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Wang X, Wu M, Liu Q, He W, Tian Y, Zhang Y, Li C, Liu Y, Yu A, Jin H. Impact of osteopenia and osteosarcopenia on the outcomes after surgery of hepatobiliary-pancreatic cancers. Front Oncol 2024; 14:1403822. [PMID: 39099698 PMCID: PMC11294096 DOI: 10.3389/fonc.2024.1403822] [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: 03/20/2024] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Objective The purpose of this study is to investigate potential associations between osteopenia, osteosarcopenia, and postoperative outcomes in patients with hepatobiliary-pancreatic cancer (HBPC). Methods Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between osteopenia, osteosarcopenia, and outcomes of surgical treatment of HBPC patients from the start of each database to September 29, 2023. The Newcastle-Ottawa Scale was used to rate the quality of the studies. Results This analysis included a total of 16 articles with a combined patient cohort of 2,599 individuals. The results demonstrated that HBPC patients with osteopenia had significantly inferior OS (HR: 2.27, 95% CI: 1.70-3.03, p < 0.001) and RFS (HR: 1.96, 95% CI: 1.42-2.71, p < 0.001) compared to those without osteopenia. Subgroup analysis demonstrated that these findings were consistent across univariate and multivariate analyses, as well as hepatocellular carcinoma, biliary tract cancer, and pancreatic cancer. The risk of postoperative major complications was significantly higher in patients with osteopenia compared to those without osteopenia (OR: 1.66, 95% CI: 1.19-2.33, p < 0.001). Besides, we also found that the presence of osteosarcopenia in HBPC patients was significantly related to poorer OS (HR: 3.31, 95% CI: 2.00-5.48, p < 0.001) and PFS (HR: 2.50, 95% CI: 1.62-3.84, p < 0.001) in comparison to those without osteosarcopenia. Conclusion Preoperative osteopenia and osteosarcopenia can predict poorer OS and RFS with HBPC after surgery.
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Affiliation(s)
- Xiaofeng Wang
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Min Wu
- Department of Oncology, Third People’s Hospital of Honghe Prefecture, Gejiu, China
| | - Qian Liu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Wei He
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yong Tian
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yan Zhang
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Cuiping Li
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yanni Liu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Anqi Yu
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Hongyan Jin
- Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
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Tang H, Wang R, Hu N, Wang J, Wei Z, Gao X, Xie C, Qiu Y, Chen X. The association between computed tomography-based osteosarcopenia and osteoporotic vertebral fractures: a longitudinal study. J Endocrinol Invest 2024:10.1007/s40618-024-02415-1. [PMID: 38890220 DOI: 10.1007/s40618-024-02415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Osteoporosis and sarcopenia usually coexist in older population. The concept of osteosarcopenia has been proposed in recent years. However, studies on the relationship between osteosarcopenia and the risk of fracture are rare, and the association is unclear at present. This study aimed to investigate the association between osteosarcopenia evaluated based on chest computed tomography (CT) and osteoporotic vertebral fracture (OVF). METHODS This study recruited 7906 individuals aged 50 years and older who did not have OVFs and underwent chest CT for physical examination between July 2016 and September 2019. Subjects were followed up annually until June 2023. Osteosarcopenia was defined by a low muscle area of the erector spinae (< 25.4 cm2) and the bone attenuation (Hounsfield unit, HU < 135). Genant's grades were used to define OVFs. Control subjects were selected by Propensity Score Matching at a ratio 20:1. Cox proportional hazards models were used to assess the associations between osteosarcopenia and OVFs. RESULTS Of the 7906 participants included, 95 had a new OVF within a median follow-up of 3 years. A total of 1900 control subjects were matched. Individuals in the osteosarcopenia group had a higher prevalence of spinal fractures than those in normal group (16.4% vs. 0.4%, P < 0.001). Osteosarcopenia was independently associated with OVF (adjusted hazard ratio (aHR): 12.67, 95% confidence interval (CI) 3.79-42.40) and severe OVF (aHR = 14.07, 95% CI 1.84-107.66). Similar trends were observed in males, females and those subjects aged older than 60 years. Osteosarcopenia had good predictive efficacy for OVF (area under the curve = 0.836). A nomogram was also developed for clinical application. CONCLUSION Osteosarcopenia assessed based on chest CT was associated with OVF, and osteosarcopenia has good performance for vertebral fracture prediction.
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Affiliation(s)
- H Tang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - R Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - N Hu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - J Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - Z Wei
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - X Gao
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China
| | - C Xie
- Center for Musculoskeletal Research, School of Medicine and Dentistry, University of Rochester, Rochester, NY, 14642, USA
| | - Y Qiu
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China.
| | - X Chen
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China.
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Stoodley IL, Berthon BS, Scott HA, Williams EJ, Baines PJ, Knox H, Wood S, Paradzayi B, Cameron-Smith D, Wood LG. Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults. Nutrients 2024; 16:1380. [PMID: 38732628 PMCID: PMC11085115 DOI: 10.3390/nu16091380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.
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Affiliation(s)
- Isobel L. Stoodley
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Bronwyn S. Berthon
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hayley A. Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Evan J. Williams
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Penelope J. Baines
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hannah Knox
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Sophie Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Beauty Paradzayi
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
| | - David Cameron-Smith
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive, #07-02 MD6, Singapore 117599, Singapore;
| | - Lisa G. Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
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Matsumoto M, Onda S, Igarashi Y, Hamura R, Uwagawa T, Furukawa K, Shirai Y, Gocho T, Haruki K, Ikegami T. Osteosarcopenia is a significant predictor of recurrence and the prognosis after resection for extrahepatic bile duct cancer. Surg Today 2024; 54:407-418. [PMID: 37700170 DOI: 10.1007/s00595-023-02747-0] [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: 05/26/2023] [Accepted: 08/06/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE This study examined the impact of osteosarcopenia on recurrence and the prognosis after resection for extrahepatic biliary tract cancer (EBTC). METHODS We retrospectively analyzed 138 patients after resection for perihilar cholangiocarcinoma (11), distal cholangiocarcinoma (54), gallbladder carcinoma (30), or ampullary carcinoma (43). Osteosarcopenia is defined as the concomitant occurrence of osteopenia and sarcopenia. We investigated the relationship between osteosarcopenia and the overall survival (OS) and disease-free survival (DFS) in univariate and multivariate analyses. RESULTS Osteosarcopenia was identified in 38 patients (27.5%) before propensity score (PS) matching. In the multivariate analysis, the independent recurrence factors were the prognostic nutrition index (p = 0.015), osteosarcopenia (p < 0.001), poorly differentiated adenocarcinoma (p = 0.004), perineural invasion (p = 0.002), and non-curability (p = 0.008), whereas the independent prognostic factors were prognostic nutrition index (p = 0.030), osteosarcopenia (p < 0.001), poorly differentiated adenocarcinoma (p = 0.007), lymphatic invasion (p = 0.018), and non-curability (p = 0.004). After PS matching, there was no significant difference in the variables between the patients with and without osteosarcopenia (n = 34 each). The 5-year DFS and OS after PS matching in patients with osteosarcopenia were significantly worse than in patients without osteosarcopenia (17.6% vs. 38.8%, p = 0.013 and 20.6% vs. 57.4%, p = 0.0005, respectively). CONCLUSIONS Preoperative osteosarcopenia could predict the DFS and OS of patients after resection for EBTC.
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Affiliation(s)
- Michinori Matsumoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yosuke Igarashi
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tadashi Uwagawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yanagaki M, Onda S, Gocho T, Igarashi Y, Shirai Y, Okui N, Matsumoto M, Sakamoto T, Haruki K, Ikegami T. Prognostic impact of osteosarcopenia in patients undergoing pancreatic resection for pancreatic ductal adenocarcinoma. Langenbecks Arch Surg 2024; 409:130. [PMID: 38634913 DOI: 10.1007/s00423-024-03315-x] [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: 01/05/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND We investigated the prognostic impact of osteosarcopenia, defined as the combination of osteopenia and sarcopenia, in patients undergoing pancreatic resection for pancreatic ductal adenocarcinoma (PDAC). METHODS The relationship of osteosarcopenia with disease-free survival and overall survival was analyzed in 183 patients who underwent elective pancreatic resection for PDAC. Computed tomography was used to measure the pixel density in the midvertebral core of the 11th thoracic vertebra for evaluation of osteopenia and in the psoas muscle area of the 3rd lumbar vertebra for evaluation of sarcopenia. Osteosarcopenia was defined as the simultaneous presence of both osteopenia and sarcopenia. The study employed a retrospective design to examine the relationship between osteosarcopenia and survival outcomes. RESULTS Osteosarcopenia was identified in 61 (33%) patients. In the univariate analysis, disease-free survival was significantly worse in patients with male sex (p = 0.031), pathological stage ≥ III PDAC (p = 0.001), NLR, ≥ 2.71 (p = 0.041), sarcopenia (p = 0.027), osteopenia (p = 0.001), and osteosarcopenia (p < 0.001), and overall survival was significantly worse in patients with male sex (p = 0.001), pathological stage ≥ III PDAC (p = 0.001), distal pancreatectomy (p = 0.025), sarcopenia (p = 0.003), osteopenia (p < 0.001), and osteosarcopenia (p < 0.001). In the multivariate analysis, the independent predictors of disease-free survival were osteosarcopenia (p < 0.001) and pathological stage ≥ III PDAC (p = 0.002), and the independent predictors of overall survival were osteosarcopenia (p < 0.001), male sex (p = 0.006) and pathological stage ≥ III PDAC (p = 0.001). CONCLUSION Osteosarcopenia has an adverse prognostic impact on long-term outcomes in patients undergoing pancreatic resection for PDAC.
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Affiliation(s)
- Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Takeshi Gocho
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yosuke Igarashi
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Norimitsu Okui
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michinori Matsumoto
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Taro Sakamoto
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Asavamongkolkul A, Adulkasem N, Chotiyarnwong P, Vanitcharoenkul E, Chandhanayingyong C, Laohaprasitiporn P, Soparat K, Unnanuntana A. Prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults: a nationwide cross-sectional study. JBMR Plus 2024; 8:ziad020. [PMID: 38505534 PMCID: PMC10945715 DOI: 10.1093/jbmrpl/ziad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 03/21/2024] Open
Abstract
Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60-107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand's national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.
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Affiliation(s)
- Apichat Asavamongkolkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nath Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Panai Laohaprasitiporn
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Krabkaew Soparat
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Hwang J, Park S. Korean Nationwide Exploration of Sarcopenia Prevalence and Risk Factors in Late Middle-Aged Women. Healthcare (Basel) 2024; 12:362. [PMID: 38338247 PMCID: PMC10855089 DOI: 10.3390/healthcare12030362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
This study examined specific clinical risk factors for age-related loss of skeletal muscle mass in late middle-aged women with sarcopenia. This Korean nationwide cross-sectional study analyzed data from 2814 community-dwelling women aged from 50 to 64 years old and screened them for sarcopenia. This study examined various risk factors such as age; height; weight; body mass index; waist circumference; skeletal muscle mass index; systolic and diastolic blood pressure; smoking and drinking habits; fasting glucose levels; triglyceride; and cholesterol levels. Complex sampling analysis was used for the data set. Prevalence of sarcopenia with a weighted prevalence of 13.43% (95% confidence interval: 2.15-15.78). The risk factors for sarcopenia were height, body mass index, waist circumference, skeletal muscle mass index, systolic blood pressure, diastolic blood pressure, triglyceride level, and total cholesterol level (p < 0.05). Weight, fasting glucose level, drinking status, and smoking status were not significant (p > 0.05). These results are expected to contribute to the existing literature on sarcopenia and identify potential risk factors associated with the development of sarcopenia in late middle-aged females. By acknowledging prevalence and recognized risk factors, healthcare professionals may augment their proficiency in recognizing and discerning potential instances of sarcopenia in female patients.
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Affiliation(s)
- Jongseok Hwang
- Institute of Human Ecology, Yeungnam University, Gyeongsan-si 38541, Republic of Korea;
| | - Soonjee Park
- Department of Clothing and Fashion, Yeungnam University, Gyeongsan-si 38541, Republic of Korea
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Ma S, Xing X, Huang H, Gao X, Xu X, Yang J, Liao C, Zhang X, Liu J, Tian W, Liao L. Skeletal muscle-derived extracellular vesicles transport glycolytic enzymes to mediate muscle-to-bone crosstalk. Cell Metab 2023; 35:2028-2043.e7. [PMID: 37939660 DOI: 10.1016/j.cmet.2023.10.013] [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: 03/12/2023] [Revised: 07/25/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023]
Abstract
Identification of cues originating from skeletal muscle that govern bone formation is essential for understanding the crosstalk between muscle and bone and for developing therapies for degenerative bone diseases. Here, we identified that skeletal muscle secreted multiple extracellular vesicles (Mu-EVs). These Mu-EVs traveled through the bloodstream to reach bone, where they were phagocytized by bone marrow mesenchymal stem/stromal cells (BMSCs). Mu-EVs promoted osteogenic differentiation of BMSCs and protected against disuse osteoporosis in mice. The quantity and bioactivity of Mu-EVs were tightly correlated with the function of skeletal muscle. Proteomic analysis revealed numerous proteins in Mu-EVs, some potentially regulating bone metabolism, especially glycolysis. Subsequent investigations indicated that Mu-EVs promoted the glycolysis of BMSCs by delivering lactate dehydrogenase A into these cells. In summary, these findings reveal that Mu-EVs play a vital role in BMSC metabolism regulation and bone formation stimulation, offering a promising approach for treating disuse osteoporosis.
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Affiliation(s)
- Shixing Ma
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiaotao Xing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Haisen Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xin Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xun Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jian Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chengcheng Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xuanhao Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jinglun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Li Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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9
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Maeda K, Imatani J, Narazaki S, Ozaki T. Bone mineral density, limb muscle mass, muscle strength, and exercise capacity are reduced in female patients with distal radius fractures when the unaffected side grip strength is less than 18 kg. J Orthop Sci 2023; 28:1279-1284. [PMID: 36182638 DOI: 10.1016/j.jos.2022.09.001] [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: 05/09/2022] [Revised: 07/19/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Prevention of domino effects after distal radius fractures is important for improving life expectancy. Fragility fractures secondary to falls are associated with decreased bone mineral density, muscle strength, and exercise capacity. Grip strength is one of the simplest and most useful tests to comprehensively judge muscle strength. The purpose of this study was to examine whether grip strength is associated with bone mineral density, limb muscle mass, muscle strength, and exercise capacity, by comparing patient backgrounds based on the presence or absence of grip weakness in female patients with distal radius fractures. METHODS This study included women with distal radius fractures who visited our orthopedics outpatient department between April 2015 and April 2020. Bone mineral density, limb muscle mass, skeletal muscle mass index, muscle strength (grip strength on unaffected side and quadriceps muscle strength), the Timed Up and Go test, and the Two-Step test were evaluated six to eight weeks after injury. Patients were divided into two groups according to the cutoff value of grip strength (18-21 kg), and 90 age-adjusted and matched participants were compared and examined. RESULTS At the cutoff value of 18 kg, a significant decrease in lumbar spine and total proximal femur bone mineral density (p < 0.05, p < 0.05), limb muscle mass and skeletal muscle mass index (p < 0.01, p < 0.05), quadriceps femoris muscle strength (p < 0.01), the Timed Up and Go test (p < 0.05), and the Two-Step test (p < 0.01), was observed in the grip-weakness group compared to that in the no-grip-weakness group. CONCLUSIONS In women with distal radius fracture and grip strength <18 kg on the unaffected side, bone mineral density, limb muscle mass, quadriceps femoris strength, and exercise capacity may be reduced. These results suggest reduced grip strength may be an indicator for further testing to prevent domino effects.
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Affiliation(s)
| | - Junya Imatani
- Department of Orthopedics, Okayama Saiseikai General Hospital, Japan
| | - Shinji Narazaki
- Department of Orthopedics, Okayama Saiseikai General Hospital, Japan
| | - Toshifumi Ozaki
- Department of Orthopedics, Okayama University Medical School, Japan
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10
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Cheng L, Wang S. Correlation between bone mineral density and sarcopenia in US adults: a population-based study. J Orthop Surg Res 2023; 18:588. [PMID: 37559054 PMCID: PMC10410911 DOI: 10.1186/s13018-023-04034-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION In the aging process of the body, in addition to changes in fat and muscle content, there is also bone loss, implying the possibility of a strong muscle-bone-lipid link. In this study, we initially investigated the relationship between lumbar BMD and low muscle mass and the relationship between "muscle-bone-lipid." METHODS The datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were used in a cross-sectional investigation. BMD and appendicular skeletal muscle (ASM) were measured by dual-energy X-ray absorptiometry (DXA), and appendicular skeletal muscle was adjusted by body mass index (BMI) as a marker of sarcopenia. Weighted multivariate regression and logistic regression analysis were used to explore the independent relationship between lumbar BMD and sarcopenia. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship. RESULT In 8386 participants with ages 20-59 years, there was a negative association between lumbar BMD and sarcopenia. In the fully adjusted model, the risk of developing sarcopenia decreased by 93% for each 1-unit increase in lumbar BMD (OR = 0.07, 95%CI 0.03-0.20). The risk of sarcopenia was 58% lower in participants in the highest quartile of lumbar BMD than in those in the lowest quartile (OR = 0.42, 95%CI 0.27-0.64). This negative association was more pronounced in the population of women with BMI ≥ 25. CONCLUSION Our findings suggest that lumbar BMD is negatively associated with sarcopenia in US adults. The dynamic balance between "muscle-bone-lipid" is likely to be related to the pathogenesis of bone loss.
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Affiliation(s)
- Lulu Cheng
- College of Acupuncture-Moxibustion and Tuina, Anhui University of Chinese Medicine, Hefei, 230012, China.
- Graduate School, Wuhan Sports University, Wuhan, 430079, China.
| | - Siyu Wang
- Graduate School, Wuhan Sports University, Wuhan, 430079, China
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11
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Seaton MP, Nichols JF, Rauh MJ, Kado DM, Wetherell JL, Lenze EJ, Wing D. Associations of Lean Mass, Muscular Strength, and Physical Function with Trabecular Bone Score in Older Adults. J Clin Densitom 2023; 26:101370. [PMID: 37100686 DOI: 10.1016/j.jocd.2023.101370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION/BACKGROUND Trabecular bone score (TBS) is an indirect measurement of bone quality and microarchitecture determined from dual-energy X-ray absorptiometry (DXA) imaging of the lumbar spine. TBS predicts fracture risk independent of bone mass/density, suggesting this assessment of bone quality adds value to the understanding of patients' bone health. While lean mass and muscular strength have been associated with higher bone density and lower fracture risk among older adults, the literature is limited regarding the relationship of lean mass and strength with TBS. The purpose of this study was to determine associations of DXA-determined total body and trunk lean mass, maximal muscular strength, and gait speed as a measure of physical function, with TBS in 141 older adults (65-84 yr, 72.5 +/- 5.1 yr, 74% women). METHODOLOGY Assessments included lumbar spine (L1-L4) bone density and total body and trunk lean mass by DXA, lower body (leg press) and upper body (seated row) strength by one repetition maximum tests, hand grip strength, and usual gait speed. TBS was derived from the lumbar spine DXA scan. Multivariable linear regression determined the contribution of proposed predictors to TBS. RESULTS After adjusting for age, sex, and lumbar spine bone density, upper body strength significantly predicted TBS (unadjusted/adjusted R2= 0.16/ 0.11, β coefficient =0.378, p=0.005), while total body lean mass index showed a trend in the expected direction (β coefficient =0.243, p=0.053). Gait speed and grip strength were not associated with TBS (p>0.05). CONCLUSION Maximum strength of primarily back muscles measured as the seated row appears important to bone quality as measured by TBS, independent of bone density. Additional research on exercise training targeting back strength is needed to determine its clinical utility in preventing vertebral fractures among older adults.
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Affiliation(s)
- Margaret P Seaton
- University of California, Department of Neurological Surgery, San Francisco, CA, United States; Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Jeanne F Nichols
- Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States.
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Deborah M Kado
- Stanford University, Geriatric Research Education and Clinical Center (GRECC), VA Palo Alto Health System, Palo Alto, CA, United States
| | - Julie Loebach Wetherell
- VA San Diego Healthcare System Mental Health Division and University of California, San Diego Department of Psychiatry, United States
| | - Eric J Lenze
- Washington University School of Medicine - Healthy Mind Lab, Department of Psychiatry, United States
| | - David Wing
- Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States
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12
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Takaoka H, Furuya T, Shiga Y, Maki S, Inage K, Yamaguchi S, Yamashita T, Sasho T, Kawano H, Ohtori S. Comparison of Muscle Mass Between Healthy Subjects and Patients With Malignant Tumors Undergoing Outpatient Treatment. Cureus 2023; 15:e42462. [PMID: 37637672 PMCID: PMC10450224 DOI: 10.7759/cureus.42462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
Background In recent years, advances in the treatment of malignant tumors have improved life expectancy and diversified treatment options. However, maintaining high activities of daily living in patients is essential for appropriately treating the primary disease, and interventions for patients with impaired motor function will lead to improved quality of life. Here, we compared the muscle mass of malignant tumor patients who are visiting bone metastasis outpatient clinics with that of healthy subjects. Methods We compared the muscle mass of 61 malignant tumor patients with an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (mean 66.3 ± 12.0 years; 30 males and 31 females) attending our bone metastasis outpatient clinic since 2018 with that of 315 healthy subjects (mean 65.0 ± 17.7 years; 110 males and 205 females). Body mass index, skeletal muscle mass, and body fat percentage were assessed by bioimpedance analysis, and the skeletal muscle mass index (SMI) was calculated. Results To eliminate age bias in the malignant tumor patients and healthy subjects, 1:1 propensity score matching was performed separately for males and females. There was no significant difference in right upper limb, left upper limb, right lower limb, or left lower limb mass or SMI between the two groups, whereas trunk muscle mass and muscle mass were significantly higher in the healthy females compared with malignant tumor females. Conclusion There was no significant difference in the SMI measured by bioimpedance analysis between the two groups in either males or females, while muscle mass and trunk muscle mass were significantly lower in female malignant tumor patients than in healthy subjects. These results suggest that even malignant tumor patients whose performance status was maintained enough to allow outpatient visits still had impaired motor function.
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Affiliation(s)
- Hiromitsu Takaoka
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Satoshi Yamaguchi
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
| | - Takeshi Yamashita
- Department of Orthopaedic Surgery, Oyumino Central Hospital, Chiba, JPN
| | - Takahisa Sasho
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
- Center for Preventive Medical Sciences, Chiba University, Chiba, JPN
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, JPN
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University's Graduate School of Medicine, Chiba, JPN
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Carcelén-Fraile MDC, Aibar-Almazán A, Afanador-Restrepo DF, Rivas-Campo Y, Rodríguez-López C, Carcelén-Fraile MDM, Castellote-Caballero Y, Hita-Contreras F. Does an Association among Sarcopenia and Metabolic Risk Factors Exist in People Older Than 65 Years? A Systematic Review and Meta-Analysis of Observational Studies. Life (Basel) 2023; 13:life13030648. [PMID: 36983804 PMCID: PMC10058840 DOI: 10.3390/life13030648] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Sarcopenia is defined as the generalized and progressive loss of skeletal muscle strength and mass that may be affected by metabolic factors, although this relationship has been poorly studied. The aim of this review and meta-analysis was to analyze the relationship among the different metabolic risk factors and sarcopenia in people older than 65 years. Following the PRISMA 2020 guide, we searched for articles that studied the relationship among sarcopenia and metabolic risk factors in adults over 65 years of age, published between 2012 and 2022 in four databases: PubMed, Web of Science, Cochrane Plus, and CINAHL. A total of 370 articles were identified in the initial search, of which 13 articles were selected for inclusion in this review. It was observed that metabolic risk factors such as Body Mass Index, systolic and diastolic blood pressure, glucose, cholesterol, or triglycerides had a significant association with sarcopenia. There is evidence of the association of different metabolic risk factors with sarcopenia in adults over 65 years of age, so it is necessary to carry out studies that investigate different strategies that reduce the appearance of sarcopenia, and with it, the incidence of metabolic diseases.
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Affiliation(s)
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaen, Spain
- Correspondence:
| | | | - Yulieth Rivas-Campo
- Faculty of Human and Social Sciences, University of San Buenaventura-Cali, Santiago de Cali 760016, Colombia
| | | | | | | | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaen, Spain
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Assessment of the Impact of Physical Activity on the Musculoskeletal System in Early Degenerative Knee Joint Lesions in an Animal Model. Int J Mol Sci 2023; 24:ijms24043540. [PMID: 36834951 PMCID: PMC9960538 DOI: 10.3390/ijms24043540] [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: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
Osteoarthritis (OA) is one of the most prevalent diseases of the osteoarticular system. Progressive destruction of joints is accompanied by development of pathological changes in the muscle tissue, i.e., weakening, atrophy, and remodelling (sarcopenia). The aim of the present study is to assess the impact of physical activity on the musculoskeletal system in an animal model of early degenerative lesions in the knee joint. The study involved 30 male Wistar rats. The animals were allocated to three subgroups of 10 animals each. Each animal from the three subgroups received sodium iodoacetate by injection into the patellar ligament of the right knee joint, whereas saline was administered through the patellar ligament in the left knee joint. The rats in the first group were stimulated to exercise on a treadmill. The animals in the second group were allowed to lead a natural lifestyle (no treadmill stimulation). In the third group, all parts of the right hind limb muscle were injected with Clostridium botulinum toxin type A. The study demonstrated that, compared to the active rats, bone density in the immobilised rats decreased, as indicated by the densitometric assessment of the whole body and the examination of rats' hind limbs and knee joints alone. This clearly evidenced the impact of physical activity on bone mineralisation. The weight of both fat and muscle tissues in the physically inactive rats was reduced. Additionally, the adipose tissue had higher weight in the entire right hind limbs, where monoiodoacetic acid was administered to the knee joint. The animal model clearly showed the importance of physical activity in the early stages of OA, as it slows down the process of joint destruction, bone atrophy, and muscle wasting, whereas physical inactivity contributes to progression of generalised changes in the musculoskeletal system.
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15
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Prognostic impact of osteosarcopenia in patients with advanced pancreatic cancer receiving gemcitabine plus nab-paclitaxel. Pancreatology 2023; 23:275-282. [PMID: 36792473 DOI: 10.1016/j.pan.2023.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Osteosarcopenia, defined as the combination of osteoporosis and sarcopenia, has recently gained attention as a novel prognostic factor for survival in patients with cancer. This study aimed to evaluate the prognostic impact of osteosarcopenia in metastatic pancreatic cancer (PC). METHODS We retrospectively investigated consecutive metastatic PC patients receiving first-line gemcitabine plus nab-paclitaxel (GnP). Skeletal muscle index at the third lumbar vertebra and bone mineral density at the first lumbar vertebra were measured using pretreatment computed tomography. Treatment outcomes of osteosarcopenia and non-osteosarcopenia groups were compared and analyzed. Multivariate analysis was performed to identify variables associated with survival. RESULTS Among 313 patients, osteosarcopenia was present in 59 patients (19%). The osteosarcopenia group was associated with older age, higher proportion of females, worse performance status, and higher modified Glasgow prognostic scores (mGPS). Response rates to chemotherapy, progression-free survival (3.5 months vs. 6.4 months, p < 0.001), and overall survival (5.6 months vs. 13.0 months, p < 0.001) were significantly better in the non-osteosarcopenia group. Osteosarcopenia, performance status of 1-2, mGPS score of 1-2, carcinoembryonic antigen ≥10 ng/mL, and carbohydrate antigen 19-9 ≥ 1000 IU/mL were identified as independent factors predicting shorter survival. Grade 3 or higher anemia and febrile neutropenia occurred more frequently in the osteosarcopenia group. CONCLUSIONS Osteosarcopenia was associated with poor survival in metastatic PC treated with first-line GnP. Screening for osteosarcopenia may be helpful for better management of metastatic PC.
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Jun JE, Lee SE, Lee YB, Kim G, Jin SM, Jee JH, Kim JH. Low skeletal muscle mass Accompanied by Abdominal Obesity Additively Increases the Risk of Incident Type 2 Diabetes. J Clin Endocrinol Metab 2022; 108:1173-1180. [PMID: 36394524 DOI: 10.1210/clinem/dgac662] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Low skeletal muscle mass often accompanies abdominal obesity in the aging process. OBJECTIVE We aimed to investigate the effect of reduced skeletal muscle mass and its interaction with abdominal obesity on incident type 2 diabetes. METHODS This retrospective longitudinal study included a total of 36,304 diabetes-free Koreans who underwent two or more health check-ups annually or biennially. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI) adjusted for body weight. Pre-sarcopenia was defined as an SMI <1 standard deviation of the sex-specific mean for a healthy young reference group. Abdominal obesity was defined using waist circumference ≥ 90 cm for men and ≥ 85 cm for women. Participants were classified into four groups of normal, pre-sarcopenia alone, abdominal obesity alone, and pre-sarcopenic obesity according to initial body composition. RESULTS The cumulative incidence of diabetes was 9.1% during the 7-year follow-up. Compared with the highest tertile, the lowest sex-specific SMI tertile was significantly associated with a greater risk of incident type 2 diabetes (adjusted hazard ratio [HR] = 1.31, 95% confidence interval [CI] 1.18-1.45) in a fully adjusted model. Pre-sarcopenic obesity significantly increased incident diabetes risk (adjusted HR = 1.57, 95% CI 1.42-1.73) compared with normal body composition, pre-sarcopenia alone, or abdominal obesity alone. CONCLUSIONS Low skeletal muscle mass and its coexistence with abdominal obesity additively increased the risk of incident type 2 diabetes independent of the glycometabolic parameters.
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Affiliation(s)
- Ji Eun Jun
- Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung-Eun Lee
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, Ulsan University, Ulsan, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hwan Jee
- Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea
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17
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Fukushima N, Tsuboi K, Nyumura Y, Hoshino M, Masuda T, Suzuki T, Kajimoto T, Yano F, Eto K. Prognostic significance of preoperative osteopenia on outcomes after gastrectomy for gastric cancer. Ann Gastroenterol Surg 2022; 7:255-264. [PMID: 36998304 PMCID: PMC10043770 DOI: 10.1002/ags3.12635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Aim Osteopenia, characterized by low bone mineral density, is a potential prognostic factor for patients with cancer. The aim of this study was to clarify the impact of preoperative osteopenia in patients with gastric cancer (GC) after gastrectomy. Methods We included 224 patients with GC who underwent gastrectomy between August 2013 and May 2022. Osteopenia was evaluated by measuring the pixel density in the mid-vertebral core of the 11th thoracic vertebra using computed tomography. Results Osteopenia was identified in 68 patients (30%). The osteopenia group had significantly worse overall survival (OS) and disease-free survival (DFS) than the non-osteopenia group (P < .01, P < .01, respectively). The postoperative hospital stay was significantly longer, and the occurrence of postoperative complications (Clavien-Dindo grade ≥ III) was significantly higher in the osteopenia group (P = .04, P < .01, respectively). In multivariate analysis, osteopenia (P < .01), stage ≥II (P < .01), and R1 or R2 curability (P < .01) were independent and significant predictors of DFS. Additionally, osteopenia (P < .01), intraoperative blood loss (P = .04), stage ≥II (P < .01), and R1 or R2 curability (P < .01) were independent and significant predictors of OS. Conclusion Preoperative osteopenia was independently associated with a poor prognosis and recurrence in patients who underwent gastrectomy for GC.
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Affiliation(s)
- Naoko Fukushima
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Kazuto Tsuboi
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Yuya Nyumura
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Masato Hoshino
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Takahiro Masuda
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Toshimasa Suzuki
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Tetsuya Kajimoto
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
- Department of SurgeryFuji City General HospitalShizuokaJapan
| | - Fumiaki Yano
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Ken Eto
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
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Osteopenia is associated with inferior survival in patients undergoing partial hepatectomy for hepatocellular carcinoma. Sci Rep 2022; 12:18316. [PMID: 36316524 PMCID: PMC9622743 DOI: 10.1038/s41598-022-21652-z] [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] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Osteopenia is known to be associated with clinical frailty which is linked to inferior outcomes in various clinical scenarios. However, the exact prognostic value of osteopenia in patients undergoing curative intent-surgery for hepatocellular carcinoma (HCC) is not completely understood. This retrospective study was conducted in a cohort of 151 patients who underwent partial hepatectomy for HCC in curative intent at a German university medical center (05/2008-12/2019). Preoperative computed tomography-based segmentation was used to assess osteopenia, and the prognostic impact of pathological changes in bone mineral density (BMD) on perioperative morbidity, mortality, and long-term oncological outcome was analyzed. Five-year overall survival of osteopenic patients was significantly worse compared to those with normal BMD (29% vs. 65%, p = 0.014). In line with this, the probability of disease-free survival at 5 years was significantly worse for patients with osteopenia (21% vs. 64%, p = 0.005). In our multivariable model, osteopenia was confirmed as an independent risk-factor for inferior overall survival (Hazard-ratio 7.743, p = 0.002). Concerning perioperative complications, osteopenic patients performed slightly worse, even though no statistical difference was detected (Clavien-Dindo ≥ 3b; 21% vs. 9%, p = 0.139). The present study confirms osteopenia as an independent risk-factor for inferior survival in patients undergoing partial hepatectomy for HCC in a European cohort. Further studies are warranted to validate these findings.
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Yanagaki M, Haruki K, Taniai T, Igarashi Y, Yasuda J, Furukawa K, Onda S, Shirai Y, Tsunematsu M, Ikegami T. The significance of osteosarcopenia as a predictor of the long‐term outcomes in hepatocellular carcinoma after hepatic resection. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2022; 30:453-461. [PMID: 36181339 DOI: 10.1002/jhbp.1246] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/15/2022] [Accepted: 09/07/2022] [Indexed: 02/11/2023]
Abstract
BACKGROUND Frailty, represented by sarcopenia and osteopenia, has been associated with worse survival after hepatectomy in patients with hepatocellular carcinoma. Recently, the concept and term "osteosarcopenia" have been proposed, which has been associated with worse outcome in several malignancies. METHODS This study included 227 patients who underwent elective hepatic resection for hepatocellular carcinoma. Osteopenia was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. The skeletal muscle index (SMI) was evaluated with psoas muscle areas at the third lumbar vertebra. Osteosarcopenia was defined as the concomitant occurrence of osteopenia and low SMI. We retrospectively investigated the relationship between osteosarcopenia and disease-free and overall survival. RESULTS Osteosarcopenia was identified in 27 (12%) of the patients. Multivariate analysis showed that osteosarcopenia (P < .001), C-reactive protein-to-albumin ratio ≥0.02 (P = .002), and stage ≥III (P ≤ .001) were independent predictors of disease-free survival, while osteosarcopenia (P < .001), Child-Pugh grade B (P = .002), C-reactive protein-to-albumin ratio ≥0.02 (P = .001), low SMI (P ≤ .001), and stage ≥III (P ≤ .001) were independent predictors of overall survival. CONCLUSION Preoperative osteosarcopenia may be a prognostic factor in patients with hepatocellular carcinoma after hepatic resection. Our results suggests that the preoperative maintenance of skeletal muscle and bone density may potentially improve prognosis.
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Affiliation(s)
- Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Tomohiko Taniai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Yosuke Igarashi
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Jungo Yasuda
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Masashi Tsunematsu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan
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Kato T, Ikezoe T, Tabara Y, Matsuda F, Tsuboyama T, Ichihashi N. Differences in lower limb muscle strength and balance ability between sarcopenia stages depend on sex in community-dwelling older adults. Aging Clin Exp Res 2022; 34:527-534. [PMID: 34417732 DOI: 10.1007/s40520-021-01952-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM This study aimed to compare motor function between sarcopenia stages with respect to sex in community-dwelling older adults. METHODS The participants, comprising 2107 community-dwelling older adults (738 men and 1369 women), were classified into 4 groups and the groups were operationally defined-normal, low muscle mass, low physical function, and sarcopenia groups. Lower limb muscle strength and balance ability were assessed for evaluating motor function. To compare motor function between sarcopenia stages, an analysis of covariance adjusted for age and body mass index was performed. RESULTS Lower limb muscle strengths were significantly lower not only in the sarcopenia group but also in the low muscle mass and low physical function groups than that in the normal group in both men and women. Low hip abductor muscle strength was observed in the low physical function group compared to the low muscle mass group in women, but not in men. Timed Up and Go test results in the sarcopenia and low function groups was lower than in the normal and low muscle mass groups for men and women. One-leg standing in the low physical function group was lower than that in the normal group, only for women. CONCLUSIONS Reduced motor function was observed not only in older people with sarcopenia but also in older people with only low muscle mass or low physical function, and the decline in lower limb muscle strength and balance ability in the low function group were greater in older women than in older men.
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Affiliation(s)
- Takehiro Kato
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tome Ikezoe
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tadao Tsuboyama
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- School of Health Sciences, Bukkyo University, 7 Higashitoganoo-cho, Nishinokyo, Nakagyo-ku, Kyoto, 606-8418, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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21
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Laskou F, Fuggle NR, Patel HP, Jameson K, Cooper C, Dennison E. Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study. J Cachexia Sarcopenia Muscle 2022; 13:220-229. [PMID: 34873876 PMCID: PMC8818662 DOI: 10.1002/jcsm.12870] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/27/2021] [Accepted: 10/29/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Ageing is commonly associated with sarcopenia (SP) and osteoporosis (OP), both of which are associated with disability, impaired quality of life, and mortality. The aims of this study were to explore the relationships between SP, OP, frailty, and multimorbidity in community-dwelling older adults participating in the Hertfordshire Cohort Study (HCS) and to determine whether coexistence of OP and SP was associated with a significantly heavier health burden. METHODS At baseline, 405 participants self-reported their comorbidities. Cut-offs for low grip strength and appendicular lean mass index were used according to the EWSGOP2 criteria to define SP. OP was diagnosed when T-scores of < -2.5 were present at the femoral neck or the participant reported use of the anti-OP medications including hormone replacement therapy (HRT), raloxifene, or bisphosphonates. Frailty was defined using the standard Fried definition. RESULTS One hundred ninety-nine men and 206 women were included in the study. Baseline median (interquartile range) age of participants was 75.5 (73.4-77.9) years. Twenty-six (8%) and 66 (21.4%) of the participants had SP and OP, respectively. Eighty-three (20.5%) reported three or more comorbidities. The prevalence of pre-frailty and frailty in the study sample was 57.5% and 8.1%, respectively. Having SP only was strongly associated with frailty [odds ratio (OR) 8.28, 95% confidence interval (CI) 1.27, 54.03; P = 0.027] while the association between having OP alone and frailty was weaker (OR 2.57, 95% CI 0.61, 10.78; P = 0.196). The likelihood of being frail was substantially higher in the presence of coexisting SP and OP (OR 26.15, 95% CI 3.13, 218.76; P = 0.003). SP alone and OP alone were both associated with having three or more comorbidities (OR 4.71, 95% CI 1.50, 14.76; P = 0.008 and OR 2.86, 95% CI 1.32, 6.22; P = 0.008, respectively) although the coexistence of SP and OP was not significantly associated with multimorbidity (OR 3.45, 95% CI 0.59, 20.26; P = 0.171). CONCLUSIONS Individuals living with frailty were often osteosarcopenic. Multimorbidity was common in individuals with either SP or OP. Early identification of SP and OP not only allows implementation of treatment strategies but also presents an opportunity to mitigate frailty risk.
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Affiliation(s)
- Faidra Laskou
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas R Fuggle
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.,The Alan Turing Institute, London, UK
| | - Harnish P Patel
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Medicine for Older People, University Hospital Southampton, Southampton, UK.,Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - Karen Jameson
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Elaine Dennison
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.,Victoria University of Wellington, Wellington, New Zealand
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22
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Laskou F, Patel HP, Cooper C, Dennison E. A pas de deux of osteoporosis and sarcopenia: osteosarcopenia. Climacteric 2022; 25:88-95. [PMID: 34308725 DOI: 10.1080/13697137.2021.1951204] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
The musculoskeletal conditions osteoporosis and sarcopenia are highly prevalent in older adults. Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone, whereas sarcopenia is identified by the loss of muscle strength, function and mass. Osteoporosis represents a major health problem contributing to millions of fractures worldwide on an annual basis, whereas sarcopenia is associated with a range of adverse physical and metabolic outcomes. They both affect physical and social function, confidence and quality of life as well as contributing to high health-care costs worldwide. Osteosarcopenia is the term given when both conditions occur concomitantly and it has been suggested that interactions between these two conditions may accelerate individual disease progression as co-existence of osteoporosis and sarcopenia is associated with higher morbidity from falls, fracture, disability as well as mortality. In this review, we will outline the epidemiology, pathogenesis and clinical consequences of osteosarcopenia and discuss available management strategies.
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Affiliation(s)
- F Laskou
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - H P Patel
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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23
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Mase T, Ohara K, Momoi K, Nakamura H. Association between the recognition of muscle mass and exercise habits or eating behaviors in female college students. Sci Rep 2022; 12:635. [PMID: 35022451 PMCID: PMC8755834 DOI: 10.1038/s41598-021-04518-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022] Open
Abstract
This study aimed to examine the association between muscle mass and perception of body shape, desired body shape, physical strength, exercise habits, and eating behaviors. Height, weight, and body composition in 270 female university students were measured. The questionnaire on body shape perception, desired body shape, dieting experience, current, and past exercise habits, exercise preference, and eating behaviors were administered. The analysis of covariance with body fat mass as the covariate found that the skeletal muscle index (SMI) was different among each group on each of body perception or desired body shape (all, p < 0.001). In the post hoc test on body shape perception, the SMI in "obese" was significantly more than that in "slim" (p < 0.001) and "normal" (p < 0.001). In the desired body shape, the SMI in "become thin" was more than that in "maintain as current shape" (p < 0.001). Further, a significant difference was found among the categories of diet experience, with body fat mass as the covariate. In the post hoc test, the SMI in "yes" was more than that in "no" (p < 0.001). These results indicate that not only body fat mass but skeletal muscle mass drives young females' desire for thinness even with exercise advantages.
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Affiliation(s)
- Tomoki Mase
- Faculty of Human Development and Education, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama, Kyoto, Kyoto, 605-8501, Japan.
| | - Kumiko Ohara
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Katsumasa Momoi
- Faculty of Health and Welfare, Tokushima Bunri University, 180 Nishihama-hoji, Yamashiro-cho, Tokushima, Tokushima, 770-8514, Japan
| | - Harunobu Nakamura
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan
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24
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Shiba T, Sawaya Y, Hirose T, Sato R, Ishizaka M, Kubo A, Urano T. Features of older community-dwelling adults with osteosarcopenia requiring support or care. J Phys Ther Sci 2022; 34:341-346. [PMID: 35527844 PMCID: PMC9057679 DOI: 10.1589/jpts.34.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 11/30/2022] Open
Abstract
[Purpose] This study aimed to investigate the problems associated with osteosarcopenia
and its effect on physical performance, nutritional status, and support or care required
by older community-dwelling adults. [Participants and Methods] This study investigated 141
older community-dwelling adults requiring support or care using an ambulatory
rehabilitation service. The patients were divided into a control, osteopenia only,
sarcopenia only, and osteosarcopenia group. We investigated the associations of each
condition with the baseline information, grip strength, gait speed, Mini Nutritional
Assessment-Short Form score, and support or care level required. [Results] The
osteosarcopenia group consisted of 43.3% of the total study participants. Osteosarcopenia
was more closely associated with body mass index, support or care level, grip strength,
gait speed, skeletal muscle mass index, and Mini Nutritional Assessment-Short Form score
than osteopenia or sarcopenia alone. [Conclusion] Osteosarcopenia is highly prevalent in
older community-dwelling adults requiring support or care, which may suggest a greater
effect on physical performance, nutritional status, and support or care required than that
exerted by osteopenia or sarcopenia alone.
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Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
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25
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Fernandes S, Rodrigues da Silva E, New York B, Macedo P, Gonçalves R, Camara S, Larco R, Maciel A. Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review. J Nutr Health Aging 2022; 26:452-460. [PMID: 35587757 DOI: 10.1007/s12603-022-1788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. OBJECTIVES this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. METHODS In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages. RESULTS 19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world. CONCLUSION It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.
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Affiliation(s)
- S Fernandes
- Sabrina Fernandes, Universidade Federal do Rio Grande do Norte, Brazil,
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26
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Saddik H, Pinti A, Antoun A, Al Rassy N, El Hage Z, Berro AJ, Lespessailles E, Toumi H, El Hage R. Limb Muscular Strength and Bone Mineral Density in Elderly Subjects with Low Skeletal Muscle Mass Index. J Clin Densitom 2021; 24:538-547. [PMID: 33958260 DOI: 10.1016/j.jocd.2021.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 12/31/2022]
Abstract
The aim of the current study was to investigate the relationships between limb muscular strength and bone mineral density (BMD) in a group of elderly subjects with low skeletal muscle mass index (SMI).55 elderly Lebanese subjects (35 women and 20 men) participated in the current study. Handgrip, one-repetition maximum (1-RM) dumbbell curl (1-RM biceps), 1-RM lying one arm triceps (1-RM triceps), 1-RM calf raise, 1-RM leg extension and 1-RM leg curl were evaluated using validated methods.In both genders, 1-RM biceps, 1-RM triceps, 1-RM leg extension and 1-RM leg curl were positively correlated to total hip BMD. The current study shows that limb muscular strength is positively correlated to hip BMD in elderly subjects with low SMI. This may have clinical implications in the field of osteoporosis prevention in elderly subjects with low SMI.
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Affiliation(s)
- Hayman Saddik
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, El-Koura, Lebanon; I3MTO, EA4708, Université d'Orléans, Orléans, France
| | - Antonio Pinti
- Laboratoire DeVisu - Design, Visuel, Urbain, EA 2445, Université polytechnique Hauts-de-France (UPHF), Valenciennes, France
| | - Amal Antoun
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, El-Koura, Lebanon; Laboratoire Impact de l'Activité Physique sur la Santé (IAPS), Université de Toulon, 83041 Toulon Cedex 9, Toulon, France
| | - Nathalie Al Rassy
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, El-Koura, Lebanon
| | - Zaher El Hage
- Department of Psychology, Education and Physical Education, Faculty of Humanities, Notre Dame University, Louaize, Lebanon
| | - Abdel-Jalil Berro
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, El-Koura, Lebanon
| | | | - Hechmi Toumi
- I3MTO, EA4708, Université d'Orléans, Orléans, France
| | - Rawad El Hage
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, El-Koura, Lebanon.
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Does the psychological variables predict life satisfaction and purpose in life in brazilian elderly? PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2021. [DOI: 10.15448/2357-9641.2021.1.40223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims: the present study aimed to investigate the association between indicatives of stress, anxiety and depression with life satisfaction and purpose in life among Brazilian older adults.Methods: this cross-sectional study was conducted with 654 Brazilian older adults who responded the Life Satisfaction Scale, Purpose in Life Scale, Perceived Stress Scale, Geriatric Anxiety Inventory and the Geriatric Depression Scale. Data were analyzed through independent t-test, Cohen’s D, Pearson Correlations and Multivariate Regression Analysis (p<0.05).Results: results indicated slightly higher levels of stress and anxiety for women when compared to men (p<0.05); indicatives of stress, anxiety and depression were inversely correlated to life satisfaction and purpose (r = -0.19 to -0.44; p<0.05); stress (β=-0.29) and depression (β=-0.36) were significant predictors of life satisfaction (R2=0.31; p<0.01), and life purpose (R2=0.18; p<0.01) was predicted by stress (β=-0.15), anxiety (β=0.10) and depression (β=-0.39).Conclusion: It can be concluded that stress and depression are significant factors hindering older adults’ satisfaction and purpose in life.
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28
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Cho YS, Lee HY, Jeong JY, Lee JG, Kim TY, Nam SW, Sohn JH. Computed Tomography-Determined Body Composition Abnormalities Usefully Predict Long-term Mortality in Patients With Liver Cirrhosis. J Comput Assist Tomogr 2021; 45:684-690. [PMID: 34407059 DOI: 10.1097/rct.0000000000001207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We evaluated the prognostic impacts of body composition components measured by computed tomography (CT) in patients with liver cirrhosis. METHODS A total of 160 cirrhotic patients who underwent CT and hepatic venous pressure gradient measurements were retrospectively enrolled. Cross-sectional areas of skeletal muscle, visceral and subcutaneous fat, and mean CT attenuation of trabecular bone of the fourth lumbar vertebral level (L4HU) were measured. RESULTS Multivariate analysis showed model for end-stage liver disease score [hazard ratio (HR), 1.086; 95% confidence interval (CI), 1.020-1.156; P = 0.010], hepatic venous pressure gradient (HR, 1.076; 95% CI, 1.021-1.135; P = 0.006), sarcopenia (HR, 1.890; 95% CI, 1.032-3.462; P = 0.039), and L4HU (HR, 1.960 for L4HU <145 Hounsfield units; 95% CI, 1.094-3.512; P = 0.024) were independently associated with long-term mortality. In patients with decompensated cirrhosis, subcutaneous adipose tissue index was the only independent predictor (HR, 0.984; 95% CI, 0.969-0.999; P = 0.039). CONCLUSION Body composition abnormalities determined by CT are associated with long-term prognosis in cirrhotic patients.
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Affiliation(s)
- Young Seo Cho
- From the Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - Ha Young Lee
- Department of Radiology, Inha University School of Medicine, Incheon
| | | | - Jae Gon Lee
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - Tae Yeob Kim
- Department of Internal Medicine, New Hope Internal Medicine Clinic, Seoul, Korea
| | - Seong Woo Nam
- Department of Internal Medicine, National Medical Center, Seoul
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
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29
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Kim J. Longitudinal Association of Handgrip Strength with Medical Use and the Risk of Hospitalization in Korean Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.3.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Age-related loss of muscular strength may contribute to medical health condition. Decreased handgrip strength is associated with an increased risk of chronic diseases, disability, and mortality. However, it is not known whether handgrip strength is also linked with hospitalization and medical use from the long-term cohort study in middle-aged adults. Thus, we aimed to investigate the association of handgrip strength levels, medical use, and hospitalization in Korean adults.METHODS This large prospective study was based on data from Korean Longitudinal Study of Ageing 2006 to 2018. In total, 9,228 participants aged ≥45 years were included for this study. Handgrip strength was measured using dynamometer, and classified into quartiles by sex-specific cutoff point.RESULTS Significantly higher hazard ratio (HR) for hospitalization was observed in lower handgrip strength (HR: 1.22, 95% CI:1.11-1.34) compared to higher handgrip strength (reference) in the fully adjusted model. We also found longitudinal association of handgrip strength levels and the use of hospitalization and outpatient medical care during 12 years following period using mixed effect modes with time-dependent interaction.CONCLUSIONS Our results suggests that lower handgrip strength was associated with increased the risk of hospitalization and use of medical care in Korean population. This study highlights the maintaining of muscular strength may play an important role in the reduction of risk for hospitalization and medical use by preventing chronic diseases.
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Bazdyrev ED, Terentyeva NA, Krivoshapova KE, Masenko VL, Wegner EA, Kokov АN, Pomeshkina SA, Barbarash OL. Prevalence of Musculoskeletal Disorders in Patients with Coronary Artery Disease. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-06-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim. To study the prevalence of musculoskeletal disorders in patients with stable coronary artery disease (CAD).Material and methods. Patients with stable CAD (n=387) were included in the study. The subjects were admitted to the hospital for planned myocardial revascularization (ages of 50-82). The median age was 65 [59;69] years. Most of the sample consisted of males - 283 (73.1%). 323 (83.5%) patients had arterial hypertension (AH), 57.1% - history of myocardial infarction, and a quarter of the patients had type 2 diabetes mellitus (DM). The study of musculoskeletal system included the identification of sarcopenia in accordance with The European Working Group on Sarcopenia in Older People (EWGSOP, 2019); verification of osteopenia/osteoporosis according to the WHO criteria (2008); diagnosing osteosarcopenia in case of sarcopenia and osteopenia/osteoporosis coexistence.Results. At the initial screening of sarcopenia in accordance with EWGSOP, clinical signs (according to the Strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire) were detected in 41.3% of cases, but further examination (dynamometry, quantitative assessment of skeletal muscle) confirmed this diagnosis only in 19.9% of patients with CAD. Among the examined patients with CAD a low T-score according to DEXA was found in 53 (13.7%) of cases, and osteopenia was diagnosed 10 times more often than osteoporosis (90.6% vs. 9.4%). Furthermore, due to combination of low bone density (osteopenia/osteoporosis) and reduced muscle mass and strength (sarcopenia), osteosarcopenia was verified in one patient. Thus, the study revealed the prevalence of particular types of musculoskeletal disorders in 105 (27.1%) patients with stable CAD. The most common type of musculoskeletal disorder was sarcopenia - 52 cases (13.4%); osteopenia/osteoporosis was detected in 28 patients (7.2%), osteosarcopenia in 25 (6.5%). The most pronounced clinical manifestation of sarcopenia and osteopenia/osteoporosis, reflected by a higher score on the SARC-F questionnaire, low handgrip strength, small area of muscle tissue, low musculoskeletal index, as well as low values of bone mineral density, were observed in patients with osteosarcopenia. Patients with osteopenia/osteoporosis did not differ significantly from patients without musculoskeletal conditions in most parameters, with the exception of the T-score, the average SARC-F score, and muscle strength in men. The conducted correlation analysis revealed not only the relationship between the parameters of musculoskeletal function, but also their association with age, duration of AH, CAD, and type 2 DM.Conclusion. Several types of musculoskeletal disorders were found in a third of patients with CAD. Sarcopenia was revealed to be the most frequent type of musculoskeletal disorder.
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Affiliation(s)
- E. D. Bazdyrev
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - N. A. Terentyeva
- Research Institute for Complex Issues of Cardiovascular Diseases
| | | | - V. L. Masenko
- Research Institute for Complex Issues of Cardiovascular Diseases
| | | | - А. N. Kokov
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - S. A. Pomeshkina
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - O. L. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
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Saeki C, Oikawa T, Kanai T, Nakano M, Torisu Y, Sasaki N, Abo M, Saruta M, Tsubota A. Relationship between osteoporosis, sarcopenia, vertebral fracture, and osteosarcopenia in patients with primary biliary cholangitis. Eur J Gastroenterol Hepatol 2021; 33:731-737. [PMID: 32558699 PMCID: PMC8016510 DOI: 10.1097/meg.0000000000001791] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023]
Abstract
AIM Bone disorders are serious complications in patients with primary biliary cholangitis (PBC), especially in postmenopausal female patients. Given that osteoporosis interrelates closely with sarcopenia, the concept of osteosarcopenia (coexistence of the two complications) has been established. This study aimed to investigate the relationship between osteoporosis, sarcopenia, vertebral fracture, and osteosarcopenia in PBC patients. METHODS This study involved 117 consecutive PBC patients (21 males and 96 females). Bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry. Sarcopenia was diagnosed according to the Japan Society of Hepatology assessment criteria. RESULTS Of the 117 patients, 33 (28.2%), 27 (23.1%), 21 (17.9%), and 18 (15.4%) had osteoporosis, sarcopenia, vertebral fracture, and osteosarcopenia, respectively. Multivariate analysis identified sarcopenia as a significant, independent risk factor associated with osteoporosis in all and female patients [odds ratio (OR) = 4.126, P = 0.018; OR = 6.510, P = 0.001, respectively], and vice versa (OR = 3.420, P = 0.040; OR = 4.012, P = 0.026, respectively). The skeletal muscle mass index and handgrip strength were significantly correlated with the BMD of the lumbar spine, femoral neck, and total hip (r = 0.46-0.59, P < 0.001). Patients with osteosarcopenia had significantly higher prevalence of vertebral fracture (10/18; 55.6%) than those without both osteoporosis and sarcopenia (5/75; 6.7%). CONCLUSION We demonstrated the prevalence of osteoporosis, sarcopenia, vertebral fracture, and osteosarcopenia in PBC, and noted that these complications interrelated closely with each other. Comprehensive assessment and treatment strategies for bone and muscle disorders are essential for PBC patients.
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Affiliation(s)
- Chisato Saeki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Shizuoka
| | - Tsunekazu Oikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
| | - Tomoya Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Shizuoka
| | - Masanori Nakano
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Shizuoka
| | - Yuichi Torisu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
- Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, Shizuoka
| | - Nobuyuki Sasaki
- Department of Rehabilitation Medicine, The Jikei University School of Medicine
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
| | - Akihito Tsubota
- Core Research Facilities, Research Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan
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Teng Z, Zhu Y, Yu X, Liu J, Long Q, Zeng Y, Lu S. An analysis and systematic review of sarcopenia increasing osteopenia risk. PLoS One 2021; 16:e0250437. [PMID: 33909650 PMCID: PMC8081219 DOI: 10.1371/journal.pone.0250437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/07/2021] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is a progressive generalized skeletal muscle disorder, which may increase the risk of osteopenia. The aim of this study was to systematically review studies on the association between sarcopenia and osteopenia by pooled analysis. The PubMed and Embase databases were searched from inception to October 2020 for studies focusing on the association between sarcopenia and osteopenia. Two reviewers independently extracted data and assessed study quality. A pooled analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) using random-effects models. Subgroup analysis was conducted to explore the source of heterogeneity and the stability of outcome. A total of 25 independent studies involving 47,744 participants fulfilled the inclusion criteria. Sarcopenia significantly increased the risk of osteopenia (OR, 2.08; 95% CI, 1.66–2.60); Sensitivity analyses indicated the outcome was stable. Subgroup analyses showed that sarcopenia significantly increased osteopenia risk in each subgroup. No evidence of publication bias among the studies existed. In this study, our findings showed that sarcopenia significantly increased the risk of osteopenia. Thus, we suggest that sarcopenia can be a predictor of osteopenia risk.
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Affiliation(s)
- Zhaowei Teng
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yun Zhu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Xiaochao Yu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Jie Liu
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Qing Long
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yong Zeng
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- * E-mail: (YZ); (SL)
| | - Sheng Lu
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
- * E-mail: (YZ); (SL)
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Lin YH, Chen HC, Hsu NW, Chou P, Teng MMH. Hand grip strength in predicting the risk of osteoporosis in Asian adults. J Bone Miner Metab 2021; 39:289-294. [PMID: 32889572 DOI: 10.1007/s00774-020-01150-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/24/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION There is a need for a cost-effective method to identify individuals with a high risk of osteoporosis. This study aimed to investigate the suitability of hand grip strength in predicting the risk of osteoporosis in Asian adults. MATERIALS AND METHODS In this cross-sectional, hospital-based study of 1007 participants, the bone mineral density of the spine and hips was evaluated using dual-energy X-ray absorptiometry according to the 2019 International Society for Clinical Densitometry official positions. Bone microarchitecture was evaluated using the trabecular bone score, and hand grip strength was measured in the dominant hand using a hand digital dynamometer. RESULTS Hand grip strength was significantly related to bone density and bone microarchitecture. Moreover, hand grip strength was a significant predictor of osteoporosis in both women and men. For osteoporosis prediction in women, a threshold of 21.9 kg of hand grip strength had a sensitivity of 59%, specificity of 59%, and area under the curve (AUC) of 0.61. In men, a threshold of 28.7 kg had a sensitivity of 66%, specificity of 78%, and AUC of 0.75. The optimal cutoff strengths for osteoporosis depended on age and sex. CONCLUSION The measurement of hand grip strength is a simple, cost-effective and an easy assessment method for identifying individuals at a high risk of osteoporosis. The cutoff strength for evaluating osteoporosis in adults is age and sex specific.
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Affiliation(s)
- Yen-Huai Lin
- Department of Medical Imaging, Cheng Hsin General Hospital, 45 Cheng Hsin Street, Taipei, 112, Taiwan
- Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wei Hsu
- Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Public Health Bureau, Yilan County, Taiwan
| | - Pesus Chou
- Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Michael Mu Huo Teng
- Department of Medical Imaging, Cheng Hsin General Hospital, 45 Cheng Hsin Street, Taipei, 112, Taiwan.
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Ikuta S, Aihara T, Nakajima T, Kasai M, Yamanaka N. Computed tomography-measured bone mineral density as a surrogate marker of survival after resection of colorectal liver metastases. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:21. [PMID: 33553314 PMCID: PMC7859742 DOI: 10.21037/atm-20-3751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Osteopenia/osteoporosis, characterized by low bone mineral density (BMD), is a potential prognostic factor in cancer patients. We conducted a retrospective single-institution study to evaluate the prognostic impact of preoperative low BMD on colorectal liver metastases (CRLM) in patients undergoing liver resection. Methods BMD was assessed in 281 patients undergoing initial liver resection for CRLM by analyzing the preoperative computed tomography (CT) images at the level of the eleventh thoracic vertebra as the region of interest. Survival outcomes were compared between the two groups divided by the median BMD value and prognostic factors after surgery were assessed. Propensity score-based inverse probability weighting (IPW) was applied to adjust for between-group differences in baseline characteristics. Results The low BMD group had significantly more older patients (≥75 years) (P=0.01) and a higher incidence of bilobar metastases (P=0.005) than the normal BMD group. After IPW adjustment, overall survival (OS) was significantly poorer (P=0.02) and recurrence-free survival was slightly poorer (P=0.05) in the low BMD group than in the normal BMD group. IPW-adjusted regression analysis revealed that low BMD was independently associated with an adverse OS (hazard ratio, 1.42; 95% CI, 1.04–1.93; P=0.03), in addition to other factors such as tumor number, extrahepatic disease, preoperative carcinoembryonic antigen level (≥5 ng/mL), and right-sided primary tumor location. Conclusions Preoperative CT-measured low BMD can serve as a surrogate marker of adverse OS in CRLM patients undergoing liver resection. Prevention and early intervention for osteopenia/osteoporosis may be suggested for these patients.
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Affiliation(s)
- Shinichi Ikuta
- Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan
| | - Tsukasa Aihara
- Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan
| | | | - Meidai Kasai
- Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan
| | - Naoki Yamanaka
- Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan
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Sasaki F, Hayashi M, Ono T, Nakashima T. The regulation of RANKL by mechanical force. J Bone Miner Metab 2021; 39:34-44. [PMID: 32889574 DOI: 10.1007/s00774-020-01145-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 12/15/2022]
Abstract
Receptor activator of nuclear factor-κB ligand (RANKL) is a key mediator of osteoclast differentiation and bone resorption. Osteoblast-lineage cells including osteoblasts and osteocytes express RANKL, which is regulated by several different factors, including hormones, cytokines, and mechanical forces. In vivo and in vitro analyses have demonstrated that various types of mechanosensing proteins on the cell membrane (i.e. mechanosensors) and intracellular mechanosignaling proteins play essential roles in the differentiation and functions of osteoblasts, osteoclasts, and osteocytes via soluble factors, such as sclerostin, Wnt ligands, and RANKL. This section provides an overview of the in vivo and in vitro evidence for the regulation of RANKL expression by mechanosensing and mechanotransduction.
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Affiliation(s)
- Fumiyuki Sasaki
- Department of Cell Signaling, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
- Core Research for Evolutional Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Mikihito Hayashi
- Department of Cell Signaling, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
- Precursory Research for Innovative Medical Care (PRIME), Japan Agency for Medical Research and Development, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Takehito Ono
- Department of Cell Signaling, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
- Core Research for Evolutional Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Tomoki Nakashima
- Department of Cell Signaling, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
- Core Research for Evolutional Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan.
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Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 2020; 42:1547-1578. [PMID: 33001410 PMCID: PMC7528158 DOI: 10.1007/s11357-020-00272-3] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
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Affiliation(s)
- Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Deaglan McCullough
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK.
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Claire Stewart
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Toshima T, Yoshizumi T, Kosai-Fujimoto Y, Inokuchi S, Yoshiya S, Takeishi K, Itoh S, Harada N, Ikegami T, Soejima Y, Mori M. Prognostic Impact of Osteopenia in Patients Who Underwent Living Donor Liver Transplantation for Hepatocellular Carcinoma. World J Surg 2020; 44:258-267. [PMID: 31624895 DOI: 10.1007/s00268-019-05206-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Osteopenia, loss of bone mineral density (BMD), was recently identified to be independently associated with early marker of deconditioning that precedes sarcopenia in patients with hepatocellular carcinoma (HCC). The aim of this study was to clarify the impact of osteopenia as the risk factor for mortality after living donor liver transplantation (LDLT) compared with already-reported biological markers. METHODS Data were collected retrospectively for all consecutive patients who underwent LDLT for HCC at our institution between January 1998 and December 2015. BMD was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. Data related to clinicopathological parameters and prognosis were analyzed. RESULTS The median value of BMD was 163.6 Hounsfield units and osteopenia was identified in 103 (53.4%) of the 193 recipients, according to the age-specific formula. In addition to the other tumor burdens, such as tumor numbers ≥5 (HR 2.521, P = 0.027), DCP levels >200 mAU/mL (HR 2.678, P = 0.006), and neutrophil-to-lymphocyte ratio ≥3.01 (HR 2.068, P = 0.025), osteopenia (HR 2.106, P = 0.024) was independent risk factor for mortality by multivariate analysis. Overall survival of the patients who met the two risk factors and more was significantly lower than the others (HR 5.382, P < 0.001). Besides, the calibration plot for the 5-year overall survival using nomogram was predicted very well (C-index 0.746). CONCLUSIONS Preoperative osteopenia was independently associated with post-LDLT mortality among patients with HCC. Moreover, risk score and nomogram with calibration curve were developed to confirm the clinical usefulness of osteopenia for post-LDLT patients.
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Affiliation(s)
- Takeo Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yukiko Kosai-Fujimoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shoichi Inokuchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shohei Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toru Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuji Soejima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Invernizzi M, de Sire A, Carda S, Venetis K, Renò F, Cisari C, Fusco N. Bone Muscle Crosstalk in Spinal Cord Injuries: Pathophysiology and Implications for Patients' Quality of Life. Curr Osteoporos Rep 2020; 18:422-431. [PMID: 32519284 DOI: 10.1007/s11914-020-00601-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The goal of this review is to provide a comprehensive overview of (i) bone and muscle tissue modifications pathophysiology in spinal cord injury (SCI), (ii) experimental data on the physiopathological mechanisms underpinning these modifications and their similarities with the aging process, and (iii) potential clinical implications in the management of the disabling sequelae of SCI. RECENT FINDINGS Several studies attempted to describe the biology underpinning the links between bone and muscle tissues in the setting of highly disabling conditions, such as osteoporosis, sarcopenia, and neurodegenerative disorders, although these bidirectional connections remain still unclear. SCI could be considered an in vivo paradigmatic model of the bone muscle interactions in unloading conditions that might be expanded in the field of neurodegenerative disorders or cancer studies. Future studies should take into consideration the newer insights into bone muscle crosstalk in order to develop multitargeted and therapeutic interventions.
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Affiliation(s)
- Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Rehabilitation Unit, "Mons. L. Novarese" Hospital, Moncrivello, Vercelli, Italy
| | - Stefano Carda
- Neuropsychology and Neurorehabilitation Service, Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Konstantinos Venetis
- Ph.D. Program in Translational Medicine, University of Milan, Milan, Italy
- Division of Pathology, IRCCS European Institute of Oncology (IEO), Milan, Italy
| | - Filippo Renò
- Innovative Research Laboratory for Wound Healing, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Carlo Cisari
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Physical Medicine and Rehabilitation Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Nicola Fusco
- Division of Pathology, IRCCS European Institute of Oncology (IEO), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Confortin S, Ono L, Marques L, Ceolin G, d’Orsi E, Barbosa A. Osteopenia/Osteoporosis and Its Association with Sarcopenia: EpiFloripa Aging Study 2013/2014. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000508924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Abstract
BACKGROUND Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia, is an emerging geriatric giant, which poses a serious global health burden. METHODS AND RESULTS The prevalence of osteosarcopenia ranges in community-dwelling older adults [5-37% (≥65 years)] with the highest rates observed in those with fractures (low-trauma fracture: ~46%; hip fracture: 17.1-96.3%). Among 2353 community-dwelling adults, risk factors associated with osteosarcopenia include older age [men: 14.3% (60-64 years) to 59.4% (≥75 years); women: 20.3% (60-64 years) to 48.3% (≥75 years), P < 0.05], physical inactivity [inverse relationship: 0.64, 95% confidence interval (CI) 0.46-0.88 (sexes combined)], low body mass index (inverse relationship: men: 0.84, 95% CI 0.81-0.88; women: 0.77, 95% CI 0.74-0.80), and higher fat mass (men: 1.46, 95% CI 1.11-1.92; women: 2.25, 95% CI 1.71-2.95). Among 148 geriatric inpatients, osteosarcopenic individuals demonstrate poorer nutritional status (mini-nutritional assessment scores: 8.50 ± 2.52 points, P < 0.001) vs. osteoporosis or sarcopenia alone, while among 253 older Australians, osteosarcopenia is associated with impaired balance and functional capacity [odds ratios (ORs): 2.56-7.19; P < 0.05] vs. non-osteosarcopenia. Osteosarcopenia also associates with falls (ORs: 2.83-3.63; P < 0.05), fractures (ORs: 3.86-4.38; P < 0.05), and earlier death [hazard ratio (1-year follow-up): 1.84, 95% CI; 0.69-4.92, P = 0.023] vs. non-osteosarcopenia. CONCLUSIONS This syndrome is expected to grow in age-related and disease-related states, a likely consequence of immunosenescence coinciding with increased sedentarism, obesity, and fat infiltration of muscle and bone. Evidence suggests the pathophysiology of osteosarcopenia includes genetic polymorphisms, reduced mechanical loading, and impaired endocrine functioning, as well as altered crosstalk between muscle, bone, and fat cells. Clinicians should screen for osteosarcopenia via imaging methods (i.e. dual-energy X-ray absorptiometry) to quantify muscle and bone mass, in addition to assessing muscle strength (i.e. grip strength) and functional capacity (i.e. gait speed). A comprehensive geriatric assessment, including medical history and risk factors, must also be undertaken. Treatment of this syndrome should include osteoporotic drugs [bone anabolics/antiresorptives (i.e. teriparatide, denosumab, bisphosphates)] where indicated, and progressive resistance and balance exercises (at least 2-3 times/week). To maximize musculoskeletal health, nutritional recommendations [protein (1.2-1.5 g/kg/day), vitamin D (800-1000 IU/day), calcium (1300 mg/day), and creatine (3-5 g/day)] must also be met. It is anticipated that diagnosis and treatment for osteosarcopenia will become part of routine healthcare in the future. However, further work is required to identify biomarkers, which, in turn, may increase diagnosis, risk stratification, and targeted treatments to improve health outcomes.
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Affiliation(s)
- Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical SchoolUniversity of MelbourneMelbourneAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneAustralia
| | - Jesse Zanker
- Department of Medicine, Western Health, Melbourne Medical SchoolUniversity of MelbourneMelbourneAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneAustralia
| | - Gustavo Duque
- Department of Medicine, Western Health, Melbourne Medical SchoolUniversity of MelbourneMelbourneAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneAustralia
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Kirk B, Phu S, Brennan-Olsen SL, Bani Hassan E, Duque G. Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults. Eur Geriatr Med 2020; 11:443-450. [DOI: 10.1007/s41999-020-00301-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/19/2020] [Indexed: 12/18/2022]
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Sarcopenia negatively affects hip structure analysis variables in a group of Lebanese postmenopausal women. BMC Bioinformatics 2020; 21:86. [PMID: 32164524 PMCID: PMC7068911 DOI: 10.1186/s12859-020-3353-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The current study's purpose is to compare hip structural analysis variables in a group of postmenopausal women with sarcopenia and another group of postmenopausal women with normal skeletal muscle mass index. To do so, the current study included 8 postmenopausal women (whose ages ranged between 65 and 84 years) with sarcopenia and 60 age-matched controls (with normal skeletal muscle mass index (SMI)). Body composition and bone parameters were evaluated by dual-energy X-ray absorptiometry (DXA). RESULTS Weight, lean mass, body mass index, femoral neck cross-sectional area (FN CSA), FN section modulus (Z), FN cross sectional moment of inertia (CSMI), intertrochanteric (IT) CSA, IT Z, IT CSMI, IT cortical thickness (CT), femoral shaft (FS) CSA, FS Z and FS CSMI were significantly greater (p < 0.05) in women with normal SMI compared to women with sarcopenia. In the whole population, SMI was positively associated with IT CSA, IT Z, IT CSMI, IT CT, FS CSA, FS Z, FS CSMI, FS CT but negatively correlated to IT buckling ratio (BR) and FS BR. CONCLUSION The current study suggests that sarcopenia has a negative effect on hip bone strength indices in postmenopausal women.
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Impact of the preoperative bone mineral density on the outcomes after resection of pancreatic cancer. Surg Today 2020; 50:757-766. [PMID: 31925578 DOI: 10.1007/s00595-019-01954-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/14/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of this study is to evaluate the correlation between bone mineral density (BMD) and other body composition markers, as well as, the impact of preoperative BMD on the surgical outcomes after resection of pancreatic cancer. METHODS This retrospective study included 275 patients who underwent surgical resection of pancreatic cancer in our institute between 2003 and 2016. Patients were divided according to BMD into low and normal groups and their postoperative outcomes were compared. Risk factors for mortality and tumor recurrence were also evaluated. RESULTS Patients with low BMD were older (P < 0.001), had a higher intramuscular adipose tissue content (P = 0.011) and higher visceral fat area (P = 0.003). The incidence of postoperative pancreatic fistula (POPF) (grade ≥ B) was higher in the low BMD group. No significant difference was observed between the two groups regarding overall survival and recurrence-free survival and low BMD was not a risk factor for mortality or tumor recurrence after resection of pancreatic cancer. CONCLUSION A low preoperative BMD was not found to be a risk factor for mortality or tumor recurrence after resection of pancreatic cancer; however, it was associated with a higher incidence of clinically relevant POPF.
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Pinho JP, Forner-Cordero A, Rodrigues Pereira RM, Hernandez AJ, Dórea EL, Mezêncio B, Takayama L, Alvarenga JC, Serrão JC, Amadio AC. A High-Intensity Exercise Intervention Improves Older Women Lumbar Spine and Distal Tibia Bone Microstructure and Function: A 20-Week Randomized Controlled Trial. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2020; 8:2100108. [PMID: 31966932 PMCID: PMC6964965 DOI: 10.1109/jtehm.2019.2963189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/10/2019] [Accepted: 12/05/2019] [Indexed: 12/28/2022]
Abstract
Introduction: The effects of ageing on bone can be mitigated with different types of physical training, such as power training. However, stimuli that combine increasing external and internal loads concomitantly may improve bone quality. The goal of this study was to assess the efficacy of a combined power and plyometric training on lumbar spine and distal tibia microstructure and function. Methods: 38 sedentary elderly women between 60 and 70 years were randomly allocated in experimental (N = 21) and control group (N = 17). The effects of the 20-week protocol on lumbar spine microstructure and tibia microstructure and function were assessed by trabecular bone score (TBS), high resolution peripheral quantitative computed tomography (HR-pQCT) and microfinite element analysis. Results: when compared to the effects found in the control group, the experimental group showed significant improvements in lumbar spine TBS (Hedges' g = 0.77); and in distal tibia trabecular thickness (g = 0.82) and trabecular bone mineral density (g=0.63). Conclusion: our findings underscore the effectiveness of the proposed intervention, suggesting it as a new strategy to slow down and even reverse the structural and functional losses in the skeletal system due to ageing.
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Affiliation(s)
- João Pedro Pinho
- Laboratory of Biomechanics, School of Physical Education and SportsUniversity of São PauloSão Paulo05508-220Brazil
- Biomechatronics LaboratoryEscola Politécnica of the University of São PauloSão Paulo05508-220Brazil
| | - Arturo Forner-Cordero
- Biomechatronics LaboratoryEscola Politécnica of the University of São PauloSão Paulo05508-220Brazil
- Institute of Advanced StudiesSão Paulo05508-220Brazil
| | | | - Arnaldo José Hernandez
- Department of Orthopedics and Traumatology, Medical SchoolUniversity of São PauloSão Paulo05508-220Brazil
| | - Egídio Lima Dórea
- University Hospital, University of São PauloSão Paulo05508-220Brazil
| | - Bruno Mezêncio
- Laboratory of Biomechanics, School of Physical Education and SportsUniversity of São PauloSão Paulo05508-220Brazil
| | - Liliam Takayama
- Biomechatronics LaboratoryEscola Politécnica of the University of São PauloSão Paulo05508-220Brazil
| | | | - Júlio Cerca Serrão
- Laboratory of Biomechanics, School of Physical Education and SportsUniversity of São PauloSão Paulo05508-220Brazil
| | - Alberto Carlos Amadio
- Laboratory of Biomechanics, School of Physical Education and SportsUniversity of São PauloSão Paulo05508-220Brazil
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Confortin SC, Ono LM, Marques LP, Figueiró TH, Ceolin G, Barbosa AR, d’Orsi E. Sarcopenia, bone mineral density, and vitamin D: EpiFloripa aging study 2013/2014. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-212320202000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To verify associations between osteopenia/osteoporosis and vitamin D and sarcopenia in the older adult population of Florianopolis, Brazil. METHODS: A cross-sectional population-based study, with 604 older adults (60 years and over). The appendicular muscle mass index (AMMI) was used to identify sarcopenia, with cutoffs of AMMI (Kg/m2) < 7.26 kg/m2 for men and < 5.50 kg/m2 for women indicating inadequate values (sarcopenia). The independent variable osteopenia/osteoporosis was measured using bone mineral density (BMD, g/cm2): T-Scores for whole body BMD, lumbar spine BMD, and femoral neck BMD, categorized as normal (BMD ≥ -1 SD) or osteopenia/osteoporosis (BMD < -1 SD from the mean of the young adult reference population). Fasting serum samples were collected and assayed using the microparticle chemiluminescence (CMIA)/Liaison method. Vitamin D concentrations of < 30 ng/mL were defined as hypovitaminosis. Crude and adjusted logistic regression analyses were performed. RESULTS: Osteopenia/osteoporosis in the lumbar spine and femoral neck were associated with higher odds of sarcopenia in women and men. Osteopenia/osteoporosis in the whole body was associated with sarcopenia in women only. Vitamin D was not associated with sarcopenia in either sex. CONCLUSIONS: Having osteopenia/osteoporosis is associated with sarcopenia in the older adult population.
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Lewandowicz A, Sławiński P, Kądalska E, Targowski T. Some clarifications of terminology may facilitate sarcopenia assessment. Arch Med Sci 2020; 16:225-232. [PMID: 32051727 PMCID: PMC6963130 DOI: 10.5114/aoms.2020.91293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/13/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
- Andrzej Lewandowicz
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Sławiński
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Ewa Kądalska
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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He Q, Wang X, Yang C, Zhuang X, Yue Y, Jing H, Hu J, Sun M, Guo L. Metabolic and Nutritional Characteristics in Middle-Aged and Elderly Sarcopenia Patients with Type 2 Diabetes. J Diabetes Res 2020; 2020:6973469. [PMID: 33204732 PMCID: PMC7661113 DOI: 10.1155/2020/6973469] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/13/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022] Open
Abstract
Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength (n = 405) and a nonsarcopenia group with normal muscle strength (n = 720) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.
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Affiliation(s)
- Qinghua He
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, China
| | - Xiuzhi Wang
- Department of Endocrinology, Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing 10120, China
| | - Caizhe Yang
- Department of Endocrinology, Air Force Medical Center, PLA, Beijing 100142, China
| | - Xiaoming Zhuang
- Department of Endocrinology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Yanfen Yue
- Department of Nutriology, Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing 10120, China
| | - Hongjiang Jing
- Department of Nutriology, Air Force Medical Center, PLA, Beijing 100142, China
| | - Jing Hu
- Department of Nutriology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Mingxiao Sun
- Department of Endocrinology, Beijing Eden Hospital, Beijing 100195, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, China
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Qi H, Sheng Y, Chen S, Wang S, Zhang A, Cai J, Lai B, Ding G. Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin Exp Res 2019; 31:1549-1556. [PMID: 31317519 PMCID: PMC6825032 DOI: 10.1007/s40520-019-01266-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
Background As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear. Aims To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects. Methods 318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance. Results We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip. Conclusions The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.
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Affiliation(s)
- Hanmei Qi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Yunlu Sheng
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Shu Chen
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Siting Wang
- Division of Intensive Care Unit, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Aisen Zhang
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Jinmei Cai
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Bing Lai
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Guoxian Ding
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Miyachi Y, Kaido T, Yao S, Shirai H, Kobayashi A, Hamaguchi Y, Kamo N, Yagi S, Uemoto S. Bone Mineral Density as a Risk Factor for Patients Undergoing Surgery for Hepatocellular Carcinoma. World J Surg 2019; 43:920-928. [PMID: 30465085 DOI: 10.1007/s00268-018-4861-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND We have reported the impact of sarcopenia and body composition on patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, the impact of bone mineral density (BMD) on outcomes after hepatectomy for HCC and correlation with other parameters including sarcopenia are unclear. METHODS We retrospectively analyzed 465 patients who underwent primary hepatectomy for HCC between April 2005 and March 2015. We analyzed the plain CT images at the level of the eleventh thoracic vertebra with the region of interest and defined as preoperative BMD. RESULTS In this cohort, male (n = 367) and female (n = 98) patients showed significant heterogeneity in age, body composition markers, tumor factors, peri-operative parameters and so on. The median preoperative BMD in male and female patients was 155 and 139 HU, respectively (P = 0.005). BMD was negatively correlated with age in female (r = -0.590, P < 0.001) and intramuscular adipose tissue content in both male and female (r = -0.332 and -0.359, respectively, P < 0.001). For males, BMD < 160 HU was associated with worse cancer-specific survival post-hepatectomy (P = 0.015). In contrast, females were not (P = 0.135). For male patients, multivariate analysis identified low BMD as an independent risk factor for death (hazard ratio 1.720, 95% confidence interval 1.038-2.922, P = 0.035) after hepatectomy for HCC. CONCLUSION Preoperative low BMD was an independent risk factor for cancer-specific mortality after hepatectomy for HCC.
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Affiliation(s)
- Yosuke Miyachi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Toshimi Kaido
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Siuan Yao
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hisaya Shirai
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Atsushi Kobayashi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuhei Hamaguchi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Naoko Kamo
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shintaro Yagi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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