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Zhu F, Guo J, Zheng W. Associations between sarcopenia and depression in middle-aged and older adults: the moderating effect of smoking. Sci Rep 2024; 14:15187. [PMID: 38956420 PMCID: PMC11219743 DOI: 10.1038/s41598-024-65343-3] [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: 01/22/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
The aim of this study were to estimate associations of sarcopenic status with depressive symptoms. We used mixed-effects linear model to estimate longitudinal association between sarcopenic status and rate of change in 10-item Center for Epidemiologic Studies Depression (CES-D) scores, and used Cox regression model to estimate the association between sarcopenic status and incident depression (CES-D ≥ 10). Stratification analyses were performed when the interactions between sarcopenic status and covariates were significant. A total of 6522 participants were ultimately included. After adjusting for covariates, participants with possible sarcopenia (β = 0.117; 95% CI 0.067 to 0.166; P < 0.001) and sarcopenia (β: 0.093; 95% CI 0.027-0.159; P < 0.001) had a faster increase in CES-D scores compared with normal individuals. Interactions between smoking and sarcopenic status were significant (Pinteraction < 0.05). We found significantly positive associations of sarcopenic status with CES-D scores in nonsmokers, but not in current and past smokers. Besides, compared with normal participants, those with possible sarcopenia (HR 1.15; 95% CI 1.05 to 1.27) and sarcopenia (HR 1.28; 95% CI 1.12 to 1.46) (Ptrend < 0.001) had elevated risks of incident depression. Sarcopenia is associated with a faster increase in CES-D scores and increased risks of depression among Chinese middle-aged and older adults. Stronger associations between sarcopenia and trajectory of CES-D scores were found in nonsmokers than in smokers.
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Affiliation(s)
- Feiyun Zhu
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China
| | - Jing Guo
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weijun Zheng
- School of Public Health, Zhejiang Chinese Medical University, Office 412, 548# Bingjiang District, Hangzhou, 310053, Zhejiang, China.
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Bahari H, Seifi N, Foroumandi E, Kourepaz F, Shahabi HE, Ervin K, Khabari N, Ferns GA, Ghayour-Mobarhan M. Dietary acid load, depression, and anxiety: results of a population-based study. BMC Psychiatry 2023; 23:679. [PMID: 37723484 PMCID: PMC10506201 DOI: 10.1186/s12888-023-05163-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Dietary acid load seems to be associated with psychological disorders through several mechanisms, and may barricade their treatment and recovery. The aim of current study was to evaluate the relationship between dietary acid load, using potential renal acid load (PRAL) and dietary acid load (DAL) scores, with the severity of depression and anxiety among Iranian adults. METHODS A total of 6531 participants aged 35-65 years were recruited in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using PRAL and DAL scores. Depression and anxiety were screened using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS In the fully adjusted model, women with the highest DAL or PRAL had higher odds of more severe depression compared to those in the lowest category (OR = 1.20; 95% CI = 1.03-1.42 and OR = 1.20; 95% CI = 1.03-1.39, respectively). No significant association was observed between DAL and PRAL and depression severity in men and in the population as a whole. Regarding the association between PRAL and anxiety severity, there was no significant association when separated by sex. However, in the fully adjusted model for the whole population, participants in the highest tertile of PRAL had 13% greater odds of more severe anxiety than the lowest tertile (OR: 1.13, 95% CI: 1.01-1.13). No significant association was observed between DAL and anxiety severity in women, men or in the whole population. CONCLUSION Women, but not men, with higher dietary acid load had significantly higher odds of having more severe depression. A significant positive association was also observed between dietary acid load and anxiety in the whole population.
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Affiliation(s)
- Hossein Bahari
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Seifi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Foroumandi
- Non-Communicable Diseases Research Center, Department of Nutrition and Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Hediye Erfaniyan Shahabi
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Kimia Ervin
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Nahid Khabari
- Department of Biology, Faculty of Sciences, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, 99199-91766, Iran.
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Shi Y, Tang Y, Stanmore E, McGarrigle L, Todd C. Non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia: a scoping review. Arch Gerontol Geriatr 2023; 112:105022. [PMID: 37084601 DOI: 10.1016/j.archger.2023.105022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/17/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Sarcopenia is a progressive, age-related muscle disease that, if left untreated, imposes significant personal, social, and economic burdens. OBJECTIVE To compile and document the nature and extent of existing studies exploring non-pharmacological interventions as a strategy to prevent or treat possible sarcopenia or sarcopenia in community-dwelling older adults. METHOD Thirteen databases were searched up from January 2010 to March 2023 and filters were limited to English and Chinese language. Studies with older adults (≥60 y) in the community were included. The review was conducted and reported according to the PRISMA-ScR guidance and seven stages of methodology framework. A descriptive synthesis of trial characteristics and effectiveness was conducted. RESULTS A total of 59 studies were included in the analysis. Most studies were RCTs. Few studies enrolled older adults with possible sarcopenia. The 70-79 age group has been studied more than any other age group. Six intervention types were identified, including exercise-only, nutrition-only, health education-only, traditional Chinese medicine-only, multicomponent intervention and control type. Majority of exercise-only interventions received resistance-based exercise. In nutrition-only category, overall food intervention or nutrients intervention was more than dietary pattern. Moreover, exercise plus nutrition was the main sub-type in multicomponent interventions. Health education-only and traditional Chinese medicine-only interventions were less frequently identified. Most studies had high and moderate compliance. CONCLUSION There is evidence for the effectiveness of exercise and exercise plus nutrition interventions in improving muscle strength and physical performance, whereas the effectiveness of other intervention types or their combinations requires additional research. SCOPING REVIEW REGISTRATION Open Science Framework (OSF) Registration DOI 10.17605/OSF.IO/RK3TE.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; School of Nursing & School of Public Health, Yangzhou University, Yangzhou, Jiangsu province, China.
| | - Yimin Tang
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK.
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK.
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK; Manchester Institute for Collaborative Research on Ageing, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK.
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Shi Y, Stanmore E, McGarrigle L, Todd C. Non-pharmacological interventions for possible sarcopenia or sarcopenia in community-dwelling older adults: a scoping review protocol. BMJ Open 2023; 13:e067079. [PMID: 36810172 PMCID: PMC9944664 DOI: 10.1136/bmjopen-2022-067079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Early prevention of sarcopenia is a recommendation to reduce morbidity, mortality and improve quality of life. Several non-pharmacological interventions to reduce the risk of sarcopenia in community-dwelling older people have been proposed. Therefore, there is a need to identify the scope and differences of these interventions. This scoping review will summarise the nature and extent of the existing literature that describes and examines non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia. METHODS AND ANALYSIS The seven-stage review methodology framework will be used. Searches will be conducted in the following databases: Embase, Medline, PsycINFO, CINAHL, All EBM Reviews, Web of Science, Scopus, CBM, CNKI, WANFANG and VIP. Grey literature will also be identified from Google scholar. Search dates will be restricted to January 2010 to December 2022, in English and Chinese language only. Screening will be focused on published research, including both quantitative and qualitative study designs, and prospectively registered trials. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be followed when delineating the search decision process. Findings will be synthesised quantitatively and qualitatively as appropriate and classified using key conceptual categories. We will identify whether studies identified have been included in systematic reviews or meta-analyses, and research gaps and opportunities will be identified and summarised. ETHICS AND DISSEMINATION As this is a review, ethical approval will not be sought. The results will be published in peer-reviewed scientific journals and also disseminated in relevant disease support groups and conferences. The planned scoping review will help us identify the current status of research and gaps in the literature, so as to develop a future research agenda.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, Jiangsu province, China
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
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The association between handgrip strength and depression in cancer survivors: a cross-sectional study. BMC Geriatr 2022; 22:111. [PMID: 35144536 PMCID: PMC8829989 DOI: 10.1186/s12877-022-02795-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background The association between handgrip strength and depression in cancer survivors has been unexplored until now. We aim to examine the association between handgrip strength and depression in cancer survivors by using publicly available data (National Health and Nutrition Examination Survey). Methods Two waves of data from the National Health and Nutrition Examination Survey, from 2011–2012 and 2013–2014, were extracted and combined to explore this important issue. We extracted maximum patient handgrip strength value (from both hands). The Patient Health Questionnaire (PHQ-9) was used to evaluate depression with a cut-off > = 10 points indicating that patients had depressive symptoms. Other basic characteristics and health-related variables were also collected. We used Least Absolute Shrinkage and Selection Operator (LASSO) regression to select potential confounding factors. Multivariable linear or logistic regression models were adopted to explore whether handgrip strength as a continuous variable, or low handgrip strength, was associated with depressive symptoms. Results There were 876 cancer survivors in our present total sample, with 403 (46.0%) males and 473 females (54.0%). The mean (SD) age of the entire group was 64.67 (13.81) years. The prevalence of depression and low handgrip strength was 12.90% and 16.7%, respectively. The results showed that handgrip strength was negatively associated with depressive symptoms in cancer survivors (OR = 0.95, 95%CI:0.92–0.99; P = 0.024). In addition, after adjusting for age, gender, race; marital status, polypharmacy, sleep disorder, arthritis, congestive heart failure, history of stroke, type of cancer, chronic coronary bronchitis and being overweight, cancer survivors with low handgrip strength had a 2.02-fold risk of depression, compared to those with normal handgrip strength (OR = 2.02,95%CI:1.07–3.81; P = 0.028). Conclusions Our present study suggests that low handgrip strength, as a simple and modifiable parameter, is associated with a higher risk of depression in cancer survivors. Therefore, future larger-scale prospective cohort studies are warranted to determine this association. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02795-0.
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Shimada M, Hirashima N, Iwase H, Saito M, Kondo H, Urata N, Unita S, Kondo T, Tanaka D, Tsunekawa T, Fujishiro M. Evaluation of Muscle Cramp Associated with Liver Cirrhosis with a Focus on the Liver Function and Nutritional Status. Intern Med 2021; 60:1343-1348. [PMID: 33281163 PMCID: PMC8170239 DOI: 10.2169/internalmedicine.6231-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective We investigated the muscle cramp status of patients with liver cirrhosis by focusing on the degree of liver damage, skeletal muscle mass, and nutritional status. Methods All enrolled patients completed a questionnaire about muscle cramps. The degree of liver damage was examined using the Child-Pugh classification and the albumin-bilirubin (ALBI) grade. The nutritional status and skeletal muscle mass were examined using the Controlling Nutritional Status (CONUT) method and the psoas muscle index (PMI). Results Among the respondents, 55.7% of the patients reported experiencing muscle cramps. An analysis of the two patient groups-those who experienced muscle cramps and those who did not-revealed significant differences in Child-Pugh classification (muscle cramp-positive vs. muscle cramp-negative: A/B/C, 54.1%/32.4%/13.5% vs. 90.0%/10.0%/0.0%; p=0.004), ALBI grade (1/2/3, 20.5%/71.8%/7.7% vs. 54.8%/38.7%/6.5%; p=0.011), modified ALBI grade (1/2a/2b/3, 20.5%/20.5%/51.3%/7.7% vs. 54.8%/22.6%/16.1%/6.5%; p=0.008), CONUT score (normal/mild/moderate/severe, 25.6%/28.2%/41.0%/5.1% vs. 22.6%/61.3%/12.9%/3.2%; p=0.024), and PMI (3.85±1.13 cm2/m2 vs. 4.94±1.86 cm2/m2; p=0.012). Conclusion Our findings suggest that muscle cramps occur more frequently in patients with liver cirrhosis due to their decreased liver function and poorer nutritional status.
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Affiliation(s)
- Masaaki Shimada
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Noboru Hirashima
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Hiroaki Iwase
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Masashi Saito
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Hisashi Kondo
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Noboru Urata
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Satoshi Unita
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Takashi Kondo
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Daiki Tanaka
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Takuya Tsunekawa
- Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology & Hepatology, Nagoya University Graduate School of Medicine, Japan
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Marasco G, Dajti E, Ravaioli F, Brocchi S, Rossini B, Alemanni LV, Peta G, Bartalena L, Golfieri R, Festi D, Colecchia A, Renzulli M. Clinical impact of sarcopenia assessment in patients with liver cirrhosis. Expert Rev Gastroenterol Hepatol 2021; 15:377-388. [PMID: 33196344 DOI: 10.1080/17474124.2021.1848542] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Sarcopenia is defined as loss of skeletal muscle mass, strength, and function, and it is associated with increased morbidity and mortality in patients with chronic liver disease.Areas covered: The aim of this review is to provide a detailed report on the pathophysiological mechanisms underlying sarcopenia in cirrhotic patients, the several imaging methods available for the assessment of sarcopenia and the clinical studies evaluating the prognostic role of sarcopenia presence in cirrhotic patients.Expert opinion: Sarcopenia pathogenesis is complex and multifaceted, as chronic catabolic conditions, increased energy expenditure, reduced appetite, side effects of multiple therapies, alterations in circulating levels of hormones, low protein synthesis, presence of ascites or portosystemic shunts are all factors contributing to muscle atrophy in cirrhotic patients. Computed tomography scan is the most validated method to evaluate muscle mass and quality. Sarcopenia is associated with a higher rate waitlist mortality, hepatic encephalopathy, and lower quality of life in patients with liver cirrhosis. Future studies should make an effort to unify and validate liver disease-specific cutoffs for the definition of sarcopenia.
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Affiliation(s)
- Giovanni Marasco
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Elton Dajti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Federico Ravaioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Stefano Brocchi
- Radiology Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Benedetta Rossini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | | | - Giuliano Peta
- Radiology Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Laura Bartalena
- Radiology Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Rita Golfieri
- Radiology Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Davide Festi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Antonio Colecchia
- Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Verona, Italy
| | - Matteo Renzulli
- Radiology Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
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Low Serum 25-Hydroxyvitamin D Levels Are Related to Frailty and Sarcopenia in Patients with Chronic Liver Disease. Nutrients 2020; 12:nu12123810. [PMID: 33322706 PMCID: PMC7764249 DOI: 10.3390/nu12123810] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023] Open
Abstract
Low vitamin D status is related to frailty and/or sarcopenia in elderly individuals. However, these relationships are unclear in patients with chronic liver disease (CLD). This study aimed at exploring the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and frailty or sarcopenia in 231 patients with CLD. Frailty was determined based on five factors (weight loss, low physical activity, weakness, slowness, and exhaustion). Sarcopenia was diagnosed by applying the Japan Society of Hepatology criteria. The patients were classified into three groups according to baseline 25(OH)D levels: low (L), intermediate (I), and high (H) vitamin D (VD) groups. Of the 231 patients, 70 (30.3%) and 66 (28.6%) had frailty and sarcopenia, respectively. The prevalence rate of frailty and sarcopenia significantly increased stepwise with a decline in the vitamin D status. The L-VD group showed the highest prevalence rates of frailty and sarcopenia (49.1% (28/57), p < 0.001 for both), whereas the H-VD group showed the lowest prevalence rates of frailty (15.3% (9/59)) and sarcopenia (18.6% (11/59)) (p < 0.001 for both). Multivariate analysis identified serum 25(OH)D levels as a significant independent factor related to frailty and sarcopenia. Serum 25(OH)D levels significantly correlated with handgrip strength, skeletal muscle mass index, and gait speed. In conclusion, low serum vitamin D level, especially severe vitamin D deficient status, is closely related to frailty and sarcopenia in patients with CLD.
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Nishikawa H, Yoh K, Enomoto H, Iwata Y, Sakai Y, Kishino K, Shimono Y, Ikeda N, Takashima T, Aizawa N, Takata R, Hasegawa K, Koriyama T, Yuri Y, Nishimura T, Nishiguchi S, Iijima H. Close Correlation between Frailty and Depressive State in Chronic Liver Diseases. ACTA ACUST UNITED AC 2020; 56:medicina56070319. [PMID: 32605049 PMCID: PMC7404642 DOI: 10.3390/medicina56070319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022]
Abstract
Background and objectives: Few data with regard to the relevance between depression and frailty in chronic liver disease (CLD) patients are currently available. We aimed to elucidate the relationship between frailty and depression as evaluated by the Beck Depression Inventory—2nd edition (BDI-II) in CLD patients (n = 340, median age = 65.0 years). Methods: Frailty was defined as a clinical syndrome in which three or more of the following criteria were met: body weight loss, exhaustion, muscle weakness, slow walking speed and low physical activity. Depressive state was defined as BDI-II score 11 or greater. Results: Robust (frailty score = zero), prefrail (frailty score = one or two) and frailty were identified in 114 (33.5%), 182 (53.5%) and 44 (12.9%). The median BDI-II score was five. Depressive state was identified in 84 patients (24.7%). The median BDI-II scores in patients with robust, prefrail and frail traits were 2, 7 and 12.5 (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0003; robust vs. frail, p < 0.0001; overall p < 0.0001). The proportions of depressive state in patients with robust, prefrail and frail traits were 3.51%, 30.77% and 54.55% (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0046; robust vs. frail, p < 0.0001; overall p < 0.0001). BDI-II score significantly correlated with frailty score (rs = 0.5855, p < 0.0001). Conclusions: The close correlation between frailty and depression can be found in CLD. Preventing frailty in CLD should be approached both physiologically and psychologically.
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Affiliation(s)
- Hiroki Nishikawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
- Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
- Correspondence:
| | - Kazunori Yoh
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Hirayuki Enomoto
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshinori Iwata
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshiyuki Sakai
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Kyohei Kishino
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yoshihiro Shimono
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Naoto Ikeda
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Tomoyuki Takashima
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Nobuhiro Aizawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Ryo Takata
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Kunihiro Hasegawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Takashi Koriyama
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Yukihisa Yuri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | - Takashi Nishimura
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
| | | | - Hiroko Iijima
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan; (K.Y.); (H.E.); (Y.I.); (Y.S.); (K.K.); (Y.S.); (N.I.); (T.T.); (N.A.); (R.T.); (K.H.); (T.K.); (Y.Y.); (T.N.); (H.I.)
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Serum Zinc Level Classification System: Usefulness in Patients with Liver Cirrhosis. J Clin Med 2019; 8:jcm8122057. [PMID: 31766742 PMCID: PMC6947237 DOI: 10.3390/jcm8122057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 02/08/2023] Open
Abstract
Currently, the Japanese society of clinical nutrition (JSCN) defines serum zinc (Zn) level < 60 μg/dL as Zn deficiency and 60 μg/dL ≤ serum Zn level < 80 μg/dL as subclinical Zn deficiency, and 80 μg/dL ≤ serum Zn level < 130 μg/dL as normal Zn range. We aimed to elucidate the prognostic impact of this Zn classification system in patients with liver cirrhosis (LC) compared to the Child–Pugh classification and the albumin–bilirubin (ALBI) grading system (n = 441, median age = 66 years). The Akaike information criterion (AIC) with each evaluation method was tested in order to compare the overall survival (OS). The median serum Zn level was 65 μg/dL. There were 56 patients with normal Zn level, 227 with subclinical Zn deficiency and 158 with Zn deficiency. OS was well stratified among three groups of serum Zn level (p < 0.0001). The AIC value for survival by the Zn classification system was the lowest among three prognostic models (AIC: 518.99 in the Child–Pugh classification, 502.411 in ALBI grade and 482.762 in the Zn classification system). Multivariate analyses of factors associated with OS revealed that serum Zn classification by JSCN was an independent factor. In conclusion, the serum Zn classification proposed by JSCN appears to be helpful for estimating prognosis in LC patients.
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