscle index and muscle attenuation of abdominal muscles were calculated based on CT image at the middle of the third lumbar vertebra. Primary endpoints included all-cause mortality and death censored allograft survival.

RESULTS

Age- and sex-specific thresholds for sarcopenia and myosteatosis were established based on 1598 healthy local population. The final patient cohort consisted of 992 kidney transplant recipients (median age 34 years, interquartile range 28-44 years; 694 males), including 33 (3.3%) with sarcopenia and 95 (9.5%) with myosteatosis. Multivariate analysis revealed myosteatosis (adjusted hazard ratio = 3.08, p = 0.022) was an independent baseline risk factor of mortality after adjusting for age, the history of cancer, and the history of cardiovascular event. Multivariate analysis found preemptive transplantation (adjusted hazard ratio = 0.36, p = 0.037) was an independent protective factor of allograft loss. No difference was found in the prognosis between kidney transplant recipients with and without sarcopenia.

CONCLUSION

Myosteatosis was an independent risk factor of mortality after kidney transplantation, but sarcopenia was not. Neither sarcopenia nor myosteatosis was associated with graft loss.

Effect of Sarcopenia on the Prognosis of Clinical Outcomes in Patients With Hepatocellular Carcinoma After Hepatic Resection

BACKGROUND

We aimed to study the prognostic impact of sarcopenia on overall survival (OS), disease-free survival (DFS), and postoperative outcomes among patients with Hepatocellular carcinoma (HCC) who underwent curative hepatic resection.

METHODS

Data were collected retrospectively from patients with HCC underwent curative hepatic resection and preoperative abdominal computed tomography (CT) at our institution between January 2010 and December 2020. Sarcopenia was evaluated by the skeletal muscle mass at the inferior direction of the third-lumbar-vertebra (L3) cross-sectional area based on preoperative CT imaging using software analysis. Cutoff values for skeletal muscle index (SMI) were 43.75 and 41.10 cm2/m2 for males and females. The patients were classified into sarcopenia and nonsarcopenia groups. The association between preoperative sarcopenia and clinicopathological factors, impact of sarcopenia on survival, and postoperative outcomes were analyzed.

RESULTS

Sarcopenia was present in 39 of 83 (47.0%) patients who underwent curative hepatic resection for HCC and was significantly correlated with lower SMI, lower serum albumin levels, higher intraoperative blood loss, higher postoperative complications, and longer hospital stay. The 5-year OS was significantly lower in sarcopenic patients than in nonsarcopenic patients (58.2% vs 83.6%; P = .006), but the 5-year DFS was not significantly different between the 2 groups. Multivariate analysis revealed that sarcopenia was a significant risk factor for poor OS (HR 4.728; 95% CI, 1.458-15.329; P = .010).

CONCLUSION

Sarcopenia was identified as a prognostic factor for poor OS after hepatic resection, and major postoperative complications were more frequent in sarcopenia. Early sarcopenia detection and management may improve OS and clinical outcomes in postoperative HCC.

Machine Learning Applications in Sarcopenia Detection and Management: A Comprehensive Survey

This extensive review examines sarcopenia, a condition characterized by a loss of muscle mass, stamina, and physical performance, with a particular emphasis on its detection and management using contemporary technologies. It highlights the lack of global agreement or standardization regarding the definition of sarcopenia and the various techniques used to measure muscle mass, stamina, and physical performance. The distinctive criteria employed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGSOP) for diagnosing sarcopenia are examined, emphasizing potential obstacles in comparing research results across studies. The paper delves into the use of machine learning techniques in sarcopenia detection and diagnosis, noting challenges such as data accessibility, data imbalance, and feature selection. It suggests that wearable devices, like activity trackers and smartwatches, could offer valuable insights into sarcopenia progression and aid individuals in monitoring and managing their condition. Additionally, the paper investigates the potential of blockchain technology and edge computing in healthcare data storage, discussing models and systems that leverage these technologies to secure patient data privacy and enhance personal health information management. However, it acknowledges the limitations of these models and systems, including inefficiencies in handling large volumes of medical data and the lack of dynamic selection capability. In conclusion, the paper provides a comprehensive summary of current sarcopenia research, emphasizing the potential of modern technologies in enhancing the detection and management of the condition while also highlighting the need for further research to address challenges in standardization, data management, and effective technology use.

Lack of association between serum myonectin levels and sarcopenia in older Asian adults

Myonectin is a muscle-secreted factor that helps maintain homeostasis in the body by regulating several functions, including lipid metabolism. Previous studies suggested that myonectin may play a role in muscle health in an autocrine manner, but its impact on human skeletal muscle is still unclear. We aimed to investigate the relationship of serum myonectin levels with sarcopenia and related muscle parameters. We conducted a cross-sectional study of 142 older adults whose muscle mass, grip strength, gait speed, chair stands, and short physical performance battery (SPPB) were evaluated in the geriatric clinic of a tertiary medical center. Sarcopenia was defined based on Asian-specific cutoff values, and circulating myonectin levels were measured using an enzyme immunoassay. Before and after adjusting for age, sex, and body mass index, the serum myonectin level was not significantly different when the patients were stratified by status of sarcopenia, muscle mass, muscle strength, and physical performance. Furthermore, whether given as a continuous variable or divided into quartile groups, the serum myonectin level had no association with the skeletal muscle mass, grip strength, gait speed, chair stand test, or SPPB score. Our findings did not confirm the potential role of myonectin in muscle metabolism observed in experimental research. Thus, serum myonectin levels cannot predict the risk of sarcopenia in older Asian adults.

Are dietary intake and nutritional status of specific polyunsaturated fatty acids correlated with sarcopenia outcomes in community-dwelling older adults with sarcopenia? - Exploratory results from ENHANce

AIMS

To explore the relationship between dietary polyunsaturated fatty acids (PUFAs) intake, nutritional PUFAs status and sarcopenia outcomes in sarcopenic older adults.

METHODS

The Exercise and Nutrition for Healthy AgeiNg (ENHANce) is an ongoing 5-armed triple blinded randomized controlled trial, in sarcopenic older adults (> 65y) aiming to assess the effect of combined anabolic interventions (protein, omega-3 supplement and exercise) on physical performance in these adults, compared to single/placebo interventions. Baseline data were used for a secondary, exploratory, cross-sectional analysis. Dietary PUFAs intake was assessed with 4-day food records, status with RBC membrane fatty acids profiles. Spearman's rho(ρ) correlation coefficients were calculated to explore associations of PUFAs intake and status with sarcopenia-defining parameters (muscle strength, mass and physical performance), physical activity (step count) and quality of life (SF-36, SarQoL).

RESULTS

In total, 29 subjects (9♂/20♀, mean age 76.3 ± 5.4y) were included. Total omega-3 intake of participants (1.99 ± 0.99 g/d) was below the recommended intake (♂:2.8-5.6 g/d; ♀:2.2-4.4 g/d). Intake and status of PUFAs were not correlated. Regarding correlations with outcomes, α-linolenic acid status was inversely associated with appendicular lean mass (aLM) (ρ:-0.439; p = 0.017), whereas docosahexaenoic acid status was positively associated with aLM (ρ:0.388; p = 0.038). Some omega-3 PUFAs intake and status markers were positively associated with step count, SF-36 and SarQoL scores, whereas gamma-linolenic acid status was inversely associated with SF-36 physical component summary score (ρ = -0.426; p = 0.024).

CONCLUSIONS

Although intake of omega-3 and omega-6 was low, the present exploratory study generated new hypotheses for potential correlations of PUFAs intake and status with sarcopenia outcomes in older adults with sarcopenia.

Association between Nutritional Status, Lifestyle Habits, and Disease Activity in Dalmatian Patients with Rheumatoid Arthritis

The aim of this study was to evaluate body composition, handgrip strength, quality of life, disease duration and activity and lifestyle habits in patients with rheumatoid arthritis (RA) and to evaluate possible associations between all of the abovementioned factors. Seventy-five stable RA patients were included. Data on sociodemographic data, disease activity, quality of life, nutritional risk, body mass composition, anthropometric parameters, and clinical and laboratory parameters were collected for each study participant. The results showed that the mean score of the disease activity score (DAS28) was 5.4, the mean score of the health assessment questionnaire-disability index (HAQ-DI) was 1.19, and the mean disease duration in our population was 13.9 years. Our studied population had a long disease duration and high disease activity. Positive predictors of muscle mass in RA patients were daily caloric intake, fat-free mass, bone mass, basal metabolic rate, total body water, weight, body mass index (BMI), height, and muscle strength. There were no significant negative predictors. Positive predictors of muscle strength in RA patients were daily caloric intake, basal metabolic rate, predicted muscle mass, fat-free mass, bone mass, weight, total body water, metabolic age, hemoglobin, BMI, and number of exercises per week. In contrast, negative predictors of muscle strength were number of comorbidities, number of swollen joints, DAS, number of tender joints, erythrocyte sedimentation rate (ESR), and duration of RA. An association was also found between bone mineral density and both muscle mass and muscle strength. A structured nutritional approach in terms of multidisciplinary collaboration between rheumatologist, dietitian and physical medicine specialist is needed in the Dalmatian RA population.

Body composition in sarcopenia in middle-aged individuals

Sarcopenia is characterized by a progressive loss of muscle mass, strength, and function, leading to poor outcomes and reduced quality of life. In middle age, the decrease in muscle mass begins to be progressive. Bioimpedancemetry allows diagnosing this condition before the onset of clinical symptoms. The purpose of the study: to evaluate the parameters of body composition in the early diagnosis of sarcopenia in middle-aged people. Materials and Methods: The participants were divided into two groups the main one with sarcopenia 146 people and the control group 75 people. The complex of examinations included: neuropsychological testing (Hospital Anxiety and Depression Scale (HADS), quality of life questionnaire for patients with sarcopenia (SarQoL), short health assessment form (SF-36)), 4-meter walking speed test, dynamometry and bioimpedancemetry. The results of neuropsychological examination did not differ in the main and control groups. Patients with sarcopenia showed a decrease in muscle strength according to dynamometry. The scores of the walking speed assessment test in the study group were significantly higher than in the control group. The main and control groups had excessive body weight. According to the results of bioimpedanceometry, the main group had increased fat mass, percentage of fat mass, visceral fat area, and fat mass index compared with the control group. Skeletal muscle mass was less in the main group, probable sarcopenia was confirmed by decreased appendicular mass, decreased protein and mineral content was also recorded. There was a more pronounced decrease in cell mass in the main group. In patients with sarcopenia the volume of intracellular and extracellular fluid was less than in the control group. Significant differences were considered at p0.05. Conclusions: the introduction of bioimpedancemetry and dynamometry into early screening for muscle mass reduction will allow timely start of therapeutic and preventive measures even in middle age, which will lead to a decrease in the progression of sarcopenia in the elderly, as well as improve the quality of life.

Markers for the Prediction of Probably Sarcopenia in Middle-Aged Individuals

Sarcopenia is a condition that is characterized by a progressive loss of muscle mass, strength, and function, resulting in reduced quality of life. The aim of the study was to analyze the significance of pro-inflammatory markers in the prognostic diagnosis of sarcopenia. The participants were divided into two groups: the main group of 146 people and the control-75 people. The complex of examinations included neuropsychological testing (Hospital Anxiety and Depression Scale (HADS), quality-of-life questionnaire for patients with sarcopenia (SarQoL), and short health assessment form (MOS SF-36)), a 6 m walking speed test, manual dynamometry, bioimpedancemetry, and metabolic markers (nitrates, fibroblast growth factor 21, and malondialdehyde). When analyzing metabolic markers in the main group, a twofold increase in nitrates in the main group was recorded in a subsequent analysis adjusted for multiple variables, there was a negative association between the nitrate levels for weak grip strength and appendicular muscle mass. An additional analysis revealed that the complaint of pain in the lower extremities was more frequent in patients of the main group, as well as constipation and the pathology of thyroid gland, and they were more frequently diagnosed with arterial hypertension. At the same time, patients from the main group more frequently took vitamin D. When conducting body composition, the main group recorded a higher weight visceral fat content, as well as a decrease in appendicular and skeletal muscle mass; these changes were accompanied by a decrease in protein and minerals. Among the markers that differed significantly were nitrates, and it was this that was associated with decreased muscle strength and appendicular mass, which may indicate both a possible mechanism and a possible predictive marker. The results of this study can be used to develop a screening method for diagnosing sarcopenia at the outpatient stage.

Prevalence and Risk Factors of Sarcopenia among Older Adults Aged ≥65 Years Admitted to Daycare Centers of Taiwan: Using AWGS 2019 Guidelines

Sarcopenia is a geriatric syndrome which is likely to cause disability, body unbalance, and mortality and thus can lead to heavy healthcare expenditure and caregiver burden. Although some studies have addressed the prevalence of sarcopenia for older adults, there are limited studies conducted in daycare centers. The present study aimed to (i) estimate the prevalence of sarcopenia and (ii) explore associated factors of sarcopenia and standing balance among older adults admitted to daycare centers in Taiwan. The cross-sectional study collected data on demographics, health status, handgrip strength, gait speed (GS), skeletal muscle mass, Taiwan-Mini Nutritional Assessment Short-Form (TW-MNA-SF), and Short Physical Performance Battery from daycare centers in northern Taiwan. The definition of sarcopenia followed the Asian Working Group for Sarcopenia 2019 guidelines. Among 173 participants ≥65 year-old, 50.9% had confirmed sarcopenia, 47.4% possible sarcopenia, and 1.7% normal. Results showed that calf circumference, TW-MNA-SF, dementia, and body mass index (BMI) were associated with sarcopenia. Moreover, BMI, GS, and sarcopenia were associated factors of standing balance. The study estimated a high prevalence of sarcopenia in daycare centers and identified some significant factors of sarcopenia and standing balance. Early nutritional and physiotherapy interventions could benefit older adults to prevent sarcopenia or unbalance.