Sex-Specific Differences in Lower Body Fat Distribution and Association with Physical Performance among Healthy Community-Dwelling Older Adults: A Pilot Study

Assessment of body compositions in the prediction of metabolic syndrome in adults

Background

The musculoskeletal system participates in the pathology of metabolic disorders. Several studies have focused on body composition changes; however, the adipose tissue between muscle bundles with different metabolic statuses has rarely been studied. This study sought to explore the association between body compositions and metabolic disorders in Asians, and identify whether these body compositions can be used to detect metabolic disorders with different waist circumferences (WCs) by computed tomography (CT).

Methods

A total of 116 subjects were included in the study and categorized into the following four groups according to WC and metabolic syndrome (MS): (I) the healthy control group; (II) the normal WC with metabolic disorder group; (III) the normal WC with MS group; and (IV) the larger WC with MS group. The International Diabetes Federation (IDF) criteria based on WC, laboratory tests, body mass index (BMI), and medical history was used to diagnose MS. Body composition parameters, such as muscle attenuation, the cross-sectional area of subcutaneous adipose tissue (SAT), muscle, extramyocellular lipid (EMCL), visceral adipose tissue (VAT), and the ratios between different compositions [e.g., the SMR (SAT/muscle), EMR (EMCL/muscle), and VMR (VAT/muscle)] were calculated for the thigh and abdomen. The areas under the curve (AUCs) of the receiver operating characteristic (ROC) curves adjusted for multiple comparisons were used to discriminate among metabolic disorders.

Results

The groups with metabolic disorders had more SAT (P=0.001) and EMCL (P=0.040) in the thigh, and more VAT (P=0.001) and a higher SMR (P<0.001) in the abdomen. EMCL and muscle attenuation in the thigh (AUCs =0.790 and 0.791), and the VMR and SMR in the abdomen were better able to diagnose metabolic disorders (AUCs =0.752 and 0.746) than other body composition parameters. While SAT and EMCL in the thigh (AUCs =0.768 and 0.760), and VAT and the VMR in the abdomen (AUCs =0.788 and 0.775) were better able to diagnose MS than other parameters.

Conclusions

Body composition parameters for the thigh and abdomen could assist in detecting patients with an increased risk of MS.

Association of body composition and physical activity with pain and function in knee osteoarthritis patients: a cross-sectional study

OBJECTIVE

The objective of this study is to delineate disparities between patients with knee osteoarthritis (KOA) based on obesity status, investigate the interplay among body composition, physical activity and knee pain/function in patients with KOA and conduct subgroup analyses focusing on those with KOA and obesity.

DESIGN

Cross-sectional study.

SETTING

Residents of eight communities in Shijiazhuang, Hebei Province, China, were surveyed from March 2021 to November 2021.

PARTICIPANTS

178 patients with symptomatic KOA aged 40 years or older were included.

MAIN OUTCOMES AND MEASURES

The primary outcome measure was knee pain, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index-pain (WOMAC-P) scale. Secondary outcome measures included function, evaluated through the WOMAC-function (WOMAC-F) scale and the Five-Time-Sit-to-Stand Test (FTSST). Data analysis involved t-tests, Wilcoxon rank-sum tests, χ2 tests, linear and logistical regression analysis.

RESULTS

Participants (n=178) were 41-80 years of age (median: 65, P25-P75: 58-70), and 82% were female. Obese patients (n=103) had worse knee pain and self-reported function (p<0.05). In general patients with KOA, body fat mass was positively associated with bilateral knee pain (β=1.21 (95% CI 0.03 to 0.15)), WOMAC-P scores (β=0.25 (95% CI 0.23 to 1.22)), WOMAC-F scores (β=0.28 (95% CI 0.35 to 1.29)) and FTSST (β=0.19 (95% CI 0.03 to 0.42)), moderate-intensity to low-intensity physical activity was negatively associated with bilateral knee pain (β=-0.80 (95% CI -0.10 to -0.01)) and Skeletal Muscle Index (SMI) was negatively associated with WOMAC-F scores (β=-0.16 (95% CI -0.66 to -0.03)). In patients with KOA and obesity, SMI was negatively associated with FTSST (β=-0.30 (95% CI -3.94 to -0.00)).

CONCLUSION

Patients with KOA and obesity had worse knee pain and self-reported function compared with non-obese patients. Greater fat mass, lower muscle mass and lower moderate-intensity to low-intensity physical activity were associated with increased knee pain and poor self-reported function. More skeletal muscle mass was associated with the improvement of objective function.

Comparison of the serum creatinine- and cystatin-C-based indices as screening biomarkers for sarcopenia in community-dwelling older adults

BACKGROUND

Several creatinine- and cystatin-C-based indices have been proposed as sarcopenia predictors. This study aimed to compare serum creatinine- and cystatin-C-based indices as screening biomarkers for sarcopenia in community-dwelling older adults.

METHODS

A cross-sectional study was conducted on 945 participants aged between 70 and 84 years (men=47.5%; mean age=76.0 ± 3.9 years) from the Korean Frailty and Aging Cohort Study. The serum creatinine-to-cystatin-C ratio estimated glomerular filtration rate (eGFR) ratio (eGFRcystatin-C/eGFRcreatinine), sarcopenia index (serum creatinine × eGFRcreatinine), predicted skeletal muscle mass index (pSMI), and total body muscle mass index (TBMM) were compared.

RESULTS

The prevalence of sarcopenia was 19.9% in men and 14.0% in women. The pSMI and TBMM showed higher correlations with appendicular lean mass and grip strength in men (pSMI: rs=0.356-0.701, p < 0.001; TBMM: rs=0.320-0.730, p < 0.001) and women (pSMI: rs=0.299-0.669, p < 0.001; TBMM: rs=0.256-0.658, p < 0.001) than the other indices. The area under the receiver operating characteristic curves (AUC) of the serum indices for predicting sarcopenia showed the highest accuracy for pSMI (men: AUC=0.77, p < 0.001; women: AUC=0.71, p < 0.001). After adjusting for potential confounders, pSMI was associated with the likelihood of sarcopenia in both men (odds ratio [OR]=0.170; 95% confidence interval [CI]=0.103-0.279) and women (OR=0.167; 95% CI=0.087-0.321).

CONCLUSION

pSMI and TBMM accurately determined sarcopenia than the other indices. Furthermore, a higher pSMI was strongly associated with a decreased risk of sarcopenia compared to TBMM. These findings suggest pSMI as a potential biomarker for sarcopenia screening in community-dwelling older adults.

The Influence of Social Support on the Mental Health of Elderly Individuals in Healthy Communities with the Framework of Mental Toughness

INTRODUCTION

This work aims to explore the impacts of social support measures such as analyzing greening urban spaces and improving greenspace quality on the mental health of the elderly based on the mental resilience framework to build a healthy community.

METHODS

Through literature research and a questionnaire survey, this study designs a questionnaire including basic information, a life satisfaction scale, a positive and negative emotion scale, social support rating scale, a life orientation test-revised version, and psychological resilience scale. In order to classify the scales, machine learning (ML) approaches are applied in this work.

RESULTS

The results demonstrate great variations in the scores of the elderly with various health problems in the domain of psychological resilience (p<0.001). Social support and subjective well-being are strongly related (p<0.001). Additionally, positive correlations are observed among perceived, objective, and support use (p<0.001).

CONCLUSION

Finally, it is found that psychological resilience and social support play a significant role in mediating mental health problems in elderly individuals. Therefore, social support measures such as analyzing greening urban spaces and improving greenspace quality can be adopted to improve the mental health of the elderly to build healthy communities. On this basis, this work is of certain reference value and practical significance for the construction of healthy communities and the positive influence on the mental health of elderly individuals.