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Sun Y, Xu Z, You W, Zhou Y, Nong Q, Chen W, Shan T. Lipidomics and single-cell RNA sequencing reveal lipid and cell dynamics of porcine glycerol-injured skeletal muscle regeneration model. Life Sci 2024; 350:122742. [PMID: 38797365 DOI: 10.1016/j.lfs.2024.122742] [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: 01/31/2024] [Revised: 05/18/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
AIMS Intramuscular fat (IMF) infiltration and extracellular matrix (ECM) deposition are characteristic features of muscle dysfunction, such as muscular dystrophy and severe muscle injuries. However, the underlying mechanisms of cellular origin, adipocyte formation and fibrosis in skeletal muscle are still unclear. MAIN METHODS Pigs were injected with 50 % glycerol (GLY) to induce skeletal muscle injury and regeneration. The acyl chain composition was analyzed by lipidomics, and the cell atlas and molecular signatures were revealed via single-cell RNA sequencing (scRNA-seq). Adipogenesis analysis was performed on fibroblast/fibro-adipogenic progenitors (FAPs) isolated from pigs. KEY FINDINGS The porcine GLY-injured skeletal muscle regeneration model was characterized by IMF infiltration and ECM deposition. Skeletal muscle stem cells (MuSCs) and FAP clusters were analyzed to explore the potential mechanisms of adipogenesis and fibrosis, and it was found that the TGF-β signaling pathway might be a key switch that regulates differentiation. Consistently, activation of the TGF-β signaling pathway increased SMAD2/3 phosphorylation and inhibited adipogenesis in FAPs, while inhibition of the TGF-β signaling pathway increased the expression of PPARγ and promoted adipogenesis. SIGNIFICANCE GLY-induced muscle injury and regeneration provides comprehensive insights for the development of therapies for human skeletal muscle dysfunction and fatty infiltration-related diseases in which the TGF-β/SMAD signaling pathway might play a primary regulatory role.
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Affiliation(s)
- Ye Sun
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Ziye Xu
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Wenjing You
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Yanbing Zhou
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Qiuyun Nong
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Wentao Chen
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China
| | - Tizhong Shan
- College of Animal Sciences, Zhejiang University, Hangzhou, China; The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Hangzhou, China; Zhejiang Provincial Laboratory of Feed and Animal Nutrition, Hangzhou, China.
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Sun Y, Liu BW, Zhang X, Yin FZ. Relationships Between the Apolipoprotein Levels and Sarcopenia in Inpatients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:2085-2094. [PMID: 38799278 PMCID: PMC11122175 DOI: 10.2147/dmso.s461324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
Background Apolipoprotein (Apo) may be associated with sarcopenia in elderly inpatients with type 2 diabetes mellitus (T2DM), but fewer studies are available. In this study, we explored the association of ApoA1, ApoB, and ApoB/ApoA1 with sarcopenia and compared the predictive role of Apo indicators for sarcopenia in an elderly T2DM. Objective To investigate the relationships between the Apo and sarcopenia in elderly inpatients with T2DM. Methods This study included 253 inpatients with T2DM (mean age of 70.11±5.44 years, 32.8% male). The inpatients were divided into the sarcopenic group (n = 100) and non-sarcopenic group (n = 153). The associations among the Apo and sarcopenia were assessed using multivariate analyses. Results Inpatients in the sarcopenia group showed lower ApoA1 levels than those in the non-sarcopenia group (1.25±0.21 vs 1.36±0.20 g/L, P < 0.05) and showed higher ApoB/ApoA1 and ApoB levels than those in the non-sarcopenia group (0.82±0.27 vs 0.69±0.19 g/L, P < 0.05;1.00±0.32 vs 0.93±0.24 g/L, P < 0.05, respectively). After adjusting for age and BMI, the logistic regression model indicated that ApoA1 was a protective factor for elderly inpatients with T2DM sarcopenia.(OR =0.079,95% CI: 0.021~0.306, P < 0.05);ApoB and AopB/AopA1 were risk factors for elderly inpatients with T2DM sarcopenia.(OR =3.578,95% CI:1.318~9.715, P < 0.05;OR =16.440,95% CI:4.437~60.427, P < 0.05, respectively). AopB/AopA1 provided an AUC value of 0.765 in elderly men.(95% CI: 0.665~0.866, P<0.05). Conclusion ApoA1, AopB, and AopB/AopA1 are associated with sarcopenia in elderly inpatients with T2DM, and AopB/AopA1 may be a potential predictor of sarcopenia in elderly men with T2DM.
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Affiliation(s)
- Yang Sun
- Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China
| | - Bo-Wei Liu
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China
| | - Xin Zhang
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China
| | - Fu-Zai Yin
- Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China
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Francis D, Kotteeswaran K, Padinhare Veedu P. Severity of Neuropathy-Related Disability and Associated Factors of Diabetic Peripheral Neuropathy in a Tertiary Healthcare Center: A Comparative Cross-Sectional Study. Cureus 2024; 16:e55568. [PMID: 38576639 PMCID: PMC10994166 DOI: 10.7759/cureus.55568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The widespread presence of diabetic peripheral neuropathy (DN) and its related variables among diagnosed diabetes mellitus (DM) patients in Kerala lacks sufficient evidence. The objective of this study was to evaluate the frequency of DN and its related risk variables among those with DM who were receiving care at a tertiary health institution in Kerala. MATERIALS AND METHODS This study was conducted in a tertiary health center in Kerala using a cross-sectional design. The diagnosis of diabetes was established by assessing the glycated hemoglobin A1c (HbA1c) level and the fasting blood glucose (FBG) level. A validated survey questionnaire was employed to gather demographic data as well as the medical history of DM and associated ailments. A thorough physical examination, BMI, and blood pressure were recorded. Dermatological, musculoskeletal, neurological, and vascular assessments were conducted. The subjects were assessed for neuropathy using a neuropathy disability score (NDS). Consequently, those who met the criteria for DM were classified into two groups: those with neuropathy and those without neuropathy. All research participants underwent laboratory examinations such as blood lipid profiles, HbA1c, and vitamin B12 complex concentrations. RESULTS The study included 200 DM patients; 120 men and 80 women. Study participants were 40-70 years old, with a median age of 53. The prevalence of DN significantly increased with age (p<0.001). The longer a patient had DM, the higher the prevalence of DN, and this variance in percentage was statistically significant (p<0.009) with an OR (odds ratio) of 9.246. A statistically significant 81 (40.5%) of participants graduated, compared to 119 (59.5%) with only higher secondary education or less (OR = 2.042; p = 0.014). Approximately 107 (53.5%) of individuals earned an income under two lakhs, and this disparity was deemed statistically significant (p = 0.003) with an OR of 2.357. In the group of individuals being studied, 53 (26.5%) of them experienced a decrease in pressure sensation, 47 (23.5%) had a decrease or absence of vibration perception, 48 (24%) had an absence or decreased pinprick response, and 46 (23%) had an absent ankle reflex. The study found that the most commonly reported symptoms were tingling (n = 44; 22%), numbness (n = 42; 21%), burning (n = 37; 18.5%), pricking (n = 29; 14.5%), and pain (n = 27; 13.5%). A strong association was found between DN and glycemic status, namely, FBG levels exceeding 140 mg/dL (OR = 4.511, p < 0.001) and HbA1c levels exceeding 6.5% (OR = 3.87, p < 0.001). The prevalence of abnormal vitamin B12 levels in individuals with DN was 63% (p = 0.19), indicating that the finding was not statistically significant. Within the group of individuals with DN being studied, 22% exhibited mild neuropathy, 34% displayed moderate neuropathy, and 44% had severe neuropathy. The DN individuals had significantly reduced ankle dorsiflexion in cases of severe NDS scores compared to those with mild to moderate NDS scores (p = 0.009). During the binary logistic regression analysis, it was shown that the duration of DM (OR = 1.73; p = 0.038) and FBG levels (OR = 2.87; p = 0.018) were determined as predictors for DN. CONCLUSION The findings of this study reveal that the duration of diabetes, age, literacy level, income, HbA1c, and FBG were substantially related to a higher likelihood of DN among diabetic patients.
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Affiliation(s)
- Daris Francis
- Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, IND
| | - Kandaswami Kotteeswaran
- Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, IND
| | - Pramod Padinhare Veedu
- Department of Physiotherapy, Lourde Institute of Allied Health Sciences, Taliparamba, IND
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Chen K, Hu S, Liao R, Yin S, Huang Y, Wang P. Application of conventional ultrasound coupled with shear wave elastography in the assessment of muscle strength in patients with type 2 diabetes. Quant Imaging Med Surg 2024; 14:1716-1728. [PMID: 38415110 PMCID: PMC10895149 DOI: 10.21037/qims-23-1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/12/2023] [Indexed: 02/29/2024]
Abstract
Background In patients with type 2 diabetes mellitus (T2DM), a decrease in muscle function may be related to changes in the biomechanical properties of skeletal muscles. However, the correlations between muscle function and the characteristics of muscle size and stiffness as measured by ultrasound in patients with T2DM are unclear. The aim of this study was to investigate the abilities of conventional ultrasound and shear wave elastography (SWE) to assess muscle properties in patients with T2DM and to correlate the findings with isokinetic muscle testing and functional tests. Methods Sixty patients from the Department of Endocrinology in The Third Affiliated Hospital of Southern Medical University diagnosed with T2DM were recruited in this cross-sectional study from September 2021 to September 2022. T2DM was defined based on the American Diabetes Association criteria. The exclusion criteria were a history of injury or operation of the lower limb or clinical signs of neuromuscular disorders, any muscle-induced disease, and the presence of other types of diabetes mellitus. Thirty-five matched healthy volunteers were continuously included in the control group. SWE was used to measure the muscle stiffness of the quadriceps femoris [vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM), vastus intermedius (VI)] and the biceps brachii (BB) in a relaxed position, and the shear wave velocity (SWV) values were recorded. Muscle size was measured using conventional ultrasound. The participants underwent isokinetic knee extension/flexion (60°/sec) to assess muscle strength and functional tests of physical performance, including the short physical performance battery, 30-s chair stand test, timed up-and-go test, and 6-meter walk test. All demographics and measured variables were compared using the independent samples t-test. Interclass correlation coefficient analysis was performed on the measurement data obtained by the two operators, and Pearson correlation coefficients were used to determine the relationships between variables. Results Patients with T2DM exhibited worse physical performance (P<0.05) and weaker lower limb muscle strength (P<0.05) than did healthy controls, but their handgrip strength was comparable (P=0.102). Patients with T2DM had significantly decreased muscle thickness [RF thickness: 10.69±3.21 vs. 13.09±2.41 mm, mean difference =-2.40, 95% confidence interval (CI): -3.56 to -1.24, P<0.001; anterior quadriceps thickness: 23.45±7.11 vs. 27.25±5.25 mm, mean difference =-3.80, 95% CI: -6.33 to -1.26, P=0.004] and RF cross-sectional area (3.04±1.10 vs. 4.11±0.95 cm2, mean difference =-1.07, 95% CI: -1.49 to -0.64; P<0.001) compared to healthy controls. Smaller muscle size was associated with decreased muscle strength (r=0.44-0.69, all P values <0.001). Except for the BB (3.48±0.38 vs. 3.61±0.61 m/s, mean difference =-0.12, 95% CI: -0.35 to 0.11; P=0.257) and VI (2.59±0.34 vs. 2.52±0.23 m/s, mean difference =0.03, 95% CI: -0.06 to 0.18; P=0.299), the muscle stiffness in patients with T2DM was significantly decreased. For the patients with T2DM and healthy participants, the SWV of the RF was 1.66±0.23 and 1.83±0.18 m/s (mean difference =-0.17, 95% CI: -0.25 to -0.08; P<0.001), respectively; that of the VM was 1.34±0.15 and 1.51±0.16 m/s (mean difference =-0.17, 95% CI: -0.24 to -0.10; P<0.001), respectively; and that of VL was 1.38±0.19 and 1.53±0.19 m/s (mean difference =-0.15, 95% CI: -0.23 to -0.07; P<0.001), respectively. Excellent interobserver reliability of the SWV measurements on the muscle of T2DM patients was observed (all intraclass correlation coefficients >0.75; P<0.001). The SWV showed moderate correlations with muscle strength in the RF, VM, and VL (r=0.30-0.61; all P values <0.05). Conclusions Ultrasound technology exhibits good reliability for repeated measurements of muscle size and stiffness. Reduced muscle stiffness as detected by SWE was demonstrated in patients with diabetes and was associated with decreased muscle strength and impaired functional activity.
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Affiliation(s)
- Kaifan Chen
- Department of Ultrasonography, The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangzhou, China
| | - Shidi Hu
- Department of Endocrinology, The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangzhou, China
| | - Renmou Liao
- Institute of Rehabilitation Medicine, The Foshan Fifth People's Hospital, Foshan, China
| | - Sishu Yin
- Department of Ultrasonography, The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangzhou, China
| | - Yuqian Huang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangzhou, China
| | - Ping Wang
- Department of Ultrasonography, The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Guangzhou, China
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Chen H, Wu Z, Chen D, Huang F. Correlation between blood glucose level and poor wound healing after posterior lumbar interbody fusion in patients with type 2 diabetes. Int Wound J 2024; 21:e14340. [PMID: 37580856 PMCID: PMC10777750 DOI: 10.1111/iwj.14340] [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: 06/03/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
To investigate the correlation of blood glucose level with poor wound healing (PWH) after posterior lumbar interbody fusion (PLIF) in patients with type 2 diabetes (T2D). From January 2016 to January 2023, a case-control study was conducted to analyse the clinical data of 400 patients with T2D who were treated by PLIF and internal fixation at our hospital. The following data were recorded: gender; age; body mass index (BMI); surgical stage; average perioperative blood glucose level; perioperative blood glucose variance; perioperative blood glucose coefficient of variation; glycated haemoglobin level; preoperative levels of total protein, albumin and haemoglobin; postoperative levels of total protein, albumin and haemoglobin; surgical time; intraoperative bleeding volume; operator; postoperative drainage volume; and postoperative drainage tube removal time of each group. The indicators for monitoring blood glucose variability (GV) included the SD of blood glucose level (SDBG), coefficient of variation (CV) and maximum amplitude of variation (LAGE) before and after surgery. According to the diagnostic criteria for PWH, patients with postoperative PWH were determined and assigned to two groups: Group A (good wound healing group; n = 330 patients) and Group B (poor wound healing group; n = 70 patients). The preoperative and postoperative blood GV indicators, namely SDBG, CV and LAGE, were compared between these two groups. We also determined the relationship between perioperative blood GV parameters and PWH after PLIF surgery and its predictive value through correlation analysis and receiver-operating characteristic curve. Of the 400 enrolled patients, 70 patients had PWH. Univariate analysis revealed significant differences between the two groups in the course of diabetes, mean fasting blood glucose (MFBG), SDBG, CV, LAGE, preoperative hypoglycaemic program, surgical segment, postoperative drainage time, incision length and other factors (p < 0.05). However, no significant differences were noted in factors such as gender, age, body mass index, hypertension, coronary heart disease, admission fasting blood glucose, preoperative haemoglobin A1c, surgical time, intraoperative bleeding volume, intraoperative blood transfusion volume and postoperative drainage volume (p > 0.05). The area under the curve (AUC) values of preoperative SDBG, CV and LAGE were 0.6657, 0.6432 and 0.6584, respectively. The cut-off values were 1.13 mmol/L, 6.97% and 0.75 mmol/L, respectively. The AUC values for postoperative SDBG, CV and LAGE were 0.5885, 0.6255 and 0.6261, respectively. The cut-off values were 1.94 mmol/L, 24.32% and 2.75 mmol/L, respectively. The multivariate ridge regression analysis showed that preoperative MFBG, SDBG, CV and LAGE; postoperative SDBG, CV and LAGE; postoperative long drainage time; and multiple surgical segments were independent risk factors for T2D patients to develop surgical site infection after PLIF (p < 0.05). The perioperative blood GV in patients with T2D is closely related to the occurrence of PWH after PLIF. Reducing blood GV may help to reduce the occurrence of PWH after PLIF.
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Affiliation(s)
- Huajian Chen
- Department One of Spine SurgeryZhongshan Hospital of Traditional Chinese MedicineZhongshanPeople's Republic of China
- Department Seven of Traumatology OrthopedicFoshan Hospital of Traditional Chinese MedicineFoshanPeople's Republic of China
| | - Zhengjie Wu
- Department Seven of Traumatology OrthopedicFoshan Hospital of Traditional Chinese MedicineFoshanPeople's Republic of China
| | - Deyuan Chen
- Department One of Spine SurgeryZhongshan Hospital of Traditional Chinese MedicineZhongshanPeople's Republic of China
| | - Fuli Huang
- Department One of Spine SurgeryZhongshan Hospital of Traditional Chinese MedicineZhongshanPeople's Republic of China
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Yoshida K, Miura Y, Nakanishi S, Tanaka S, Kuniyasu K, Matsumoto S, Hanayama K. The impact of diabetic polyneuropathy on toe grip strength in patients with type 2 diabetes mellitus: a cross-sectional study. J Diabetes Metab Disord 2023; 22:1391-1397. [PMID: 37969917 PMCID: PMC10638331 DOI: 10.1007/s40200-023-01260-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/01/2023] [Indexed: 11/17/2023]
Abstract
Purpose Type 2 diabetes mellitus (T2DM) and concomitant diabetic polyneuropathy (DPN) induce muscle weakness. Muscle weakness in the foot is associated with foot deformities and falls. However, factors affecting toe grip strength (TGS) are not well known. Therefore, the present study investigated factors related to TGS in patients with T2DM. Methods This was a cross-sectional study involving 100 patients with T2DM who were hospitalized for the treatment of T2DM and 50 healthy adults. The subjects were divided into three groups: a group of healthy subjects, a group of T2DM patients without DPN, and a group of T2DM patients with DPN. Hierarchical multiple regression analysis was performed with TGS and the TGS-to-weight ratio (TGS/Wt%) as dependent variables and with age, the presence of T2DM, and DPN as independent variables, and sex and BMI as confounders. Results There were no significant differences in age or sex among the three groups. In the final regression analysis, age and presence of T2DM and DPN were associated in both models with TGS and TGS/Wt% as dependent variables. Conclusion DPN, T2DM, and age were found to be related to TGS. The findings of this study could contribute to healthcare providers developing foot care and rehabilitation programs for diabetic patients. Trial registration This study was registered with UMIN-CTR (UMIN000034320) on 1 November 2018.
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Affiliation(s)
- Koji Yoshida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Yasushi Miura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shuhei Nakanishi
- Division of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School, Kurashiki, Japan
| | - Shigeharu Tanaka
- School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Katsushi Kuniyasu
- Department of Physical Therapist, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Shinsuke Matsumoto
- Department of Physical Therapist, Kawasaki Junior College of Rehabilitation, Kurashiki, Japan
| | - Kozo Hanayama
- Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Japan
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Shahrjerdi S, Bahrpeyma F, Bagherian SA. Acute short term effects of endurance and resistance training on balance control in patients with diabetic peripheral neuropathy. Int J Neurosci 2023; 133:1017-1023. [PMID: 35109765 DOI: 10.1080/00207454.2022.2033739] [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: 09/03/2020] [Revised: 11/08/2020] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Exercise training have numerous beneficial effects on the complications of diabetic peripheral neuropathy. Exercise training may cause immediate effects on balance control in DPN patients. This study aims to assess the Acute Short Term effects of endurance and resistance exercise training on balance control in DPN patients. METHODS In this study, 11 patients with DPN and 11 healthy subjects participated. Patients and healthy subjects did endurance and resistance training in two separate exercise sessions. Dynamic balance and functional balance test were assessed before and after the interventions. Independent t-test was used to compare balance indices before and after training, the intervention effects were examined using ANOVA repeated measure test. The statistical significance level was set at p < 0.05. RESULTS The results showed that dynamic and functional balance in DPN patients were significantly lower than in healthy subjects. Anterior-posterior stability and total stability indices and functional balance test deteriorated significantly after training. CONCLUSION Endurance or resistance training may lead to acute disturbance of dynamic and functional balance in DPN patients. Hence, immediately after exercise, patients with diabetes are at an increased risk of falling, therefore, preventive considerations are necessary.
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Affiliation(s)
- Samira Shahrjerdi
- Department of physical therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Bahrpeyma
- Department of physical therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Ahmad Bagherian
- Department of physical therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Berli MC, Azaiez N, Götschi T, Pfirrmann CWA, Uçkay I, Sutter R, Waibel FWA, Rosskopf AB. Muscle atrophy in diabetic patients with Charcot foot: a case-control study. Skeletal Radiol 2023; 52:1661-1668. [PMID: 36997748 PMCID: PMC10348944 DOI: 10.1007/s00256-023-04328-1] [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: 01/23/2023] [Revised: 03/19/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE To evaluate the distribution and severity of muscle atrophy in diabetic patients with active Charcot foot (CF) compared to diabetic patients without CF. Furthermore, to correlate the muscle atrophy with severity of CF disease. MATERIAL/METHODS In this retrospective study, MR images of 35 diabetic patients (21 male, median:62.1 years ± 9.9SD) with active CF were compared with an age- and gender-matched control group of diabetic patients without CF. Two readers evaluated fatty muscle infiltration (Goutallier-classification) in the mid- and hindfoot. Furthermore, muscle trophic (cross-sectional muscle area (CSA)), intramuscular edema (none/mild versus moderate/severe), and the severity of CF disease (Balgrist Score) were assessed. RESULTS Interreader correlation for fatty infiltration was substantial to almost perfect (kappa-values:0.73-1.0). Frequency of fatty muscle infiltration was high in both groups (CF:97.1-100%; control:77.1-91.4%), but severe infiltration was significantly more frequent in CF patients (p-values: < 0.001-0.043). Muscle edema was also frequently seen in both groups, but significantly more often in the CF group (p-values: < 0.001-0.003). CSAs of hindfoot muscles were significantly smaller in the CF group. For the flexor digitorum brevis muscle, a cutoff value of 139 mm2 (sensitivity:62.9%; specificity:82.9%) in the hindfoot was found to differentiate between CF disease and the control group. No correlation was seen between fatty muscle infiltration and the Balgrist Score. CONCLUSION Muscle atrophy and muscle edema are significantly more severe in diabetic patients with CF disease. Muscle atrophy does not correlate with the severity of active CF disease. A CSA < 139 mm2 of the flexor digitorum brevis muscle in the hindfoot may indicate CF disease.
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Affiliation(s)
- Martin C Berli
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Nicolas Azaiez
- Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Tobias Götschi
- Unit for Clinical and Applied Research (UCAR), Balgrist University Hospital, Zurich, Switzerland
- Institute for Biomechanics, Swiss Federal Institute of Technology, Zurich, Switzerland
| | | | - Ilker Uçkay
- Unit for Clinical and Applied Research (UCAR), Balgrist University Hospital, Zurich, Switzerland
| | - Reto Sutter
- Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Felix W A Waibel
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Andrea B Rosskopf
- Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
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Inacio M, Esser P, Li J, Xu L, Zeng H, He R, Dawes H, Liu F. Spectral parameters of gait differentiate diabetic patients from healthy individuals. Foot (Edinb) 2023; 56:102038. [PMID: 37201241 DOI: 10.1016/j.foot.2023.102038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/14/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a clinical condition that affects gait performance and control in millions of individuals worldwide. Contrary to basic spatiotemporal parameters, gait-based spectral analysis may provide useful insights into gait neuromotor control. Hence, this study was set to investigate the spectral content of gait at the preferred speed in patients with DM. METHODS Total 1117 individuals [658 DM and 649 healthy adults (HA)] performed a 10 m walk while wearing an inertial measurement unit over the fourth lumbar vertebra. Mann-Whitney-U test was used for between-group gait parameters comparisons. RESULTS DM group had a slower step time (1.2%, p < 0.05) and gait speed (2.4%, p < 0.05) than HA. Additionally, DM individuals showed reduced dominant frequency (DM:0.24 Hz vs HA:0.25 Hz on average, p < 0.05). Increased antero-posterior and vertical dominant frequency width (DM:1.73 Hz vs HA:1.76 Hz on average, p < 0.05) and medio-lateral relative power spectral density at the dominant frequency (DM:6.19% vs HA:5.96%, p < 0.05). CONCLUSIONS It was demonstrated for the first time that the gait spectral content, not only corroborates spatiotemporal characteristics, but also provides further insight into their neuromotor control deficits in diabetic patients. Ultimately, this type of analysis in the diabetic population can help guide the therapeutic interventions to prevent diabetic foot.
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Affiliation(s)
- Mario Inacio
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK; University of Maia, Maia, Portugal; Research Center in Sport Science, Health Sciences and Human Development, Vila Real, Portugal.
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Junxian Li
- Dept of Endocrinology and Metabolism of Shanghai General Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China; Dept of Endocrinology and Metabolism of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China
| | - Lei Xu
- Dept of Endocrinology and Metabolism of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China
| | - Hui Zeng
- Dept of Endocrinology and Metabolism of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China
| | - Rui He
- Dept of Endocrinology and Metabolism of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China
| | - Helen Dawes
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK; College of Medicine and Health, University of Exeter, Exeter, UK; Department of Clinical Neurology, University of Oxford, Oxford UK; Oxford Health Biomedical Research Centre, UK
| | - Fang Liu
- Dept of Endocrinology and Metabolism of Shanghai General Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China; Dept of Endocrinology and Metabolism of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao-Tong University, School of Medicine, China.
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10
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Motor skills training-induced activation of descending pathways mediating cortical command to hindlimb motoneurons in experimental diabetic rats. Exp Neurol 2023; 363:114357. [PMID: 36849002 DOI: 10.1016/j.expneurol.2023.114357] [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: 11/13/2022] [Revised: 01/29/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
Diabetes disrupts the corticospinal tract (CST) system components that control hindlimb and trunk movement, resulting in weakness of the lower extremities. However, there is no information about a method to improve these disorders. This study aimed to investigate the rehabilitative effects of 2 weeks of aerobic training (AT) and complex motor skills training (ST) on motor disorders in streptozotocin-induced type 1 diabetic rats. In this study, electrophysiological mapping of the motor cortex showed that the diabetes mellitus (DM)-ST group had a larger motor cortical area compared to the DM-AT group and sedentary diabetic animals. Moreover, hand grip strength and rotarod latency increased in the DM-ST group; however, these two parameters did not change in the DM-AT group, as well as in control and sedentary diabetic rats. Furthermore, in the DM-ST group, cortical stimulation-induced and motor-evoked potentials were preserved after the interception of the CST; however, this potential disappeared after additional lesions were made on lateral funiculus, suggesting that their function extends to activating motor descending pathways other than the CST locating lateral funiculus. According to immunohistochemical analysis, the larger fibers present on the dorsal part of the lateral funiculus, which corresponds to the rubrospinal tract of the DM-ST group, expressed the phosphorylated growth-associated protein, 43 kD, which is a specific marker of axons with plastic changes. Additionally, electrical stimulation of the red nucleus revealed expansion of the hindlimb-responsible area and increased motor-evoked potentials of the hindlimb in the DM-ST group, suggesting a strengthening of synaptic connections between the red nucleus and spinal interneurons driving motoneurons. These results reveal that ST induces plastic changes in the rubrospinal tract in a diabetic model, which can compensate for diabetes by disrupting the CST system components that control the hindlimb. This finding suggests that ST can be a novel rehabilitation strategy to improve motor dysfunctions in diabetic patients.
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11
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Low thigh muscle strength in relation to myosteatosis in patients with type 2 diabetes mellitus. Sci Rep 2023; 13:1957. [PMID: 36732561 PMCID: PMC9895033 DOI: 10.1038/s41598-022-24002-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/08/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed to investigate the association of thigh muscle fat infiltration by quantitative MRI with muscle strength in patients with type 2 diabetes mellitus (T2DM). Seventy T2DM patients and sixty control subjects (71 males; age: 52 ± 8 years) underwent 3.0T MRI and isokinetic muscle strength measurements to obtain the skeletal muscle index (SMI), intermuscular adipose tissue (IMAT) proton density fat fraction (PDFF), intramuscular fat (IMF) PDFF, peak torque (PT) and total work (TW) of knee extensors and flexors. The differences of measurements between T2DM patients and asymptomatic volunteers were compared. Multivariate regression analysis was used to determine significant predictors of thigh extension and flexion strength. The SMI, IMAT and IMF PDFF of thigh muscles in T2DM patients were higher than that in the control group (p < 0.001), while PT and TW were lower than those in the control subjects (p < 0.05). Both IMF and IMAT PDFF were negatively correlated with PT, TW in participants with T2DM (extensors: r = - 0.72, - 0.70, p < 0.001; r = - 0.62, - 0.56, p < 0.05. flexors: r = - 0.37, - 0.43, p < 0.05; r = - 0.39, - 0.46, p < 0.05). Moderate and strong correlations between HOMA-IR and muscle strength measurements, muscle PDFFs were observed in extensors and flexors. IMF PDFF and age were the statistically significant predictor of PT and TW of extensors of thigh in multivariate regression analysis. Therefore, the thigh muscle PDFF increased was associated with muscle strength decreased in T2DM patients beyond SMI. Age are also important factors influencing thigh muscle PDFF and strength in T2DM patients.
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12
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Bahrpeyma F, Shahrjerdi S, C. M. Savelberg H, Bagherian S, Jamshidpour B. Force generation and muscle activation of knee extensor and flexor muscles in type 2 diabetes mellitus patients. JOURNAL OF MEDICAL SIGNALS & SENSORS 2023. [DOI: 10.4103/jmss.jmss_129_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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13
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Kaga H, Tamura Y, Someya Y, Naito H, Tabata H, Kakehi S, Yamasaki N, Sato M, Kadowaki S, Suzuki R, Sugimoto D, Kawamori R, Watada H. Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study. J Cachexia Sarcopenia Muscle 2022; 13:2835-2842. [PMID: 36052707 PMCID: PMC9745500 DOI: 10.1002/jcsm.13074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/16/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sarcopenia is a major cause of disability in the elderly. Although type 2 diabetes is a risk factor for increased sarcopenia, the relationship between prediabetes and sarcopenia has not been elucidated. We aimed to examine the relationship between sarcopenia and prediabetes. METHODS The design of this study is a cross-sectional study. We evaluated glucose metabolism using the 75-g oral glucose tolerance test and glycated haemoglobin, appendicular skeletal muscle mass, and hand grip strength in 1629 older adults living in an urban area of Tokyo, Japan. We investigated the frequency of sarcopenia in participants with normal glucose tolerance (NGT), prediabetes and diabetes. A multivariable logistic regression model was used to analyse the association between glucose tolerance and the prevalence of sarcopenia. RESULTS The mean age of participants was 73.1 ± 5.4 years. In men, 44.3% had NGT, 26.6% had prediabetes, and 29.1% had diabetes. In women, the distribution was 56.1%, 28.8% and 15.2%. The prevalence of sarcopenia was 12.7% in men and 11.9% in women. Logistic regression revealed that prediabetes and diabetes are independent risk factors for sarcopenia in men (prediabetes, odds ratio [OR] = 2.081 [95% confidence interval {CI}: 1.031-4.199]; diabetes, OR = 2.614 [95% CI: 1.362-5.018]) and diabetes, but not prediabetes, is an independent risk factor for sarcopenia in women (prediabetes, OR = 1.036 [95% CI: 0.611-1.757]; diabetes, OR = 2.099 [95% CI: 1.146-3.844]). In both sexes, higher age (men, OR = 1.086 [95% CI: 1.028-1.146]; women, OR = 1.195 [95% CI: 1.142-1.251]), higher body fat percentage (men, OR = 1.346 [95% CI: 1.240-1.461]; women, OR = 1.218 [95% CI: 1.138-1.303]) and lower body mass index (men, OR = 0.371 [95% CI: 0.299-0.461]; women, OR = 0.498 [95% CI: 0.419-0.593]) were independent risk factors for sarcopenia. CONCLUSIONS Although we confirmed that diabetes mellitus is associated with sarcopenia in both sexes, prediabetes is associated with sarcopenia in men, but not in women.
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Affiliation(s)
- Hideyoshi Kaga
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshifumi Tamura
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hitoshi Naito
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroki Tabata
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Saori Kakehi
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nozomu Yamasaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Motonori Sato
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Satoshi Kadowaki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ruriko Suzuki
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Daisuke Sugimoto
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryuzo Kawamori
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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14
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Ding L, Fan Y, Qiao J, He J, Wang R, He Q, Cui J, Ma Z, Zheng F, Gao H, Dai C, Wei H, Li J, Cao Y, Hu G, Liu M. Distribution of lean mass and mortality risk in patients with type 2 diabetes. Prim Care Diabetes 2022; 16:824-828. [PMID: 36272915 DOI: 10.1016/j.pcd.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/27/2022] [Accepted: 09/04/2022] [Indexed: 11/07/2022]
Abstract
AIMS The aim of the study is to evaluate the association of distribution of lean mass with the risk of all-cause mortality among patients with type 2 diabetes. METHODS The present cohort study included 2 335 patients with type 2 diabetes. Lean mass was assessed by dual energy X-ray absorptiometry. Cox proportional hazards regressions were used to estimate the association of lean mass distribution on the risk of mortality. RESULTS The average age of the patients was 58 years at baseline and 51.4% of patients were women. During a median follow-up of 4.31 years, 128 patients died. The multivariable-adjusted hazards ratios for all-cause mortality were 1.00, 1.63 (0.89-2.99), and 2.68(1.51-4.76) across the tertiles of android-to-gynoid lean mass ratio (P for trend < 0.001), respectively. The positive association of android-to-gynoid lean mass ratio with the risk of all-cause mortality was present among patients of different ages, body mass index ≥ 24 kg/m2, hemoglobin A1c ≥ 7.0%, nonsmokers, men, patients using insulin, and patients with diabetes durations of more than 10 years. CONCLUSIONS Higher android-to-gynoid lean mass ratio, assessed by dual energy X-ray absorptiometry, was significantly associated with increased risk of all-cause mortality among patients with type 2 diabetes.
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Affiliation(s)
- Li Ding
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Yuxin Fan
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China; Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Jingting Qiao
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Jing He
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Ruodan Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Qing He
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Jingqiu Cui
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Zhongshu Ma
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Fangqiu Zheng
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Hua Gao
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Chenlin Dai
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Jun Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Yuming Cao
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China.
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15
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Asiri F, Reddy RS, Narapureddy BR, Raizah A. Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15514. [PMID: 36497588 PMCID: PMC9741323 DOI: 10.3390/ijerph192315514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Hip-joint position sense (JPS) accuracy may be impaired in individuals with type 2 diabetes mellitus (T2DM). An impaired hip JPS can alter postural control and bodily balance. The objectives of this study are to (1) compare the hip JPS between T2DM and asymptomatic and (2) assess the relationship between hip JPS and glycosylated hemoglobin (HbAlc). This comparative cross-sectional study included 117 elderly individuals with T2DM (mean age: 59.82 ± 6.80 y) and 142 who were asymptomatic (mean age: 57.52 ± 6.90 y). The hip JPS was measured using a digital inclinometer. The individuals were repositioned to a target position with their eyes closed, and the magnitudes of matching errors were estimated as reposition errors. The hip JPS was evaluated in the flexion and abduction directions. The magnitude of reposition errors was significantly larger in the T2DM group in the right flexion (p < 0.001), the right abduction (p < 0.001), the left flexion (p < 0.001), and the left abduction (p < 0.001) directions compared to the asymptomatic group. HbA1c values showed a significant positive correlation with JPS in the right-hip flexion (r = 0.43, p < 0.001), the right-hip abduction (r = 0.36, p < 0.001), the left-hip flexion (r = 0.44, p < 0.001), and the left-hip abduction (r = 0.49, p < 0.001) directions. Hip JPS testing may be considered when assessing and formulating treatment strategies for individuals with type 2 diabetes. Future research should focus on how hip JPS can impact balance and falls in individuals with T2DM.
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Affiliation(s)
- Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Bayapa Reddy Narapureddy
- Department of Public Health, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopaedics, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
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16
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Feng H, Liu T, Yousuf S, Zhang X, Huang W, Li A, Xie L, Miao X. Identification of potential miRNA-mRNA regulatory network and the key miRNAs in intramuscular and subcutaneous adipose. Front Vet Sci 2022; 9:976603. [PMID: 36090166 PMCID: PMC9453844 DOI: 10.3389/fvets.2022.976603] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Intramuscular fat (IMF) is an important indicator for evaluating meat quality. Breeds with high IMF content are often accompanied by high subcutaneous fat (SCF), severely affecting the meat rate of pigs. Studying the mechanisms of miRNAs related to lipogenesis and lipid metabolism has important implications for pig breeding. We constructed two small RNA libraries from intramuscular and subcutaneous fat to evaluate the patterns of lipogenesis in Laiwu pig, a Chinese breed. A total of 286 differentially expressed miRNAs (DEmiRNAs), including 193 known miRNA and 93 novel miRNAs, were identified from two types of adipose. GO and KEGG enrichment analysis for DEmiRNAs showed that their target genes involved in many adipogenesis and lipid metabolism biological processes and signaling pathways, such as Wnt signaling pathway,MAPK signaling pathway, Hippo signaling pathway, PI3K-Akt signaling pathway, Melanogenesis, Signaling pathways regulating pluripotency of stem cells and so on. Then, we constructed a miRNA-mRNA interaction network to find out which miRNAs were the key miRNAs of regulation in Wnt signaling pathway. In this pathway, miR-331-3p, miR-339-5p, miR-874 and novel346_mature target PPARD, WNT10B, RSPO3, WNT2B. This study provides a theoretical basis for further understanding the post-transcriptional regulation mechanism of meat quality formation and predicting and treating diseases caused by ectopic fat.
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17
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Sarcopenia in community-dwelling older adults is associated with the diversity and composition of the gut microbiota. Exp Gerontol 2022; 167:111927. [PMID: 35981616 DOI: 10.1016/j.exger.2022.111927] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022]
Abstract
Sarcopenia is a prognostic indicator of negative consequences in older adults, including physical disability, frailty, and mortality. Few studies have investigated the associations between sarcopenia and the gut microbiota. We sought such associations in community-dwelling older adults aged ≥60 years. Sarcopenia was defined as low muscle mass, plus reduced physical performance, and/or low skeletal muscle strength. 16S rRNA next-generation sequencing was used to identify the components of the gut microbiota in fecal samples from 27 older adults with sarcopenia and 33 without sarcopenia. Relationships between sarcopenia and the diversity and composition of the gut microbiota were analyzed. Diversities at the species level were detected between the sarcopenia and control groups (P = 0.049). The abundance of Prevotella and Prevotella copri was significantly lower (P = 0.021 and P = 0.018 respectively) and that of Parabacteroides sp. higher in the sarcopenia than the control group (P = 0.010). Linear discriminant analysis of effect size revealed differences in the microbiota composition between the two groups. Sarcopenia was related with the presence of Anaerotruncus and Phascolarctobacterium sp. and the absence of Prevotella sp. and Prevotella copri. Further research is warranted to clarify whether changes in the gut microbiota cause sarcopenia onset or development.
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18
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Suzuki Y, Suzuki H, Ishikawa T, Yamada Y, Yatoh S, Sugano Y, Iwasaki H, Sekiya M, Yahagi N, Hada Y, Shimano H. Exploratory analysis using machine learning of predictive factors for falls in type 2 diabetes. Sci Rep 2022; 12:11965. [PMID: 35831378 PMCID: PMC9279484 DOI: 10.1038/s41598-022-15224-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/21/2022] [Indexed: 11/09/2022] Open
Abstract
We aimed to investigate the status of falls and to identify important risk factors for falls in persons with type 2 diabetes (T2D) including the non-elderly. Participants were 316 persons with T2D who were assessed for medical history, laboratory data and physical capabilities during hospitalization and given a questionnaire on falls one year after discharge. Two different statistical models, logistic regression and random forest classifier, were used to identify the important predictors of falls. The response rate to the survey was 72%; of the 226 respondents, there were 129 males and 97 females (median age 62 years). The fall rate during the first year after discharge was 19%. Logistic regression revealed that knee extension strength, fasting C-peptide (F-CPR) level and dorsiflexion strength were independent predictors of falls. The random forest classifier placed grip strength, F-CPR, knee extension strength, dorsiflexion strength and proliferative diabetic retinopathy among the 5 most important variables for falls. Lower extremity muscle weakness, elevated F-CPR levels and reduced grip strength were shown to be important risk factors for falls in T2D. Analysis by random forest can identify new risk factors for falls in addition to logistic regression.
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Affiliation(s)
- Yasuhiro Suzuki
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Hiroaki Suzuki
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | | | | | - Shigeru Yatoh
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoko Sugano
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hitoshi Iwasaki
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Motohiro Sekiya
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoya Yahagi
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hitoshi Shimano
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.,Life Science Center of Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, 100-0004, Japan
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19
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Bidirectional roles of skeletal muscle fibro-adipogenic progenitors in homeostasis and disease. Ageing Res Rev 2022; 80:101682. [PMID: 35809776 DOI: 10.1016/j.arr.2022.101682] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/09/2022] [Accepted: 07/04/2022] [Indexed: 02/07/2023]
Abstract
Sarcopenia and myopathies cause progressive muscle weakness and degeneration, which are closely associated with fat infiltration and fibrosis in muscle. Recently, experimental research has shed light on fibro-adipogenic progenitors (FAPs), also known as muscle-resident mesenchymal progenitors with multiple differentiation potential for adipogenesis, fibrosis, osteogenesis and chondrogenesis. They are considered key regulators of muscle homeostasis and integrity. They play supportive roles in muscle development and repair by orchestrating the regulatory interplay between muscle stem cells (MuSCs) and immune cells. Interestingly, FAPs also contribute to intramuscular fat infiltration, fibrosis and other pathologies when the functional integrity of the network is compromised. In this review, we summarize recent insights into the roles of FAPs in maintenance of skeletal muscle homeostasis, and discuss the underlying mechanisms regulating FAPs behavior and fate, highlighting their roles in participating in efficient muscle repair and fat infiltrated muscle degeneration as well as during muscle atrophy. We suggest that controlling and predicting FAPs differentiation may become a promising strategy to improve muscle function and prevent irreparable muscle damage.
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Filgueiras JR, Sales CP, da Silva IG, Dos Santos CM, Neto EDCM, da Rocha RB, Cardoso VS. Morphological and functional changes in skeletal muscle in type 2 diabetes mellitus: A systematic review and meta-analysis. Physiother Theory Pract 2022:1-27. [PMID: 35345979 DOI: 10.1080/09593985.2022.2057375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Changes in the skeletal muscle are common in patients with type 2 diabetes mellitus (T2DM). These changes impair your motor skills. OBJECTIVE This systematic review aimed to investigate changes in skeletal muscle in patients with T2DM. METHODS The search was carried out in the PubMed, Scopus, and Web of Science databases until December 1, 2021. Observational studies that evaluated musculoskeletal changes in people with T2DM were included. The review was based on PRISMA recommendations. The primary parameters analyzed were muscle strength, muscle mass, muscle power, and muscle endurance. RESULTS Forty-eight studies were included, with a total of 26,042 participants. The results revealed that T2DM is associated with a reduction in handgrip [-2.64 (CI 95% = -3.33 to -1.95, Z = -7.50, p < .0001], and knee extension muscle strength [-0.56 (CI 95% = -0.76 to -0.36, Z = -5.64, p < .0001)], a higher percentage of type II fibers [11.74 (CI 95% = 6.24 to 17.25, Z = 4.18, p < .0001)], and a lower percentage of type I fibers [-15.69 (CI 95% = -18.22 to -13.16, Z = -12.16, p < .0001], in addition to a greater thickness of the calcaneus tendon (p < .0001). CONCLUSION Individuals with T2DM present skeletal muscle impairments, mainly reduced muscle strength, mass, and endurance; increase in the thickness of the calcaneus tendon, and alteration in the proportion of type I and II fibers, even in the initial stage of the disease.
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Affiliation(s)
- Jardeson Rocha Filgueiras
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Cleudiane Pereira Sales
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Ivanilson Gomes da Silva
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | - Cristiana Maria Dos Santos
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Postgraduate Program in Biomedical Sciences, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil
| | | | | | - Vinicius Saura Cardoso
- BioSignal Laboratory, School of Physical Therapy, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Postgraduate Program in Biomedical Sciences, Parnaiba Delta Federal University (UFDPar). Av. São Sebastião, Parnaíba-Piauí, Brazil.,Center of Medical Specialties. Av. Capitão Claro, Parnaíba-Piauí, Brazil
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21
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Feng H, Liu T, Yousuf S, Zhang X, Huang W, Li A, Xie L, Miao X. Identification and analysis of lncRNA, miRNA and mRNA related to subcutaneous and intramuscular fat in Laiwu pigs. Front Endocrinol (Lausanne) 2022; 13:1081460. [PMID: 36714570 PMCID: PMC9880541 DOI: 10.3389/fendo.2022.1081460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Long non-coding RNAs (lncRNAs) regulate adipocyte differentiation and metabolism, However, their function on subcutaneous and intramuscular adipose tissues in pigs is unclear. Intramuscular fat (IMF) is an important indicator for evaluating meat quality. Breeds with high IMF content are often accompanied by high subcutaneous fat (SCF), which severely affects the meat rate of pigs. It is of great significance for porcine breeding to study the mechanism of lncRNA related to adipogenesis and lipid metabolism. METHODS We identified differentially expressed lncRNAs, miRNAs and mRNAs in subcutaneous and intramuscular adipose tissues in three female Laiwu pigs by deep RNA-sequencing(|log2foldchange|≥1, P_value ≤ 0.05). The gene expression profiles of IMF and SCF in Laiwu pigs were comparatively analyzed by Bioinformatics methods to identify key lncRNAs, miRNAs, and mRNAs associated with lipid metabolism and adipogenesis. RESULTS A total of 1209 lncRNAs (DElncRNAs), 286 miRNAs (DEmiRNAs), and 1597 mRNAs (DEgenes) were differentially expressed between two types of adipose. Among them, 17 DElncRNAs and 103 target genes play a role in the co-expression network, as well as 59 DElncRNAs, 44 DEmiRNAs, and 88 DEgenes involved in ceRNA network. In GO(Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis of DElncRNAs their target genes involved in many adipogenesis and lipid metabolism biological processes and signaling pathways, such as PPAR signaling pathway, Wnt signaling pathway, MAPK signaling pathway. CONCLUSIONS By constructing co-expression and ceRNAs network we found that Wnt signaling pathway play a critical regulatory role in intramuscular adipogenesis and lipid accumulation in Laiwu pigs. TCONS_00006525, TCONS_00046551 and TCONS_00000528 may target WNT5A, WNT10B and FDZ3 in co-expression network, TCONS_00026517 and other lncRNAs regulate the expression of PPARG, RXRG and SCD in ceRNA network, and were involved in Wnt signaling pathway. This study provides a theoretical basis for further understanding the post-transcriptional regulation mechanism of meat quality formation, predicting and treating diseases caused by ectopic fat.
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22
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Dong L, Hu Y, Xu L, Zeng H, Shen W, Esser P, Dawes H, Liu F. Abnormal vibration perception threshold alters the gait features in type 2 diabetes mellitus patients. Front Endocrinol (Lausanne) 2022; 13:1092764. [PMID: 36844372 PMCID: PMC9944365 DOI: 10.3389/fendo.2022.1092764] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/30/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE It is generally believed that gait characteristics of diabetic neuropathic patients differ from those of non-diabetic ones. However, it is still unclear how the abnormal foot sensation influences the gait during walking in type 2 diabetes mellitus (T2DM). For the purpose of gaining a better insight into the alterations of detailed gait parameters and figuring out important aspects in the gait indexes by peripheral neuropathy in elder T2DM patients, we compared the gait features in participants with normal glucose tolerance (NGT) controls and diabetic individuals complicated by peripheral neuropathy or not. SUBJECTS AND METHODS Gait parameters were observed during the 10-m walk on flat land among different conditions of diabetes in 1,741 participants from three clinical centers. Subjects were divided into four groups: persons with NGT were taken as the control group; patients with T2DM included three subgroups: DM control (no chronic complications), DM-DPN (DM complicated by only peripheral neuropathy), and DM-DPN+LEAD (DM complicated by both neuropathy and artery disease). The clinical characteristics and gait parameters were assessed and compared among these four groups. Analyses of variance were employed to verify possible differences of gait parameters between groups and conditions. Stepwise multivariate regression analysis was performed to reveal possible predictors of gait deficits. Receiver operating characteristic (ROC) curve analysis was employed to find any discriminatory power of diabetic peripheral neuropathy (DPN) for the step time. RESULTS In participants burdened with DPN, whether complicated by lower extremity arterial disease (LEAD) or not, step time increased sharply (p < 0.05). Stepwise multivariate regression models showed that independent variables of gait abnormality were sex, age, leg length, vibration perception threshold (VPT), and ankle-brachial index (ABI) (p < 0.01). Meanwhile, VPT was a significant independent predictor of step time, spatiotemporal variability (SDA), and temporal variability (SDB) (p < 0.05). ROC curve analysis was explored to find the discriminatory power of DPN for the occurrence of increased step time. The area under the curve (AUC) value was 0.608 (95% CI: 0.562-0.654, p < 0.01), and the cutoff point was 538.41 ms accompanied by a higher VPT. A significant positive association was observed between increased step time and the highest VPT group [odds ratio (OR) = 1.83, 95% CI: 1.32-2.55, p< 0.01]. In female patients, this OR value elevated to 2.16 (95% CI: 1.25-3.73, p< 0.01). CONCLUSIONS In addition to sex, age, and leg length, VPT was a distinct factor that associated with altered gait parameters. DPN is associated with increased step time, and the step time increases with worsening VPT in type 2 diabetes.
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Affiliation(s)
- Lining Dong
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyun Hu
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Xu
- Shanghai Jiao-Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multi-disciplinary Collaboration Diabetic Foot Group, Shanghai, China
| | - Hui Zeng
- Shanghai Jiao-Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multi-disciplinary Collaboration Diabetic Foot Group, Shanghai, China
| | - Wenqi Shen
- Shanghai Jiao-Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multi-disciplinary Collaboration Diabetic Foot Group, Shanghai, China
| | - Patrick Esser
- Faculty of Health and Life Sciences, Oxford Brooks University Affiliated Movement Science Institute, Headington, United Kingdom
| | - Helen Dawes
- Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, College of Medicine, University of Exeter, Exeter, United Kingdom
- *Correspondence: Helen Dawes, ; Fang Liu,
| | - Fang Liu
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Jiao-Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multi-disciplinary Collaboration Diabetic Foot Group, Shanghai, China
- *Correspondence: Helen Dawes, ; Fang Liu,
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23
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Orlando G, Balducci S, Boulton AJM, Degens H, Reeves ND. Neuromuscular dysfunction and exercise training in people with diabetic peripheral neuropathy: A narrative review. Diabetes Res Clin Pract 2022; 183:109183. [PMID: 34929255 DOI: 10.1016/j.diabres.2021.109183] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 11/21/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is a common condition that is associated with neuromuscular dysfunction and peripheral sensory impairment. These deficits predispose patients to sensory and motor system limitations, foot ulcers and a high risk of falls. Exercise training has been proposed as an effective tool to alleviate neural deficits and improve whole-body function. Here we review the effects of DPN on neuromuscular function, the mechanisms underlying this impairment, and the neural and muscular adaptations to exercise training. Muscle dysfunction is an early hallmark of DPN. Deficits in muscle strength, power, mass and a greater fatigability are particularly severe in the lower extremity muscles. Non-enzymatic glycation of motor proteins, impaired excitation-contraction coupling and loss of motor units have been indicated as the main factors underlying muscular dysfunction. Among the exercise-based solutions, aerobic training improves neural structure and function and ameliorates neuropathic signs and symptoms. Resistance training induces marked improvement of muscle performance and may alleviate neuropathic pain. A combination of aerobic and resistance training (i.e., combined training) restores small sensory nerve damage, reduces symptoms, and improves muscle function. The evidence so far suggests that exercise training is highly beneficial and should be included in the standard care for DPN patients.
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Affiliation(s)
- Giorgio Orlando
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.
| | | | - Andrew J M Boulton
- Department of Medicine, Manchester Royal Infirmary, Manchester, UK; Diabetes Research Institute, University of Miami, Miami, FL, USA
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK; Lithuanian Sport University, Kaunas, Lithuania
| | - Neil D Reeves
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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24
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Kataoka H, Miyatake N, Matsuda N, Hikasa Y, Kitayama N, Nagai S, Tanaka S. The Association between Chronic Hemodialysis and Toe Pinch Force in Japanese Patients: Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9121745. [PMID: 34946476 PMCID: PMC8701902 DOI: 10.3390/healthcare9121745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this cross-sectional study was to investigate the effect of chronic hemodialysis on toe pinch force (TPF). A total of 37 chronic hemodialysis patients without type 2 diabetes mellitus (T2DM) (age: 69.4 ± 11.8 years, duration of hemodialysis: 3.5 ± 3.4 years) were enrolled in this study. The TPF in chronic hemodialysis patients without T2DM was compared with that in 34 apparently healthy participants and 37 chronic hemodialysis patients with T2DM. There was no significant difference in clinical profiles between healthy participants and chronic hemodialysis patients with and without T2DM. The TPF in chronic hemodialysis patients without T2DM was lower compared with that in healthy participants (2.70 ± 1.05 kg vs. 3.34 ± 0.99 kg, p = 0.025). In addition, the TPF in patients with T2DM was even lower compared with that in patients without T2DM (2.12 ± 1.01 kg vs. 2.70 ± 1.05 kg, p = 0.042). This study showed a dramatic reduction in TPF in chronic hemodialysis patients, especially in those with T2DM.
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Affiliation(s)
- Hiroaki Kataoka
- Department of Physical Therapy, Faculty of Health Sciences, Okayama Healthcare Professional University, Okayama 700-0913, Japan
- Department of Hygiene, Faculty of Medicine, Kagawa University, Takamatsu 760-0016, Japan;
- Correspondence: ; Tel.: +81-86-233-8020; Fax: +81-86-233-8030
| | - Nobuyuki Miyatake
- Department of Hygiene, Faculty of Medicine, Kagawa University, Takamatsu 760-0016, Japan;
| | - Naoko Matsuda
- Department of Rehabilitation, Osafune Clinic, Okayama 701-4264, Japan;
| | - Yasuaki Hikasa
- Department of Rehabilitation, Obata Medical Clinic, Okayama 708-0806, Japan;
| | - Naomi Kitayama
- Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu 760-0018, Japan; (N.K.); (S.N.)
| | - Shion Nagai
- Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu 760-0018, Japan; (N.K.); (S.N.)
| | - Satoshi Tanaka
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima 723-0053, Japan;
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25
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Olson LC, Redden JT, Schwartz Z, Cohen DJ, McClure MJ. Advanced Glycation End-Products in Skeletal Muscle Aging. Bioengineering (Basel) 2021; 8:bioengineering8110168. [PMID: 34821734 PMCID: PMC8614898 DOI: 10.3390/bioengineering8110168] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 12/17/2022] Open
Abstract
Advanced age causes skeletal muscle to undergo deleterious changes including muscle atrophy, fast-to-slow muscle fiber transition, and an increase in collagenous material that culminates in the age-dependent muscle wasting disease known as sarcopenia. Advanced glycation end-products (AGEs) non-enzymatically accumulate on the muscular collagens in old age via the Maillard reaction, potentiating the accumulation of intramuscular collagen and stiffening the microenvironment through collagen cross-linking. This review contextualizes known aspects of skeletal muscle extracellular matrix (ECM) aging, especially the role of collagens and AGE cross-linking, and underpins the motor nerve’s role in this aging process. Specific directions for future research are also discussed, with the understudied role of AGEs in skeletal muscle aging highlighted. Despite more than a half century of research, the role that intramuscular collagen aggregation and cross-linking plays in sarcopenia is well accepted yet not well integrated with current knowledge of AGE’s effects on muscle physiology. Furthermore, the possible impact that motor nerve aging has on intramuscular cross-linking and muscular AGE levels is posited.
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Affiliation(s)
- Lucas C. Olson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - James T. Redden
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - David J. Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
| | - Michael J. McClure
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Correspondence:
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26
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Nakamura K, Yoshida D, Honda T, Hata J, Shibata M, Hirakawa Y, Furuta Y, Kishimoto H, Ohara T, Chen S, Kitazono T, Nakashima Y, Ninomiya T. Midlife and late-life diabetes and sarcopenia in a general older Japanese population: The Hisayama Study. J Diabetes Investig 2021; 12:1899-1907. [PMID: 33742564 PMCID: PMC8504915 DOI: 10.1111/jdi.13550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the association between midlife or late-life diabetes and the development of sarcopenia in an older Japanese population. MATERIALS AND METHODS A total of 824 Japanese residents aged 65 to 84 years without sarcopenia were followed up from 2012 to 2017. Sarcopenia was determined following the Asian Working Group for Sarcopenia definition. The time of diabetes diagnosis was classified as midlife or late-life diabetes by the age at first diagnosis of diabetes (< 65 or ≥ 65 years) based on annual health checkups data over the past 24 years. The duration of diabetes was categorized into three groups of < 10, 10-15, and > 15 years. The odds ratios of incident sarcopenia according to the diabetic status were estimated using a logistic regression analysis. RESULTS During follow-up, 47 subjects developed sarcopenia. The multivariable-adjusted odds ratio for incident sarcopenia was significantly greater in subjects with diabetes at baseline than in those without it (odds ratio 2.51, 95% confidence interval 1.26-5.00). Subjects with midlife diabetes had a significantly greater risk of incident sarcopenia, whereas no significant association between late-life diabetes and incident sarcopenia was observed. With a longer duration of diabetes, the risk of incident sarcopenia increased significantly (P for trend = 0.002). CONCLUSIONS The present study suggests that midlife diabetes and a longer duration of diabetes are significant risk factors for incident sarcopenia in the older population. Preventing diabetes in midlife may reduce the risk of the development of sarcopenia in later life.
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Grants
- JP16H02692 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP19H03863 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18H0273 Ministry of Education, Culture, Sports, Science and Technology of Japan
- 7 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP17H04126 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K09412 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K07565 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP19K07890 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP20K11020 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP20K1050 Ministry of Education, Culture, Sports, Science and Technology of Japan
- 3 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP19K23971 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K17925 Ministry of Education, Culture, Sports, Science and Technology of Japan
- 20FA1002 Ministry of Health, Labour and Welfare of Japan
- JP20fk0108075 Japan Agency for Medical Research and Development
- JP20km0405202 Japan Agency for Medical Research and Development
- JP20dk0207025 Japan Agency for Medical Research and Development
- Ministry of Education, Culture, Sports, Science and Technology of Japan
- Ministry of Health, Labour and Welfare of Japan
- Japan Agency for Medical Research and Development
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Affiliation(s)
- Kimitaka Nakamura
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Orthopaedic SurgeryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Daigo Yoshida
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanori Honda
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Jun Hata
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Mao Shibata
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medical‐Engineering Collaboration for Healthy LongevityGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiro Kishimoto
- Faculty of Arts and ScienceKyushu UniversityFukuokaJapan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of NeuropsychiatryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Sanmei Chen
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanari Kitazono
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yasuharu Nakashima
- Department of Orthopaedic SurgeryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
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27
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Nishihara K, Kawai H, Kera T, Hirano H, Fujiwara Y, Ihara K, Kim H, Obuchi S. Comparisons of muscle thicknesses, echo intensities, and motor functions between community-dwelling older Japanese adults with and without diabetes. Arch Gerontol Geriatr 2021; 97:104516. [PMID: 34543815 DOI: 10.1016/j.archger.2021.104516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Individuals with diabetes tend to show decreased muscle volume and motor function compared to those without diabetes. Ultrasound is a non-invasive and potentially safe method to assess muscle function in patients with diabetes; however, the characteristics of muscle thickness and quality, measured by ultrasound, in individuals with diabetes are unclear. METHODS This study included 825 community-dwelling older individuals who underwent the Otassha Study comprehensive health survey. We measured the muscle thicknesses and echo intensities of rectus femoris and vastus intermedius; motor function, assessed using knee extension strength; one-leg standing balance; normal walk; fastest walk; timed up-and-go test; and grip strength. Participants were stratified by sex and categorized into those with and without diabetes. We examined inter-group differences in measured values. RESULTS Only knee extension strength showed significantly lower values in men with diabetes than in those without diabetes. Echo intensities and motor function significantly differed between women with and without diabetes. In adjusted multiple comparisons p values, echo intensities and grip strength significantly differed only in women with diabetes, unlike men with diabetes. Echo intensity of the rectus femoris was significantly higher in women with diabetes than in those without diabetes after adjusting for confounders, but similar to that in men. CONCLUSION We observed the deterioration of knee extension strength in men and women with diabetes compared to that in those without diabetes; however, the effects on muscle quality were inconsistent between the sexes. Our study suggested recommending exercise programs, especially for older women with diabetes.
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Affiliation(s)
- Ken Nishihara
- Department of Physical Therapy, Saitama Prefectural University, 820 Sannomiya, Koshigaya-shi, Saitama 343-8540, Japan.
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Takeshi Kera
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan.
| | | | | | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan.
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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28
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Ferrara PJ, Verkerke ARP, Maschek JA, Shahtout JL, Siripoksup P, Eshima H, Johnson JM, Petrocelli JJ, Mahmassani ZS, Green TD, McClung JM, Cox JE, Drummond MJ, Funai K. Low lysophosphatidylcholine induces skeletal muscle myopathy that is aggravated by high-fat diet feeding. FASEB J 2021; 35:e21867. [PMID: 34499764 DOI: 10.1096/fj.202101104r] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 12/25/2022]
Abstract
Obesity alters skeletal muscle lipidome and promotes myopathy, but it is unknown whether aberrant muscle lipidome contributes to the reduction in skeletal muscle contractile force-generating capacity. Comprehensive lipidomic analyses of mouse skeletal muscle revealed a very strong positive correlation between the abundance of lysophosphatidylcholine (lyso-PC), a class of lipids that is known to be downregulated with obesity, with maximal tetanic force production. The level of lyso-PC is regulated primarily by lyso-PC acyltransferase 3 (LPCAT3), which acylates lyso-PC to form phosphatidylcholine. Tamoxifen-inducible skeletal muscle-specific overexpression of LPCAT3 (LPCAT3-MKI) was sufficient to reduce muscle lyso-PC content in both standard chow diet- and high-fat diet (HFD)-fed conditions. Strikingly, the assessment of skeletal muscle force-generating capacity ex vivo revealed that muscles from LPCAT3-MKI mice were weaker regardless of diet. Defects in force production were more apparent in HFD-fed condition, where tetanic force production was 40% lower in muscles from LPCAT3-MKI compared to that of control mice. These observations were partly explained by reductions in the cross-sectional area in type IIa and IIx fibers, and signs of muscle edema in the absence of fibrosis. Future studies will pursue the mechanism by which LPCAT3 may alter protein turnover to promote myopathy.
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Affiliation(s)
- Patrick J Ferrara
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA.,Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Anthony R P Verkerke
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA
| | - J Alan Maschek
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Metabolomics, Mass Spectrometry, and Proteomics Core, University of Utah, Salt Lake City, Utah, USA
| | - Justin L Shahtout
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Piyarat Siripoksup
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Hiroaki Eshima
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of International Tourism, Nagasaki International University, Sasebo, Japan
| | - Jordan M Johnson
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA
| | - Jonathan J Petrocelli
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Ziad S Mahmassani
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Thomas D Green
- East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA
| | - Joseph M McClung
- East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA
| | - James E Cox
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Metabolomics, Mass Spectrometry, and Proteomics Core, University of Utah, Salt Lake City, Utah, USA.,Department of Biochemistry, University of Utah, Salt Lake City, Utah, USA
| | - Micah J Drummond
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Katsuhiko Funai
- Diabetes and Metabolism Research Center, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, North Carolina, USA.,Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA.,Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
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Ma R, Li W. CHANGES IN THE FLEXOR AND EXTENSOR MUSCLES AT DIFFERENT SPEEDS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127072021_0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Centrifugal strength is an important element for strength quality. Developing muscle centrifugal strength can effectively increase the stability of lower limbs and reduce the risk of injury. Objective: To explore the characteristics of contractile force of flexor ahods in strength training and rehabilitation training, and the extensor muscles of the knee joint in athletes with different speeds of centripetal force. Methods: The knee joint muscle group of 8 first-level male high jumpers and 8 second-level male high jumpers were tested by isokinetic centrifugal contraction; the angular test velocity was 60 °/s, 120 °/s, 240 °/s, and the indexes included peak torque, relative peak torque (peak torque/body weight), and the peak torque flexural extension ratio. Results: With the centrifugal contraction of the knee joint muscle group (P < 0.05), the second-level high jumpers should increase the ability of the knee flexor muscle group of the take-off leg. In the case of constant velocity centrifugal contraction (P < 0.01), taking off time must be reduced, that is, taking off speed must be accelerated. Conclusions: The difference in the knee joint muscle isokinetic test results is one of the reasons for the difference in knee joint flexor and extensor muscle contractility under the different speed forces of high jumpers. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Rui Ma
- ZhengZhou University, China; Pukyong University in South Korea, South Korea
| | - Wenyan Li
- ZhengZhou University, China; Pukyong University in South Korea, South Korea; Fifth Affiliated Hospital of Zhengzhou University, China
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Reeves ND, Orlando G, Brown SJ. Sensory-Motor Mechanisms Increasing Falls Risk in Diabetic Peripheral Neuropathy. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57050457. [PMID: 34066681 PMCID: PMC8150714 DOI: 10.3390/medicina57050457] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/16/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is associated with peripheral sensory and motor nerve damage that affects up to half of diabetes patients and is an independent risk factor for falls. Clinical implications of DPN-related falls include injury, psychological distress and physical activity curtailment. This review describes how the sensory and motor deficits associated with DPN underpin biomechanical alterations to the pattern of walking (gait), which contribute to balance impairments underpinning falls. Changes to gait with diabetes occur even before the onset of measurable DPN, but changes become much more marked with DPN. Gait impairments with diabetes and DPN include alterations to walking speed, step length, step width and joint ranges of motion. These alterations also impact the rotational forces around joints known as joint moments, which are reduced as part of a natural strategy to lower the muscular demands of gait to compensate for lower strength capacities due to diabetes and DPN. Muscle weakness and atrophy are most striking in patients with DPN, but also present in non-neuropathic diabetes patients, affecting not only distal muscles of the foot and ankle, but also proximal thigh muscles. Insensate feet with DPN cause a delayed neuromuscular response immediately following foot–ground contact during gait and this is a major factor contributing to increased falls risk. Pronounced balance impairments measured in the gait laboratory are only seen in DPN patients and not non-neuropathic diabetes patients. Self-perception of unsteadiness matches gait laboratory measures and can distinguish between patients with and without DPN. Diabetic foot ulcers and their associated risk factors including insensate feet with DPN and offloading devices further increase falls risk. Falls prevention strategies based on sensory and motor mechanisms should target those most at risk of falls with DPN, with further research needed to optimise interventions.
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Hasegawa Y, Takahashi F, Hashimoto Y, Munekawa C, Hosomi Y, Okamura T, Okada H, Senmaru T, Nakanishi N, Majima S, Ushigome E, Hamaguchi M, Yamazaki M, Fukui M. Effect of COVID-19 Pandemic on the Change in Skeletal Muscle Mass in Older Patients with Type 2 Diabetes: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084188. [PMID: 33920957 PMCID: PMC8071268 DOI: 10.3390/ijerph18084188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI-baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (-0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (-0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (-0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (-0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.
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HEMMATI H, FORGHAN M, ABBASI RANJBAR Z, JAFARYPARVAR Z, RAFIEI E, ANDALIB S. Beyond diabetes mellitus type 2: neuropathy, arterial disease and foot deformity. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.20.05098-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chen CN, Chen TC, Tsai SC, Hwu CM. Factors associated with relative muscle strength in patients with type 2 diabetes mellitus. Arch Gerontol Geriatr 2021; 95:104384. [PMID: 33740478 DOI: 10.1016/j.archger.2021.104384] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Some patients with type 2 diabetes mellitus (T2DM) experience decreased mobility associated with lower relative muscle strength (normalized with muscle mass). This study aimed to identify factors predicting relative muscle strength of patients with T2DM assessed at regular clinical visits. METHODS A total of 144 T2DM patients underwent fasting blood drawing (determining white blood cell count [WBC], diabetic kidney disease [DKD], and glycated hemoglobin [HbA1c]) and the assessment of body composition, diabetic peripheral neuropathy (DPN), activity level, and muscle strength (grip, knee extensor, and ankle plantar flexor strength). One-way ANOVA and multiple regression models were used to identify factors associated with the relative muscle strength. RESULTS Our data showed that age, diabetes duration, fat percentage, WBC, DPN, and DKD were negatively associated with the relative muscle strength. Specifically, a greater WBC was associated with lower relative muscle strength of both distal and proximal muscle groups of extremities after the adjustment of other associated factors. DPN was associated with lower relative strength of the distal muscle groups of extremities. CONCLUSIONS WBC may be used as a marker of inflammation, and greater count, even within the normal range, is negatively associated with the relative muscle strength in patients with T2DM.
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Affiliation(s)
- Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Chung Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shiow-Chwen Tsai
- Institute of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Chii-Min Hwu
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
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Impact of dietary protein intake on the incidence of low muscle strength in middle-aged and older adults. Clin Nutr 2021; 40:1467-1474. [PMID: 33740517 DOI: 10.1016/j.clnu.2021.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/17/2020] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND A reduction in skeletal muscle strength is a prognostic indicator of negative consequences, such as physical disability, frailty, and mortality in older adults. Studies investigating associations between the risk of reduction in skeletal muscle strength and the amount of dietary protein which is a factor influenced muscle health are scarce, particularly in Asian populations. Therefore, we investigated the association between the amount and change in daily protein intake and the prospective risk of developing low skeletal muscle strength in middle-aged and older adults. METHODS This study used data from the Korean Genome and Epidemiology Study as an ongoing population-based cohort study of adults aged 40 years and over. The amount of daily protein consumed was assessed using a semi-quantitative food frequency questionnaire. Low skeletal muscle strength was measured with a handgrip strength dynamometer. RESULTS In total, 32,458 adults (11,358 males and 21,100 females) were evaluated. The amount of daily dietary protein consumed was not associated with the risk of low muscle strength over the 4-year follow-up period after adjusting for covariates. No associations between low muscle strength events according to the change in the amount of protein consumed from the baseline to the follow-up surveys were identified. CONCLUSIONS The amount of and change in dietary protein consumed were not associated with developing low muscle strength in middle-aged and older adults. Further studies with a focus on physical activity-protein intake interactions and specific conditions, such as mobility-limited adults or hospitalized patients, are warranted to clarify the relationship between protein intake status and the incidence of low skeletal muscle strength.
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Eetvelde BLV, Lapauw B, Proot P, Wyngaert KV, Helleputte S, Stautemas J, Cambier DC, Calders P. The impact of diabetic neuropathy on the distal versus proximal comparison of weakness in lower and upper limb muscles of patients with type 2 diabetes mellitus: a cross-sectional study. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:464-474. [PMID: 34854385 PMCID: PMC8672402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to determine the impact of diabetic neuropathy (dNP) on the distal versus proximal comparison of weakness in lower and upper limb muscles of patients with type 2 Diabetes Mellitus (T2DM). METHODS 19 healthy male controls without neuropathy (HC) and 35 male T2DM patients, without dNP (n=8), with sensory dNP (n=13) or with sensorimotor dNP (dNPsm; n=14), were enrolled in this study. Maximal isometric (IM) and isokinetic (IK) muscle strength and IK muscle endurance of the dominant knee, ankle and elbow, and maximal IM handgrip strength were measured by means of dynamometry. RESULTS Ankle muscle endurance was lower compared to the knee, independently of dNP (p<0.001). Maximal IK ankle muscle strength was also lower compared to the knee, albeit only in dNPsm (p=0.003). No differences were found between maximal IM handgrip and elbow strength. CONCLUSIONS Our results suggest an impact of T2DM -with or without dNP- on lower limb muscle strength more distally than proximally, while this was not observed in the upper limb. The gradient of dNP seemed to be a determining factor for the maximal muscle strength, and not for muscle endurance, in the lower limb.
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Affiliation(s)
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Belgium
| | - Pascal Proot
- Department of Neurology, Ghent University Hospital, Belgium
| | | | - Simon Helleputte
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Jan Stautemas
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Dirk C. Cambier
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences, Ghent University, Belgium,Corresponding author: Prof. dr. Patrick Calders, Department of Rehabilitation Sciences, Campus UZ Gent, Corneel Heymanslaan 10, B3, Entrance 46, 9000 Ghent, Belgium E-mail:
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Stouge A, Khan KS, Kristensen AG, Tankisi H, Schlaffke L, Froeling M, Væggemose M, Andersen H. MRI of Skeletal Muscles in Participants with Type 2 Diabetes with or without Diabetic Polyneuropathy. Radiology 2020; 297:608-619. [PMID: 33048033 DOI: 10.1148/radiol.2020192647] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundDiabetic polyneuropathy (DPN) is associated with loss of muscle strength. MRI including diffusion-tensor imaging (DTI) may enable detection of muscle abnormalities related to type 2 diabetes mellitus (DM2) and DPN.PurposeTo assess skeletal muscle abnormalities in participants with DM2 with or without DPN by using MRI.Materials and MethodsThis prospective cross-sectional study included participants with DM2 and DPN (DPN positive), participants with DM2 without DPN (DPN negative), and healthy control (HC) participants enrolled between August 2017 and June 2018. Muscle strength at the knee and ankle was determined with isokinetic dynamometry. MRI of the lower extremities included the Dixon sequence, multicomponent T2 mapping, and DTI calculated fat fractions (FFs), T2 relaxation of muscle (T2water), fractional anisotropy (FA), and diffusivity (mean, axial, and radial). One-way analysis of variance and Tukey honestly significant difference were applied for comparison between groups, and multivariate regression models were used for association between MRI parameters, nerve conduction, strength, and body mass index (BMI).ResultsTwenty participants with DPN (mean age, 65 years ± 9 [standard deviation]; 70% men; mean BMI, 34 kg/m2 ± 5), 20 participants without DPN (mean age, 64 years ± 9; 55% men; mean BMI, 30 kg/m2 ± 6), and 20 HC participants (mean age, 61 years ± 10; 55% men; mean BMI, 27 kg/m2 ± 5) were enrolled in this study. Muscle strength adjusted for age, sex, and BMI was lower in participants with DPN than in DPN-negative and HC participants in the upper and lower leg (plantar flexors [PF], 62% vs 78% vs 89%; P < .001; knee extensors [KE], 73% vs 95% vs 93%; P < .001). FF was higher in leg muscle groups of participants with DPN than in DPN-negative and HC participants (PF, 20% vs 10% vs 8%; P < .001; KE, 13% vs 8% vs 6%; P < .001). T2water was prolonged in leg muscle groups of participants with DPN when compared with HC participants (PF, 33 msec vs 31 msec; P < .001; KE, 32 msec vs 31 msec; P = .002) and in the lower leg when compared with participants without DPN (PF, 33 msec vs 32 msec; P = .03). In multivariate regression models, strength was associated with FA (b = -0.0004), T2water (b = -0.03 msec), and FF (b = -0.1%) at thigh level (P < .001). Furthermore, FA (b = -0.007), T2water (b = -0.53 msec), and FF (b = -4.0%) were associated with nerve conduction at calf level (P < .001).ConclusionMRI of leg muscle groups revealed fat accumulation, differences in water composition, and structural changes in participants with type 2 diabetes mellitus and neuropathy. Abnormalities were most pronounced in the plantar flexors.© RSNA, 2020Online supplemental material is available for this article.See also the editorial by Sneag and Tan in this issue.
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Affiliation(s)
- Anders Stouge
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Karolina S Khan
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Alexander G Kristensen
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Hatice Tankisi
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Lara Schlaffke
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Martijn Froeling
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Michael Væggemose
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
| | - Henning Andersen
- From the Departments of Neurology and International Diabetic Neuropathy Consortium (A.S., K.S.K., H.A.), Clinical Neurophysiology and International Diabetic Neuropathy Consortium (A.G.K.), Clinical Neurophysiology (H.T.), and Neurology (M.V.), Neurologisk Afdeling, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Image Division, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (L.S., M.F.); and Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany (L.S.)
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Sarcopenia risk and diabetes mellitus are independent factors for lower limb muscle strength in older patients with acute stroke: A cross-sectional study. Nutrition 2020; 84:111025. [PMID: 33109453 DOI: 10.1016/j.nut.2020.111025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Lower extremity (LE) muscle strength is an important factor for functional outcome in patients with stroke. However, to our knowledge, the factors influencing LE muscle strength in older patients with acute stroke have not been studied. The aim of this study was to investigate the relationships between prestroke sarcopenia risk and comorbidities with LE muscle strength in older patients with acute stroke. METHODS In this cross-sectional study, we assessed LE muscle strength using the Motricity IUndex (MI), and prestroke sarcopenia risk using SARC-F, a questionnaire for sarcopenia. Multivariate regression analysis was used to investigate the relationship of MI with sarcopenia risk, neurologic deficit assessed by the National Institutes of Health Stroke Scale (NIHSS), and comorbidities in these patients. RESULTS We enrolled 223 patients aged 65 and over with acute stroke (127 men and 96 women; mean age 76 y). Multivariate analyses for MI after adjusting for potential confounders, NIHSS score, diabetes mellitus, and the presence of sarcopenia risk were independently and negatively associated with MI in older patients with stroke (β = -0.775, P < 0.001; β = -0109, P = 0.010; β = -0.097, P = 0.030, respectively). CONCLUSIONS Prestroke sarcopenia and diabetes mellitus are associated with LE muscle strength in older patients with acute stroke, and these assessments would be useful for clinicians.
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Nomura T, Kawae T, Kataoka H, Ikeda Y. Loss of lower extremity muscle strength based on diabetic polyneuropathy in older patients with type 2 diabetes: Multicenter Survey of the Isometric Lower Extremity Strength in Type 2 Diabetes: Phase 2 study. J Diabetes Investig 2020; 12:390-397. [PMID: 32649788 PMCID: PMC7926230 DOI: 10.1111/jdi.13354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/29/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Aims/Introduction Diabetic polyneuropathy (DPN) is a factor that reduces lower extremity muscle strength (LEMS) in older type 2 diabetes patients. This relationship remains unclear in longitudinal studies. Therefore, we longitudinally investigated the apparent effects of DPN on changes in LEMS. Furthermore, we cross‐sectionally examined relationships among DPN, LEMS, mobility and health‐related quality of life. Materials and Methods Bodyweight‐normalized (relative) knee extension force (KEF) was examined in 51 DPN and 54 non‐DPN patients (68.9 ± 5.6 and 70.2 ± 5.9 years, respectively) at baseline and follow up at 3.6 ± 0.6 years. At follow up, mobility was measured using a 25‐question geriatric locomotive function scale. Health‐related quality of life was assessed using the five‐dimensions of EuroQol for quality‐adjusted life years calculation. Results Relative KEF in the DPN group was significantly lower at follow up (1.22 ± 0.47 Nm/kg) than at baseline (1.31 ± 0.47 Nm/kg; P < 0.05). DPN significantly affected changes in relative KEF. Mobility decreased by 41 and 65% in the non‐DPN and DPN groups, respectively. Quality‐adjusted life years were significantly lower in the DPN group (0.856 ± 0.131) than in the non‐DPN group (0.920 ± 0.105; P < 0.01). Relative KEF was a significant independent variable that explained quality‐adjusted life years. Conclusions DPN clearly reduced LEMS in older type 2 diabetes patients within 4 years. Furthermore, DPN resulted in a loss of LEMS and decrease in mobility. Therefore, DPN development should be monitored closely, with glycemic control and LEMS kept at a high level to maintain health‐related quality of life in older patients with type 2 diabetes.
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Affiliation(s)
- Takuo Nomura
- Department of Rehabilitation Sciences, Kansai University of Welfare Sciences, Osaka, Japan
| | - Toshihiro Kawae
- Division of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroaki Kataoka
- Rehabilitation Center, KKR Takamatsu Hospital, Kagawa, Japan
| | - Yukio Ikeda
- Diabetes Center, Kochi Memorial Hospital, Kochi, Japan
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DiLiberto FE, Nawoczenski DA, Tome J, Tan RK, DiGiovanni BF. Changes in Muscle Morphology Following Gastrocnemius Recession for Achilles Tendinopathy: A Prospective Cohort Imaging Study. Foot Ankle Spec 2020; 13:297-305. [PMID: 31230471 DOI: 10.1177/1938640019857805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The purpose of this study was to evaluate changes in posterior compartment muscle volume and intramuscular fat content following gastrocnemius recession in people with Achilles tendinopathy (AT). Methods. Eight patients diagnosed with unilateral recalcitrant AT and an isolated gastrocnemius contracture participated in this prospective cohort study. Magnetic resonance imaging was performed on both limbs of each participant before and 6 months following an isolated gastrocnemius recession. Involved limb muscle volumes and fat fractions (FFs) of the medial gastrocnemius, lateral gastrocnemius, and soleus muscle were normalized to the uninvolved limb. Preoperative to postoperative comparisons were made with Wilcoxon signed-rank tests. Results. Soleus or lateral gastrocnemius muscle volumes or FFs were not significantly different between study time points. A significant difference was found in medial gastrocnemius muscle volume (decrease; P = .012) and FF (increase; P = .017). Conclusion. A major goal of the Strayer gastrocnemius recession, selective lengthening of the posterior compartment while preserving soleus muscle morphology, was supported. The observed changes isolated to the medial gastrocnemius muscle may reduce ankle plantarflexion torque capacity. Study findings may help inform selection of surgical candidates, refine anticipated outcomes, and better direct postoperative rehabilitation following gastrocnemius recession for AT.Levels of Evidence: Level IV: Prospective cohort study.
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Affiliation(s)
- Frank E DiLiberto
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (FED).,Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, Rochester, New York (DAN, BFD).,School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, Ithaca, New York (JT).,Department of Imaging Sciences, University of Rochester Medical Center, Highland Hospital, Rochester, New York (RKT)
| | - Deborah A Nawoczenski
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (FED).,Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, Rochester, New York (DAN, BFD).,School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, Ithaca, New York (JT).,Department of Imaging Sciences, University of Rochester Medical Center, Highland Hospital, Rochester, New York (RKT)
| | - Josh Tome
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (FED).,Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, Rochester, New York (DAN, BFD).,School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, Ithaca, New York (JT).,Department of Imaging Sciences, University of Rochester Medical Center, Highland Hospital, Rochester, New York (RKT)
| | - Raymond K Tan
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (FED).,Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, Rochester, New York (DAN, BFD).,School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, Ithaca, New York (JT).,Department of Imaging Sciences, University of Rochester Medical Center, Highland Hospital, Rochester, New York (RKT)
| | - Benedict F DiGiovanni
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois (FED).,Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, University of Rochester Medical Center, Rochester, New York (DAN, BFD).,School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, Ithaca, New York (JT).,Department of Imaging Sciences, University of Rochester Medical Center, Highland Hospital, Rochester, New York (RKT)
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PhysIOpathology of NEuromuscular function rElated to fatigue in chronic Renal disease in the elderly (PIONEER): study protocol. BMC Nephrol 2020; 21:305. [PMID: 32711479 PMCID: PMC7382847 DOI: 10.1186/s12882-020-01976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) is associated with reduced muscular strength resulting in profound fatigue. The physiopathology of these changes, their prevalence and evolution are still debated. Moreover, we have little data on elderly CKD patients. The present study protocol aims to 1) quantify the prevalence of low muscle strength (dynapenia) in a cohort of elderly patients with advanced CKD and to 2) characterize their force production coupled with electromyographic features and the symptoms of fatigue compared to a matched control group. METHODS This is a case-control, prospective, interventional study. INCLUSION CRITERIA age ≥ 60 years; CKD Stage 3b-5; clinical stability (i.e. no hospitalization and ≤ 25% in creatinine increase in the previous 3 months). Controls with normal kidney function will be matched in terms of age, gender and diabetes mellitus (requisite: estimated glomerular filtration rate ≥ 60 ml/min/1.73m2 available in the last 6 months). Exclusion criteria for cases and controls: neuromuscular disease, life expectancy < 3 months. The handgrip strength protocol is an intermittent test consisting in 6 series of 9 repetitions of 3-s sub-maximum contractions at 40% of the maximum voluntary contraction (MVC) and 2 s of resting time between contractions. Each series is separated by one fast sub-maximum contraction and one MVC. Strength is assessed with a high-frequency handgrip dynamometer paired with surface electromyography. Symptoms of fatigue are assessed using MFI-20 and FACIT-F questionnaires. In order to reach a statistical power of 96%, we plan to enroll 110 subjects in each group. DISCUSSION The novelty of this study resides in the application of an already validated set of tests in a population in which this combination (dynamometer, electromyography and questionnaires) has not previously been explored. We expect a high prevalence of dynapenia and a higher fatigability in CKD patients. A positive correlation is expected between reported fatigue and fatigability. Better appreciation of the prevalence and the relationship between fatigability and a sensation of fatigue can help us target interventions in CKD patients to improve quality of life and survival. TRIAL REGISTRATION The study was approved by Ethical Committee EST III n°20.03.01 and was recorded as a Clinical Trial (NCT04330807) on April 2, 2020.
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Horii N, Hasegawa N, Fujie S, Uchida M, Iemitsu M. Resistance exercise‐induced increase in muscle 5α‐dihydrotestosterone contributes to the activation of muscle Akt/mTOR/p70S6K‐ and Akt/AS160/GLUT4‐signaling pathways in type 2 diabetic rats. FASEB J 2020; 34:11047-11057. [DOI: 10.1096/fj.201903223rr] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/21/2020] [Accepted: 06/11/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Naoki Horii
- Faculty of Sport and Health Science Ritsumeikan University Kusatsu Japan
- Research Fellow of Japan Society for the Promotion of Science Chiyoda‐ku Japan
| | - Natsuki Hasegawa
- Research Organization of Science and Technology Ritsumeikan University Kusatsu Japan
| | - Shumpei Fujie
- Faculty of Sport and Health Science Ritsumeikan University Kusatsu Japan
| | - Masataka Uchida
- Faculty of Sport and Health Science Ritsumeikan University Kusatsu Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science Ritsumeikan University Kusatsu Japan
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Long-term retrospective observation study to evaluate effects of adiponectin on skeletal muscle in renal transplant recipients. Sci Rep 2020; 10:10723. [PMID: 32612097 PMCID: PMC7330033 DOI: 10.1038/s41598-020-67711-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/02/2020] [Indexed: 12/16/2022] Open
Abstract
Although it has been reported that chronic kidney disease exacerbates sarcopenia progression, the mechanisms of the process remain unclear. Fifty-one patients who underwent renal transplantation at our hospital since 1998 (31 males and 20 females; aged 29–52 years at the time of transplantation) were retrospectively examined for the relationships among the psoas muscle index (PMI), intramuscular adipose tissue content (IMAC), serum adiponectin fractions (high-/low-molecular-weight) and new-onset diabetes after transplantation (NODAT). Before transplantation, age at kidney transplantation negatively correlated with PMI and positively correlated with IMAC (rS = − 0.427, p < 0.01; rS = 0.464, p < 0.01, respectively). Both at 1 and 5 years after transplantation, PMI was higher than before transplantation (p < 0.01). IMAC transiently decreased to − 0.39 at 1 year after kidney transplantation but subsequently increased to − 0.36 at 5 years after kidney transplantation. Multivariate analyses revealed that the mean increase in high-molecular weight adiponectin concentrations was an exacerbating factor for the mean change in PMI (p = 0.003). Moreover, the mean increases in IMAC were exacerbating factors for NODAT. In conclusion, the increase in the PMI is associated with high–molecular weight adiponectin levels after renal transplantation.
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Reduced Skeletal Muscle Volume and Increased Skeletal Muscle Fat Deposition Characterize Diabetes in Individuals after Pancreatitis: A Magnetic Resonance Imaging Study. Diseases 2020; 8:diseases8030025. [PMID: 32630360 PMCID: PMC7565190 DOI: 10.3390/diseases8030025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/19/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Skeletal muscle has been implicated in the pathogenesis of type 2 diabetes but it has never been investigated in diabetes after pancreatitis. The aim was to investigate the relationship between psoas muscle volume (PMV) and diabetes in individuals after pancreatitis, as well as its associations with ectopic fat phenotypes and insulin traits. Methods: Individuals after an attack of pancreatitis and healthy individuals were studied in a cross-sectional fashion. All participants underwent magnetic resonance imaging, based on which PMV, skeletal muscle fat deposition (SMFD), as well as liver and intra-pancreatic fat depositions were derived. Fasting and postprandial blood samples were collected to calculate indices of insulin sensitivity and secretion. Linear regression analyses were conducted, adjusting for possible confounders (age, sex, body composition, comorbidities, use of insulin, and others). Results: A total of 153 participants were studied. PMV was significantly decreased in the diabetes group compared with healthy controls (β = −30.0, p = 0.034 in the most adjusted model). SMFD was significantly inversely associated with PMV (β = −3.1, p < 0.001 in the most adjusted model). The Matsuda index of insulin sensitivity was significantly directly associated with PMV (β = 1.6, p = 0.010 in the most adjusted model). Conclusions: Diabetes in individuals after pancreatitis is characterized by reduced PMV. Reduced PMV is associated with increased SMFD and decreased insulin sensitivity in individuals after pancreatitis.
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Kataoka H, Miyatake N, Kitayama N, Murao S, Tanaka S. An exploratory study of relationship between lower-limb muscle mass and diabetic polyneuropathy in patients with type 2 diabetes. J Diabetes Metab Disord 2020; 19:281-287. [PMID: 32550177 DOI: 10.1007/s40200-020-00505-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 02/04/2020] [Indexed: 12/25/2022]
Abstract
Purpose This exploratory study compared the lower-limb muscle mass (thigh muscle mass [TMM] and lower-leg muscle mass [LLMM]) in type 2 diabetic patients with and without diabetic polyneuropathy (DPN). Methods A total of 130 patients with type 2 diabetes, hospitalized for glycemic control, were enrolled in this cross-sectional study. TMM and LLMM were measured using the bioelectrical impedance method. The muscle mass value was normalized by the bodyweight, and the total muscle mass was calculated by combining the muscle mass on the left and right (%TMM and %LLMM). DPN was evaluated according to the Japanese criteria. Anthropometric parameters, blood pressure, laboratory data, exercise habits, medication, related index of diabetes, and diabetic complications were analyzed. Results Sixty patients, comprising of 32 males (47.8%) and 28 females (44.4%) with type 2 diabetes (46.2%), had DPN. The %TTM and %LLMM were significantly lower in type 2 diabetic patients with DPN than in those without DPN. Multiple regression analysis identified DPN, age, and hemoglobin A1c (HbA1c) as the determinants of %TMM, and DPN and HbA1c were identified as the determinants of %LLMM in type 2 diabetic patients. Discussion The %TMM and %LLMM were significantly decreased in type 2 diabetic patients with DPN. DPN was found to be the strongest determinant of %TMM and %LLMM. Preventing and improving DPN, through active physical therapy, may increase the muscle mass of the lower limbs.
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Affiliation(s)
- Hiroaki Kataoka
- Department of Physical Therapy, Okayama Institute for Medical and Technical Sciences, 3-2-18, Daiku, Kitaku, Okayama-city, Okayama 700-0913 Japan
- Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu, Kagawa Japan
- Department of Hygiene, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa Japan
| | - Nobuyuki Miyatake
- Department of Hygiene, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa Japan
| | - Naomi Kitayama
- Rehabilitation Center, KKR Takamatsu Hospital, Takamatsu, Kagawa Japan
| | - Satoshi Murao
- Department of Diabetes and Endocrinology, KKR Takamatsu Hospital, Takamatsu, Kagawa Japan
| | - Satoshi Tanaka
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
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Dieckmeyer M, Zoffl F, Grundl L, Inhuber S, Schlaeger S, Burian E, Zimmer C, Kirschke JS, Karampinos DC, Baum T, Sollmann N. Association of quadriceps muscle, gluteal muscle, and femoral bone marrow composition using chemical shift encoding-based water-fat MRI: a preliminary study in healthy young volunteers. Eur Radiol Exp 2020; 4:35. [PMID: 32518982 PMCID: PMC7283400 DOI: 10.1186/s41747-020-00162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/17/2020] [Indexed: 12/04/2022] Open
Abstract
Background We investigated the composition of the gluteal (gluteus maximus, medius, and minimus) and quadriceps (rectus femoris, vastus lateralis, medialis, and intermedius) muscle groups and its associations with femoral bone marrow using chemical shift encoding-based water-fat magnetic resonance imaging (CSE-MRI) to improve our understanding of muscle-bone interaction. Methods Thirty healthy volunteers (15 males, aged 30.5 ± 4.9 years [mean ± standard deviation]; 15 females, aged 29.9 ± 7.1 years) were recruited. A six-echo three-dimensional spoiled gradient-echo sequence was used for 3-T CSE-MRI at the thigh and hip region. The proton density fat fraction (PDFF) of the gluteal and quadriceps muscle groups as well as of the femoral head, neck, and greater trochanter bone marrow were extracted and averaged over both sides. Results PDFF values of all analysed bone marrow compartments were significantly higher in men than in women (p ≤ 0.047). PDFF values of the analysed muscles showed no significant difference between men and women (p ≥ 0.707). After adjusting for age and body mass index, moderate significant correlations of PDFF values were observed between the gluteal and quadriceps muscle groups (r = 0.670) and between femoral subregions (from r = 0.613 to r = 0.655). Regarding muscle-bone interactions, only the PDFF of the quadriceps muscle and greater trochanter bone marrow showed a significant correlation (r = 0.375). Conclusions The composition of the muscle and bone marrow compartments at the thigh and hip region in young, healthy subjects seems to be quite distinct, without evidence for a strong muscle-bone interaction.
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Affiliation(s)
- Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Zoffl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Lioba Grundl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Stephanie Inhuber
- Department of Sport and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Sarah Schlaeger
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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Van Eetvelde BLM, Lapauw B, Proot P, Vanden Wyngaert K, Celie B, Cambier D, Calders P. The impact of sensory and/or sensorimotor neuropathy on lower limb muscle endurance, explosive and maximal muscle strength in patients with type 2 diabetes mellitus. J Diabetes Complications 2020; 34:107562. [PMID: 32122790 DOI: 10.1016/j.jdiacomp.2020.107562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 12/29/2022]
Abstract
AIMS The purpose of this study was to investigate the impact of diabetic neuropathy (dNP) on lower limb endurance, explosive and maximal muscle strength in patients with Type 2 Diabetes Mellitus (T2DM). METHODS Fifty-four participants, aged between 55 and 85, were enrolled in this observational comparative study. The patients with T2DM had an average HbA1c of 7.4% (±1.03) and diabetes duration of 13 years. Participants were classified by means of electroneuromyography as T2DM without dNP (dNP-; n = 8), T2DM with sensory dNP (dNPs; n = 13), T2DM with sensorimotor dNP (dNPsm; n = 14), and healthy controls without neuropathy (C; n = 19). Maximal muscle strength and muscle endurance of the dominant knee and ankle were measured by dynamometry, while explosive muscle strength was evaluated by mechanography. RESULTS Muscle endurance "total work" in knee extension and ankle plantar flexion was higher in the healthy controls compared to dNP-, dNPs and dNPsm, in knee flexion compared to dNPs and dNPsm, and in ankle dorsiflexion compared to dNPsm only (p<0.05). Furthermore, relative explosive muscle strength "total power/body weight" and relative maximal muscle strength "peak torque/lean body mass of the dominant leg" considering knee flexion, ankle plantar flexion and dorsiflexion, were higher in healthy controls compared to the dNPsm group, and for maximal muscle strength ankle dorsiflexion even between dNP- and dNPsm (p < 0.05). CONCLUSIONS Muscle endurance is impaired in patients with T2DM, independent of the presence of dNP. Explosive and maximal muscle strength are more likely affected by the presence and severity of dNP.
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Affiliation(s)
- Birgit L M Van Eetvelde
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Pascal Proot
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Karsten Vanden Wyngaert
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Bert Celie
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Dirk Cambier
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Patrick Calders
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
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Younesian H, Farahpour N, Mazde M, Simoneau M, Turcot K. Standing Balance Performance and Knee Extensors' Strength in Diabetic Patients with Neuropathy. J Appl Biomech 2020; 36:171-177. [PMID: 32335529 DOI: 10.1123/jab.2019-0365] [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: 11/18/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 11/18/2022]
Abstract
Diabetes peripheral neuropathy (DPN) leads to balance impairment among diabetes mellitus (DM). The aims of this study were to (1) distinguish between DM patients who have/do not have DPN and to (2) compare quadriceps' strength and balance performance of DM, DPN, and healthy groups. Fifteen healthy females and 33 females with type 2 diabetic patients participated. The electrodiagnostic method was used to classify diabetic patients into DM and DPN. A dynamometer was used to measure quadriceps' strength. Single-leg standing on a force plate was also used to quantify participants' balance. Smaller conduction velocity and amplitude and greater distal latency of all nerves were observed in the DPN compared with the DM in particular for sensory nerve. In DPN, conduction velocity was asymmetrical. The quadriceps' strength of both legs in DPN and the right leg in DM was smaller than in the control group. The root mean square of the center of pressure was similar between DM and DPN. But it was larger in DPN than in the control group. DPN is associated with asymmetrical conduction velocity, smaller quadriceps' strength, and weaker balance performance that is suggestive of higher risk of falling. Balance training is recommended for the DPN group during their rehabilitation to reduce their falling risk.
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Affiliation(s)
- Hananeh Younesian
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
- Bu-Ali Sina University
| | | | | | - Martin Simoneau
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
| | - Katia Turcot
- Laval University
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)
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Inverse Correlation Between Grip Strength and Serum Phosphorus: A Retrospective Observational Study in Japanese Elderly with Poorly Controlled Type 2 Diabetes. Geriatrics (Basel) 2020; 5:geriatrics5020033. [PMID: 32438707 PMCID: PMC7346010 DOI: 10.3390/geriatrics5020033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to investigate factors associated with sarcopenia among elderly patients with poorly controlled diabetes mellitus (DM). We retrospectively analyzed 41 patients with type 2 DM, aged ≥65 years who required diabetes education hospitalization. Patients were classified into two groups according to the presence or absence of a weakened hand grip, and clinical characteristics were compared. Patients with a weakened hand grip (n = 21) scored worse on a mini-mental state examination (24.3 vs. 26.5, p = 0.04), showed a higher prevalence of diabetic peripheral neuropathy (76% vs. 40%, p = 0.03), and had a higher serum phosphorus concentration (3.8 vs. 3.3 mg/dL, p < 0.01) compared to those without a weakened hand grip (n = 20). The serum phosphorus concentration was inversely correlated to hand grip strength (r = -0.501, p < 0.001) among the total of 41 patients. This inverse association was also confirmed after adjusting the effects of estimated glomerular filtration rate, age, and glycated hemoglobin. Thus, cognitive impairment, diabetic peripheral neuropathy, and high serum phosphorus concentrations are associated with hand grip weakness in elderly patients with type 2 DM.
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Malhotra K, Baggott PJ, Livingstone J. Vitamin D in the Foot and Ankle: A Review of the Literature. J Am Podiatr Med Assoc 2020; 110:436238. [PMID: 31589473 DOI: 10.7547/18-087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Vitamin D is an essential vitamin that targets several tissues and organs and plays an important role in calcium homeostasis. Vitamin D deficiency is common, particularly at higher latitudes, where there is reduced exposure to ultraviolet B radiation. We reviewed the role of vitamin D and its deficiency in foot and ankle pathology. METHODS The effects of vitamin D deficiency have been extensively studied, but only a small portion of the literature has focused on the foot and ankle. Most evidence regarding the foot and ankle consists of retrospective studies, which cannot determine whether vitamin D deficiency is, in fact, the cause of the pathologies being investigated. RESULTS The available evidence suggests that insufficient vitamin D levels may result in an increased incidence of foot and ankle fractures. The effects of vitamin D deficiency on fracture healing, bone marrow edema syndrome, osteochondral lesions of the talus, strength around the foot and ankle, tendon disorders, elective foot and ankle surgery, and other foot and ankle conditions are less clear. CONCLUSIONS Based on the available evidence, we cannot recommend routine testing or supplementation of vitamin D in patients with foot and ankle pathology. However, supplementation is cheap, safe, and may be of benefit in patients at high risk for deficiency. When vitamin D is supplemented, the evidence suggests that calcium should be co-supplemented. Further high-quality research is needed into the effect of vitamin D in the foot and ankle. Cost-benefit analyses of routine testing and supplementation of vitamin D for foot and ankle pathology are also required.
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Perazzolo M, Reeves ND, Bowling FL, Boulton AJM, Raffi M, Marple‐Horvat DE. Altered accelerator pedal control in a driving simulator in people with diabetic peripheral neuropathy. Diabet Med 2020; 37:335-342. [PMID: 30924960 PMCID: PMC7004113 DOI: 10.1111/dme.13957] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether the sensory-motor impairment attributable to diabetic peripheral neuropathy would affect control of the accelerator pedal during a driving simulator task. METHODS A total of 32 active drivers, 11 with diabetic peripheral neuropathy (mean ± sd age 67±5.0 years), 10 with diabetes but no neuropathy (diabetes group; mean ± sd age 62±10 years), and 11 healthy individuals without diabetes (healthy group; mean ± sd age 60±11 years), undertook a test on a dynamometer to assess ankle plantar flexor muscle strength and ankle joint proprioception function of the right leg, in addition to a driving simulator task. The following variables were measured: maximal ankle plantar flexor muscle strength; speed of strength generation (Nm/s); and ankle joint proprioception (ankle repositioning error, degrees). In the driving simulator task, driving speed (mph), accelerator pedal signal (degrees) and the duration of specific 'loss-of-control events' (s) were measured during two drives (Drive 1, Drive 2). RESULTS Participants with diabetic peripheral neuropathy had a lower speed of strength generation (P<0.001), lower maximal ankle plantar flexor muscle strength (P<0.001) and impaired ankle proprioception (P=0.034) compared to healthy participants. The diabetic peripheral neuropathy group drove more slowly compared with the healthy group (Drive 1 P=0.048; Drive 2 P=0.042) and showed marked differences in the use of the accelerator pedal compared to both the diabetes group (P=0.010) and the healthy group (P=0.002). Participants with diabetic peripheral neuropathy had the longest duration of loss-of-control events, but after one drive, this was greatly reduced (P=0.023). CONCLUSIONS Muscle function, ankle proprioception and accelerator pedal control are all affected in people with diabetic peripheral neuropathy, adversely influencing driving performance, but potential for improvement with targeted practice remains possible.
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Affiliation(s)
- M. Perazzolo
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - N. D. Reeves
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
| | - F. L. Bowling
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - A. J. M. Boulton
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Diabetes Research InstituteUniversity of MiamiMiamiFLUSA
| | - M. Raffi
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - D. E. Marple‐Horvat
- Research Centre for Musculoskeletal Science and Sports MedicineSchool of Healthcare ScienceFaculty of Science and EngineeringManchester Metropolitan UniversityManchesterUK
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