Effects of sleep deprivation on sarcopenia and obesity: A narrative review of randomized controlled and crossover trials

Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis

OBJECTIVES

In adults, short and long sleep duration has been associated with sarcopenia risk. Studies have shown that various factors, including biological and psychological factors, could be the underlying cause of the association between aberrant sleep duration and sarcopenia risk. In this study, we have qualitatively and quantitatively summarized previously published studies on sleep duration to assess the relationship between sleep duration and sarcopenia risk in adults. This would aid in enhancing our understanding of recent advancements in this field and the association between sleep duration and sarcopenia risk.

DESIGN

Systematic review and meta-analysis.

SETTING AND PARTICIPANTS

In this review, we included studies evaluating the association between the duration of sleep and sarcopenia in adults in observational studies.

METHODS

Five electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Web of Science) were searched to April 20, 2023, to identify studies related to sarcopenia and sleep duration. Next, we calculated the odds ratios (ORs) for sarcopenia prevalence based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0.

RESULTS

Sarcopenia prevalence was high (18%) in adults with long sleep duration. Our results showed a significant association between short duration of sleep and high sarcopenia prevalence in older adults (OR 1.2, 95% CI 1.02-1.41, I2 = 56.6%). Furthermore, a significant association was observed between all participants with long-duration sleep and high sarcopenia prevalence (OR 1.53, 95% CI 1.34-1.75, I2 = 56.8%). We also observed significant heterogeneity in the adjusted ORs.

CONCLUSIONS AND IMPLICATIONS

There was a correlation between sarcopenia and short or long sleep duration, especially in older adults. In adults with a long duration of sleep, sarcopenia prevalence was relatively high.

Daytime napping, comorbidity profiles, and the risk of sarcopenia in older individuals

Appropriate daytime napping is associated with the decreased risk of cerebro-cardiovascular diseases, but whether daytime napping affects sarcopenia remains to be explored. Our study plans to examine the associations between sarcopenia with daytime napping and comorbidity. The study population came from the China Health and Retirement Longitudinal Study 2011-2015. Latent class analysis (LCA) was used to identify comorbidity profiles based on 14 doctor-diagnosed chronic diseases. Subsequently, smooth function and restricted cubic spline with three binomial regression models determined the associations between sarcopenia with daytime napping and comorbidity profiles. About 18.7% (2,894) and 5.4% (832) of 15,404 individuals were diagnosed with sarcopenia and severe sarcopenia. LCA delineated four classes as the best fit as follows: dominant heart diseases or risks (class 1, N = 2,203), dominant chronic lung diseases (class 2, N = 740), minimal or least diseases (class 3, N = 10,612, reference), and dominant digestive diseases and rheumatism (class 4, N = 1849). Compared with the reference group (class 3), the multivariate-adjusted ORs (95% CIs) of sarcopenia in model 3 were 0.72 (0.60-0.88) for class 1, 1.17 (0.92-1.51) for class 2, and 0.92 (0.77-1.09) for class 4. Smooth function and restricted cubic spline suggested that individuals who napped about 60 min seemingly had the lowest risk of sarcopenia. Individuals who napped for 1-59 min (adjusted OR = 0.80, 95% CI: 0.68-0.94) and 60-119 min (adjusted OR = 0.83, 95% CI: 0.72-0.95) had the significantly lower risk of sarcopenia but not severe sarcopenia than those who did not nap. Insufficient and excessive daytime napping might be associated with the increased risk of sarcopenia, especially in individuals with a dominant chronic lung disease profile.

Insufficient sleep disrupts glucose metabolism during pregnancy by inhibiting PGC-1α

Background

Gestational diabetes mellitus (GDM) impacted about 17 million pregnancies globally and predisposes both the mother and her offspring to metabolic disorders. Insufficient sleep has been shown to be associated with GDM. This study aimed to explore the molecular link between sleep and GDM.

Methods

The sleep of pregnant mice was disturbed with motion a rod and the mice received either dimethyl sulfoxide (DMSO) or ZLN005. Insulin resistance was assessed by intraperitoneal glucose tolerance test (GTT). Adenosine triphosphate (ATP), reactive oxygen species (ROS), and cytokines were measured with respective commercial kits. Gene expression was analyzed with quantitative polymerase chain reaction (qPCR), western blot, and/or immunohistochemistry (IHC).

Results

Sleep disturbance increased blood glucose level and insulin resistance, increased ROS and inflammatory cytokines, and reduced ATP level in pregnant mice. The expression levels of PGC-1α and downstream metabolic genes and antioxidant genes in pregnant mouse muscle were inhibited by sleep disturbance. ZLN005 promoted expression of PGC-1α and its target genes, increased muscle ATP level, decreased muscle ROS, and reduced blood glucose level and insulin resistance in sleep disturbed pregnant mice, indicating that PGC-1α played a critical role in sleep insufficiency caused GDM and might be a target for intervention.

Conclusions

PGC-1 was a key player in the sleep disorder GDM and might be a target for treatment.

Sarcopenia and nervous system disorders

Sarcopenia has an insidious start that can induce physical malfunction, raise the risk of falls, disability, and mortality in the old, severely impair the aged persons' quality of life and health. More and more studies have demonstrated that sarcopenia is linked to neurological diseases in recent years. This review examines the advancement of sarcopenia and neurological illnesses research.

Vitamin D in Osteosarcopenic Obesity

Osteosarcopenic obesity is a unique clinical condition where low bone and muscle mass coexist in individuals with obesity. Alterations in adipose tissue, skeletal muscle and bone are strictly interconnected, and vitamin D plays key roles in several metabolic pathways that are involved in maintaining musculoskeletal health and glucose homeostasis. We reviewed the available literature on mechanisms underlying osteosarcopenic obesity, with a focus on the role of vitamin D in the pathogenesis and treatment of the condition. We found that, although evidence from large observational studies and pre-clinical experiments strongly supports a role of vitamin D deficiency in the pathogenesis of osteosarcopenic obesity, the common belief that vitamin D improves musculoskeletal health lacks solid clinical evidence, as trials specifically aimed at assessing the effects of vitamin D supplementation in patients with osteosarcopenic obesity are not available, and trials that investigated the role of vitamin D on muscle and bone health in other patient populations either showed no or even detrimental effects. We conclude that large observational and interventional studies including individuals with osteosarcopenic obesity representative of different sex, age and race are needed to better define the role of vitamin D in the pathogenesis and treatment of this condition.

The Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms

The age-related decrease in skeletal muscle mass together with the loss of muscle power and function is defined sarcopenia. Mounting evidence suggests that the prevalence of sarcopenia is higher in patients with type 2 diabetes mellitus (T2DM), and different mechanisms may be responsible for this association such as impaired insulin sensitivity, chronic hyperglycemia, advanced glycosylation end products, subclinical inflammation, microvascular and macrovascular complications. Glucose-lowering drugs prescribed for patients with T2DM might impact on these mechanisms leading to harmful or beneficial effect on skeletal muscle. Importantly, beyond their glucose-lowering effects, glucose-lowering drugs may affect per se the equilibrium between protein anabolism and catabolism through several mechanisms involved in skeletal muscle physiology, contributing to sarcopenia. The aim of this narrative review is to provide an update on the effects of glucose-lowering drugs on sarcopenia in individuals with T2DM, focusing on the parameters used to define sarcopenia: muscle strength (evaluated by handgrip strength), muscle quantity/quality (evaluated by appendicular lean mass or skeletal muscle mass and their indexes), and physical performance (evaluated by gait speed or short physical performance battery). Furthermore, we also describe the plausible mechanisms by which glucose-lowering drugs may impact on sarcopenia.