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Kurik G, Kelly-Bissue C, Lõhmus A, Muhhamedjanov K, Ilves N, Forbes A. Standardising and simplifying the Global Leadership Initiative on Malnutrition (GLIM) for its more general application. Clin Nutr ESPEN 2024; 62:120-127. [PMID: 38901933 DOI: 10.1016/j.clnesp.2024.05.010] [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: 10/17/2023] [Revised: 04/27/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Malnutrition is present in 20-50% of hospital patients but its recognition is often neither timely nor complete. The Global Leadership Initiative on Malnutrition (GLIM) aims to improve this, but its successful implementation may be compromised by its dependence on (a choice of) prior screening tools and difficulties in consistent assessment of muscle mass. AIMS To explore different approaches to screening and muscle assessment in GLIM and to offer simpler choices for its more widespread application. METHODS (1) Data from 300 consenting in-patients provided Nutritional Risk Screening (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Subjective Global Assessment (SGA) scores. GLIM scoring was preceded by NRS-2002 or MUST (using threshold scores of 1 or 2 for MUST), or no prior screening. The results of GLIM scoring preceded by different screening approaches were compared with those of SGA. (2) The literature on mid-upper arm circumference (MUAC) and calf circumference (CC) as simple, non-invasive, objective methods of muscle assessment methods was reviewed (3) The cumulative times taken to obtain GLIM scores were measured and corrected for the different screening strategies. RESULTS (1) Participants' mean age was 60 years, 157 (52%) were female and mean BMI was 27.8 kg/m2. In comparison with SGA, GLIM with no prior screening had the highest sensitivity (65%) and negative predictive value (NPV) (76%), but the lowest specificity (90%) and positive predictive value (PPV) (84%). The equivalent figures for GLIM with prior MUST "1" were 62%, 75%, 93% and 88%; with prior NRS-2002, 55%∗, 73%, 98%∗ and 95%∗; and with prior MUST "2", 44%∗, 69%∗, 98%∗, 95%∗. The area under an ROC curve was the highest (0.78) when GLIM was performed without screening or with prior MUST "1". (2) Being less affected by oedema and gender differences than calf circumference, MUAC could serve as a standard globally accessible muscle mass assessment method which can be supplemented by technical approaches if available and deemed necessary. (3) The overall per-capita time requirement of GLIM was 240-245 s without prior screening, and was increased by 2-3% with prior MUST "1", by 27-29% with prior NRS-2002 and decreased by 8-9% with prior MUST "2". CONCLUSIONS Preceding GLIM by screening can decrease its sensitivity and increase overall time utilisation; "gold standard" muscle assessment is not globally accessible. Our results therefore support considering using GLIM as a combined screening and assessment tool, with MUAC as the method of muscle assessment which can be supplemented by technical approaches if available and deemed necessary. This could potentially both simplify the use of GLIM and improve the early detection of malnutrition. ∗Indicates statistically significant difference from use of GLIM without prior screening.
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Affiliation(s)
- G Kurik
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia
| | - C Kelly-Bissue
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia
| | - A Lõhmus
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia
| | - K Muhhamedjanov
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia
| | - N Ilves
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia
| | - A Forbes
- Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia.
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Winter IP, Ferguson BK, Wilson PB. Associations between urine specific gravity and race/ethnicity at the population level: Implications for hydration status categorization. Am J Hum Biol 2024:e24139. [PMID: 39016205 DOI: 10.1002/ajhb.24139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/18/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE We aimed to evaluate how urine specific gravity (USG) and rates of supposed hypohydration vary by race/ethnicity, and to examine how adjustment for several important factors impacts estimated USG. METHODS Using the National Health and Nutrition Examination Survey, this cross-sectional study evaluated a total of 4195 (2098 female, 2097 male) Americans and categorized them as supposedly hypohydrated (USG≥1.020) or not using spot urine samples. USG and prevalence of supposed hypohydration were compared across racial/ethnic groups, separately by gender. The analyses considered the impact of urine creatinine, body composition, age, dietary nutrients, and physical activity. RESULTS Differences in supposed hypohydration prevalence were observed by race/ethnicity in men (p = .030) and women (p < .001). In unadjusted models, Black women's USG (1.0189) was higher (p < .05) than all the other race/ethnicity groups' USG (1.0142-1.0171). In men, Blacks' USG (1.0197) was higher (p < .05) than the USG of Whites (1.0177) and other/multi-racial (1.0176) but not Mexican Americans (1.0196) or other Hispanics (1.0192). Adjustments for age, arm circumference, nutrients (protein, sodium, potassium, and moisture), and physical activity minimally influenced USG estimates. Further adjustment for urine creatinine lowered USG for Black women and men by 0.003 and 0.0023, respectively, with no notable lowering of USG in the other races/ethnicities. Supplemental analyses matching Whites and Blacks on age, moisture intake, and poverty-to-income ratio confirmed racial differences in urine creatinine and USG, though the effects were most pronounced in women. CONCLUSIONS Using a USG≥1.020 to identify hypohydration in all races/ethnicities may be inappropriate due to, among other factors, differences in urinary creatinine.
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Affiliation(s)
- Ian P Winter
- Human Performance Laboratory, Old Dominion University, Norfolk, Virginia, USA
| | - Brian K Ferguson
- Human Performance Laboratory, Old Dominion University, Norfolk, Virginia, USA
| | - Patrick B Wilson
- Human Performance Laboratory, Old Dominion University, Norfolk, Virginia, USA
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Posokhov IN, Praskurnichiy EA, Orlova OS, Sukhodolova EA, Lystseva AV. Validation of two automatic sphygmomanometers according to the modified International Standardization Organization 81060-2:2018 protocol in adults with a mid-upper arm circumference of 22 centimeters or less. Blood Press Monit 2024:00126097-990000000-00116. [PMID: 38958495 DOI: 10.1097/mbp.0000000000000715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE A recent International Organization for Standardization (ISO) Task Group report calls for research to investingate potential special populations in validation studies of automated blood pressure (BP) devices. Accordingly, we aimed to determine the accuracy of two previously validated BP monitors passed in a general population when measured in adults with a mid-upper arm circumference (MUAC) ≤ 22 cm. METHODS Test device A was the OMRON HEM 7121 equipped with the HEM CS24 cuff designed for an arm circumference of 17-22 cm. Test device B was the YuWell YE660Е with the YuWell '360°' cuff (18-36 cm). Data from 37 participants aged 20.14 ± 2.23 (18-28) years were analyzed according to criterion 1 of ISO Standard 81060-2 : 2018. RESULTS According to criterion 1, the mean ± SD of the BP differences for the device A was -7.81 ± 5.20/-10.66 ± 5.48 mmHg (systolic/diastolic) and for the device B was -8.00 ± 6.30/-16.11 ± 5.15 mmHg (systolic/diastolic), respectively. This means that neither device met the requirements. CONCLUSION Since devices A and B, which had passed in a general population study, failed in adults aged 18-28 years with an MUAC ≤ 22 cm, such individuals might be considered as new special population for validation studies.
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Affiliation(s)
- Igor N Posokhov
- Department of Therapy, State Scientific Center of the Russian Federation - Federal Medical Biophysical Center named after A.I. Burnazyan
| | - Evgeny A Praskurnichiy
- Department of Therapy, State Scientific Center of the Russian Federation - Federal Medical Biophysical Center named after A.I. Burnazyan
- Department of Therapy, Faculty of Medicine and Biology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Olga S Orlova
- Department of Therapy, State Scientific Center of the Russian Federation - Federal Medical Biophysical Center named after A.I. Burnazyan
- Department of Therapy, Faculty of Medicine and Biology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ekaterina A Sukhodolova
- Department of Therapy, Faculty of Medicine and Biology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Aleksandra V Lystseva
- Department of Therapy, Faculty of Medicine and Biology, Pirogov Russian National Research Medical University, Moscow, Russia
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Spangler HB, Lynch DH, Howard AG, Tien HC, Du S, Zhang B, Wang H, Gordon Larsen P, Batsis JA. Association Between Mid-arm Muscle Circumference and Cognitive Function: A Longitudinal Study of Chinese Adults. J Geriatr Psychiatry Neurol 2024; 37:272-281. [PMID: 37993115 PMCID: PMC11089828 DOI: 10.1177/08919887231218087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Dementia affects 55 million people worldwide and low muscle mass may be associated with cognitive decline. Mid-arm muscle circumference (MAMC) correlates with dual-energy Xray absorptiometry and bioelectrical impedance analyses, yet are not routinely available. Therefore, we examined the association between MAMC and cognitive performance in older adults. METHODS We included community-dwelling adults ≥55 years from the China Health and Nutrition Survey. Cognitive function was estimated based on a subset of the modified Telephone Interview for Cognitive Status (0-27, low-high) during years (1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, 2018). A multivariable linear mixed-effects model was used to test whether MAMC was associated with rate of cognitive decline across age groups and cognitive function overall. RESULTS Of 3702 adults (53% female, 63.2 ± 7.3 years), mean MAMC was 21.4 cm ± 3.0 and baseline cognitive score was 13.6 points ±6.6. We found no evidence that the age-related rate of cognitive decline differed by MAMC (P = .77). Declines between 5-year age groups ranged from -.80 [SE (standard error) .18] to -1.09 [.22] for those at a mean MAMC, as compared to -.86 [.25] to -1.24 [.31] for those at a 1 MAMC 1 standard deviation above the mean. Higher MAMC was associated with better cognitive function with .13 [.06] higher scores for each corresponding 1 standard deviation increase in MAMC across all ages. CONCLUSION Higher MAMC at any age was associated with better cognitive performance in older adults. Understanding the relationship between muscle mass and cognition may identify at-risk subgroups needing targeted interventions to preserve cognition.
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Affiliation(s)
- Hillary B. Spangler
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - David H. Lynch
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hsiao-Chuan Tien
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shufa Du
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Penny Gordon Larsen
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John A. Batsis
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Srikrajang S, Komolsuradej N. Association between Height-Changing Scores and Risk of Sarcopenia Estimated from Anthropometric Measurements in Older Adults: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1005. [PMID: 38786415 PMCID: PMC11121361 DOI: 10.3390/healthcare12101005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
Anthropometric assessments are commonly used to diagnose sarcopenia in older adults. However, the ongoing exploration of novel approaches aims to improve the early detection of sarcopenia. This study investigated the association between the height-changing score (HCS) and the risk of sarcopenia defined by anthropometric measurements in 340 older adults (mean age: 66.2 years). The HCS derived from the difference in height and demi-span equivalent height (DEH) was used as an indicator of declining height in the older adults. Multivariate logistic regression analysis revealed a significant association between the HCS and the risk of sarcopenia in both male and female older adults (OR = 1.146, 95% CI [1.021, 1.286], p = 0.021). In addition, income, BMI, and nutritional status were significantly associated with the risk of sarcopenia (OR = -1.933, 95% CI [0.271, 0.986], p = 0.045; OR = -2.099, 95% CI [0.386, 0.587], p < 0.001; OR = -1.443, 95% CI [0.555, 0.866], p = 0.001, respectively). The white blood cell count, lymphocyte count, and HDL cholesterol were blood biomarkers significantly correlated with calf circumference. It can be suggested that the HCS acts as an indicator and screening tool for sarcopenia risk in older adults, highlighting the potential impact of decreased height on muscle mass loss. Encouraging nutritional support can help mitigate the risk of sarcopenia.
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Affiliation(s)
- Siwaluk Srikrajang
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanich Road, Songkhla 90110, Thailand;
| | - Narucha Komolsuradej
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanich Road, Songkhla 90110, Thailand
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García-Fuente I, Corral-Gudino L, Gabella-Martín M, Olivet-de-la-Fuente VE, Pérez-Nieto J, Miramontes-González P. How to detect non-institutionalized older patients at risk of malnutrition during their hospitalization? Comparison of 8 screening tools for malnutrition or nutritional risk. Rev Clin Esp 2024; 224:217-224. [PMID: 38490479 DOI: 10.1016/j.rceng.2024.03.003] [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: 01/02/2024] [Accepted: 02/28/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection. OBJECTIVE To assess the concordance of different nutritional scales in hospitalized patients. METHODS Prospective study in non-institutionalized patients over 65 years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN 3, 8 and 14) were compared. As gold standard we use the Global Malnutrition Leadership Initiative for Malnutrition (GLIM) definition of malnutrition. RESULTS Eighty-five patients (37% female, median age 83 years) were included. Forty-eight percent (95% CI 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN 3 scale was the most sensitive (93%; 95% CI 87-98) and MUST the most specific (91%; CI 85-99). The most effective scale for excluding suspected malnutrition was SCREEN 3 (LR- 0.17; 95% CI 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95% CI 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465. CONCLUSIONS A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.
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Affiliation(s)
- I García-Fuente
- Servicio de Medicina Interna, Hospital Universitario de Valladolid, Valladolid, Spain; Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; IBioVALL (Instituto de Investigación Biosanitaria de Valladolid), Valladolid, Spain
| | - L Corral-Gudino
- Servicio de Medicina Interna, Hospital Universitario de Valladolid, Valladolid, Spain; Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; IBioVALL (Instituto de Investigación Biosanitaria de Valladolid), Valladolid, Spain.
| | - M Gabella-Martín
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - J Pérez-Nieto
- Enfermería, Hospital Universitario Río Hortega, Valladolid, Spain
| | - P Miramontes-González
- Servicio de Medicina Interna, Hospital Universitario de Valladolid, Valladolid, Spain; Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; IBioVALL (Instituto de Investigación Biosanitaria de Valladolid), Valladolid, Spain
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Öztürk ME, Yabanci Ayhan N. The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:325-339. [PMID: 38183317 DOI: 10.1111/jir.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. METHODS The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5 ± 7 years (range 18-60 years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30 kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. RESULTS Participants had mild (42.3%; n = 30), moderate (29.6%; n = 21) or severe IDD (28.2%; n = 20). They were underweight (12.7%; n = 9), normal weight (59.2%; n = 42) or overweight and/or obese (28.2%; n = 20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. CONCLUSIONS While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.
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Affiliation(s)
- M E Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - N Yabanci Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Felipe TL, Grili PPDF, Vidigal CV, Albergaria BH, da Cruz GF, Marques-Rocha JL, Guandalini VR. Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo9. [PMID: 38765537 PMCID: PMC11075426 DOI: 10.61622/rbgo/2024ao09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/11/2023] [Indexed: 05/22/2024] Open
Abstract
Objective To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM). Methods This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%. Results A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m2 for the predictive equation and 7.66 kg/m2 for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively. Conclusion The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.
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Affiliation(s)
- Thaís Loureiro Felipe
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | | | - Camila Vilarinho Vidigal
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | - Ben-Hur Albergaria
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | - Geise Ferreira da Cruz
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | - José Luiz Marques-Rocha
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
| | - Valdete Regina Guandalini
- Universidade Federal do Espírito SantoVitóriaESBrazilUniversidade Federal do Espírito Santo, Vitória, ES, Brazil.
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Lee ST, Lim JP, Tan CN, Yeo A, Chew J, Lim WS. SARC-F and modified versions using arm and calf circumference: Diagnostic performance for sarcopenia screening and the impact of obesity. Geriatr Gerontol Int 2024; 24 Suppl 1:182-188. [PMID: 38095277 DOI: 10.1111/ggi.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 03/27/2024]
Abstract
AIM SARC-F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid-arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC-F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC-F, SARC-CalF, SARC-F + MAC, and SARC-CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance. METHODS We studied 230 healthy non-frail community-dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC-F, SARC-CalF, SARC-F + MAC and SARC-CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non-obese groups. RESULTS The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC-CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67-0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC-CalF (AUC 0.70, 95% CI 0.62-0.78; sensitivity 21.0%; specificity 95.8%). SARC-F (AUC 0.57, 95% CI 0.49-0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non-obese groups for SARC-F + MAC (AUC 0.75, 95% CI 0.65-0.85 vs. 0.58, 95% CI 0.46-0.70) and SARC-CalF + MAC (AUC 0.75, 95% CI 0.66-0.85 vs. 0.70, 95% CI 0.59-0.81). CONCLUSIONS The addition of arm circumference to SARC-CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC-CalF for community screening of sarcopenia amongst healthy community-dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182-188.
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Affiliation(s)
- Shi-Teng Lee
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
| | - Jun-Pei Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Cai-Ning Tan
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Audrey Yeo
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Justin Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Novena, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Novena, Singapore
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Qian S, Zhang S, Lu M, Chen S, Liu L, Liu S, Jiang F, Zhang J. The accuracy of screening tools for sarcopenia in older Chinese adults: a systematic review and meta-analysis. Front Public Health 2024; 12:1310383. [PMID: 38375338 PMCID: PMC10876058 DOI: 10.3389/fpubh.2024.1310383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Objective This review aimed to analyze and compare the accuracy of eight screening tools for sarcopenia in older Chinese adults according to different diagnostic criteria. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched between the publication of the first expert consensus on sarcopenia in 2010 and April 2023 using relevant MeSH terms. We evaluated the risk bias of the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The pooled result of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and plot the summary receiver operating characteristic curve (SROC) were calculated by using a bivariate random-effects model. The accuracies of sensitivity and specificity of the screening tools were compared using the Z-test. Results A total of 30 studies (23,193 participants) were included, except for calf circumference (CC), Ishii, and Finger-ring Test; Screening tools for sarcopenia in older Chinese adults have consistently shown low to moderate sensitivity and moderate to high specificity. Regional and sex differences affect the accuracy of the screening tools. In terms of sensitivity and specificity, the CC, Ishii, and Finger-ring Test were superior to the other screening tools. Conclusion The Asian Working Group on Sarcopenia (AWGS) 2019 criteria are more appropriate for the diagnosis of sarcopenia in older Chinese adults. According to the AWGS 2019, CC and Ishii are recommended for sarcopenia screening in older Chinese adults.
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Affiliation(s)
- Siyu Qian
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Siqing Zhang
- School of Physical Education, Huazhong University of Science and Technology, Wuhan, China
| | - Mengchen Lu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Shuhang Chen
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Liyao Liu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Siqi Liu
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Fanglin Jiang
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Jisheng Zhang
- School of Physical Education, Hunan Normal University, Changsha, China
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11
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Montemurro A, Rodríguez-Juan JJ, Martínez-García MDM, Ruiz-Cárdenas JD. Validity of a video-analysis-based app to detect prefrailty or frailty plus sarcopenia syndromes in community-dwelling older adults: Diagnostic accuracy study. Digit Health 2024; 10:20552076241232878. [PMID: 38384370 PMCID: PMC10880523 DOI: 10.1177/20552076241232878] [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] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Objectives Sarcopenia and frailty have been associated with an increased risk of suffering health-related adverse events but the combination of both conditions results in worse health-related outcomes than either condition alone. Since both syndromes are reversible states, their early detection is fundamental. This study aims to validate a video analysis-based App to detect the presence of frailty or prefrailty plus sarcopenia syndromes and to analyze its construct validity with health-related risk factors. Methods A total of 686 community-dwelling older adults (median-age: 72, 59% female) were enrolled. Muscle power generated during a sit-to-stand test using the App and calf circumference were considered the index test. The reference standards were the EWGSOP2 criteria (five-chair stand test plus appendicular skeletal mass or skeletal muscle index) and Fried's frailty phenotype. Area under the curve (AUC), sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. Results The prevalence of both syndromes varied from 2.9% to 7.2% depending on the diagnostic criteria used for sarcopenia assessment. Excellent-to-outstanding AUC values were observed (range 0.80-0.92). Sensitivity and specificity ranged from 75% to 100% and 81.7% to 87.2%, respectively. PPV and NPV ranged from 12.1% to 37.5% and 97.9% to 100%, respectively. Individuals diagnosed by the App showed an increased risk of polypharmacy, depression, comorbidities, falls, hospitalization, low socioeconomical and educational levels, and smoking and poor self-perceived health compared to their healthy counterparts. Conclusions This App seems to be reliable to detect the simultaneous presence of both syndromes in community-dwelling older adults. Individuals diagnosed by the App showed more odds to have health-related risk factors.
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Affiliation(s)
- Alessio Montemurro
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
| | - Juan J Rodríguez-Juan
- Physiotherapy Department, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - María del Mar Martínez-García
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
- Cystic Fibrosis Association of Murcia, Murcia, Spain
| | - Juan D Ruiz-Cárdenas
- Physiotherapy Department, Faculty of Physiotherapy, Podiatry and Occupational Therapy, Universidad Católica de Murcia, Murcia, Spain
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12
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Xiao L, Dai M, Zhao F, Shen Y, Kwan RYC, Salvador JT, Zhang L, Luo Y, Liu Q, Yang P. Assessing the risk factors associated with sarcopenia in patients with liver cirrhosis: a case-control study. Sci Rep 2023; 13:21845. [PMID: 38071233 PMCID: PMC10710435 DOI: 10.1038/s41598-023-48955-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Sarcopenia is a disease characterized by decreased muscle mass and strength, affecting 20-70% of patients with cirrhosis, and is associated with poor prognosis, complications, and high mortality. At present, the epidemiological investigation of sarcopenia in patients with liver cirrhosis is relatively limited, and because of the differences in population characteristics, regions, diagnostic criteria and diagnostic tools, the prevalence of sarcopenia in various studies varies greatly. The definition of sarcopenia in this study adopted the criteria of the Asian Working Group on Sarcopenia (AWGS 2019), including muscle mass and muscle strength / physical performance. A total of 271 patients with liver cirrhosis were included in this cross-sectional study to explore the influencing factors of sarcopenia in patients with liver cirrhosis. The prevalence of sarcopenia was 27.7%, 27.3% in male and 28.4% in female. The results of binary logistic regression analysis showed that age, physical activity, BMI, mid-upper arm muscle circumference, hepatic encephalopathy, nutritional status, alkaline phosphatase, albumin and total cholesterol were significantly correlated with the occurrence of sarcopenia in patients with liver cirrhosis. After adjusting for the potential influencing factors, it was found that the correlation between age and sarcopenia was weakened (OR = 0.870, 95% CI 0.338-2.239). The current findings show that sarcopenia is common in patients with cirrhosis and is independently associated with age, physical activity, BMI, nutritional status, and albumin, and serum alkaline phosphatase and total cholesterol are associated with the development of sarcopenia. Regular exercise may help maintain the grip strength of patients with cirrhosis and delay the deterioration of liver function.
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Affiliation(s)
- LeYao Xiao
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - Mei Dai
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - Fei Zhao
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | - YouShu Shen
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
| | | | - Jordan Tovera Salvador
- Philippine Women's University, Manila, Philippines
- Nursing Education Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Li Zhang
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China.
| | - YaWen Luo
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Qian Liu
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China
- Nursing Department of the Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ping Yang
- Deparment of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
- School of Nursing, Zunyi Medical University, Zunyi, 563000, China.
- Nursing Department of the Affiliated Hospital of Zunyi Medical University, Zunyi, China.
- Philippine Women's University, Manila, Philippines.
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Lian R, Jiang G, Liu Q, Shi Q, Luo S, Lu J, Yang M. Validated Tools for Screening Sarcopenia: A Scoping Review. J Am Med Dir Assoc 2023; 24:1645-1654. [PMID: 37567245 DOI: 10.1016/j.jamda.2023.06.036] [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: 05/16/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE Choosing the optimal sarcopenia screening tool for a specific clinical scenario is challenging. We aimed to summarize all validated sarcopenia screening tools with diagnostic accuracy tested in one or more study populations. DESIGN Scoping review. SETTING AND PARTICIPANTS Hospitals, nursing homes, communities, or health checkups. METHODS We systematically searched 3 databases in April 2022: MEDLINE, EMBASE, and CENTRAL. Two review authors independently performed the study selection and data extraction. The included tools' contents, characteristics, and number of citations were summarized and visualized. RESULTS We summarized 102 diagnostic accuracy studies involving 53 screening tools, classified into 7 groups: questionnaires (n = 13); serum biomarkers (n = 10); formulas, algorithms, and models (n = 9); physical ability tests (n = 9); integration tools (n = 7); anthropometric indices (n = 3); and ultrasound or bioimpedance analysis (n = 2). The most commonly used questionnaire was SARC-F (770 citations), followed by SARC-CalF (254 citations) and MSRA-7 (61 citations). Handgrip strength and Ishii score were the most widely used physical performance tests (331 citations) and formulas (294 citations), respectively. Sarcopenia index (based on serum cystatin C and creatinine) and calf circumference were the most commonly used serum biomarkers (123 citations) and anthropometric indexes (127 citations), respectively. Ultrasound was the most commonly used imaging tool for screening sarcopenia (57 citations). The included tools varied significantly in content. Various tools assessed some or all components of sarcopenia with different methods, and others assessed different domains, such as age, body mass index, falls, diet, and even mental health. We also summarized the screening tools that were validated in different clinical settings (hospitals, communities, nursing homes, and health checkups). CONCLUSIONS AND IMPLICATIONS More than 50 validated tools are currently available for screening sarcopenia in different clinical settings. The results of this review may help clinicians and researchers in selecting optimal tools for sarcopenia in different clinical scenarios and in developing future tools.
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Affiliation(s)
- Rongna Lian
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Gengchen Jiang
- The First School of Clinical Medicine, Lanzhou University, Gansu, China
| | - Qianqian Liu
- The First School of Clinical Medicine, Lanzhou University, Gansu, China
| | - Qiling Shi
- The First School of Clinical Medicine, Lanzhou University, Gansu, China
| | - Shuyue Luo
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Lu
- Medical Insurance Office, West China Hospital, Sichuan University, Chengdu, China; Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Ming Yang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
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14
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Elif Öztürk M, Yabancı Ayhan N. Evaluation of malnutrition and screening tools in hospitalized children. Clin Nutr ESPEN 2023; 57:770-778. [PMID: 37739737 DOI: 10.1016/j.clnesp.2023.08.031] [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: 04/18/2023] [Revised: 07/29/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. METHODS A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. RESULTS A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than -2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p < 0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p < 0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p > 0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. CONCLUSIONS Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.
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Affiliation(s)
- Meryem Elif Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Nurcan Yabancı Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey.
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15
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Wang L, Ye C, Zhao F, Wu H, Wang R, Zhang Z, Li J. Association Between the Dietary Inflammatory Index and the Risk of Fracture in Chinese Adults: Longitudinal Study. JMIR Public Health Surveill 2023; 9:e43501. [PMID: 37590048 PMCID: PMC10472179 DOI: 10.2196/43501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Chronic inflammation plays a crucial role in tissue injury, osteoporosis, and fracture. The dietary inflammatory index (DII) is a tool for assessing the potential for inflammation in the diet. However, the association between the DII and fractures remains controversial from previous studies. OBJECTIVE We aimed to explore the correlation between the DII and fracture risk in Chinese adults. METHODS We included 11,999 adults (5519 men and 6480 women) who were a part of the China Health and Nutrition Survey (1997-2015) prospective cohort. A 3-day, 24-hour meal review method was used to calculate the DII score. The fractures were identified using a questionnaire. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs for fractures. Subgroup, sensitivity, and restricted cubic spline analyses were performed. RESULTS During the 18 years of follow-up (median follow-up 9.0 years), 463 men and 439 women developed fractures. The median DII score was 0.64 (IQR -1.74 to 1.46) for the total sample, 0.75 (IQR -1.68 to 1.50) for men, and 0.53 (IQR -1.79 to 1.42) for women. The DII score had a positive correlation with the risk of fracture among women but not among men. For men, after adjusting for covariates, the HRs for quintiles of DII were 1, 0.96 (95% CI 0.66-1.41), 1.05 (95% CI 0.74-1.49), 0.89 (95% CI 0.62-1.26), and 0.94 (95% CI 0.67-1.34; trend: P=.62). The HRs for women were 1, 1.13 (95% CI 0.72-1.79), 1.24 (95% CI 0.83-1.86), 1.51 (95% CI 1.02-2.22), and 1.62 (95% CI 1.10-2.39; trend: P=.004). The restricted cubic spline analysis showed a significant association between fracture risk and DII score in women (overall association: P=.01); as the DII scores were >0.53, HRs showed a significant upward trend. Women aged <50 years or who are nonsmokers, who are nondrinkers, or with nonabdominal obesity had a positive association between fracture risk and the DII score. In sensitivity analyses, after excluding people with diabetes or hypertension, there was still a positive association between fracture risk and the DII score in women. Among the DII components, the DII scores of protein (trend: P=.03), niacin (trend: P=.002), and iron (trend: P=.02) showed significant associations with the risk of fracture in women. CONCLUSIONS Proinflammatory diet consumption increased the fracture risk in Chinese women aged <50 years. The high consumption of anti-inflammatory foods and low consumption of proinflammatory foods may be an important strategy to prevent fractures in women.
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Affiliation(s)
- Lu Wang
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
| | - Chen Ye
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Fanghong Zhao
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Hongjing Wu
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
| | - Ruoyu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
- Beijing's Key Laboratory of Food Safety Toxicology Research and Evaluation, Beijing, China
| | - Jie Li
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
- Beijing Fengtai District Center for Disease Control and Prevention, Beijing, China
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Chun HS, Lee M, Lee HA, Lee S, Kim S, Jung YJ, Lee C, Kim H, Lee HA, Kim HY, Yoo K, Kim TH, Ahn SH, Kim SU. Risk Stratification for Sarcopenic Obesity in Subjects With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2023; 21:2298-2307.e18. [PMID: 36462755 DOI: 10.1016/j.cgh.2022.11.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND & AIMS The impact of the severity of sarcopenic obesity (SO) in nonalcoholic fatty liver disease (NAFLD) on the risk of significant liver fibrosis or cardiovascular disease (CVD) remains unclear. We aimed to identify high-risk subjects with SO for significant liver fibrosis or CVD among subjects with SO and NAFLD. METHODS This multicenter, retrospective study involved 23,889 subjects with NAFLD who underwent a health screening program (2014-2020). Sarcopenia was defined based on gender-specific sarcopenia index cutoff using multi-frequency bioelectric impedance analysis. High-risk subjects with SO were defined as those with significant liver fibrosis by fibrosis-4 index >2.67 or atherosclerotic CVD risk score >20%. Multivariable logistic regression analysis for identifying high-risk subjects with SO was performed in a cross-sectional cohort with SO, and further validation was performed in a longitudinal cohort. RESULTS SO prevalence was 5.4% (n = 1297 of 23,889). Older age (unstandardized beta [β] = 3.23; P < .001), male (β = 1.66; P = .027), sarcopenia index (β = -6.25; P = .019), and metabolic syndrome (β = 1.75; P < .001) were significant risk factors for high-risk SO. Based on a high-risk SO screening model, high-risk subjects with SO had significantly higher odds of significant liver fibrosis (training: adjusted odds ratio [aOR], 3.72; validation: aOR, 2.38) or CVD (training: aOR, 5.20; validation: aOR, 3.71) than subjects without SO (all P < .001). In subgroup analyses, the cumulative incidence of significant liver fibrosis or CVD development was significantly higher in high-risk subjects with SO than in low-risk subjects with SO in a longitudinal cohort considering all-cause mortality and liver transplantation as competing risks (sub-distribution hazard ratio, 5.37; P < .001). CONCLUSION The high-risk screening model may enable the identification of high-risk subjects with SO with NAFLD.
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Affiliation(s)
- Ho Soo Chun
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
| | - Minjong Lee
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea.
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Sejin Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soyeon Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ye Jun Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chaewon Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoeun Kim
- Department of Health Promotion, Health Promotion Center, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Han Ah Lee
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
| | - Hwi Young Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
| | - Kwon Yoo
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
| | - Tae Hun Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Yonsei Liver Center, Severance Hospital, Seoul, Korea.
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Maccarone MC, Coraci D, Bernini A, Sarandria N, Valente MR, Frigo AC, Dionyssiotis Y, Masiero S. Sarcopenia prevalence and association with nutritional status in cohort of elderly patients affected by musculoskeletal concerns: a real-life analysis. Front Endocrinol (Lausanne) 2023; 14:1194676. [PMID: 37435492 PMCID: PMC10331423 DOI: 10.3389/fendo.2023.1194676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/13/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The progressive loss of skeletal muscle mass, strength, and function that frequently occurs as people get older is referred to as sarcopenia. Elderly musculoskeletal aging, sarcopenia, and obesity are all intimately connected. Our study's aim is to investigate the prevalence of sarcopenia in a real cohort of patients over 65 with musculoskeletal conditions referring to a Rehabilitation Unit. The secondary aim of our study is to investigate associations between sarcopenia and alterations in nutritional status and Body Mass Index (BMI). Finally, quality of life and global health has been investigated in our population. Materials and methods From January 2019 to January 2021, 247 patients over 65 years old with musculoskeletal concerns were enrolled and participated in an observational study. As outcome measures, the Mini Nutritional Assessment (MNA), the 12-Item Short Form Health Survey (SF-12), and the Cumulative Illness Rating Scale Severity Index (CIRS-SI) were used. Additionally, measurements of total skeletal muscle mass (SMM) and appendicular muscle mass (ASMM) using bioelectrical impedance analysis, as well as a hand grip strength test of the non-dominant hand were taken. The Mid Upper Arm Circumference (MUAC) and the Calf Circumference (CC) were measured and recorded as further indications of possible sarcopenia. Results A percentage of 46.1% of subjects with overt sarcopenia was found and 10.1% showed a severe sarcopenia. Patients with severe sarcopenia showed significantly lower values of BMI and MNA. Additionally, sarcopenic patients showed significantly lower values in MNA when compared to non-sarcopenic patients. Considering SF-12, only the physical score revealed slight significant differences. In particular, patients affected by probable or severe sarcopenia presented a lower value than non-sarcopenic patients. Concerning MUAC and CC, severe sarcopenic patients showed significant lower values for both the body parts. Conclusion Our study considers a cohort of real-life elderly subjects with musculoskeletal concerns and shows that these subjects are highly susceptible to sarcopenia. Therefore, rehabilitation for elderly patients with musculoskeletal concerns requires to be customized and multidisciplinary. Future research should further investigate these aspects in order to enable the early identification of sarcopenia and the formulation of customized rehabilitative programs. .
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Affiliation(s)
- Maria Chiara Maccarone
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Daniele Coraci
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padua, Italy
| | - Andrea Bernini
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Nicola Sarandria
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Marta Rossella Valente
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padua, Italy
| | - Yannis Dionyssiotis
- Spinal Cord Injury Rehabilitation Clinic, University of Patras, Patras, Greece
| | - Stefano Masiero
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padua, Italy
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18
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Wang C, Guo X, Xu X, Liang S, Wang W, Zhu F, Wang S, Wu J, Zhang L, Sun X, Chen X, Cai G. Association between sarcopenia and frailty in elderly patients with chronic kidney disease. J Cachexia Sarcopenia Muscle 2023. [PMID: 37300354 PMCID: PMC10401549 DOI: 10.1002/jcsm.13275] [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: 05/30/2022] [Revised: 09/01/2022] [Accepted: 05/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Frailty and sarcopenia are prevalent in chronic kidney disease (CKD) populations and could increase the risk for adverse health outcomes. Few studies assess the correlation between frailty, sarcopenia and CKD in non-dialysis patients. Therefore, this study aimed to determine frailty-associated factors in elderly CKD stage I-IV patients, expected to early identify and intervene in the frailty of elderly CKD patients. METHODS A total of 774 elderly CKD I-IV patients (>60 years of age) recruited from 29 clinical centers in China between March 2017 and September 2019 were included in this study. We established a Frailty Index (FI) model to evaluate frailty risk and verified the distributional property of FI in the study population. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia 2019. Multinomial logistic regression analysis was used to assess the associated factors for frailty. RESULTS Seven hundred seventy-four patients (median age 67 years, 66.0% males) were included in this analysis, with a median estimated glomerular filtration rate of 52.8 mL/min/1.73 m2 . The prevalence of sarcopenia was 30.6%. The FI exhibited a right-skewed distribution. The age-related slope of FI was 1.4% per year on a logarithmic scale (r2 = 0.706, 95% CI 0.9, 1.8, P < 0.001). The upper limit of FI was around 0.43. The FI was related to mortality (HR = 1.06, 95% CI 1.00, 1.12, P = 0.041). Multivariate multinomial logistic regression analysis showed that sarcopenia, advanced age, CKD stage II-IV, low level of serum albumin and increased waist-hip ratio were significantly associated with high FI status, while advanced age and CKD stage III-IV were significantly associated with for median FI status. Moreover, the results from the subgroup were consistent with the leading results. CONCLUSIONS Sarcopenia was independently associated with an increased risk for frailty in elderly CKD I-IV patients. Patients with sarcopenia, advanced age, high CKD stage, high waist-hip ratio and low serum albumin level should be assessed for frailty.
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Affiliation(s)
- Che Wang
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Xinru Guo
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Xieguanxuan Xu
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Shuang Liang
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Wenling Wang
- Department of Nephrology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fanglei Zhu
- Department of Nephrology, Fuxing Hospital Affiliate to Capital University of Medical Sciences, Beijing, China
| | - Siyang Wang
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
- 953th Hospital, Shigatse Branch, Xinqiao Hospital, Army Medical University (Third Military Medical University), Shigatse, China
| | - Jie Wu
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Li Zhang
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Xuefeng Sun
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Xiangmei Chen
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
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Krzymińska-Siemaszko R, Deskur-Śmielecka E, Kaluźniak-Szymanowska A, Murawiak M, Wieczorowska-Tobis K. Comparison of Diagnostic Value of the SARC-F and Its Four Modified Versions in Polish Community-Dwelling Older Adults. Clin Interv Aging 2023; 18:783-797. [PMID: 37215395 PMCID: PMC10198270 DOI: 10.2147/cia.s408616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/22/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Sarcopenia is associated with adverse outcomes in elderly persons, including functional disability, falls, and even death. Therefore, older adults should be routinely screened for sarcopenia. Due to the unsatisfactory sensitivity of the SARC-F questionnaire, four modified versions have been elaborated: SARC-CalF, SARC-F+EBM, SARC-F+AC, and SARC-CalF+AC. The diagnostic performance of the four modifications of SARC-F has yet to be compared. Materials and Methods We performed the sensitivity/specificity analysis and compared the overall diagnostic accuracy of the five questionnaires in 260 community-dwelling volunteers aged ≥ 60 yrs from Poland. The study was performed against three reference standards: the European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, and modified EWGSOP2 criteria. Results The prevalence of sarcopenia based on these criteria was 20.8%, 11.2%, and 17.3%, respectively. Concerning the three reference standards, the sensitivity of SARC-F, SARC-CalF, SARC-F+EBM, SARC-F+AC, and SARC-CalF+AC ranged from 31.5-44.8%, 57.4-65.5%, 48.1-62.1%, 71.4-79.2% and 71.4-79.2%, respectively. The specificity ranged from 86.6-87.4%, 86.1-90.3%, 82.3-84.0%, 69.4-78.2%, and 72.1-79.7%, respectively. The AUCs of SARC-F, SARC-CalF, SARC-F+EBM, SARC-F+AC, and SARC-CalF+AC ranged from 0.643-0.700, 0.757-0.792, 0.740-0.775, 0.767-0.812 and 0.771-0.852, respectively. Conclusion The SARC-F questionnaire has low diagnostic accuracy, which limits its usefulness as a sarcopenia screening tool. Incorporating two simple anthropometric measurements, ie, arm and calf circumference, notably improves the diagnostic performance of SARC-F. Based on our results, SARC-CalF+AC seems to be the best screening tool for sarcopenia screening in community-dwelling older adults.
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Affiliation(s)
| | - Ewa Deskur-Śmielecka
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Marika Murawiak
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
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20
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Zhang H, Yin M, Liu Q, Ding F, Hou L, Deng Y, Cui T, Han Y, Pang W, Ye W, Yue J, He Y. Machine and deep learning-based clinical characteristics and laboratory markers for the prediction of sarcopenia. Chin Med J (Engl) 2023; 136:967-973. [PMID: 37098831 PMCID: PMC10278711 DOI: 10.1097/cm9.0000000000002633] [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: 05/20/2022] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts. METHODS We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models. RESULTS The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749). CONCLUSIONS The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population. TRIAL REGISTRATION Chictr.org, ChiCTR 1800018895.
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Affiliation(s)
- He Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Mengting Yin
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qianhui Liu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Fei Ding
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lisha Hou
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yiping Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tao Cui
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Yixian Han
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Weiguang Pang
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, Liaoning 110819, China
| | - Wenbin Ye
- Department of Geriatrics, Xiamen Hospital of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Xiamen, Fujian 361015, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yong He
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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21
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Gold SL, Raman M, Sands BE, Ungaro R, Sabino J. Review article: Putting some muscle into sarcopenia-the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease. Aliment Pharmacol Ther 2023; 57:1216-1230. [PMID: 37051722 DOI: 10.1111/apt.17498] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Sarcopenia, a loss of skeletal muscle mass or function, affects up to 50% of patients with inflammatory bowel disease (IBD) and is associated with poor clinical outcomes including increased hospitalizations, need for surgery and post-operative complications. Despite the high prevalence and clinical significance of sarcopenia in patients with IBD, few patients undergo routine muscle evaluation. AIM The goal of this study was to review the mechanisms of sarcopenia in patients with IBD and understand novel modalities to assess and treat impaired muscle mass or function. METHODS Pubmed and Cochrane databases were searched including articles published up to February 2023 utilizing the following keywords: "inflammatory bowel disease", "IBD", "Crohn's disease", "ulcerative colitis", "sarcopenia", "myosteatosis", "muscle health", and "frailty". RESULTS The pathogenesis of sarcopenia in IBD is not well defined, however, there is evidence supporting the role of malabsorption, reduced protein intake, chronic inflammation, dysbiosis, decreased physical activity, medication effects and hormone signaling from visceral adiposity. Traditional sarcopenia assessment techniques include direct measurements on cross sectional imaging. However, given the time, cost and radiation exposure associated with cross sectional imaging, new bedside tools are now available to estimate muscle mass, including assessment of grip strength, mid upper arm circumference and body composition utilizing bioelectrical impedance analysis. In addition, novel biomarkers for assessing muscle mass and techniques utilizing point of care ultrasound have been proposed to make sarcopenia evaluation more streamlined in the IBD clinic. CONCLUSION Sarcopenia is associated with poor clinical outcomes independent of IBD activity and therefore muscle health should be assessed in all IBD patients at routine intervals. Future studies to better our understanding of the pathophysiology as well as most effective management of sarcopenia in IBD will help guide clinical care and reduce disease related complications.
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Affiliation(s)
- Stephanie L Gold
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Bruce E Sands
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ryan Ungaro
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - João Sabino
- Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
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22
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Martinez-Tapia C, Rougette K, Fossey-Diaz V, Cudennec T, Taleb C, Balardy L, Mertens C, Mitha N, Bringuier M, Maley K, Estivin S, Quipourt V, Canoui-Poitrine F, Baldini C, Poisson J, Paillaud E. Prevalence of Four Sarcopenia Criteria in Older Patients with Cancer, and Their Predictive Value for 6-Month Mortality: The NutriAgeCancer National Prospective Cohort Study. Nutrients 2023; 15:nu15061508. [PMID: 36986238 PMCID: PMC10051227 DOI: 10.3390/nu15061508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Older cancer patients have an elevated risk of sarcopenia. The aim was to estimate the prevalence of four criteria for sarcopenia case finding, assessment, diagnosis, and severity determination: abnormal strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F), low hand-grip strength (HGS), low arm circumference (AC, a muscle mass proxy), and low physical performance (PP). Sarcopenia (low HGS and AC) and severe sarcopenia (low HGS, AC, and PP) and their predictive values for 6-month mortality were estimated in the whole population and by metastatic status. We analyzed data from the NutriAgeCancer French nationwide study of cancer patients aged ≥70 referred for geriatric assessment before anti-cancer treatment. We performed Cox proportional hazards analysis for each criterion separately and all criteria combined. Overall, 781 patients from 41 geriatric oncology clinics were included (mean age: 83.1; females: 53%; main cancer types: digestive (29%) and breast (17%); metastases: 42%). The prevalence of abnormal SARC-F, low HGS, a low AC, low PP, sarcopenia, and severe sarcopenia were, respectively, 35.5%, 44.6%, 44.7%, 35.2%, 24.5%, and 11.7%. An abnormal SARC-F and/or low HGS, sarcopenia, and severe sarcopenia were associated with 6-month mortality in patients with metastases (adjusted hazard ratios [95% confidence interval]: 2.72 [1.34-5.49], 3.16 [1.48-6.75] and 6.41 [2.5-16.5], respectively). Sarcopenia was strongly predictive of 6-month mortality in patients with metastatic cancer.
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Affiliation(s)
| | - Kevin Rougette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Georges Pompidou European Hospital, Department of Geriatric Medicine, Oncogeriatric Coordination Unit (UCOG), F-75015 Paris, France
| | - Virginie Fossey-Diaz
- AP-HP, Hôpital Bretonneau, Service de Gériatrie, UCOG Paris Nord, F-75018 Paris, France
| | - Tristan Cudennec
- AP-HP, Hôpital Ambroise-Paré, Department of Geriatrics, UCOG Paris Ouest, F-92100 Boulogne-Billancourt, France
| | - Cherifa Taleb
- AP-HP, Hôpital René-Muret, Service de Gériatrie, HUPSSD, UCOG Paris Seine Saint Denis, F-93270 Sevran, France
| | - Laurent Balardy
- Centre Hospitalier Universitaire de Toulouse, Geriatric Department, Internal Medicine and Oncogeriatry Unit, UCOG Midi-Pyrénées, F-31000 Toulouse, France
| | - Cécile Mertens
- CHU Bordeaux, Clinical Gerontology Department, Aquitaine Interregional UCOG, F-33000 Bordeaux, France
| | - Nathalie Mitha
- CHU de Grenoble Alpes, Geriatric Medicine Department, UCOG Arc Alpin, F-38700 Grenoble, France
| | - Michael Bringuier
- Institut Curie, PSL Research University, Department of Medical Oncology and Department of Supportive Care, UCOG Paris Ouest, F-92210 Saint-Cloud, France
| | - Karin Maley
- Groupe Hospitalier Diaconesses-Croix-Saint-Simon, Geriatric Medicine Department, UCOG Paris Est, F-75020 Paris, France
| | - Sandrine Estivin
- Brest University Hospital, Internal Medicine and Geriatrics, UCOG de Bretagne, F-29200 Brest, France
| | - Valérie Quipourt
- Dijon University Hospital, Department of Geriatrics and Internal Medicine, Bourgogne Interregional UCOG, F-21000 Dijon, France
| | - Florence Canoui-Poitrine
- Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
- AP-HP, Henri-Mondor Hospital, Public Health Department, F-94010 Creteil, France
| | - Capucine Baldini
- Drug Development Department DITEP, Gustave Roussy, F-94800 Villejuif, France
| | - Johanne Poisson
- Université Paris-Cité, Inserm, Centre de Recherche sur L'inflammation, UMR 1149, F-75018 Paris, France
- AP-HP, Oncogeriatric Coordination Unit (UCOG), Department of Geriatric Medicine, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, F-75015 Paris, France
| | - Elena Paillaud
- Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Georges Pompidou European Hospital, Department of Geriatric Medicine, Oncogeriatric Coordination Unit (UCOG), F-75015 Paris, France
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23
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Charkiewicz M, Wojszel ZB, Kasiukiewicz A, Magnuszewski L, Wojszel A. Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients—A Cross-Sectional Study in a Geriatric Ward. J Clin Med 2023; 12:jcm12062305. [PMID: 36983305 PMCID: PMC10052656 DOI: 10.3390/jcm12062305] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
The need to assess sarcopenia and frailty in patients with chronic heart failure (HF) has recently been raised. This cross-sectional study of 416 geriatric ward patients (median age (Me)—82 (IQR, 77–86) years, 77.4% female, 96.9% community dwelling) aimed to assess the prevalence of dynapenia, frailty syndrome, functional and nutritional health, and co-morbidity regarding their HF status. We collected data from comprehensive geriatric assessment. We observed HF in 162 (38.9%) patients, with 80 (49.4%) classified as New York Heart Association (NYHA) class III or IV. HF patients were significantly older, more frequently male, obese, hospitalized in the previous year, burdened with multimorbidity and polypharmacy, classified as frail, dependent on daily living activities, and physically non-active. Ischemic heart disease, atrial fibrillation, diabetes, peripheral arterial disease, anemia, chronic kidney disease, history of myocardial infarction, and stroke were found significantly more often in the HF group. A considerably higher percentage of HF patients had dynapenia (54.9% versus 41.9%, p = 0.02), but the difference was significant only in women. We found no significant difference between HF and no-HF groups regarding muscle performance, except for lower median gait speed in the HF group—0.53 m/s (0.35–0.89 m/s) versus 0.68 m/s (0.44–0.99 m/s), p = 0.02). HF patients significantly more often had low grip strength accompanied by slow gait, suggesting probable severe sarcopenia (40.4% vs. 29% in patients without HF, p = 0.046). In the regression analysis, significantly higher odds for HF were observed for lower mid-arm circumference (MAC) and dynapenia when controlling for age, sex, body mass index (BMI), calf circumference (CC), peripheral arterial disease, history of stroke, ischemic heart disease, atrial fibrillation, and diabetes mellitus. Conclusions: HF geriatric patients are often burdened with frailty, obesity, multimorbidity, and polypharmacy. As a result, they are more likely to present low muscle strength (potential sarcopenia), which is frequently accompanied by functional limitations (suggestive of more advanced stages of sarcopenia). This tendency is evident mainly in older women. Nevertheless, sarcopenia can be independently associated with HF in older patients with multimorbidity and disability who are hospitalized in a geriatric department, as a multivariable logistic regression analysis demonstrated.
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Affiliation(s)
- Miroslaw Charkiewicz
- Department of Cardiology, Hospital of the Ministry of Interior and Administration in Bialystok, 15-471 Bialystok, Poland
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, 15-471 Bialystok, Poland
- Correspondence: ; Tel.: +48-47-710-4244
| | - Agnieszka Kasiukiewicz
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, 15-471 Bialystok, Poland
| | - Lukasz Magnuszewski
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Doctoral Studies, Faculty of Health Sciences, Medical University of Bialystok, 15-471 Bialystok, Poland
| | - Aleksandra Wojszel
- Interdisciplinary Student’s Scientific Society at the Department of Geriatrics, Faculty of Health Sciences, Medical University of Bialystok, 15-471 Bialystok, Poland
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Luo S, Chen X, Hou L, Yue J, Liu X, Xia X, Dong B, Cao L. The accuracy of body mass index and calf circumference values when assessing sarcopenia in a multi-ethnic cohort of middle-aged and older adults: West China health and aging trend study results. Heliyon 2023; 9:e15027. [PMID: 37151646 PMCID: PMC10161364 DOI: 10.1016/j.heliyon.2023.e15027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Objective This analysis was designed to explore the utility of body mass index (BMI) and calf circumference (CC) values in the diagnosis of sarcopenia. Methods A cross-sectional analysis of community-dwelling adults ≥50 years old was conducted. An InBody 770 bioimpedance analysis (BIA) device was used for measuring muscle mass, a grip-strength dynamometer was used to assess muscle strength, and a 4 m gait speed (GS) analysis was used to gauge physical function. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to define sarcopenia. The cut-off values for BMI and CC were based on the computed Younden's index values and AWGS 2019 criteria, respectively. The area under the ROC curves (AUC), specificity, sensitivity, and positive and negative predictive values (PPV and NPV) were calculated to establish the value of BMI and CC for the diagnosis of sarcopenia. Results In total, the data of 4177 participants ≥50 years of age were analyzed. These included 2668 (63.9%) females and 1509 (36.1%) males. Of these participants, 946 (22.6%) met the criteria for sarcopenia, including 408 (27%) males and 538 (20.2%) females. The sensitivity, specificity, and NPVs obtained when using BMI and CC values to predict sarcopenia were as follows: 84.03%/65.51%/0.90 and 74.76%/83.51%/0.87, respectively, in males; 87.36%/64.12%/0.94 and 78.25%/82.09%/0.93, in females. The respective AUC values for BMI and CC in males were 0.83 (0.80-0.85) and 0.85 (0.83-0.88), while in females they were 0.85 (0.83-0.87) and 0.88 (0.87-0.90). Conclusions These data suggest that BMI and CC can both serve as accurate predictors of sarcopenic incidence in a multi-ethnic population ≥50 years of age. The specificity values for BMI were relatively low in both males and females, however, underscoring the relative advantages of measuring CC when assessing individual sarcopenia risk.
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Plytzanopoulou P, Papasotiriou M, Politis P, Papachrysanthou T, Andriopoulos C, Drakou A, Papachristou E, Papastamatiou M, Kehagias I. Cardiac valve calcification in patients on maintenance dialysis. The role of malnutrition-inflammation syndrome, adiposity andcomponents of sarcopenia. A cross-sectional study. Clin Nutr ESPEN 2022; 52:421-430. [PMID: 36513482 DOI: 10.1016/j.clnesp.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND & AIMS Cardiac valve calcification (CVC) is a predictor of cardiovascular disease and all-cause mortality in end stage kidney disease (ESKD) patients. Several risk factors are related to CVC in patients with ESKD including traditional ones as well as inflammation, bone mineral disease and malnutrition. Adiposity is associated with dyslipidemia and proinflammatory activity which could predispose for CVC. Sarcopenia or dynapenia is a state common in patients with ESKD. This study aimed to investigate the relationship of adiposity, sarcopenia and malnutrition-inflammation markers with CVC in patients on maintenance hemodialysis. METHODS CVC in aortic (AVC), mitral valves (MVC) and systolic and diastolic dysfunction (DD) were assessed by using two-dimensional echocardiography. Nutritional, adiposity and anthropometric assessments were made using several indices respectively. Creatinine index and muscle strength measurements were also performed. Biochemical parameters such as total proteins, albumin, calcium, phosphate, plasma lipoproteins, C-Reactive Protein and parathyroid hormone were also measured. RESULTS Adiposity, nutritional, and sarcopenia parameters did not show any difference between patients with or without CVC. Age ≥ 65 years [PR: 1.47 p = 0.012], DD [PR: 2.31, p = 0.005], high CRP/albumin ratio [PR: 1.46, p = 0.01], mid arm circumference (MAC) < 26 cm [PR: 1.37, p = 0.03] were associated with increased prevalence of AVC, while DD [PR: 1.97 p = 0.02], high CRP/albumin ratio [PR: 1.56, p = 0.02], and MAC < 26 cm [PR: 1.52, p = 0.01], showed positive correlation with MVC. Age ≥ 65 years [PR: 1.33, p = 0.028], DD [PR: 1.72, p = 0.01], high CRP/albumin ratio [PR: 1.53, p = 0.003], and MAC < 26 cm [PR: 1.4, p = 0.006], related to greater prevalence of calcification at any valve. CONCLUSIONS Ageing, diastolic dysfunction, MAC and increased CRP/albumin ratio were powerful predictors of CVC in patients on hemodialysis.
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Affiliation(s)
| | | | | | | | | | - Athina Drakou
- Department of Nephrology, "Henry Dunant" Hospital Center, Athens, Greece
| | | | | | - Ioannis Kehagias
- Department of Surgery, University Hospital of Patras, Patras, Greece
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El Osta N, Wehbe A, Sleiman N, Drancourt N, El Osta L, Hennequin M. Dental Criteria Could Alert for Malnutrition Risk and Inappropriate Choice of Food Texture in Older Subjects with Dementia: An Analytical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15086. [PMID: 36429816 PMCID: PMC9690132 DOI: 10.3390/ijerph192215086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Oral health indicators are usually collected to alert for the presence of infectious diseases, but the impact of poor oral health on the nutritional status of older people with dementia is often neglected. This study aims to explore the relationship between the number of posterior dental functional units (PFUs) and the anthropometric measure of malnutrition, the mid-upper arm circumference (MUAC), in older people with dementia while controlling for other variables, and to analyze whether the number of PFUs is considered when adjusting the texture of the food provided at mealtimes. A total of 103 individuals who were 70 years or older with dementia were recruited from seven institutions. Cognitive impairment was assessed using the Mini Mental State Examination. Data were collected from medical records (sociodemographic characteristics, presence of chronic diseases, prescribed medications, results of serum albumin level), as well as questionnaires (type of feeding routes, type of food texture, supplements intake, Activity of Daily Living index), clinical examinations (MUAC), and oral health parameters (PFUs, oral dryness, oral hygiene). MUAC was the dependent outcome variable. MUAC was associated with the number of PFUs (p = 0.032); participants with PFU ≤ 4 were 7.5 times more likely to have MUAC < 21 cm than others. Other associations were found between MUAC and albumin level (OR = 12.5; p = 0.001), modified food texture (OR = 4.2; p = 0.035), and length of institutional stay (OR = 5.2; p = 0.033); however, the type of oral feeding was not significantly related to the number of PFUs (p = 0.487) so there is an inadequate correlation between food texture and oral health status. Similar to MUAC, the number of PFUs could be an oral anthropometric criterion that is recorded during routine hygiene care to alert for the risk of malnutrition and the inappropriate choice of food texture in older individuals with dementia.
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Affiliation(s)
- Nada El Osta
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Amine Wehbe
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Nelly Sleiman
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Noemie Drancourt
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- CHU of Clermont-Ferrand, Service d’Odontologie, 63003 Clermont-Ferrand, France
| | - Lana El Osta
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- CHU of Clermont-Ferrand, Service d’Odontologie, 63003 Clermont-Ferrand, France
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Dobrovolskaya OV, Demin NV, Nikitinskaya OA, Toroptsova NV, Feklistov AY. Nutritional status in patients with rheumatoid arthritis: is there an association with the sarcopenic phenotype of body composition? RHEUMATOLOGY SCIENCE AND PRACTICE 2022. [DOI: 10.47360/1995-4484-2022-566-572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Aim – to evaluate the nutritional status and its relationship with the sarcopenic phenotype of body composition in women with rheumatoid arthritis (RA).Material and methods. The study included 91 women aged 40 to 75 years with RA according to ACR/EULAR criteria (2010) and a disease duration of at least 1 year. A questionnaire, laboratory and densitometric examination were conducted. Nutritional status was assessed using a MNA (Mini Nutricial Assessment) questionnaire.Results. Malnutrition and at risk of malnutrition according to the MNA were detected in 44.0% of patients with RA. These patients differed from those with normal nutritional status with a higher risk of osteoporotic hip fractures according to FRAX (p=0.035), lower appendicular muscle mass (AMM) (p=0.048) and lower self-assessment of health status (p=0.012). Patients significantly differed in nutritional status according to MNA, daily intake of calcium with food, circumferences of the mid-upper arm, calf, waist and hips, depending on the presence of sarcopenic phenotype. Multivariate regression analysis showed that the sarcopenic phenotype was associated with a nutritional status according to MNA less than 24 points (odds ratio (OR) – 6.14; p=0.036), daily calcium intake less than 500 mg (OR=9.55; p=0.007) and mid-upper arm circumference less than 25 cm (OR=9.32; p=0.015).Conclusion. Malnutrition was found in almost half of the patients with RA. It was revealed that a low nutritional status according to the MNA, low calcium intake and mid-upper arm circumference less than 25 cm increased the risk of having a sarcopenic phenotype in women with RA.
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Affiliation(s)
| | - N. V. Demin
- V.A. Nasonova Research Institute of Rheumatology
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Stavrou G, Tzikos G, Menni AE, Chatziantoniou G, Vouchara A, Fyntanidou B, Grosomanidis V, Kotzampassi K. Endothelial Damage and Muscle Wasting in Cardiac Surgery Patients. Cureus 2022; 14:e30534. [PMID: 36415406 PMCID: PMC9675898 DOI: 10.7759/cureus.30534] [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] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
This is a post-hoc analysis to assess the effect of anesthesia, surgical trauma, and extracorporeal circuit on endothelial integrity, microvascular permeability, and extracellular fluid balance, as well as on skeletal muscle catabolism, in patients undergoing elective cardiac surgery. We included 127 well-nourished patients undergoing “on-pump” elective cardiac surgery. One day prior to surgery (D0) and again on postoperative day 7 (POD7), body mass index, body composition assessment, hand-grip strength (HGS), and mid-upper arm muscle circumference (MAMC) were measured. Patients were assigned to early recovery (ER) and late recovery (LR) groups, depending on the duration of ICU stay (cut-off 48 hours). The magnitude of change (Δ) in all parameters studied was assessed in ER versus LR groups, regarding (i) epithelial tissue dysfunction (Δ-Extra-Cellular Water percentage (Δ-ECW%), Δ-Phase Angle (Δ-PhA)), (ii) skeletal muscle mass catabolism (Δ-Skeletal muscle mass reduction%, Δ-Hand Grip Strength (Δ-HGS) and Δ-Mid Upper-Arm Muscle Circumference (Δ-MAMC)). Baseline measurements were similar in both groups. A significant difference was observed in all Δ-parameters studied (Δ-ECW%, Δ-PhA and muscle catabolism, Δ-HGS, Δ-MAMC), the worse results being correlated to the LR group. The results raise the issue that patients with early recovery may silently have pathological conditions, continuing even on the day of discharge - further research should be planned.
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Jung E, Hiratsuka Y, Suh SY, Won SH, Choi SE, Kang B, Lee S, Kim Y, Suh K, Kim JW, Kim S, Kim J, Lee KW. Association between mid-upper arm circumference and functional status in patients with advanced cancer. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yeung SSY, Lee JSW, Kwok T. A Nutritionally Complete Oral Nutritional Supplement Powder Improved Nutritional Outcomes in Free-Living Adults at Risk of Malnutrition: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11354. [PMID: 36141627 PMCID: PMC9517313 DOI: 10.3390/ijerph191811354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This randomized controlled trial investigated the effectiveness of an oral nutritional supplement (ONS) on nutrition-related outcomes over 12 weeks in Chinese adults with or at risk of malnutrition. METHODS 88 Chinese adults ≥18 years living independently in Hong Kong with Mini Nutritional Assessment-Short Form (MNA-SF) score ≤11 were randomly assigned to (1) 2 servings/day of nutritionally complete ONS powder made with water (Fresubin® Powder (Fresubin Kabi Deutschland GmbH, Bad Homburg, Germany), 600 kcal, 22.4 g protein) for 12 weeks (intervention group) or (2) no treatment (control group). The primary outcome was increase in body weight (BW) over 12 weeks. Secondary outcomes included improvement in body mass index (BMI), mid-arm circumference (MAC), calf circumference, MNA-SF score, quality of life, self-rated health, frailty, and diet quality. RESULTS The intervention group showed a significantly higher mean increase in BW compared with the control group (1.381 kg, intervention vs control, p < 0.001). The intervention group also showed significantly higher mean increases in BMI, MAC, calf circumference, intake of energy, protein, vitamin D, and calcium compared with the control group. No group differences in the changes of other outcomes were observed. CONCLUSIONS For Chinese free-living adults at risk of malnutrition, daily consumption of a nutritionally complete ONS powder improved nutritional outcomes compared with the control group.
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Affiliation(s)
- Suey S. Y. Yeung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jenny S. W. Lee
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
- Department of Medicine and Geriatrics, To Po Hospital, Hong Kong, China
| | - Timothy Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Montemurro A, Ruiz-Cárdenas JD, Martínez-García MDM, Rodríguez-Juan JJ. Validity of an iPhone App to Detect Prefrailty and Sarcopenia Syndromes in Community-Dwelling Older Adults: The Protocol for a Diagnostic Accuracy Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166010. [PMID: 36015771 PMCID: PMC9416054 DOI: 10.3390/s22166010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/13/2023]
Abstract
Prefrailty and sarcopenia in combination are more predictive of mortality than either condition alone. Early detection of these syndromes determines the prognosis of health-related adverse events since both conditions can be reversed through appropriate interventions. Nowadays, there is a lack of cheap, portable, rapid, and easy-to-use tools for detecting prefrailty and sarcopenia in combination. The aim of this study is to validate an iPhone App to detect prefrailty and sarcopenia syndromes in community-dwelling older adults. A diagnostic test accuracy study will include at least 400 participants aged 60 or over without cognitive impairment and physical disability recruited from elderly social centers of Murcia (Spain). Sit-to-stand muscle power measured through a slow-motion video analysis mobile application will be considered as the index test in combination with muscle mass (calf circumference or upper mid-arm circumference). Frailty syndrome (Fried's Phenotype) and sarcopenia (EWGSOP2) will both be considered as reference standards. Sensibility, specificity, positive and negative predictive values and likelihood ratios will be calculated as well as the area under the curve of the receiver operating characteristic. This mobile application will add the benefit for screening large populations in short time periods within a field-based setting, where space and technology are often constrained (NCT05148351).
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Affiliation(s)
- Alessio Montemurro
- Physiotherapy Department, Faculty of Health Sciences, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
| | - Juan D. Ruiz-Cárdenas
- Physiotherapy Department, Faculty of Health Sciences, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
| | - María del Mar Martínez-García
- Physiotherapy Department, Faculty of Health Sciences, Universidad Católica de Murcia, Campus de los Jerónimos, 30107 Murcia, Spain
- Cystic Fibrosis Association of Murcia, Av. de las Palmeras, 37, 30120 Murcia, Spain
| | - Juan J. Rodríguez-Juan
- Physiotherapy Department, Facultad de Medicina, Universidad de Murcia, Campus Espinardo, 30100 Murcia, Spain
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Neck circumference may predict sarcopenia in Japanese older adults requiring long-term care. Geriatr Nurs 2022; 47:159-163. [PMID: 35914493 DOI: 10.1016/j.gerinurse.2022.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
Several studies have established the advantage of using anthropometric measurements as indicators of sarcopenia. Nevertheless, no study has explored the association between sarcopenia and neck circumference. In this cross-sectional study, we examined the data of 90 older adults requiring long-term care to evaluate this association and establish cut-off points for individuals at risk of sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) 2019. A significant association was found between sarcopenia and neck circumference using binomial logistic regression and receiver operating characteristic analyses. The optimal cut-off value for neck circumference associated with increased risk for sarcopenia among older adults was 32.8 cm for females and 38.0 cm for males. Given the potential of declining neck circumference as an anthropometric marker of sarcopenia, it has clinical applications in screening for sarcopenia in older adults requiring long-term care.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
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Anthropometric Indices as Predictive Screening Tools for Obesity in Adults; The Need to Define Sex-Specific Cut-Off Points for Anthropometric Indices. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12126165] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Due to the lack of full agreement as to the best indicators for obesity diagnosis and type, the aim of this study was to assess the comparative classification capabilities with the use of BIA results and selected anthropometric indices in individuals aged 20–60 years. This was a cross-sectional observational study among 368 Caucasian subjects aged 20–60 years. Body size and four skinfolds measurement were taken. To assess individual body composition, the bioelectrical impedance (BIA) method was applied. The results of fat mass (FM, kg) and fat-free mass (FFM, kg) were taken to calculate FM/FFM, fat mass index (FMI), and fat free mass index (FFMI). Receiver-operating characteristic (ROC) curve analysis was employed to compare the predictive power of different anthropometric indices in differentiating the classification of obesity in adults. The results of this study demonstrated and confirmed the need to change the approach to commonly used indicators such as BMI (body mass index) or WHtR (waist-to-height ratio), which should lead to the establishment of new criteria for the diagnosis of obesity that will also be sex-specific, in the adult population. The measurement of body fat content should become a generally accepted indicator for effective diagnosis, as well as for screening, of obesity.
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Maiworm A, Langner R, Wilm S, Hermann DM, Frohnhofen H, Gronewold J. Developing a novel tool to assess the ability to self-administer medication in non-demented in-hospital patients: ABLYMED study protocol. BMC Geriatr 2022; 22:466. [PMID: 35641903 PMCID: PMC9158197 DOI: 10.1186/s12877-022-03147-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older people often suffer from multimorbidity resulting in polypharmacy. The correct administration of medication is a crucial factor influencing treatment efficacy. However, tools for evaluating the ability to self-administer different dosage forms of medications are lacking. The objectives of the ABLYMED study are to 1) assess the ability to self-administer different dosage forms of medication in older non-demented in-hospital patients who report autonomous management of medication, 2) identify factors influencing the ability to self-administer medication, and 3) develop a standardized tool to validly assess the ability to self-administer different dosage forms of medications based on the final study results. METHODS One hundred in-patients from the department of orthopedics and trauma surgery of the University Hospital Düsseldorf ≥ 70 years of age and regularly taking ≥ 5 different drugs autonomously will be prospectively recruited into the observational cross-sectional single-center ABLYMED study. Patients undergo an interview addressing demographic and clinical information, medication history (which medications are taken since when, in which dose and dosage form, and subjective proficiency of taking these medications), medication adherence, and factors possibly influencing adherence including personality traits and perceived quality of the medication regimen. Quality of the medication regimen is also rated by clinicians according to validated lists. Further, patients receive a comprehensive geriatric assessment including measures of cognition, mobility, and functional status. The ability to self-administer medication is assessed by having patients perform different tasks related to medication self-administration, which are video recorded and rated by different experts. The patients' self-reported ability will be correlated with the observed performance in the self-administration tasks. Further, factors correlating with the reported and observed ability to self-administer medication will be evaluated using correlation and regression models. Based on the final study results, a novel tool to assess the ability of older patients to self-administer medication will be developed. DISCUSSION In addition to guideline-based pharmacotherapy, correct intake of prescribed medication is crucial for optimal therapy of multimorbidity in older people. Tools to validly assess the ability of older patients to self-administer different dosage forms of medications are lacking, but should be included in comprehensive geriatric assessments to secure functional health. TRIAL REGISTRATION Development of an assessment instrument to evaluate the ability to manage various dosage forms, DRKS-ID: DRKS00025788 , (date of registration: 07/09/2021).
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Affiliation(s)
- Anneke Maiworm
- Hospital Pharmacy, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Systems Neuroscience, University Hospital Düsseldorf, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Stefan Wilm
- Institute of General Practice, Centre for Health and Society (Chs), University Hospital Düsseldorf, Düsseldorf, Germany
| | - Dirk M Hermann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Helmut Frohnhofen
- Department of Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.,Faculty of Health, Department of Medicine, Geriatrics, University Witten-Herdecke, Witten, Germany
| | - Janine Gronewold
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.
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Wang X, Li X, Jin R, Yang J, Huang R, Wei L, Liu F, Rao H. Mid-upper arm circumference is associated with liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease: A population based observational study. Hepatol Commun 2022; 6:2262-2272. [PMID: 35560825 PMCID: PMC9426403 DOI: 10.1002/hep4.1990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/24/2022] [Accepted: 04/22/2022] [Indexed: 11/06/2022] Open
Abstract
Metabolic-associated fatty liver disease (MAFLD) is a series of liver diseases based on liver steatosis and metabolic disorders. Steatosis, as the core factor in MAFLD diagnosis, and fibrosis, as the major determinant of adverse outcomes of MAFLD, need to be assessed simply and accurately. In this study, we explored the significance of mid-upper arm circumference (MUAC) in evaluating liver steatosis and fibrosis in patients with MAFLD. We included 2397 cases with MAFLD from the 2017-2018 National Health and Nutrition Examination Surveys (NHANES) database. Liver steatosis and fibrosis were measured by vibration controlled transient elastography. Anthropometric parameters and demographic and serological data were obtained from the NHANES database. The association between MUAC and liver steatosis and fibrosis were evaluated by a multivariable linear regression model, a weighted generalized additive model, and smooth curve fitting using R. MUAC was positively associated with liver steatosis in every multivariate linear regression model (model 1: β = 3.3513; 95% confidence interval [CI], 2.7722-3.9304; model 2: β = 3.8492; 95% CI, 3.2441-4.4542; model 3: β = 2.4987; 95% CI, 1.8371-3.1604), and this positive association was consistent in both men and women and among different race groups (Mexican American, other Hispanic, non-Hispanic White, Black, Asian, and other race). On the other hand, MUAC was positively associated with liver fibrosis in every multivariate linear regression model, and this positive association also was consistent in both men and women and among non-Hispanic White and Black populations. Increased MUAC was positively associated with liver steatosis and fibrosis in patients with MAFLD. This was particularly true for MUAC ≥ 42.0 cm. MUAC might be a simple and convenient evaluation tool for MAFLD.
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Affiliation(s)
- Xiaoxiao Wang
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Xiaohe Li
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Rui Jin
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Jia Yang
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Rui Huang
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Lai Wei
- Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Feng Liu
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
| | - Huiying Rao
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, China
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Xiang Q, Li Y, Xia X, Deng C, Wu X, Hou L, Yue J, Dong B. Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis. BMC Geriatr 2022; 22:327. [PMID: 35428245 PMCID: PMC9012026 DOI: 10.1186/s12877-022-03036-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/07/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Objective
Standard modalities recommended for sarcopenia diagnosis may be unavailable in primary care settings. We aimed to comprehensively evaluate and compare associations of some better popularized nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis in community-dwelling middle-aged and elderly adults, including geriatric nutrition risk index (GNRI), albumin (ALB), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST) and body mass index (BMI).
Methods
Based on the West China Health and Aging Trend study, the current study included participants aged 50 or older who were recruited in 2018. Sarcopenia-related assessment and diagnosis were in line with Asian Working Group for Sarcopenia 2019. For each single index, we assessed its association with sarcopenia presence by univariate and multivariate logistic regression analysis; we also computed diagnostic measures including the area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, accuracy at the optimal cut-off value determined according to Youden’s index.
Results
A total of 3829 subjects were included, consisting of 516 and 3313 subjects in the sarcopenia and non-sarcopenia groups, respectively. Regarding the risk for sarcopenia presence, the fully adjusted odds ratios of GNRI, ALB, CC, MAC, TST and BMI per standard deviation decrease were 2.95 (95% CI 2.51–3.47, P < 0.001), 1.01 (95% CI 0.90–1.15, P = 0.816), 4.56 (95% CI 3.82–5.44, P < 0.001), 4.24 (95% CI 3.56–5.05, P < 0.001), 1.67 (95% CI 1.92–1.45, P < 0.001) and 4.09 (95% CI 3.41–4.91, P < 0.001), respectively. Regarding the value in sarcopenia diagnosis in the entire study population, their AUCs could be ordered as MAC (0.85, 95% CI 0.83–0.86) > GNRI (0.80, 95% CI 0.78–0.82), CC (0.83, 95% CI 0.81–0.85), BMI (0.81, 95% CI 0.79–0.83) > TST (0.72, 95% CI 0.70–0.74) > ALB (0.62, 95% CI 0.60–0.65). At the relevant optimal cut-off values, the sensitivity was the highest for CC (0.83, 95% CI 0.80–0.87) and MAC (0.80, 95% CI 0.77–0.84), while GNRI showed the highest specificity (0.79, 95% CI 0.78–0.81) and accuracy (0.78, 95% 0.76–0.79).
Conclusion
Overall diagnostic performance was the best for MAC, followed by GNRI, CC, BMI, and the worst for TST, ALB in distinguishing sarcopenia from non-sarcopenia in middle-aged and elderly adults in community-based settings. CC or MAC might do better in reducing missed diagnosis, while GNRI was superior in reducing misdiagnosis.
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Takimoto M, Yasui-Yamada S, Nasu N, Kagiya N, Aotani N, Kurokawa Y, Tani-Suzuki Y, Kashihara H, Saito Y, Nishi M, Shimada M, Hamada Y. Development and Validation of Cutoff Value for Reduced Muscle Mass for GLIM Criteria in Patients with Gastrointestinal and Hepatobiliary-Pancreatic Cancers. Nutrients 2022; 14:nu14050943. [PMID: 35267918 PMCID: PMC8912591 DOI: 10.3390/nu14050943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) criteria recommends using race- and sex-adjusted cutoff values for reduced muscle mass (RMM), but the only cutoff values available for Asians are the skeletal muscle mass index (SMI) established by the Asian Working Group for Sarcopenia (AWGS). This retrospective study aimed to develop and validate cutoff values for the fat-free mass index (FFMI) and arm circumference (AC) of Asians, and to investigate the association between GLIM malnutrition and prognosis. A total of 660 patients with primary gastrointestinal (GI) and hepatobiliary–pancreatic (HBP) cancers who underwent their first resection surgery were recruited and randomly divided into development and validation groups. The FFMI and AC cutoff values were calculated by receiver operating characteristic curve analysis for the AWGS SMI as the gold standard. The cutoff values for each RMM were used to diagnose malnutrition on the basis of GLIM criteria, and the survival rates were compared. The optimal FFMI cutoff values for RMM were 17 kg/m2 for men and 15 kg/m2 for women, and for AC were 27 cm for men and 25 cm for women. In the validation group, the accuracy of the FFMI and AC cutoff values to discriminate RMM were 85.2% and 68.8%, respectively. Using any of the three measures of RMM, overall survival rates were significantly lower in the GLIM malnutrition group. In conclusion, the cutoff values for the FFMI and AC in this study could discriminate RMM, and GLIM malnutrition using these cutoff values was associated with decreased survival.
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Affiliation(s)
- Mami Takimoto
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Sonoko Yasui-Yamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
- Correspondence: ; Tel.: +81-88-633-9124; Fax: +81-88-633-9574
| | - Nanami Nasu
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Natsumi Kagiya
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Nozomi Aotani
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Yumiko Kurokawa
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Yoshiko Tani-Suzuki
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
| | - Hideya Kashihara
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (H.K.); (M.N.); (M.S.)
| | - Yu Saito
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (H.K.); (M.N.); (M.S.)
| | - Masaaki Nishi
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (H.K.); (M.N.); (M.S.)
| | - Mitsuo Shimada
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (H.K.); (M.N.); (M.S.)
| | - Yasuhiro Hamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; (M.T.); (N.N.); (N.K.); (N.A.); (Y.K.); (Y.T.-S.); (Y.S.); (Y.H.)
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Yuan J, Lin Y, Song J, Xia R, Jiang Y, Yang X, Li Y, Dong B. Associations of Sarcopenic Parameters with Dysphagia in Older Nursing Home Residents: A Cross-Sectional Study. J Nutr Health Aging 2022; 26:339-345. [PMID: 35450989 DOI: 10.1007/s12603-022-1768-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To investigate the prevalence of sarcopenia and dysphagia in nursing homes and to analyze the associations between sarcopenic parameters and dysphagia. DESIGN A cross-sectional study. SETTING Nursing homes in Chengdu, Sichuan, China. PARTICIPANTS The study included 365 participants (122 men and 243 women) aged 60 years or older who could walk independently or with walking aids for at least 50 meters. MEASUREMENTS Dysphagia was defined by the water swallow test and sarcopenia and its components were evaluated by the criteria of the Asian Working Group for Sarcopenia, 2019. The values and percentages of sarcopenia associated parameters in relation to dysphagia were analyzed in both male and female residents. The Benjamini-Hochberg method was used to adjust for multiple comparisons. The relationship between sarcopenic components and dysphagia was analyzed using multivariate logistic regression analysis by sex. RESULTS A total of 365 residents (mean age: 84.28 years; 122 men and 243 women) were included in the study. Sarcopenia was diagnosed in 63.0% (n=230) and dysphagia in 75.3% (n = 275) of residents. For men, the percentage of sarcopenia was higher in residents with dysphagia. However, the sarcopenia percentage did not differ significantly between women with and without dysphagia. In both men and women, the handgrip strength (HGS) values were significantly lower in the dysphagic residents. The calf circumference (CC) value and appendicular skeletal muscle index (ASMI) were significantly lower in dysphagic men, while the SARC-CalF scores were higher. In women, the SPPB score was lower in residents with dysphagia. Furthermore, multivariate logistic regression analysis showed that low calf circumference (OR 4.415, 95% CI 1.561-12.490) and sarcopenia (OR 2.968, 95% CI 1.121-7.858) were significantly associated with dysphagia in men after adjusting for co-factors. CONCLUSION There is a high percentage of both dysphagia and sarcopenia in nursing home residents in West China. Low calf circumference and sarcopenia had strong associations with dysphagia among male nursing home residents.
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Affiliation(s)
- J Yuan
- Ying Li, The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,
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Ren S, Huang S, Chen M, Zhu T, Li Q, Chen X. Association between the mid-upper arm circumference (MUAC) and calf circumference (CC) screening indicators of sarcopenia with the risk of pneumonia in stable patients diagnosed with schizophrenia. Front Psychiatry 2022; 13:931933. [PMID: 36090356 PMCID: PMC9458877 DOI: 10.3389/fpsyt.2022.931933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/02/2022] [Indexed: 01/03/2023] Open
Abstract
AIM Here, we investigate the relationship between mid-upper arm circumference (MUAC) and calf circumference (CC) screening indicators of sarcopenia and the risk of pneumonia in stable patients diagnosed with schizophrenia. METHOD The study is prospective and includes inpatients with schizophrenia from two mental health centers in Western China. The studied screening indicators, MUAC and CC were assessed in standing patients. The relationship between MUAC and CC as sarcopenia screening indicators with the risk of pneumonia in patients with schizophrenia was analyzed by performing a statistical logistic regression analysis. RESULT For this study, 339 patients with schizophrenia, aged 50 years and over were recruited. Moreover, four patients with pneumonia that occurred within 1 week of the relapse of schizophrenia were excluded. As a result, only 335 patients were included in the analysis. Pneumonia has been reported in 82 (24.5%) of all included patients with schizophrenia. Our data analysis confirmed that in the male patients, the higher CC was associated with a lower risk of pneumonia (odds ratio [OR] = 0.751, 95% CI: 0.635-0.889). We have divided men into two cohorts following the values of CC. Our analysis further showed that the patients with CC ≥ 34 cm had a lower risk of pneumonia in men (OR = 0.36, 95% CI: 0.163-0.795). CONCLUSION We demonstrate that CC is associated with pneumonia risk in stable men with schizophrenia.
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Affiliation(s)
- Silan Ren
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, China
| | - Sha Huang
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
| | - Ming Chen
- Psychiatric Hospital of Ziyang, Ziyang, China
| | - Tian Zhu
- Psychiatric Hospital of Ziyang, Ziyang, China
| | - Qiuxia Li
- Psychiatric Hospital of Ziyang, Ziyang, China
| | - Xiaoyan Chen
- Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China
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Qi Q, Sun K, Rong Y, Li Z, Wu Y, Zhang D, Song S, Wang H, Feng L. Body composition of the upper limb associated with hypertension, hypercholesterolemia, and diabetes. Front Endocrinol (Lausanne) 2022; 13:985031. [PMID: 36120449 PMCID: PMC9471382 DOI: 10.3389/fendo.2022.985031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
The associations between segmental body composition and metabolic diseases remain equivocal. This study aimed to investigate this association using the example of U.S. adults. This cross-sectional study included 12,148 participants from the National Health and Nutrition Examination Survey (NHANES) (2011-2018). Multivariable logistic regression models were used to estimate associations between segmental body composition quartiles of hypertension, hypercholesterolemia, and diabetes. Among 12,148 participants, 3,569, 5,683, and 1,212 had hypertension, hypercholesterolemia, and diabetes, respectively. After adjusting for potential confounders, increased percent upper limb lean body mass was associated with a lower risk of hypertension (OR= 0.88, 95%CI: 0.84, 0.92, P trend<0.001), hypercholesterolemia (OR= 0.93, 95%CI: 0.89, 0.96, P trend<0.001), and diabetes (OR= 0.96, 95%CI: 0.95, 0.98, P trend<0.001). Increased upper limb fat mass is associated with an increased risk of hypertension (OR= 1.11, 95%CI: 1.07, 1.15, P trend<0.001), hypercholesterolemia (OR= 1.05, 95%CI: 1.01, 1.09, P trend=0.07), and diabetes (OR= 1.03, 95%CI: 1.01, 1.05, P trend=0.014). The same correlations were found in the torso and whole-body composition parameters. We observed that for women, lean body mass has a better protective effect on metabolic diseases [hypertension (OR= 0.88, 95%CI: 0.82, 0.93), hypercholesteremia (OR =0.86, 95%CI: 0.81, 0.92), diabetes (OR= 0.97, 95%CI: 0.85, 0.99)]; for men, increased body fat is associated with greater risk of metabolic disease[hypertension (OR= 1.24, 95%CI: 1.15, 1.33), hypercholesteremia (OR =1.09, 95%CI: 1.01, 1.18), diabetes (OR= 1.06, 95%CI: 1.01, 1.10)]. There were significant differences between different gender. These findings suggested that upper limb and torso adiposity should be considered when assessing chronic metabolic disease risk using body composition.
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Affiliation(s)
- Qianjin Qi
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Kui Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ying Rong
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhaoping Li
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yixia Wu
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Di Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shuaihua Song
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Haoran Wang
- Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li Feng
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Chen M, Lei X, Zhu T, Li Q, Chen X. Evaluation of the Accuracy of Six Simple Screening Tools for Sarcopenia in Schizophrenic Patients. J Nutr Health Aging 2022; 26:571-575. [PMID: 35718865 DOI: 10.1007/s12603-022-1799-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Our objective was to evaluate if SARC-F, SARC-CalF, SARC-F-EBM, calf circumference (CC), mid-upper-arm circumference (MUAC) and Ishii test can be used to accurately screen for sarcopenia in schizophrenic patients. METHOD We enrolled schizophrenic patients aged 50 or older, who were regularly taking antipsychotic medications, at two mental health centres. Bioimpedance-based muscle-mass was analysed with an InBody 770 instrument, while muscle strength was measured with a digital grip-strength dynamometer. The physical performance of the patients was gauged from their gait speed over 6 m. Standard AWGS2019 diagnostic criteria were used, and the accuracies of the six screening methods were indicated by the sensitivity, negative predictive value (NPV), and area under receiver operating characteristic curve (AUC). RESULTS A total of 339 stable schizophrenic patients were enrolled. The overall prevalence of sarcopenia was 53.1%, and the prevalence was 55.6% and 47.66%, respectively, for males and females. The prevalence of sarcopenia obesity in the total population was 16.22%, and that of males and females was 18.97% and 10.28%, respectively. The SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test sensitivity/NPV in screening for sarcopenia were 41.86%/0.52, 79.07%/0.7, 28.68%/0.51, 78.3%/0.71, 76.74%/0.7, 89.92%/0.84, respectively, in males and 45.1%/0.59, 94.12%/0.91, 54.9%/0.7, 92.16%/60.91, 74.51%/0.77, 96.08%/0.94, respectively, in females. In males, the AUCs of the SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test were 0.601 (95%CI, 0.528-0.673), 0.754 (95%CI,0.69-0.817), 0.657 (95%CI,0.588-0.727), 0.8 (95%CI, 0.744-0.856), 0.781 (95%CI, 0.721-0.84) and 0.88 (95%CI, 0.837-0.922), respectively, and in females, they were 0.587(95%CI,0.479-0.696), 0.794 (95%CI,0.709-0.878), 0.799 (95%CI,0.71-0.888), 0.893 (95%CI, 0.833-0.953), 0.843 (95%CI, 0.772-0.915) and 0.855 (95%CI, 0.784-0.926), respectively. CONCLUSION The prevalence of sarcopenia in schizophrenic patients is high. Clinical doctors should screen for sarcopenia in schizophrenic patients and provide timely interventions to reduce the occurrence of adverse events. The above six tools can be used as screening tools, and the Ishii test is the most suitable for screening.
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Affiliation(s)
- M Chen
- Xiaoyan Chen, MD; Southwest Medical University Zigong Affiliated Hospital; Zigong Mental Health Center; Zigong, Sichuan Province, China;
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Tey SL, Huynh DTT, Berde Y, Baggs G, How CH, Low YL, Cheong M, Chow WL, Tan NC, Chew STH. Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore. Sci Rep 2021; 11:23071. [PMID: 34845250 PMCID: PMC8630119 DOI: 10.1038/s41598-021-02274-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.
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Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore.
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Mumbai, India
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, OH, 43219, USA
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore, 529889, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Yen Ling Low
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore, 529889, Singapore
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore, 529889, Singapore
| | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore.,SingHealth Polyclinics, Singapore, 150167, Singapore
| | - Samuel Teong Huang Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore, 529889, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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