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Fukushima T, Okita Y, Watanabe N, Yokota S, Nakano J, Kawai A. Evaluation of clinical factors associated with early postoperative physical function and lower extremity functional impairment in patients with soft tissue sarcoma. Disabil Rehabil 2024; 46:3426-3431. [PMID: 37622737 DOI: 10.1080/09638288.2023.2249413] [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: 02/16/2023] [Revised: 06/21/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE This study aimed to investigate the relationship between various clinical factors and physical function in the early postoperative period in patients with soft tissue sarcomas (STSs) by subjective and objective evaluations. MATERIALS AND METHODS The 90 patients enrolled in this study were classified into five groups according to tumor location: retroperitoneal, gluteal, groin, thigh, and lower leg. The Musculoskeletal Tumor Society (MSTS) score was evaluated at discharge; the timed up-and-go test (TUGT) was performed preoperatively and at discharge. Group comparisons by tumor location were performed. To identify significant factors associated with physical dysfunction, multivariate analysis was performed using an MSTS score of <80% and a change in pre and postoperative TUGT score. RESULTS There were no significant differences between the tumor location and physical function. The change in pre- and postoperative TUGT scores was significantly associated with an MSTS score of <80%. Quadriceps and tibialis anterior muscle resections were significantly associated with the change in pre- and post-operative TUGT scores. CONCLUSIONS The quadriceps and tibialis anterior muscles may affect physical dysfunction after surgery for STSs. Early postoperative rehabilitation should include the identification of resected muscles and functional improvement of residual muscles, possibly with orthotic support for knee extension and ankle dorsiflexion.
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Affiliation(s)
- Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Yusuke Okita
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Watanabe
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Shota Yokota
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
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Kohei T, Takamura D, Nonaka S, Yamada T. Association of Psoas Muscle Mass at Intensive Care Unit Admission With Physical Function and Post-discharge Destination in Survivors of Critical Illness. Cureus 2024; 16:e59609. [PMID: 38832187 PMCID: PMC11144838 DOI: 10.7759/cureus.59609] [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] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE Survivors of critical illness may have physical impairments, known as post-intensive care syndrome (PICS). Early screening for the risk of PICS is recommended to prevent PICS. Skeletal muscle mass is a clinically important indicator associated with various outcomes. This study aimed to examine the association of psoas muscle mass at intensive care unit (ICU) admission with the destination and physical function at hospital discharge. METHODS In this single-center retrospective cohort study, we reviewed the medical records of adult patients who had required emergency ICU admission and who had been intubated and mechanically ventilated. Psoas major muscle was measured as an indicator of skeletal muscle mass from abdominal computed tomography images at ICU admission. Physical function was assessed using the functional status score for the ICU and ICU mobility scale at hospital discharge. Multinomial logistic and multivariable linear regression were used to analyze the associations of the psoas muscle mass with the discharge destination and physical function at discharge. RESULTS We enrolled 124 patients (79 men and 45 women) with a median (interquartile range) age of 72.0 (62.0-80.0) years; 39 (31.5%) were discharged to home, 50 (40.3%) were transferred to rehabilitation wards, and 35 (28.2%) were transferred to long-term care settings. The psoas muscle area and volume were 16.9 (11.3-20.6) cm2 and 228.3 (180.2-282.0) cm3 in home discharge patients, 17.5 (11.5-21.5) cm2 and 248.4 (162.0-311.4) cm3 in rehabilitation ward patients, and 15.9 (10.3-19.5) cm2 and 184.0 (137.0-251.1) cm3 in long-term care patients. The areas and volumes of the psoas muscle were not significantly different in the three groups. Furthermore, psoas muscle mass was not significantly associated with the discharge destination and physical function. CONCLUSIONS Discharge destination and physical function at hospital discharge were not significantly associated with psoas muscle mass at ICU admission.
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Affiliation(s)
- Tanaka Kohei
- Department of Rehabilitation Medicine, Osaka Police Hospital, Osaka, JPN
| | - Daisuke Takamura
- Department of Rehabilitation Science, Graduate School of Health Science, Kobe University, Kobe, JPN
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, JPN
| | - Shota Nonaka
- Department of Radiology Technology, Osaka Police Hospital, Osaka, JPN
| | - Tomoki Yamada
- Emergency Critical Care Medical Center, Osaka Police Hospital, Osaka, JPN
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Matsuo K, Yoneki K, Kobayashi K, Onoda D, Mibu K, Furuzono K, Mashimo N, Yasuda S, Suzuki T, Nakao K, Tatsuki H, Tamiya S. Impact of Changes in Rectus Femoris Cross-Sectional Area Measured by Ultrasound on the Prognosis of Patients With Acute Heart Failure. Circ J 2024; 88:713-721. [PMID: 38508754 DOI: 10.1253/circj.cj-23-0925] [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] [Indexed: 03/22/2024]
Abstract
BACKGROUND Low muscle mass in patients with acute heart failure (AHF) is associated with poor prognosis; however, this is based on a single baseline measurement, with little information on changes in muscle mass during hospitalization and their clinical implications. This study investigated the relationship between changes in rectus femoris cross-sectional area (RFCSA) on ultrasound and the prognosis of patients with AHF. METHODS AND RESULTS This is a retrospective evaluation of 284 AHF patients (mean [±SD] age 79.1±11.9 years; 116 female). RFCSA assessments at admission (pre-RFCSA), ∆RFCSA (i.e., the percentage change in RFCSA from admission to 2 weeks), and composite prognosis (all-cause death and heart failure-related readmission) within 1 year were determined. Patients were divided into 4 groups according to their median pre-RFCSA and ∆RFCSA after sex stratification: Group A, higher pre-RFCSA/better ∆RFCSA; Group B, higher pre-RFCSA/worse ∆RFCSA; Group C, lower pre-RFCSA/better ∆RFCSA; Group D, lower pre-RFCSA/worse ∆RFCSA. In the Cox regression analysis, with Group A as the reference, the cumulative event rate of Group C (hazard ratio [HR] 3.39; 95% confidence interval [CI] 0.71-16.09; P=0.124) did not differ significantly; however, the cumulative event rates of Group B (HR 7.93; 95% CI 1.99-31.60; P=0.003) and Group D (HR 9.24; 95% CI 2.57-33.26; P<0.001) were significantly higher. CONCLUSIONS ∆RFCSA during hospitalization is useful for risk assessment of prognosis in patients with AHF.
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Affiliation(s)
- Koji Matsuo
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Kei Yoneki
- Department of Rehabilitation, Sagamihara Kyodo Hospital
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University
| | | | - Daiki Onoda
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Kazuhiro Mibu
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | | | - Noa Mashimo
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Shiori Yasuda
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Toru Suzuki
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Ken Nakao
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | | | - Seiji Tamiya
- Department of Cardiovascular Medicine, Sagamihara Kyodo Hospital
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Wu Y, Boer CG, Hofman A, Schiphof D, van Middelkoop M, Szilagyi IA, Sedaghati-Khayat B, Bierma-Zeinstra SMA, Voortman T, van Meurs JBJ. Weight-Bearing Physical Activity, Lower-Limb Muscle Mass, and Risk of Knee Osteoarthritis. JAMA Netw Open 2024; 7:e248968. [PMID: 38687476 PMCID: PMC11061770 DOI: 10.1001/jamanetworkopen.2024.8968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/22/2024] [Indexed: 05/02/2024] Open
Abstract
Importance It has been demonstrated that total physical activity is not associated with risk of osteoarthritis. However, the association of different types of physical activity with incident knee osteoarthritis remains unclear. Objective To determine whether weight-bearing recreational physical activities are associated with increased risk of incident knee osteoarthritis. Design, Setting, and Participants This prospective cohort study used data from the Rotterdam Study (1996 to 2009), including participants with knee x-ray measurements at baseline and follow-up examinations. Participants with knee osteoarthritis at baseline were excluded. Residents aged 45 years and older of the Ommoord district in the city of Rotterdam in The Netherlands were invited to join the Rotterdam Study (78% response rate). Analysis was conducted in June 2023. Exposure Total, weight-bearing, and non-weight-bearing recreational physical activities collected by questionnaires at baseline. Main Outcomes and Measures Incident radiographic knee osteoarthritis measured by knee x-ray was the primary outcome, and incident symptomatic knee osteoarthritis defined by x-ray and knee pain questionnaire was the secondary outcome. The association of different types of recreational physical activity with radiographic knee osteoarthritis was examined using logistic regression within generalized estimating equation framework after adjusting for potential confounders. A prespecified stratification analysis was planned on the basis of lower-limb muscle mass index (LMI) tertiles, measured by dual-energy x-ray absorptiometry. Results A total of 5003 individuals (2804 women [56.0%]; mean [SD] age, 64.5 [7.9] years) were included. The knee osteoarthritis incident rate was 8.4% (793 of 9483 knees) for a mean (SD) follow-up time of 6.33 (2.46) years. Higher weight-bearing activity was associated with increased odds of incident knee osteoarthritis (odds ratio [OR], 1.22; 95% CI, 1.10-1.35; P < .001), but non-weight-bearing activity was not (OR, 1.04; 95% CI, 0.95-1.15; P = .37). In the analysis stratified by LMI tertiles, the association of weight-bearing activity with incident osteoarthritis was found only among 431 patients in the lowest LMI tertile (OR, 1.53; 95% CI, 1.15-2.04; P = .003), but not among patients in the middle or high LMI tertile. Conclusions and Relevance The findings of this study suggest that weight-bearing activity is associated with incident knee osteoarthritis in people with low levels of lower-limb muscle mass, which might be a promising avenue for tailored advice for physical activity.
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Affiliation(s)
- Yahong Wu
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cindy G. Boer
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Amy Hofman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ingrid A. Szilagyi
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Bahar Sedaghati-Khayat
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M. A. Bierma-Zeinstra
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joyce B. J. van Meurs
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Alarcón-Rivera M, Cornejo-Mella C, Cáceres-Aravena C, Concha-Cisternas Y, Fernández-Valero P, Guzmán-Muñoz E. Relationship between appendicular muscular mass index and physical function in older people. AIMS Public Health 2024; 11:130-140. [PMID: 38617413 PMCID: PMC11007416 DOI: 10.3934/publichealth.2024006] [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: 11/02/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 04/16/2024] Open
Abstract
This study aimed to establish the relationship between the appendicular muscle mass index (AMMI), assessed from anthropometric variables, and the physical function of older people. Seventy-six older people participated in this study (72.03 ± 7.03 years). The participants underwent evaluations to determine their AMMI using anthropometry (weight, calf circumference, hip circumference, and knee height) and manual grip strength. Additionally, their physical function was evaluated using the 5-chair stand test, the 3-meter walk test, and the timed up and go test (TUG) to determine the strength of the lower limbs, the gait speed, and the dynamic balance, respectively. The results show that the AMMI did not present a significant relationship with the 5-chair stand test in both women (r = -0.135; p = 0.204) and men (r = -0.067; p = 0.349). The AMMI was moderately correlated with the gait speed in both women (r = 0.542; p < 0.001) and men (r = 0.556; p < 0.001). Finally, a statistical significance was observed in the relationship between the AMMI and the TUG test in women (r = -0.273; p = 0.047) and older men evaluated in this study (r = -0.284; p = 0.042). In conclusion, there is a relationship between the AMMI and both the dynamic balance and the gait speed. Therefore, the AMMI emerges as a potential public health assessment by enabling the clinical quantification of muscle mass and an estimation of physical function in the elderly population.
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Affiliation(s)
- Miguel Alarcón-Rivera
- School of Sports Sciences and Physical Activity, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
| | | | | | - Yeny Concha-Cisternas
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Pedagogy in Physical Education, Faculty of Education, Universidad Autónoma de Chile, Talca, Chile
| | - Paz Fernández-Valero
- Faculty of Human Sciences, School of Physical Education, Sports and Recreation, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Pedagogy in Physical Education, Faculty of Education, Universidad Autónoma de Chile, Talca, Chile
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Fukumoto Y, Taniguchi M, Hirono T, Yagi M, Yamagata M, Nakai R, Yamada Y, Kimura M, Ichihashi N. Association of Regional Muscle Thickness and Echo Intensity with Muscle Volume, Intramuscular Adipose Tissue, and Strength of the Quadriceps Femoris. Clin Interv Aging 2023; 18:1513-1521. [PMID: 37724172 PMCID: PMC10505373 DOI: 10.2147/cia.s424504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose This study aimed to investigate the association of muscle thickness (MT) and echo intensity (EI) obtained at different regions along the muscle length with muscle volume (MV), intramuscular adipose tissue (IntraMAT), and muscle strength of the quadriceps femoris (QF). Patients and Methods A total of 135 community-dwelling adults (64 men and 71 women) participated in the study. Ultrasound scanning of the rectus femoris (RF) and vastus intermedius (VI) was performed at three locations (from mid- to distal thigh). The MT of the RF and VI and EI of the RF were measured. MRI-derived MV, IntraMAT, and muscle strength of the QF were measured. Results The correlation between RF-MT and RF-MV weakened as scanning approached the distal thigh, and the difference between the coefficients for the scanning locations was significant for women. However, the correlation of VI-MT with VI-MV and that of the combined MT of RF and VI with the MV of the whole QF and muscle strength were comparable among the scanning locations for both sexes. The correlation of RF-EI with the IntraMAT of the RF and the whole QF and muscle strength was also comparable among the scanning locations for both sexes. Conclusion The results of this study suggest that ultrasound measurements at the distal thigh can predict MV, IntraMAT, and muscle strength of the QF to the same degree as those at the mid-thigh.
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Affiliation(s)
- Yoshihiro Fukumoto
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Yamagata
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryusuke Nakai
- Kyoto University Institute for the Future of Human Society, Kyoto, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kameoka, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Fukushima T, Okita Y, Watanabe N, Yokota S, Nakano J, Kawai A. Factors associated with physical function in patients after surgery for soft tissue sarcoma in the thigh. BMC Musculoskelet Disord 2023; 24:661. [PMID: 37596604 PMCID: PMC10439620 DOI: 10.1186/s12891-023-06797-w] [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: 03/27/2023] [Accepted: 08/12/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE This study aimed to examine the validity of the timed up and go test (TUGT), which is a representative, objective, and functional assessment that can evaluate walking speed, strength, and balance, and determine the significant factors associated with physical dysfunction in the early postoperative period in patients with soft tissue sarcomas (STSs). METHODS This retrospective, single-center, observational study conducted at the National Cancer Center Hospital included 54 patients with STSs in the thigh who underwent surgery. The Musculoskeletal Tumor Society (MSTS) score, which subjectively evaluates the affected limb, was evaluated at discharge, and TUGT was performed preoperatively and at discharge. Higher scores indicated good limb function in the MSTS score and poor performance in the TUGT. Spearman's correlation analysis was performed to identify the relationship between the MSTS score and TUGT. A receiver operating characteristic curve was used to calculate the cut-off value of the change in pre- and postoperative TUGT for an MSTS score of ≥ 80%. To examine the significant factors associated with physical dysfunction, multivariate regression analysis was performed using the change in pre- and postoperative TUGT as the dependent variable. RESULTS Postoperative TUGT and the change in pre- and postoperative TUGT were significantly associated with the MSTS score. The cut-off value for the change in pre- and postoperative TUGT for acceptable affected lower-limb function was 3.7 s. Furthermore, quadriceps muscle resection was significantly associated with the change in pre- and postoperative TUGT in the early postoperative period. CONCLUSIONS TUGT could be a useful objective evaluation tool for postoperative patients with STSs. The cut-off value for the change in TUGT can be used to monitor postoperative recovery. If recovery is prolonged, a rehabilitation program can be designed according to the severity of the functional impairment in muscle strength, balance, or gait. In addition, sufficient information should be obtained regarding the presence or absence of quadriceps resection, which has a significant impact on postoperative performance.
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Affiliation(s)
- Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan.
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Yusuke Okita
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Watanabe
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Shota Yokota
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
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Liu QW, Mao CJ, Lu ZH, Shi RF, Zhang YC, Zhao P, Liu CF. Sarcopenia is associated with non-motor symptoms in Han Chinese patients with Parkinson's Disease: a cross-sectional study. BMC Geriatr 2023; 23:494. [PMID: 37587447 PMCID: PMC10428605 DOI: 10.1186/s12877-023-04188-3] [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: 02/04/2022] [Accepted: 07/20/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Sarcopenia is commonly seen in the older adults and increases in incidence with age, also in Parkinson's disease (PD). Although research has indicated that the development of sarcopenia in patients with PD may be related to both motor symptoms and non-motor symptoms (NMS), the precise relationship between the two conditions remains unclear. Therefore, we aimed to investigate the incidence of sarcopenia in patients with PD and its association with NMS. METHODS The study included 123 patients with PD and 38 age- and sex-matched healthy controls (HC). All participants were evaluated for sarcopenia using the 2019 Asian Sarcopenia Diagnostic Criteria, and patients with PD underwent standard assessments of motor symptoms and NMS. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were used to examine the association between sarcopenia and NMS in patients with PD. RESULTS The incidence of sarcopenia was significantly higher in patients with PD than in HC (26.8% vs. 10.4%, p = 0.046). Multiple logistic regression analysis revealed that poorer sleep quality (odds ratio [OR]: 1.245; 95% confidence interval [CI]: 1.011-1.533; p = 0.040) and fatigue (OR: 1.085, 95% CI: 1.006-1.170, p = 0.034) were independently associated with sarcopenia. ROC analysis indicated that the optimal cut-off value for Pittsburgh Sleep Quality Index (PSQI) scores was 10, with 72.7% sensitivity and 74.4% specificity (area under the curve [AUC] = 0.776, 95% CI: 0.683-0.868, p < 0.001). The optimal cut-off value for Fatigue Severity Scale (FSS) scores was 39, with 87% sensitivity and 50% specificity (AUC = 0.725, 95% CI: 0.629 -0.820, p < 0.001). Joint use of FSS and PSQI scores increased the predictive value for sarcopenia(AUC = 0.804, 95% CI: 0.724-0.885, p < 0.001). CONCLUSION Patients with PD are more susceptible to sarcopenia than healthy older adults, and fatigue and poorer sleep are positively associated with sarcopenia. Further longitudinal studies are needed to clarify the causal relationships.
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Affiliation(s)
- Qiu-Wan Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Cheng-Jie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
| | - Zhao-Hui Lu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Rong-Fang Shi
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Ying-Chun Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Ping Zhao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
- Institute of Neuroscience, Soochow University, Suzhou, 215004, China.
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Tanaka K, Taoda A, Kashiwagi H. The impact of acute skeletal muscle loss after gastrointestinal cancer surgery on physical function. PM R 2023; 15:184-191. [PMID: 35077013 DOI: 10.1002/pmrj.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 01/08/2022] [Accepted: 01/17/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Significant skeletal muscle loss occurs commonly after cancer surgery; however, the impact of postoperative acute skeletal muscle loss on physical function remains poorly understood. OBJECTIVE To determine the impact of surgery-associated acute skeletal muscle wasting on physical function in the early postoperative period in patients with gastrointestinal cancer. DESIGN A single-center retrospective observational study. SETTING General hospital. PATIENTS Hospitalized patients with gastrointestinal cancer who were admitted for surgery. INTERVENTION Not applicable. MAIN OUTCOME MEASURES The main outcome was the partial correlation between postoperative changes in skeletal muscle index (SMI) and physical function such as handgrip strength, gait speed, and 6-minute walk test. RESULTS A total of 69 patients (41 male and 28 female) with a mean age of 70.5 years were included. SMI was significantly correlated with physical function, such as handgrip strength (r = 0.757, p < .001), maximum gait speed (r = 0.318, p = .008), and 6-minute walk test (r = 0.365, p = .002) before surgery. In contrast, partial correlation analysis between the absolute changes in SMI and physical function after controlling for SMI and each physical function before surgery showed no significant correlation. Multivariable linear regression analyses also showed that postoperative change in SMI was not significantly associated with the postoperative change in physical function but it was associated with the length of stay after surgery, SMI at admission, and absolute change in body fat percentage. CONCLUSIONS The absolute change in SMI during the early postoperative period was not linearly correlated with the degree of decline in physical function. Further studies are necessary to investigate the effects of the respective changes in skeletal muscle mass and physical function on clinical outcomes.
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Affiliation(s)
- Kohei Tanaka
- Department of Rehabilitation Medicine, Osaka, Japan
| | - Ayano Taoda
- Department of Rehabilitation Medicine, Osaka, Japan
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Sabatino A, Kooman JP, Di Motta T, Cantarelli C, Gregorini M, Bianchi S, Regolisti G, Fiaccadori E. Quadriceps muscle thickness assessed by ultrasound is independently associated with mortality in hemodialysis patients. Eur J Clin Nutr 2022; 76:1719-1726. [PMID: 35641665 DOI: 10.1038/s41430-022-01166-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Estimation of muscle mass is an integral part of nutritional assessment in End-Stage Kidney Disease (ESKD) patients on chronic hemodialysis (HD). In this respect, muscle ultrasound (US) is a valid and reliable tool but has not been previously related to outcomes in this population. Aims of this study were to assess the relationship between quadriceps muscle thickness as assessed by US and outcomes in ESKD patients on HD; we also compared US with anthropometry and malnutrition inflammation score (MIS). SUBJECTS/METHODS In this prospective study, 181 prevalent patients on HD were included. Thickness of the quadriceps rectus femoris and vastus intermedius (VIT) were assessed separately using ultrasonography, and were indexed for height squared. Mid-arm muscle circumference (MAMC) and area (MAMA) were assessed by anthropometry. MIS was evaluated. In the absence of predetermined cut-offs, values below the median of the distribution of VIT index were considered low. Instead, cut-off for anthropometric values such as MAMC and MAMA were set at ≥90% of agreement with the 50th percentile of the sex- and age-specific normal distribution. Cox-regression analysis was used to assess the association of US, MIS, and anthropometric parameters with mortality. RESULTS Patients were followed for a median of 35 months. During this period 36% of patients died. Multivariable Cox-regression analysis (adjusted for demographic, biochemical and clinical variables), demonstrated that higher VIT distal index values were independently associated with lower mortality risk (HR: 0.76 (0.59-0.99); P = 0.040), whilst higher MIS values were independently associated with higher (HR 1.22 (1.10-1.35); P < 0.001) mortality risk. When assessing muscle parameters as categorical variables, both low VIT distal index (HR: 1.71 (1.01-2.89); 0.045) and MAMC (HR: 1.74 (1.02-2.96); 0.042) were independently associated with increased risk of death. CONCLUSION Indexed distal VIT was independently associated with mortality both as continuous and as a categorical variable. Muscle US is a simple practical tool that adds prognostic information to the bedside nutritional assessment in ESKD patients on maintenance HD.
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Affiliation(s)
- Alice Sabatino
- UO Nefrologia, Azienda Ospedaliera- Universitaria Parma, Parma, Italy.
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy.
| | - Jeroen P Kooman
- Department of Internal Medicine, division of Nephrology University Hospital Maastricht, Maastricht, The Netherlands
| | - Tommaso Di Motta
- UO Nefrologia, Azienda Ospedaliera- Universitaria Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Chiara Cantarelli
- UO Nefrologia, Azienda Ospedaliera- Universitaria Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | | | | | - Giuseppe Regolisti
- Clinica e Immunologia Medica, Azienda Ospedaliero-Universitaria di Parma e Università degli Studi di Parma, Parma, Italy
| | - Enrico Fiaccadori
- UO Nefrologia, Azienda Ospedaliera- Universitaria Parma, Parma, Italy
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
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11
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Association of strength, power, and function with muscle thickness, echo intensity, and lean tissue in older males. Appl Physiol Nutr Metab 2022; 47:521-528. [PMID: 35104155 DOI: 10.1139/apnm-2021-0690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dual-energy X-ray absorptiometry (DXA) appendicular lean tissue is used to screen older adults for sarcopenia. However, emerging data indicates that ageing-related muscle atrophy largely occurs within specific muscles, which may be masked using appendicular lean tissue. Comparisons between appendicular lean tissue and site-specific measures of muscle in relation to strength and physical function are needed to advance our understanding of these features in the context of poor muscle function in aged adults. Our primary objective was to compare correlations between lean tissue and site-specific muscle characteristics in relation to strength and physical function in older males. Older males (≥65 years) were evaluated for muscle strength, physical function (6-minute walk and 30-second sit-to-stand), and muscle size (appendicular and site-specific) and composition (echo intensity) using DXA and ultrasound. Of the 32 older males (75.4 ± 7.9 years), 12 had low appendicular lean tissue. All DXA and ultrasound muscle characteristics were associated (r = 0.39 to 0.83, p < 0.05) with torque or power producing capabilities. Except for the knee flexors, no differences in correlation coefficients were observed between muscle thickness or regional lean tissue in relation to muscle strength. Neither DXA nor ultrasound muscle characteristics were associated with physical function. In older males, ultrasound-based muscle thickness and DXA lean tissue provided similar associations with strength. Novelty: Lean tissue and muscle thickness provide similar associations with strength. Muscle thickness can distinguish low and normal appendicular lean tissue in older adults.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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12
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Gholizade M, Farhadi A, Marzban M, Mahmudpour M, Nabipour I, Kalantarhormozi M, Shafiee G, Ostovar A, Larijani B, Darabi AH, Safavi E. Association between platelet, white blood cell count, platelet to white blood cell ratio and sarcopenia in community-dwelling older adults: focus on Bushehr Elderly Health (BEH) program. BMC Geriatr 2022; 22:300. [PMID: 35395731 PMCID: PMC8991783 DOI: 10.1186/s12877-022-02954-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sarcopenia is a progressive age-related skeletal muscle disorder associated with harmful impacts on health. The present study aimed to investigate the relation between sarcopenia, platelet (PLT), white blood cell (WBC), and PLT to WBC ratio (PWR) due to the importance of early sarcopenia diagnosis. METHODS This cross-sectional study was conducted based on the second stage of the Bushehr Elderly Health (BEH) Program. Sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) in accordance with the Iranian cut-off point. Univariate and adjusted multivariate logistic regression and linear regression were used to evaluate the associations. RESULTS The prevalence of sarcopenia among participants was 35.73%. PLT count and PWR were statistically higher in severe sarcopenic participants, while no differences were seen in WBC. In crude analysis, sarcopenia was not associated with quartiles of PLT, WBC, and PWR, while after adjusting for age, marital status, and sex, the association was seen in the fourth quartile of PLT and PWR [OR (95%CI) = 1.40 (1.08 to 1.81), p-value = 0.009 for PLT; OR (95%CI) =1.55 (1.20 to 2.00), p-value =0.001 for PWR]. This association remained significant in the fully adjusted model [OR (95%CI) =1.82 (1.20 to 2.78), p-value =0.005 for PLT; OR (95%CI) =1.57 (1.03 to 2.40), p-value =0.035 for PWR]. Among sarcopenia parameters, PLT count was more likely to be associated with handgrip strength and muscle mass. After stratifying the participants by gender, sarcopenia parameters were no longer statistically significant in men. CONCLUSION This study showed that PLT and PWR were associated with sarcopenia after considering confounding factors, while this association was not seen in WBC. Moreover, results showed that gender had an important impact on sarcopenia parameters.
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Affiliation(s)
- Mohamad Gholizade
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.,Department of Health Education and Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. .,Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Mehdi Mahmudpour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammadreza Kalantarhormozi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.,Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Darabi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Eisa Safavi
- Department of Paraclinic, Bushehr University of Medical Sciences, Bushehr, Iran
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13
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Ko Y, Shin Y, Sung YS, Lee J, Lee JH, Kim JK, Park J, Ko HS, Kim KW, Huh J. A reliable and robust method for the upper thigh muscle quantification on computed tomography: toward a quantitative biomarker for sarcopenia. BMC Musculoskelet Disord 2022; 23:93. [PMID: 35086521 PMCID: PMC8796642 DOI: 10.1186/s12891-022-05032-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to evaluate the feasibility of the upper thigh level as a landmark to measure muscle area for sarcopenia assessment on computed tomography (CT). Methods In the 116 healthy subjects who performed CT scans covering from mid-abdomen to feet, the skeletal muscle area in the upper thigh level at the inferior tip of ischial tuberosity (SMAUT), the mid-thigh level (SMAMT), and L3 inferior endplate level (SMAL3) were measured by two independent readers. Pearson correlation coefficients between SMAUT, SMAMT, and SMAL3 were calculated. Inter-reader agreement between the two readers were evaluated using intraclass correlation coefficient (ICC) and Bland-Altman plots with 95% limit of agreement (LOA). Results In readers 1 and 2, very high positive correlations were observed between SMAUT and SMAMT (r = 0.91 and 0.92, respectively) and between SMAUT and SMAL3 (r = 0.90 and 0.91, respectively), while high positive correlation were observed between SMAMT and SMAL3 (r = 0.87 and 0.87, respectively). Based on ICC values, the inter-reader agreement was the best in the SMAUT (0.999), followed by the SMAL3 (0.990) and SMAMT (0.956). The 95% LOAs in the Bland-Altman plots indicated that the inter-reader agreement of the SMAUT (− 0.462 to 1.513) was the best, followed by the SMAL3 (− 9.949 to 7.636) and SMAMT (− 12.105 to 14.605). Conclusion Muscle area measurement at the upper thigh level correlates well with those with the mid-thigh and L3 inferior endpoint level and shows the highest inter-reader agreement. Thus, the upper thigh level might be an excellent landmark enabling SMAUT as a reliable and robust biomarker for muscle area measurement for sarcopenia assessment. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05032-2.
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Affiliation(s)
- Yousun Ko
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - Youngbin Shin
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - Yu Sub Sung
- Clinical Research Center, Asan Medical Center, Seoul, South Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jiwoo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jei Hee Lee
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Jai Keun Kim
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Jisuk Park
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Hye Sun Ko
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
| | - Jimi Huh
- Department of Radiology, Ajou University School of Medicine & Graduate School of Medicine, Ajou University Medical Center, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea.
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14
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Wang JC, Wu WT, Chang KV, Chen LR, Chi SY, Kara M, Özçakar L. Ultrasound Imaging for the Diagnosis and Evaluation of Sarcopenia: An Umbrella Review. Life (Basel) 2021; 12:life12010009. [PMID: 35054402 PMCID: PMC8781401 DOI: 10.3390/life12010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 04/24/2023] Open
Abstract
There is an increasing number of reviews investigating the value of ultrasound (US) in the assessment of aging-related muscle loss. The present umbrella review aimed to systematically investigate the evidence of US imaging in the diagnosis and evaluation of sarcopenia. PubMed, Medline, Embase and Web of Science were searched from their inceptions to 31 October 2021. Systematic reviews and reviews using a systematic strategy for literature search were enrolled. The extracted data were narrated at the level of systematic reviews and meta-analyses. This umbrella review included four articles pertaining to 125 original studies and yielded several important findings. First, US is a reliable and valid imaging tool for the assessment of skeletal muscle mass. Second, among all the US parameters in B-mode, muscle thickness is the most commonly used one, which has good correlation with other standard measurements. Third, although sonoelastography and contrast-enhanced US are promising imaging modalities, their clinical utility is still limited at the current stage. Finally, a future systematic review is warranted to analyze how different ultrasonographic diagnostic criteria influence the prevalence of sarcopenia as well as its adverse health outcomes.
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Affiliation(s)
- Jia-Chi Wang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, National Yang Ming University, Taipei 112202, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (L.-R.C.); (S.-Y.C.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (L.-R.C.); (S.-Y.C.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei 11600, Taiwan
- Correspondence: ; Tel.: +886-223-717-101-5309
| | - Lan-Rong Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (L.-R.C.); (S.-Y.C.)
| | - Shao-Yu Chi
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (L.-R.C.); (S.-Y.C.)
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey; (M.K.); (L.Ö.)
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey; (M.K.); (L.Ö.)
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15
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Ekiz T, Kara M, Ata AM, Ricci V, Kara Ö, Özcan F, Özçakar L. Rewinding sarcopenia: a narrative review on the renin-angiotensin system. Aging Clin Exp Res 2021; 33:2379-2392. [PMID: 33394457 DOI: 10.1007/s40520-020-01761-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The purpose of this review was two-fold. First, we aimed to provide an in-depth glance on the relationship between renin-angiotensin system (RAS) dysregulation and sarcopenia. Second, we aimed to touch upon potential treatments of sarcopenia (including RAS blockers, vitamin D, and exercise) in light of the pertinent literature. METHODS Currently available research regarding the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers on knee extensor strength, grip strength, chair stand test, gate speed together with the effects of exercise on muscle mass, strength, physical performance, blood pressure and cognitive tests (particularly in older adults) was reviewed. RESULTS Although some studies have shown favorable effects of ACEIs on muscle strength and/or physical function tests, some studies have reported no/negative association in between. The favorable impact of exercise on reducing blood pressure is shown, and exercise treatment is widely recommended in the relevant literature. Different types of exercises (aerobic, resistance, dancing, music movement, water-based, golf, knitting activities or multicomponent exercises) have shown improvement in cognitive functions as well. CONCLUSION Classical RAS activity results in deleterious effects not only on the cardiovascular but also on the neuromusculoskeletal system. Therefore, treatments targeting inhibition of the classical RAS activity seem to be important in the management of several age-related pathologies, including sarcopenia. As such, ACEIs, vitamin D, exercise, and healthy diet can have prominent effects not only on the modulation of RAS but also on physical and cognitive functions and sarcopenia as well.
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Affiliation(s)
- Timur Ekiz
- Department of Physical Medicine and Rehabilitation, Türkmenbaşı Medical Center, Türkmenbaşı Bulvarı Botanik Evleri Osmanbey Apt. C Blok No:3/B Seyhan, 01130, Adana, Turkey.
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
| | - Ayşe Merve Ata
- Department of Physical Medicine and Rehabilitation, Dr. Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Özgür Kara
- Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Fırat Özcan
- Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
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16
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Razaq S, Kara M, Özçakar L. Sarcopenia: if it looks/walks like a duck, it must be a duck. Eur J Clin Nutr 2021; 76:320-321. [PMID: 34230625 DOI: 10.1038/s41430-021-00965-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/13/2021] [Accepted: 06/18/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Sarah Razaq
- Combined Military Hospital & Quetta Institute of Medical Sciences, Quetta, Pakistan.
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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17
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Matsui Y. Reply to Ata and colleagues' Letter to the Editor: Adjustments for Anterior Thigh Muscle Measuremets in Sarcopenia. J Frailty Aging 2021; 9:250. [PMID: 32996565 PMCID: PMC7308439 DOI: 10.14283/jfa.2020.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Y Matsui
- Yasumoto Matsui, MD, PhD. Center for Frailty and Locomotive syndrome, National Center for Geriatrics and Gerontology; 7-430 Morioka-cho, Obu, Aichi, Japan. e-mail address: , telephone 81-562-46-2311, fax number: 81-562-44-8518
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18
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Oba H, Matsui Y, Arai H, Watanabe T, Iida H, Mizuno T, Yamashita S, Ishizuka S, Suzuki Y, Hiraiwa H, Imagama S. Evaluation of muscle quality and quantity for the assessment of sarcopenia using mid-thigh computed tomography: a cohort study. BMC Geriatr 2021; 21:239. [PMID: 33849469 PMCID: PMC8045267 DOI: 10.1186/s12877-021-02187-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 04/02/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND For the diagnosis of Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP) revised the algorisms in 2019, where they added computed tomography (CT) as an assessment tool not only for quantity but also for quality in research purpose. However, the evidence for clinical appreciation of CT has been lacking. Therefore, we investigated the correlation between CT and various motor function tests to assess the utility of CT as a potential diagnostic tool for sarcopenia. METHODS In total, 214 patients who were examined at our center during the study period (2016-2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index by DXA and BIA, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia. RESULTS Knee muscle strength correlated with CSA (r = 0.60) and the correlation was significantly greater than that with DXA and BIA. For physical performance, standing-up test correlated with CSA (r = - 0.20) and CTV (r = - 0.40) and walking speed with CTV (r = 0.43), which was significantly greater than that with DXA and BIA. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01). Furthermore, CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01). CONCLUSIONS CSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.
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Affiliation(s)
- Hiroki Oba
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan. .,Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan.
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan
| | - Hidenori Arai
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan
| | - Tsuyoshi Watanabe
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan.,Department of Orthopedics, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan
| | - Hiroki Iida
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan.,Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan
| | - Takafumi Mizuno
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan.,Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan
| | - Satoshi Yamashita
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan
| | - Shinya Ishizuka
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan
| | - Yasuo Suzuki
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, 474-8511, Japan.,Department of Human Care Engineering, Faculty of Health Sciences, Nihon Fukushi University, Okuda, Mihamacho, Chita, Aichi, 470-3295, Japan
| | - Hideki Hiraiwa
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan
| | - Shiro Imagama
- Department of Orthopedics, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showaku, Nagoya, Aichi, 466-8560, Japan
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19
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Seo MW, Jung SW, Kim SW, Jung HC, Kim DY, Song JK. Comparisons of Muscle Quality and Muscle Growth Factor Between Sarcopenic and Non-Sarcopenic Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186581. [PMID: 32927586 PMCID: PMC7558172 DOI: 10.3390/ijerph17186581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/25/2022]
Abstract
Sarcopenia, an age-related disease, is one of the important health problems in the elderly and the prevalence of sarcopenia is rapidly increased among the Korean population. This study examined the muscle quality and muscle growth factors of elderly women to identify the potential diagnostic tool for sarcopenia. One hundred and thirty-six elderly women, aged over 65 years old, initially enrolled, but only 59 participants who met the criteria (sarcopenic group, n = 27; non-sarcopenic group, n = 32) completed the study. Muscle quality assessment included thigh cross-sectional computed tomography scan and maximal isometric muscle strength. Muscle growth factors such as GDF-15, myostatin, activin A, and follistatin were analyzed, and a battery of Senior Fitness Test was used to examine functional fitness. The statistical significance level was set at 0.05. Elderly women with sarcopenia had a lower thigh muscle volume (-20.1%), and a higher thigh intermuscular adipose tissue (15.8%) than those of the non-sarcopenic group (p < 0.05). However, no significant differences in muscle growth factors were observed between the groups. Muscle quality variables including maximal voluntary isometric contraction (OR: 0.968, p < 0.001), relative maximal voluntary isometric contraction (OR: 0.989, p < 0.05), thigh muscle volume (OR: 0.836, p < 0.001), and thigh intermuscular adipose tissue (OR: 1.138, p < 0.05) were associated with a risk of sarcopenia. Our findings suggest that the sarcopenic group exhibits a poor thigh muscle quality in comparison with the non-sarcopenic group. Muscle quality assessment can be utilized for sarcopenia identification, but our study remains inconclusive for the causality of muscle growth factors in sarcopenia.
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Affiliation(s)
- Myong-Won Seo
- Department of Taekwondo, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea;
| | - Sung-Woo Jung
- Department of Physical Education, Graduate School, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; (S.-W.J.); (S.-W.K.)
| | - Sung-Woo Kim
- Department of Physical Education, Graduate School, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; (S.-W.J.); (S.-W.K.)
| | - Hyun Chul Jung
- Department of Coaching, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea;
| | - Deog-Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University School of Medicine, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea;
| | - Jong Kook Song
- Department of Sports & Science, Graduate School of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea
- Correspondence: ; Tel.: +82-31-201-2708
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