1
|
Erkan M, Zengin İ, Bekircavuşoğlu S, Topal D, Bulut T, Erkan H. Effect of Sarcopenia on Coronary Atherosclerotic Burden, Lesion Complexity, and Major Cardiovascular Events in Elderly Patients With Acute Coronary Syndrome: A 1-year Follow-up Study. Angiology 2024; 75:651-657. [PMID: 37387271 DOI: 10.1177/00033197231187230] [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] [Indexed: 07/01/2023]
Abstract
Sarcopenia is accepted as an indicator of subclinical atherosclerosis. However, its effects on clinical coronary atherosclerotic burden and lesion complexity and major adverse cardiovascular events (MACE) in elderly patients with non-ST elevation myocardial infarction (NSTEMI) are unknown. Therefore, we evaluated these possible effects. Coronary artery disease (CAD) burden and complexity were assessed using the Gensini and TAXus and cardiac surgery (SYNTAX) score, respectively. MACE involving nonfatal myocardial infarction, rehospitalization, ischemic stroke, and total mortality were evaluated after 1 year of the index NSTEMI event. The study included 240 elderly patients; of these, 60 (25%) patients had sarcopenia. The SYNTAX score and Gensini score were similar in both groups (16.8 ± 8.7 vs 17.3 ± 9.2, P = .63 and 67.7 ± 43.9 vs 73.9 ± 45.5, P = .31, respectively). The total MACE rate was significantly higher in patients with sarcopenia than in those without sarcopenia (31.7 vs 14.4%, P = .003). In the multivariate model, age [odds ratio (OR) 1.112, 95% CI: 1.006-1.228, P = .04)], ejection fraction (OR: .923, 95% CI: .897-.951, P < .001), and sarcopenia (OR: 2.262, 95% CI: 1.039-4.924, P = .04) were independently associated with MACE. Sarcopenia was independently associated with MACE but not with CAD burden or complexity in elderly patients with NSTEMI.
Collapse
Affiliation(s)
- Merve Erkan
- Department of Radiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - İsmet Zengin
- Department of Cardiology, Bursa City Hospital, University of Health Sciences, Bursa, Turkey
| | | | - Dursun Topal
- Department of Cardiology, Bursa City Hospital, University of Health Sciences, Bursa, Turkey
| | - Turhan Bulut
- Department of Cardiology, Bursa City Hospital, University of Health Sciences, Bursa, Turkey
| | - Hakan Erkan
- Department of Cardiology, Bursa City Hospital, University of Health Sciences, Bursa, Turkey
| |
Collapse
|
2
|
Nguyen TV, Nguyen TD, Cao Dinh H, Nguyen TD, Ngo TTK, Do DV, Le TD. Association between SARC-F scores and risk of adverse outcomes in older patients with cardiovascular disease: a prospective study at a tertiary hospital in the south of Vietnam. Front Med (Lausanne) 2024; 11:1406007. [PMID: 39026554 PMCID: PMC11254660 DOI: 10.3389/fmed.2024.1406007] [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: 03/24/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Older patients typically face elevated mortality rates and greater medical resource utilization during hospitalizations compared to their younger counterparts. Sarcopenia, serving as a prognostic indicator, is related to disability, diminished quality of life, and increased mortality. The SARC-F questionnaire, known for its cost-effectiveness, offers a valuable means of assessing sarcopenia. This study aims to explore the association between SARC-F scores and risk of adverse outcomes in elderly patients with cardiovascular disease at a Ho Chi Minh City hospital. Method Participants aged 60 and above, admitted to the Department of Cardiology - Interventional and Cardiovascular Emergency of Thong Nhat Hospital in Ho Chi Minh City from November 2021 to June 2022, were recruited for the prospective, single-center study. The prognostic outcomes included all-cause death and the initial occurrence of emergency re-hospitalization within 6 months' post-discharge. The Kaplan-Meier analysis compared the overall survival rates between different SARC-F score groups. Results The study enrolled 285 patients with a median age of 74 (67, 81). During a 6-month follow-up period, there were 14 cases of mortality. A SARC-F score of 4 or higher was significantly associated with an increased risk of all-cause mortality, with HR of 2.02 (95% CI: 1.39-2.92, p < 0.001), and higher incidence of re-hospitalization events with RR of 1.66 (95% CI: 1.06 to 2.59, p = 0.026). Kaplan-Meier survival analysis indicated a notably higher mortality rate in the patients with high SARC-F scores (p < 0.001). Conclusion In elderly patients with cardiovascular disease, the SARC-F questionnaire could serve as a simple and cost-effective method for detecting mortality and the risk of re-hospitalization.
Collapse
Affiliation(s)
- Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Tuan Dinh Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hung Cao Dinh
- Department of Internal Medicine, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Department of Internal Medicine, Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tuan Dinh Nguyen
- Department of Internal Medicine, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Trinh Thi Kim Ngo
- Department of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Dung Viet Do
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Thanh Dinh Le
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| |
Collapse
|
3
|
Yuan M, Jiang L, Sun C, Lu W, Tapu SR, Zhang H, Jing G, Weng H, Peng J. Diagnostic and prognostic value of parameters of erector spinae in patients with uremic sarcopenia. Clin Radiol 2024; 79:e900-e907. [PMID: 38599949 DOI: 10.1016/j.crad.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/09/2024] [Accepted: 03/04/2024] [Indexed: 04/12/2024]
Abstract
AIM This study aimed to investigate whether computed tomography (CT)-measured erector spinae parameters (ESPs) have diagnostic, severity assessment, and prognostic predictive value in uremic sarcopenia (US). MATERIALS AND METHODS A total of 202 uremic patients were enrolled and divided into two groups: a control group and a sarcopenia group. Sarcopenia was classified into two types: severe and nonsevere. The area, volume, and density of the erector spinae (ES) were measured using chest CT images, and the relevant ESP, including the erector spinae index (ESI), total erector spinae volume (TESV), erector spinae density (ESD), and erector spinae gauge (ESG) were calculated. The occurrence of adverse events was followed-up for 36 months. The diagnostic value and severity of US were determined using the receiver operating characteristic (ROC) curve. Survival curves diagnosed using CT were plotted and compared with the curve drawn using the gold standard. Cox regression analysis was used to identify independent risk factors associated with survival in US. RESULTS With an area under the curve (AUC) of 0.840 and 0.739, the combined ESP has diagnostic value and the ability to assess the severity of US. There was no significant difference in the survival curve between the combined ESP for the diagnosis of US and the gold standard (P > 0.05). ESI is a standalone predictor of survival in patients with US. CONCLUSION ESP measured by CT has diagnostic values for US and its severity, as well as being a predictive value for the prognosis of US.
Collapse
Affiliation(s)
- M Yuan
- Department of Radiology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - L Jiang
- Department of Nephrology, Jiangdu People's Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - C Sun
- Department of Radiology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - W Lu
- Department of Neurology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - S R Tapu
- Department of Cardiology, Tongji University Affiliated East Hospital, Jimo Road 150, Pudong District, Shanghai 200120, PR China
| | - H Zhang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao 87, Gulou District, Nanjing 210009, PR China
| | - G Jing
- Department of Radiology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - H Weng
- Department of Radiology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China
| | - J Peng
- Department of Radiology, Jiangdu People' s Hospital of Yangzhou, Dongfanghong Road 9, Jiangdu District, Yangzhou 225200, PR China.
| |
Collapse
|
4
|
de Luis D, Primo D, Izaola O, Gómez JJL. Role of irisin and myostatin on sarcopenia in malnourished patients diagnosed with GLIM criteria. Nutrition 2024; 120:112348. [PMID: 38309190 DOI: 10.1016/j.nut.2023.112348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Sarcopenia is characterized by the loss of muscle mass. Skeletal muscle can produce and secrete different molecules called myokines. Irisin and myostatin are antagonistic myokines, and to our knowledge, no studies of both myokines have been conducted in patients with disease-related malnutrition (DRM). This study aimed to investigate the role of circulating irisin and myostatin in sarcopenia in patients with DRM. METHODS The study included 108 outpatients with DRM according to the Global Leadership Initiative on Malnutrition criteria. Participants had a mean age of 67.4 ± 3.4 y. Anthropometric data, muscle mass by ultrasound at the rectus femoris quadriceps (RFQ) level, impedancemetry (skeletal muscle mass [SMM], appendicular SMM [aSMM], and aSMM index [aSMMI]), dynamometry, biochemical parameters, dietary intake, circulating irisin and myostatin levels were determined in all patients. Confirmed sarcopenia was diagnosed as criteria of probable sarcopenia (low muscle strength) plus abnormal aSMMI. RESULTS Of the 108 patients, 44 presented sarcopenia (41%); 64 did not present with the disorder (59%). The following parameters were worse in patients with sarcopenia: Patients without sarcopenia were stronger than those with the disorder (7.9 ±1.3 kg; P = 0.01). Circulating irisin levels were higher in patients without sarcopenia than those with sarcopenia (651.3 ± 221.3 pg/mL; P =0.01). Myostatin levels were similar in both groups. Finally, logistic regression analysis reported a low risk for sarcopenia (odds ratio, 0.39; 95% confidence interval, 0.19-0.92; P = 0.03) in high irisin median levels as a dichotomic parameter after adjusting for body mass index, sex, energy intake, and age. CONCLUSION The present study reported that low levels of serum irisin were closely associated with sarcopenia in patients with DRM.
Collapse
Affiliation(s)
- Daniel de Luis
- Center of Investigation of Endocrinology and Clinical Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain.
| | - David Primo
- Center of Investigation of Endocrinology and Clinical Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain
| | - Olatz Izaola
- Center of Investigation of Endocrinology and Clinical Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain
| | - Juan José López Gómez
- Center of Investigation of Endocrinology and Clinical Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain
| |
Collapse
|
5
|
Jauffret C, Périchon R, Lamer A, Cortet B, Chazard E, Paccou J. Association between sarcopenia and risk of major adverse cardiac and cerebrovascular events-UK Biobank database. J Am Geriatr Soc 2024; 72:693-706. [PMID: 37945290 DOI: 10.1111/jgs.18664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/06/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Few studies on the risk of incident major adverse cardiac and cerebrovascular events (MACCEs) in sarcopenia have been reported. The objective was to assess the association between presarcopenia and sarcopenia and a higher risk of MACCEs. METHODS This study on the UK Biobank prospective cohort, used data collected between 2006 and 2021. Community-dwelling Caucasian participants aged 37 to 73 years were included if values for Handgrip Strength (HGS) and Skeletal Muscle Index (SMI) were available and if no history of MACCEs was reported. Exposure was assessed using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was measured using HGS, and muscle mass using the SMI. Presarcopenia was defined through the two definitions available in the literature, as low HGS with normal SMI and as normal HGS with low SMI, whereas sarcopenia was defined as low HGS with low SMI. The main outcome was to determine whether presarcopenia and/or sarcopenia were predictors of MACCEs (composite events). RESULTS A total of 406,411 included participants (women: 55.7%) were included. At baseline, there were 18,257 (4.7%) presarcopenics-subgroup n°1 (low HGS only), 7940 (2.1%) presarcopenics-subgroup n°2 (low SMI only), and 1124 (0.3%) sarcopenics. Over a median follow-up of 12.1 years (IQR: [11.4; 12.8]), 28,300 participants (7.0%) were diagnosed with at least one event. Compared to NonSarc, presarcopenic (subgroups n°1 and n°2) and sarcopenic status were significantly associated with a higher risk of MACCEs (respectively fully adjusted HRs: HR = 1.25 [95% CI: 1.19; 1.31], HR = 1.33 [95% CI: 1.23; 1.45] and HR = 1.62 [95% CI: 1.34; 1.95]). CONCLUSIONS In a community-dwelling population, the risk of MACCEs was higher in both presarcopenic and sarcopenic participants.
Collapse
Affiliation(s)
- Charlotte Jauffret
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| | - Renaud Périchon
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Antoine Lamer
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Bernard Cortet
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| | - Emmanuel Chazard
- ULR 2694 - METRICS, CERIM, Public Health Department, Univ. Lille, CHU Lille, Lille, France
| | - Julien Paccou
- ULR 4490 - MABLab, Rheumatology Department, Univ. Lille, CHU Lille, Lille, France
| |
Collapse
|
6
|
Liu S, Han X, Li J, Xie X, Yang Y, Jiang W, Liu L, Liu Z. Feasibility of using chest computed tomography (CT) imaging at the first lumbar vertebra (L1) level to assess skeletal muscle mass: a retrospective study. PeerJ 2023; 11:e16652. [PMID: 38099314 PMCID: PMC10720423 DOI: 10.7717/peerj.16652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
Background Skeletal muscle mass is an essential parameter for diagnosing sarcopenia. The gold standard for assessing skeletal muscle mass is using computed tomography (CT) to measure skeletal muscle area at the third lumbar vertebra (L3) level. This study aims to investigate whether skeletal muscle mass could be evaluated at the first lumbar vertebra (L1) level using images obtained from routine chest CT scans. Methods Skeletal muscle index (SMI, cm2/m2) and skeletal muscle density (SMD, HU) are commonly used to measure relative muscle mass and the degree of fat infiltration. This study used CT images at the L1 level to measure the skeletal muscle area (SMA, cm2) in 815 subjects from the health examination center. Linear regression analysis was used to explore the association between L1 and L3 measurements. The receiver operating characteristic (ROC) analysis was used to assess the predictive performance of L1 SMI for sarcopenia. The sex-specific cut-off values for low skeletal muscle mass in patients under the age of 60 were determined using the following formula: "mean - 1.28 × standard deviation." A multivariate linear regression model was established. Results A significantly higher SMI at the L1 level was found in males than in females (43.88 ± 6.33 cm2/m2 vs 33.68 ± 5.03 cm2/m2; P < 0.001). There were strong correlations between measures at the L1 and L3 levels in both the total subject and sex-specific analyses. A negative association was found between age and L3 SMI in males (r = -0.231, P = 0.038). Both body mass index (BMI) and body surface area (BSA) were positively associated with L1 SMI in both males and females. A multivariate analysis was used to establish a prediction rule to predict SMI at the L3 level. The assessment of consistency and interchangeability between predicted and actual SMI at the L3 level yielded moderately good results. Considering the significant differences observed between male and female participants, the sex-specific cut-off values of the L1 SMI for defining low skeletal muscle mass were 36.52 cm2/m2 in males and 27.29 cm2/m2 in females. Conclusions Based on a population from central China, the correlated indicators obtained at the L1 level from routine chest CT scans may serve as effective surrogate markers for those at the L3 level in assessing overall skeletal muscle mass.
Collapse
Affiliation(s)
- Shaohua Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Xia Han
- Wuhan Wuchang Hospital, Wuhan, China
| | - Jianjun Li
- Department of Radiology, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, Wuhan, China
| | - Xia Xie
- School of Computer Science and Technology, Hainan University, Haikou, China
| | - Yunkai Yang
- Eight-year Program of Clinical Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wangyan Jiang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Li Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Zhelong Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| |
Collapse
|
7
|
Yang YW, Pan P, Xia X, Zhou YW, Ge ML. Prognostic value of sarcopenia in older adults with transcatheter aortic valve implantation: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 115:105125. [PMID: 37481845 DOI: 10.1016/j.archger.2023.105125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE We conducted this systematic review and meta-analysis to summarize the prevalence of sarcopenia and its impact on mortality in patients undergoing TAVI. METHOD Medline, EMBASE, and PubMed were searched from inception to October 14, 2022 to retrieve eligible studies that assessed sarcopenia in patients undergoing TAVI. Pooled sarcopenia prevalence was calculated with 95% confidence interval (CI), and heterogeneity was estimated using the I2 test. Associations of sarcopenia with mortality of post-TAVI were expressed as hazard ratio (HR) or odds ratios (OR) and 95% CI. RESULTS 13 studies involving 5248 patients (mean age from 78.1 to 84.9 years) undergoing TAVI were included. There were eleven studies defined sarcopenia based on loss of skeletal muscle mass index (SMI), while only two studies used low muscle mass plus low muscle strength and/or low physical performance. Overall, the pooled prevalence of sarcopenia in patients undergoing TAVI was 49% (95% CI 41%-58%). Sarcopenia was associated with an increased risk of long-term (≥1 year) mortality in patients after TAVI (HR 1.57, 95% CI 1.33-1.85, P < 0.001), with similar findings in the subgroups stratified by follow-up time, definition of sarcopenia, study location, and study design. Furthermore, the 1-, 2-, and 3-year cumulative probabilities of survival in patients with sarcopenia were significantly lower than non-sarcopenia (74.0% vs 91.0%, 68.3% vs 78.0%, and 72.6% vs 79.8%, all P < 0.05). CONCLUSIONS Although there are substantial differences in diagnostic criteria, sarcopenia is highly prevalent in patients undergoing TAVI and its linked to increased long-term mortality after TAVI.
Collapse
Affiliation(s)
- Yan-Wu Yang
- The Emergency Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Pan Pan
- The Emergency Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xin Xia
- The Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yi-Wu Zhou
- The Emergency Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Mei-Ling Ge
- The Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
8
|
Liu L, Liu S, Hao M, Hu S, Yu T, Yang Y, Liu Z. Sarcopenia as an important determinant for adverse outcomes in patients with pyogenic liver abscess. PeerJ 2023; 11:e16055. [PMID: 37810784 PMCID: PMC10559880 DOI: 10.7717/peerj.16055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/17/2023] [Indexed: 10/10/2023] Open
Abstract
Background Low muscle mass/sarcopenia has been associated with poor prognosis in many diseases, but its clinical significance in pyogenic liver abscess (PLA) remains unclear. The purpose of this study is to investigate the relationship between muscle mass and prognosis of patients with PLA. Methods A total of 154 adult patients with PLA hospitalized at Tongji Hospital (Wuhan, Hubei, China) between October 2011 and June 2021 were included in this retrospective analysis. Muscle-fat related indicators were measured by computed tomography (CT) images at the third lumbar vertebra (L3) level. The data of patients between the sarcopenia group and non-sarcopenia group were compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results The skeletal muscle index (SMI) was independently associated with adverse outcomes (95% CI [0.649-0.954], P = 0.015) of PLA in multivariate logistic regression analysis. This conclusion held true in sex-specific subgroup analysis. ROC analysis indicated that SMI may predict adverse outcomes in both male (area under the ROC curve [AUC], 0.718; cut-off, 52.59; P < 0.001) and female (AUC, 0.714; cut-off, 38.39; P = 0.017) patient populations. Conclusions Sarcopenia serves as an independent risk factor for poor prognosis in PLA and patients with sarcopenia may be more prone to adverse outcomes.
Collapse
Affiliation(s)
- Li Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Shaohua Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Meng Hao
- Department of Gastroenterology, Zigui County People’s Hospital, Yichang, China
| | - Song Hu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Yu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| | - Yunkai Yang
- Eight-year Program of Clinical Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhelong Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, Hubei, China
| |
Collapse
|
9
|
Zhang H, Hu W, Yuan M, Lu D, Gao Y, Dai Q. The association between erector spinae muscle content and chronic heart failure and its severity. ESC Heart Fail 2023; 10:2982-2989. [PMID: 37522384 PMCID: PMC10567664 DOI: 10.1002/ehf2.14482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/11/2022] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
AIMS Previous studies have shown a significant reduction in skeletal muscle content in patients with chronic heart failure (CHF). The present study focused on the erector spinae muscle (ESM) to determine whether ESM content is associated with the development and severity of CHF. METHODS AND RESULTS A total of 652 patients were included in this trial for the study. According to the diagnostic criteria of CHF, 652 patients were divided into two groups, namely, the control group (268 patients) and the CHF group (384 patients). Meanwhile, to assess whether the ESM is associated with the severity of CHF, patients in the CHF group were divided into two groups according to left ventricular ejection fraction (LVEF) values: heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%, 256 patients) and heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%, 68 patients). Receiver operating curve analysis was performed to assess whether ESM content could predict CHF and determine its severity. Compared with the control group, the patients in the CHF group were older, the prevalence of coronary heart disease (CHD) and atrial fibrillation was higher, the colour ultrasound results showed that LVEF decreased significantly, and the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly. Besides, patients in the CHF group had significantly lower ESM content, and ESM is an independent predictor of heart failure, with an odds ratio of 0.713 (CHF group vs. control group, 95% confidence interval 0.626-0.811, P < 0.001). Compared with the HFpEF group, the HFrEF group has a lower prevalence of CHD, LVEF decreased significantly, the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly, also patients in the HFrEF group had significantly lower ESM content compared with patients in the HFpEF group, and ESM is an independent predictor of the severity of heart failure, with an odds ratio of 0.514 (HFrEF group vs. HFpEF group, 95% confidence interval (0.418-0.633, P < 0.05). The results of receiver operating curve analysis showed that the sensitivity and specificity of ESM content for the diagnosis of CHF were 65.6% and 71.6%, respectively, while the sensitivity and specificity of ESM content for predicting the severity of CHF were 47.1% and 89.1%, respectively. CONCLUSIONS The ESM is of great value in predicting the onset and severity of CHF.
Collapse
Affiliation(s)
- Hao Zhang
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
| | - Weiwei Hu
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
| | - Mengxuan Yuan
- Department of CardiologyAffiliated Hospital of Yangzhou UniversityYangzhouPR China
| | - Dasheng Lu
- Department of CardiologyThe Second Affiliated Hospital of Wannan Medical CollegeWuhuPR China
| | - Yang Gao
- Department of CardiologyAffiliated Hospital of Yangzhou UniversityYangzhouPR China
| | - Qiming Dai
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
| |
Collapse
|
10
|
Järvinen O, Tynkkynen JT, Virtanen M, Maaranen P, Lindström I, Vakhitov D, Laurikka J, Oksala NK, Hernesniemi JA. Psoas muscle quantified muscle status and long-term mortality after cardiovascular interventions. Ann Med 2023; 55:2259798. [PMID: 37738519 PMCID: PMC10519254 DOI: 10.1080/07853890.2023.2259798] [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: 04/29/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023] Open
Abstract
RESULTS In the meta-analysis, psoas muscle measurements were significantly associated with mortality among men (p < 0.05), with high heterogeneity in the associations across all cohorts. There was very little difference in the association between PMA and PMD and mortality (HR 0.83, 95% CI 0.69-0.99, p = 0.002; HR 0.85, 95% CI 0.77-0.94, p = 0.041 for one SD increase in PMA and PMD in the random effects model). Combining PMA and PMD into one composite variable by multiplying their values together showed the most robust association in terms of the magnitude of the effect size in men (HR, 0.77; 95% CI 0.73-0.87, p < 0.001). Indexing PMA to body size did not result in any significant differences in this association. Among women, psoas muscle measurements were not associated with long-term mortality in this meta-analysis. CONCLUSIONS Different psoas muscle measurements were significantly and very similarly associated with mortality among men but not among women. No single measurement stands out, although combining PMA and PMD seems to be a slightly stronger estimate in terms of effect size and should be considered in further studies.
Collapse
Affiliation(s)
- Otto Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre Tampere, Tampere, Finland
| | - Juho T. Tynkkynen
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Marko Virtanen
- Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Pasi Maaranen
- Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Iisa Lindström
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Damir Vakhitov
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Jari Laurikka
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre Tampere, Tampere, Finland
- Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Niku K. Oksala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre Tampere, Tampere, Finland
- Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland
| | - Jussi A. Hernesniemi
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre Tampere, Tampere, Finland
- Heart Hospital, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
11
|
Tobe A, Tanaka A, Shirai Y, Kubota Y, Kunieda T, Sato S, Furusawa K, Ishii H, Murohara T. Impact of Handgrip Strength on Clinical Outcomes after Percutaneous Coronary Intervention. J Atheroscler Thromb 2023; 30:1115-1122. [PMID: 36372431 PMCID: PMC10499459 DOI: 10.5551/jat.63854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/06/2022] [Indexed: 09/05/2023] Open
Abstract
AIM The relationship between handgrip strength (HGS) and clinical outcomes after percutaneous coronary intervention (PCI) has not yet been thoroughly investigated. METHODS This was a single-center, observational study. A total of 469 patients who underwent PCI and whose periprocedural HGS was measured were included. Patients were divided into two groups: the low HGS group (men, <28 kg; women, <18 kg) and the high HGS group (men, ≥ 28 kg; women, ≥ 18 kg). The primary outcome was the composite endpoint of all-cause death, myocardial infarction (MI), and heart failure readmission. RESULTS There were 151 patients in the low HGS group and 318 patients in the high HGS group. The age of patients in the low HGS group was significantly higher (median [interquartile range]: 78 [71-82] vs. 70 [61-75] years, p<0.001), while the body mass index and serum albumin level were significantly lower (body mass index: 22.5 [20.2-24.3] vs. 24.3 [22.3-26.6] kg/m2, p<0.001; serum albumin: 3.6 [3.1-3.9] vs. 4.0 [3.7-4.3] g/dL, p<0.001) than those in the high HGS group. During the median follow-up period of 778 days, the low HGS group had a higher incidence of composite endpoint than the high HGS group (p<0.001). The low HGS group had a higher risk of all-cause, cardiac, and non-cardiac death (p<0.001). Multivariable Cox proportional hazards analysis showed that low handgrip strength was an independent predictor for the composite endpoint (hazard ratio 1.80, 95% confidence interval 1.04-3.12, p=0.04). CONCLUSIONS Low HGS was independently associated with adverse outcomes after PCI.
Collapse
Affiliation(s)
- Akihiro Tobe
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Shirai
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiaki Kubota
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshige Kunieda
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sara Sato
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Furusawa
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Cardiology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
12
|
Xu Y, Hu T, Shen Y, Wang Y, Bao Y, Ma X. Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study. Eur J Intern Med 2023; 114:113-119. [PMID: 37164887 DOI: 10.1016/j.ejim.2023.05.007] [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: 11/21/2022] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND We aimed to explore the association between skeletal muscle mass and cardiovascular events, and its additional value on the assessment of cardiovascular diseases (CVD) over traditional risk scores. METHODS The study included 1365 community-based participants aged over 50 years and free of CVDs at baseline. Participants completed detailed assessments at baseline and received a follow-up assessment in 2021-2022 via phone calls or electronic medical records. Skeletal muscle mass was measured using an automatic bioelectric analyzer. Predicted probabilities of 10-year atherosclerotic cardiovascular disease (ASCVD) risk were estimated individually with the China-PAR equation. RESULTS After a mean follow-up of 7.6 years, 144 cardiovascular events were identified. The fully-adjusted hazard ratios (HRs) of cardiovascular events were 0.93 (0.88-0.98) and 1.08 (1.04-1.12) for skeletal muscle mass and predicted 10-year risk, respectively. Among participants over 60 years and with two or more risk factors, cardiovascular events risk increased progressively with each decreasing skeletal muscle tertile. Receiver operating characteristic curves showed that the C-statistic of predicting cardiovascular events for a 10-year risk assessment was slightly increased after adding skeletal muscle mass. The categorical net reclassification improvement (NRI) showed a 56.7% increase in the reclassification. The continuous NRI and integrated discrimination improvement increased as well. CONCLUSION Participants with low skeletal muscle mass were more likely to have cardiovascular events. Low muscle mass improved the predictive power of CVD incidence over the original risk score, indicating that muscle mass could be a valuable parameter and a declining value needed early detection in the population.
Collapse
Affiliation(s)
- Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Tingting Hu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
| |
Collapse
|
13
|
Fan W, Gu P, Pu B, Yue D, Xin Q, Zheng X, Zeng Z, Fan S. Bidirectional two-sample mendelian randomization analysis identifies causal associations between age at menarche and sarcopenia-related traits. Genes Genomics 2023; 45:1085-1095. [PMID: 37405597 DOI: 10.1007/s13258-023-01415-4] [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: 01/13/2023] [Accepted: 06/06/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Observational studies have shown that the age of menarche is associated with sarcopenia, but confounding factors make the causal relationship difficult to infer. OBJECTIVE Therefore, we conducted a bidirectional two-sample Mendelian randomized (MR) analysis to evaluate the potential causal relationship between age at menarche and sarcopenia-related traits (hand grip strength, lean mass, walking pace). METHODS We obtained the latest aggregate statistics from the Genome-wide association studies (GWAS) database on the age of menarche of 182,416 participants from ReproGen, the appendicular lean mass of 244,730 participants from EMBL's European Bioinformatics Institute, the left-hand grip strength of 401,026 participants, the right-hand grip strength of 461,089 participants and the usual walking pace of 459,915 participants from the UK Biobank. The inverse variance weighting (IVW) method and other MR methods were used to evaluate the bidirectional causal relationship between the age of menarche and sarcopenia. RESULTS The forward MR results showed that the age of menarche predicted by the gene was positively correlated with left-hand grip strength (IVWβ=0.041, P = 2.00 × 10-10), right-hand grip strength (IVWβ=0.053, P = 1.97 × 10-18), appendicular lean mass (IVWβ=0.012, P = 4.38 × 10-13) and usual walking pace (IVWβ=0.033, P = 1.62 × 10-8).In the reverse MR analysis, we also found that the usual walking pace was positively correlated with the age of menarche predicted by genes (IVWβ=0.532, P = 1.65 × 10-4). Still, there was no causal relationship between grip strength and appendicular lean mass and the age at menarche. CONCLUSION Our results show that earlier menarche will increase the risk of sarcopenia. In addition, people with higher muscle function tend to have menarche later. These findings may provide a reference for prevention strategies and interventions for menarche in advance and sarcopenia.
Collapse
Affiliation(s)
- Wei Fan
- Graduate School, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Peng Gu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bin Pu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Dan Yue
- Southwest Medical University, Luzhou, Sichuan, China
| | - Qiao Xin
- Graduate School, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - XiaoHui Zheng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - ZhanPeng Zeng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shaoyong Fan
- Hongdu traditional Chinese Medicine Hospital, Nanchang, Jiangxi, China.
| |
Collapse
|
14
|
Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, Bahrainy S, Ji Kwak M, Batchelor WB, Forman DE, Rich MW, Kirkpatrick J, Krishnaswami A, Alexander KP, Gerstenblith G, Cawthon P, deFilippi CR, Goyal P. Sarcopenia and Cardiovascular Diseases. Circulation 2023; 147:1534-1553. [PMID: 37186680 PMCID: PMC10180053 DOI: 10.1161/circulationaha.123.064071] [Citation(s) in RCA: 83] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular diseases and higher risk of mortality, falls, and reduced quality of life, particularly among older adults. Although the pathophysiologic mechanisms are complex, the broad underlying cause of sarcopenia includes an imbalance between anabolic and catabolic muscle homeostasis with or without neuronal degeneration. The intrinsic molecular mechanisms of aging, chronic illness, malnutrition, and immobility are associated with the development of sarcopenia. Screening and testing for sarcopenia may be particularly important among those with chronic disease states. Early recognition of sarcopenia is important because it can provide an opportunity for interventions to reverse or delay the progression of muscle disorder, which may ultimately impact cardiovascular outcomes. Relying on body mass index is not useful for screening because many patients will have sarcopenic obesity, a particularly important phenotype among older cardiac patients. In this review, we aimed to: (1) provide a definition of sarcopenia within the context of muscle wasting disorders; (2) summarize the associations between sarcopenia and different cardiovascular diseases; (3) highlight an approach for a diagnostic evaluation; (4) discuss management strategies for sarcopenia; and (5) outline key gaps in knowledge with implications for the future of the field.
Collapse
Affiliation(s)
- Abdulla A Damluji
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Maha Alfaraidhy
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Noora AlHajri
- Cleveland Clinic, Abu Dhabi, United Arab Emirates (N.A.)
| | | | | | | | | | | | - Wayne B Batchelor
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Daniel E Forman
- University of Pittsburgh and the Pittsburgh Geriatric Research Education and Clinical Center, PA (D.E.F.)
| | | | | | | | - Karen P Alexander
- Duke Clinical Research Institute, Duke University, Durham, NC (K.P.A.)
| | - Gary Gerstenblith
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | | | - Christopher R deFilippi
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Parag Goyal
- University of Arizona, Tucson (N.N.R., P.G.)
| |
Collapse
|
15
|
Parente EB, Ahola AJ, Kumar A, Lehto M, Groop PH. The relationship between FGF23 and body composition according to albuminuria stage in type 1 diabetes. Diabetes Res Clin Pract 2023; 198:110620. [PMID: 36914006 DOI: 10.1016/j.diabres.2023.110620] [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: 01/17/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023]
Abstract
AIMS Fibroblast growth factor 23 (FGF23) and obesity are linked to kidney disease. However, the relationship between FGF23 and body composition is unclear. Associations between FGF23 and body composition were investigated in type 1 diabetes from the Finnish Diabetic Nephropathy Study according to albuminuria stages. METHODS Data were available from 306 adults with type 1 diabetes (229 normal albumin excretion rate, T1Dnormo; 38 microalbuminuria, T1Dmicro; 39 macroalbuminuria, T1Dmacro), and 36 controls. Serum FGF23 was measured by ELISA. Body composition was assessed with dual-energy X-ray absorptiometry. Associations between body composition and serum FGF23 were investigated using linear regression models. RESULTS Compared with T1Dnormo, individuals with more advanced kidney disease were older, had longer diabetes duration, higher serum hsCRP, and higher FGF23 concentration. However, FGF23 concentration was comparable between T1Dnormo and controls. Adjusted for potential confounders, in T1Dmicro, FGF23 was positively associated with the percentages of total fat, visceral fat, and android fat tissues, while negative associations between FGF23 and lean tissue were observed. FGF23 was not associated with body composition in T1Dnormo, T1Dmacro, and controls. CONCLUSIONS In type 1 diabetes, the relationship between FGF23 and body composition is dependent on albuminuria stages.
Collapse
Affiliation(s)
- Erika B Parente
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Aila J Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Anmol Kumar
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
| |
Collapse
|
16
|
James E, Goodall S, Nichols S, Walker K, Carroll S, O'Doherty AF, Ingle L. Serum transthyretin and aminotransferases are associated with lean mass in people with coronary heart disease: Further insights from the CARE-CR study. Front Med (Lausanne) 2023; 10:1094733. [PMID: 36891188 PMCID: PMC9986330 DOI: 10.3389/fmed.2023.1094733] [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: 11/10/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Background Low muscle mass disproportionately affects people with coronary heart disease compared to healthy controls but is under-researched and insufficiently treated. Inflammation, poor nutrition, and neural decline might contribute to low muscle mass. This study aimed to assess circulatory biomarkers related to these mechanisms [albumin, transthyretin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and C-terminal agrin fragment] and their relationship with muscle mass in people with coronary heart disease. Our findings could be beneficial to indicate mechanisms of sarcopenia, detect sarcopenia, and evaluate treatment. Methods Serum blood samples from people with coronary heart disease were analysed for biomarker concentrations using enzyme-linked immunosorbent assays. Skeletal muscle mass was estimated using dual X-ray absorptiometry derived appendicular lean mass and reported as skeletal muscle index (SMI; kg m-2), and as a proportion of total body mass [appendicular skeletal mass (ASM%)]. Low muscle mass was defined as a SMI <7.0 and <6.0 kg m-2, or ASM% <25.72 and <19.43% for men and women, respectively. Associations between biomarkers and lean mass were adjusted for age and inflammation. Results Sixty-four people were assessed; 14 (21.9%) had low muscle mass. People with low muscle mass had lower transthyretin (effect size 0.34, p = 0.007), ALT (effect size 0.34, p = 0.008), and AST (effect size 0.26, p = 0.037) concentrations, compared to those with normal muscle mass. SMI was associated with inflammation-corrected ALT (r = 0.261, p = 0.039) and with inflammation- and age-adjusted AST/ALT ratio (r = -0.257, p = 0.044). Albumin and C-terminal agrin fragment were not associated with muscle mass indices. Conclusion Circulatory transthyretin, ALT and AST were associated with low muscle mass in people with coronary heart disease. Low concentrations of these biomarkers might indicate that low muscle mass is partially explained by poor nutrition and high inflammation in this cohort. Targeted treatments to address these factors could be considered for people with coronary heart disease.
Collapse
Affiliation(s)
- Emily James
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom.,Diabetes Research Centre, University of Leicester, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Simon Nichols
- Sport and Physical Activity Research Group, Sheffield Hallam University, Sheffield, United Kingdom.,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Karen Walker
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Sean Carroll
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, United Kingdom
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lee Ingle
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, United Kingdom
| |
Collapse
|
17
|
Zheng J, Yin Q, Wang SY, Wang YY, Xiao JJ, Tang TT, Ni WJ, Ren LQ, Liu H, Zhang XL, Liu BC, Wang B. Ultrasound-assessed diaphragm dysfunction predicts clinical outcomes in hemodialysis patients. Sci Rep 2022; 12:16550. [PMID: 36192453 PMCID: PMC9529158 DOI: 10.1038/s41598-022-20450-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
Skeletal muscle atrophy is prevalent and remarkably increases the risk of cardiovascular (CV) events and mortality in hemodialysis (HD) patients. However, whether diaphragm dysfunction predicts clinical outcomes in HD patients is unknown. This was a prospective cohort study of 103 HD patients. After assessment of diaphragm function by ultrasonography and collection of other baseline data, a 36-month follow-up was then initiated. Participants were divided into diaphragm dysfunction (DD+) group and normal diaphragm function (DD−) group, according to cutoff value of thickening ratio (i.e. the change ratio of diaphragm thickness) at force respiration. The primary endpoint was the first nonfatal CV event or all-cause mortality. A secondary endpoint was less serious CV events (LSCEs, a composite of heart failure readmission, cardiac arrhythmia or myocardial ischemia needed pharmacological intervention in hospital). 98 patients were eligible to analysis and 57 (58.16%) were men. 28 of 44 patients(63.64%) in DD+ group and 23 of 54 patients (42.59%) in DD− group had at least one nonfatal CV event or death (p = 0.038). Compared to DD− group, DD+ group had significantly higher incidence of LSCEs (21 vs.14, p = 0.025) and shorter survival time (22.02 ± 12.98 months vs. 26.74 ± 12.59 months, p = 0.046). Kaplan–Meier analysis revealed significantly higher risks of primary endpoint (p = 0.039), and LSCEs (p = 0.040) in DD+ group. Multivariate hazard analysis showed that DD+ group had significantly higher risk of primary endpoint [hazard ratio (HR) 1.59; 95% confident interval (CI) 1.54–1.63], and LSCEs (HR 1.47; 95%CI 1.40–1.55). Ultrasound-assessed diaphragm dysfunction predicts clinical outcomes in HD patients. Trial registration: This study was registered with Chinese Clinical Trials Registry (www.chictr.org.cn) as ChiCTR1800016500 on Jun 05, 2018.
Collapse
Affiliation(s)
- Jing Zheng
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China.,Department of Gerontology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Qing Yin
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Shi-Yuan Wang
- Department Epidemiology and Health Statistics, Southeast University, Nanjing, Jiangsu, China
| | - Ying-Yan Wang
- Department of Ultrasound Medicine, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Jing-Jie Xiao
- Covenant Health Palliative Institute, Edmonton, AB, Canada
| | - Tao-Tao Tang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Wei-Jie Ni
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Li-Qun Ren
- Department of Gerontology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Hong Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Xiao-Liang Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Bi-Cheng Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China.
| | - Bin Wang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, Jiangsu Province, China.
| |
Collapse
|
18
|
Purnamasari D, Tetrasiwi EN, Kartiko GJ, Astrella C, Husam K, Laksmi PW. Sarcopenia and Chronic Complications of Type 2 Diabetes Mellitus. Rev Diabet Stud 2022; 18:157-165. [PMID: 36309772 PMCID: PMC9652710 DOI: 10.1900/rds.2022.18.157] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sarcopenia, defined as the loss of skeletal muscle mass and strength and/or a decrease in physical performance, is classically related to aging. However, chronic disease, including type 2 diabetes mellitus (T2DM), may accelerate the development of sarcopenia. Previous studies found strong association between T2DM and sarcopenia. Insulin resistance that exists in T2DM is thought to be the key mediator for impaired physical function and mobility which may lead to sarcopenia. T2DM may cause sarcopenia through the mediation of insulin resistance, inflammation, accumulation of advanced glycation end-products, and oxidative stress that may affect muscle mass and strength, protein metabolism, and vascular and mitochondrial dysfunction. On the other hand, loss of muscle in sarcopenia may play a role in the development of T2DM through the decreased production of myokines that play a role in glucose and fat metabolism. This review highlights the findings of existing literature on the relationship between T2DM and sarcopenia which emphasize the pathophysiology, chronic vascular complications, and the course of macrovascular and microvascular complications in T2DM.
Collapse
Affiliation(s)
- Dyah Purnamasari
- Division of Endocrinology Metabolism and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia,,Metabolic Disorder, Cardiovascular and Aging Research Center, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Erpryta Nurdia Tetrasiwi
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Gracia Jovita Kartiko
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Cindy Astrella
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Khoirul Husam
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Purwita Wijaya Laksmi
- Division of Geriatric, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,Address correspondence to: Purwita Wijaya Laksmi, e-mail:
| |
Collapse
|
19
|
Lin JA, Hou JD, Wu SY. Effect of Sarcopenia on Mortality in Type 2 Diabetes: A Long-Term Follow-Up Propensity Score-Matched Diabetes Cohort Study. J Clin Med 2022; 11:jcm11154424. [PMID: 35956041 PMCID: PMC9369839 DOI: 10.3390/jcm11154424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 12/26/2022] Open
Abstract
Purpose: The effect of sarcopenia on the survival of patients with type 2 diabetes remains unclear. Therefore, we designed a propensity score-matched population-based cohort study to compare the patients with diabetes with or without sarcopenia. Patients and Methods: We included patients with type 2 diabetes and categorized them into two groups according to whether they had sarcopenia and compared their survival; patients in the groups were matched at a ratio of 1:2. Results: The matching process yielded a final cohort of 201,698 patients (132,805 and 68,893 in the sarcopenia and nonsarcopenia diabetes groups, respectively) who were eligible for further analysis. According to both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (aHRs; 95% confidence interval [CI]) of all-cause death for the sarcopenia diabetes group compared with the control group: 1.35 (1.33−1.38; p < 0.001). The aHRs (95% CIs) of all-cause death for those aged 41−50, 51−60, and >60 years (compared with those aged ≤40 years) were 1.53 (1.48−1.60), 2.61 (2.52−2.72), and 6.21 (5.99−6.45), respectively. The aHR (95% CI) of all-cause death for the male patients compared with the female patients was 1.56 (1.54−1.60). The aHRs (95% CIs) of all-cause death for those with adapted Diabetes Complications Severity Index (aDCSI) scores of 1, 2, 3, 4, and ≥5 (compared with an aDCSI score of 0) were 1.01 (1.00−1.14), 1.38 (1.35−1.42), 1.58 (1.54−1.63), and 2.23 (2.14−2.33), respectively. Conclusion: Patients with type 2 diabetes and sarcopenia had higher mortality than did those without sarcopenia.
Collapse
Affiliation(s)
- Jui-An Lin
- Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Anesthesiology, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Pain Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Anesthesiology, School of Medicine, Shung Shan Medical University, Taichung City 40201, Taiwan
- Department of Anesthesiology, Shung Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Jin-De Hou
- Department of Anesthesiology, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Division of Anesthesiology, Hualien Armed Forces General Hospital, Hualien 97144, Taiwan
| | - Szu-Yuan Wu
- Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11031, Taiwan;
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 24205, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 24205, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan
- Department of Management, College of Management, Fo Guang University, Yilan 262307, Taiwan
- Correspondence:
| |
Collapse
|
20
|
Kammerlander A, Lyass A, Mahoney TF, Taron J, Eslami P, Lu MT, Long MT, Vasan RS, Massaro JM, Hoffmann U. Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study. Eur Radiol 2022; 32:7068-7078. [PMID: 35779090 PMCID: PMC9474583 DOI: 10.1007/s00330-022-08934-w] [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: 04/18/2022] [Revised: 04/18/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
Objectives To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting. Methods We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area). We tested the association of these muscle mass measures with prevalent and incident cardiometabolic risk factors and incident CVD events during a follow-up of 11.0 ± 2.7 years. Results In this community-based sample (49% women, mean age: 50.0 ± 10.0 years), all muscle quantity measures were significantly associated with prevalent and incident cardiometabolic risk factors and CVD events. However, only TAM-Fraction remained significantly associated with key outcomes (e.g., adj. OR 0.68 [0.55, 0.84] and HR 0.73 [0.57, 0.92] for incident hypertension and CVD events, respectively) after adjustment for age, sex, body mass index, and waist circumference. Moreover, only higher TAM-Fraction was associated with a lower risk (e.g., adj. OR: 0.56 [0.36–0.89] for incident diabetes versus TAM-Area: adj. OR 1.26 [0.79–2.01] and TAM-Index: 1.09 [0.75–1.58]). Conclusion TAM-Fraction on a single CT slice at L3/L4 is a novel body composition marker of cardiometabolic risk in a primary prevention setting that has the potential to improve risk stratification beyond traditional measures of obesity. Key Points • In this analysis of the Framingham Heart Study (n = 3016), TAM-F on a single slice CT was more closely associated with prevalent and incident cardiometabolic risk factors as compared to TAM alone or TAM indexed to body surface area. • TAM-F on a single abdominal CT slice at the level of L3/L4 could serve as a standard measure of muscle mass and improve risk prediction
Collapse
Affiliation(s)
- Andreas Kammerlander
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Division of Cardiology, Medical University of Vienna, Vienna, Austria.
| | - Asya Lyass
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - Taylor F Mahoney
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jana Taron
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Parastou Eslami
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael T Lu
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michelle T Long
- Section of Gastroenterology, Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ramachandran S Vasan
- Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,The Boston University and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA
| | - Joseph M Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Udo Hoffmann
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
21
|
Chen YY, Chen WL, Peng TC, Liaw FY, Chao YP, Kao TW. Relationship between Sarcopenia and Cardiovascular Disease Risk among Taiwanese Older Adults. Public Health Nutr 2022; 25:1-21. [PMID: 35318907 PMCID: PMC9991747 DOI: 10.1017/s1368980022000684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/26/2021] [Accepted: 03/09/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Increasing evidence supports sarcopenia as an important parameter for predicting cardiometabolic risks. The objective of this study was to investigate the relationship between muscle mass, muscle strength, and physical performance, and cardiovascular risk among older community-dwelling adults. DESIGN The associations between dynapenia, sarcopenia, and Framingham risk score (FRS) were estimated by multivariate regression models. SETTING Muscle mass is estimated by skeletal muscle mass index using a bioelectrical impedance analysis. Muscle strength is measured by handgrip strength using an analog isometric dynamometer. Physical performance is measured by gait speed using a 6-meter walking distance. Dynapenia was defined as low muscle strength and/or slow gait speed presents with normal muscle mass. The diagnosis of presarcopenia and sarcopenia was based on criteria proposed by the Asian Working Group for Sarcopenia in 2014. The FRS was used for evaluating 10-year coronary heart disease risk. PARTICIPANTS Adults aged 65 years and older who attended health examinations from 2015 to 2017 were recruited. RESULTS There were totally 709 subjects enrolled in this study. Dynapenic men (n=47) had 17.70±5.08% FRS and sarcopenic women (n=74) had 7.74±6.06% FRS. Participants with presarcopenia had the lowest FRS (men: 15.41±5.35%; women: 5.25±3.70%). Men with dynapenia had higher FRS than the presarcopenia group with odds ratio (OR) of 2.52 (95% Confidence Interval [CI]: 1.03-6.14). Women with sarcopenia had significantly higher FRS than the presarcopenia group with OR of 2.81 (95%CI: 1.09-7.27). CONCLUSION Older dynapenic men and older sarcopenic women had higher risks of 10-year coronary heart disease. Presarcopenic older adults had the lowest coronary heart disease risk in both genders.
Collapse
Affiliation(s)
- Yuan-Yuei Chen
- Department of Pathology, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of Pathology, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, 114Taipei, Taiwan, Republic of China
- Department of Biochemistry, National Defense Medical Center, TaipeiTaiwan, Republic of China
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, 114Taipei, Taiwan, Republic of China
| | - Fang-Yih Liaw
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, 114Taipei, Taiwan, Republic of China
| | - Yuan-Ping Chao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, 114Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, 114Taipei, Taiwan, Republic of China
| |
Collapse
|
22
|
Bilski J, Pierzchalski P, Szczepanik M, Bonior J, Zoladz JA. Multifactorial Mechanism of Sarcopenia and Sarcopenic Obesity. Role of Physical Exercise, Microbiota and Myokines. Cells 2022; 11:cells11010160. [PMID: 35011721 PMCID: PMC8750433 DOI: 10.3390/cells11010160] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity and ageing place a tremendous strain on the global healthcare system. Age-related sarcopenia is characterized by decreased muscular strength, decreased muscle quantity, quality, and decreased functional performance. Sarcopenic obesity (SO) is a condition that combines sarcopenia and obesity and has a substantial influence on the older adults’ health. Because of the complicated pathophysiology, there are disagreements and challenges in identifying and diagnosing SO. Recently, it has become clear that dysbiosis may play a role in the onset and progression of sarcopenia and SO. Skeletal muscle secretes myokines during contraction, which play an important role in controlling muscle growth, function, and metabolic balance. Myokine dysfunction can cause and aggravate obesity, sarcopenia, and SO. The only ways to prevent and slow the progression of sarcopenia, particularly sarcopenic obesity, are physical activity and correct nutritional support. While exercise cannot completely prevent sarcopenia and age-related loss in muscular function, it can certainly delay development and slow down the rate of sarcopenia. The purpose of this review was to discuss potential pathways to muscle deterioration in obese individuals. We also want to present the current understanding of the role of various factors, including microbiota and myokines, in the process of sarcopenia and SO.
Collapse
Affiliation(s)
- Jan Bilski
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Correspondence: ; Tel.: +48-12-421-93-51
| | - Piotr Pierzchalski
- Department of Medical Physiology, Chair of Biomedical Sciences, Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, 31-126 Krakow, Poland; (P.P.); (J.B.)
| | - Marian Szczepanik
- Department of Medical Biology, Chair of Biomedical Sciences, Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Joanna Bonior
- Department of Medical Physiology, Chair of Biomedical Sciences, Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, 31-126 Krakow, Poland; (P.P.); (J.B.)
| | - Jerzy A. Zoladz
- Chair of Exercise Physiology and Muscle Bioenergetics, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland;
| |
Collapse
|
23
|
He N, Zhang Y, Zhang L, Zhang S, Ye H. Relationship Between Sarcopenia and Cardiovascular Diseases in the Elderly: An Overview. Front Cardiovasc Med 2021; 8:743710. [PMID: 34957238 PMCID: PMC8695853 DOI: 10.3389/fcvm.2021.743710] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/19/2021] [Indexed: 12/13/2022] Open
Abstract
With the advent of population aging, aging-related diseases have become a challenge for governments worldwide. Sarcopenia has defined as a clinical syndrome associated with age-related loss such as skeletal muscle mass, strength, function, and physical performance. It is commonly seen in elderly patients with chronic diseases. Changes in lean mass are common critical determinants in the pathophysiology and progression of cardiovascular diseases (CVDs). Sarcopenia may be one of the most important causes of poor physical function and decreased cardiopulmonary function in elderly patients with CVDs. Sarcopenia may induce CVDs through common pathogenic pathways such as malnutrition, physical inactivity, insulin resistance, inflammation; these mechanisms interact. In this study, we aimed to investigate the relationship between sarcopenia and CVDs in the elderly. Further research is urgently needed to understand better the relationship, pathophysiology, clinical presentation, diagnostic criteria, and mechanisms of sarcopenia and CVDs, which may shed light on potential interventions to improve clinical outcomes and provide greater insight into the disorders above.
Collapse
Affiliation(s)
- Nana He
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
- Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China
| | - Yuelin Zhang
- Department of Medicine, University of Ningbo, Ningbo, China
| | - Lu Zhang
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| | - Shun Zhang
- Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China
| | - Honghua Ye
- Department of Cardiology, HwaMei Hospital (Previously Named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, Ningbo, China
| |
Collapse
|
24
|
Park S, Kim SH, Shin JY. Combined association of skeletal muscle mass and grip strength with cardiovascular diseases in patients with type 2 diabetes. J Diabetes 2021; 13:1015-1024. [PMID: 34288415 DOI: 10.1111/1753-0407.13216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Appendicular skeletal muscle mass (ASM) and grip strength (GS) have been suggested to be related to cardiovascular diseases (CVDs), but their association with type 2 diabetes (T2D) remains unclear. Therefore, we examined the combined association of ASM and GS with the prevalence of CVD in patients with T2D. METHODS A total of 1230 patients with T2D were recruited and divided into four groups based on the sex-specific median values of ASM adjusted for body mass index (ASM/BMI; short: SM) and GS: high SM/high GS (HSM/HGS), high SM/low GS (HSM/LGS), low SM/high GS (LSM/HGS), and low SM/low GS (LSM/LGS). RESULTS The LSM/LGS group was older and had higher values of systolic blood pressure, homeostasis model assessment of insulin resistance, waist circumference, and C-reactive protein but lower high-density lipoprotein cholesterol concentrations than the HSM/HGS group. After adjusting for potential confounders, the odds ratios (ORs) and 95% CIs for CVD, coronary heart disease (CHD), ischemic stroke, and peripheral arterial disease (PAD) in the LSM/LGS group were 2.90 (1.89-4.47), 2.39 (1.46-3.92), 1.77 (0.84-3.71), and 5.83 (1.58-21.48), respectively. After adjusting for variable confounders among patients with higher glycosylated hemoglobin (HbA1c) (≥7.1%), the ORs and 95% CIs for CVD and CHD in the LSM/LGS group were 7.27 (3.37-15.67) and 6.17 (2.65-14.37), respectively. CONCLUSIONS The combination of low SM and GS was strongly associated with CVD, CHD, and PAD in patients with T2D, especially in those with higher HbA1c levels.
Collapse
Affiliation(s)
- Sunmin Park
- Department of Food & Nutrition, Hoseo University, Asan, Republic of Korea
| | - Sung-Hoon Kim
- Department of Internal Medicine, MizMedi Hospital, Seoul, Republic of Korea
| | - Jang Yel Shin
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| |
Collapse
|
25
|
Miao SL, Lin TT, Chen FF, Wang L, Zheng XW, Tang K. Association between low skeletal muscle mass and subclinical coronary atherosclerosis in asymptomatic individuals evaluated by CT. Clin Radiol 2021; 77:e162-e169. [PMID: 34852917 DOI: 10.1016/j.crad.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022]
Abstract
AIM To investigate the associations of skeletal muscle area and density with coronary atherosclerotic plaques and significant stenosis in asymptomatic adults. MATERIALS AND METHODS A total of 243 consecutive subjects who had voluntarily undergone abdominal unenhanced computed tomography (CT) and coronary CT angiography (CCTA) as part of a general health examination were investigated retrospectively. Skeletal muscle area index (SMI) and skeletal muscle density (SMD) was assessed using CT. Coronary atherosclerotic plaques and stenosis on CCTA were evaluated. The associations of low SMI and low SMD with coronary atherosclerotic plaques and significant stenosis were determined by logistic regression analysis. RESULTS After adjustment for cardiovascular risk factors, there were significant associations of low SMI or low SMD with atherosclerotic plaque, total significant stenosis, and significant stenosis caused by calcified or mixed plaques (for all p<0.05). In addition, multivariate regression analysis also showed that low SMI was independently associated with calcified plaque (p=0.038) and non-calcified plaque (p=0.006), and individuals with low SMD were more likely to have mixed plaque (p=0.001). CONCLUSION Assessment of the skeletal muscle on CT help to identify asymptomatic adults at risk for coronary atherosclerosis.
Collapse
Affiliation(s)
- S-L Miao
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - T-T Lin
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - F-F Chen
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - L Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - X-W Zheng
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - K Tang
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
26
|
Sarcopenia predicts adverse outcomes in an elderly population with coronary artery disease: a systematic review and meta-analysis. BMC Geriatr 2021; 21:493. [PMID: 34521369 PMCID: PMC8439080 DOI: 10.1186/s12877-021-02438-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/26/2021] [Indexed: 01/07/2023] Open
Abstract
Background The development of sarcopenia is attributed to normal aging and factors like type 2 diabetes, obesity, inactivity, reduced testosterone levels, and malnutrition, which are factors of poor prognosis in patients with coronary artery disease (CAD). This study aimed to perform a meta-analysis to assess whether preoperative sarcopenia can be used to predict the outcomes after cardiac surgery in elderly patients with CAD. Methods PubMed, Embase, the Cochrane library, and Web of Science were searched for available papers published up to December 2020. The primary outcome was major adverse cardiovascular outcomes (MACE). The secondary outcomes were mortality and heart failure (HF)-related hospitalization. The random-effects model was used. Hazard ratios (HRs) with 95% confidence intervals (95%CIs) were estimated. Results Ten studies were included, with 3707 patients followed for 6 months to 4.5 ± 2.3 years. The sarcopenia population had a higher rate of MACE compared to the non-sarcopenia population (HR = 2.27, 95%CI: 1.58–3.27, P < 0.001; I2 = 60.0%, Pheterogeneity = 0.02). The association between sarcopenia and MACE was significant when using the psoas muscle area index (PMI) to define sarcopenia (HR = 2.86, 95%CI: 1.84–4.46, P < 0.001; I2 = 0%, Pheterogeneity = 0.604). Sarcopenia was not associated with higher late mortality (HR = 2.15, 95%CI: 0.89–5.22, P = 0.090; I2 = 91.0%, Pheterogeneity < 0.001), all-cause mortality (HR = 1.35, 95%CI: 0.14–12.84, P = 0.792; I2 = 90.5%, Pheterogeneity = 0.001), and death, HF-related hospitalization (HR = 1.37, 95%CI: 0.59–3.16, P = 0.459; I2 = 62.0%, Pheterogeneity = 0.105). The sensitivity analysis revealed no outlying study in the analysis of the association between sarcopenia and MACE after coronary intervention. Conclusion Sarcopenia is associated with poor MACE outcomes in patients with CAD. The results could help determine subpopulations of patients needing special monitoring after CAD surgery. The present study included several kinds of participants; although non-heterogeneity was found, interpretation should be cautious. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02438-w.
Collapse
|
27
|
Joshi A, Mancini R, Probst S, Abikhzer G, Langlois Y, Morin JF, Rudski LG, Afilalo J. Sarcopenia in cardiac surgery: Dual X-ray absorptiometry study from the McGill frailty registry. Am Heart J 2021; 239:52-58. [PMID: 33957101 DOI: 10.1016/j.ahj.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND To determine the prevalence and prognostic value of sarcopenia measured by dual x-ray absorptiometry (DXA) and physical performance tests in patients undergoing coronary artery bypass surgery or heart valve procedures. METHODS Adults undergoing cardiac surgery were prospectively enrolled and completed a questionnaire, physical performance battery, and a DXA scan (GE Lunar) to measure appendicular muscle mass indexed to height2 (AMMI). Patients were categorized as sarcopenic based on European Working Group 2 guidelines if they had low AMMI defined as <7 kg/m2 for men or <5.5 kg/m2 for women, and low muscle strength defined as 5 chair rise time ≥15 seconds. Cox proportional hazards regression was used to test the association between sarcopenia and all-cause mortality over a median follow-up of 4.3 years. RESULTS The cohort consisted of 141 patients with a mean age of 69.7 ± 10.0 years and 21% females. The prevalence rates of low AMMI, slow chair rise time, and sarcopenia (low AMMI and slow chair rise time) were 24%, 57%, 13%, respectively. The 4-year survival rate was 79% in the non-sarcopenic group as compared to 56% in the sarcopenic group (Log-rank P = 0.01). In the multivariable model, each standard deviation of decreasing AMMI and increasing chair rise time was associated with a hazard ratio for all-cause mortality of 1.84 (95% CI 1.18, 2.86) and 1.79 (95% CI 1.26, 2.54), respectively. CONCLUSION Lower-extremity muscle strength and DXA-based muscle mass are objective indicators of sarcopenia that are independently predictive of all-cause mortality in older cardiac surgery patients.
Collapse
|
28
|
Abstract
Age is an independent risk factor for cardiovascular disease. With the accelerated growth of the population of older adults, geriatric and cardiac care are becoming increasingly entwined. Although cardiovascular disease in younger adults often occurs as an isolated problem, it is more likely to occur in combination with clinical challenges related to age in older patients. Management of cardiovascular disease is transmuted by the context of multimorbidity, frailty, polypharmacy, cognitive dysfunction, functional decline, and other complexities of age. This means that additional insight and skills are needed to manage a broader range of relevant problems in older patients with cardiovascular disease. This review covers geriatric conditions that are relevant when treating older adults with cardiovascular disease, particularly management considerations. Traditional practice guidelines are generally well suited for robust older adults, but many others benefit from a relatively more personalized therapeutic approach that allows for a range of medical circumstances and idiosyncratic goals of care. This requires weighing of risks and benefits amidst the patient's aggregate clinical status and the ability to communicate effectively about this with patients and, where appropriate, their care givers in a process of shared decision making. Such a personalized approach can be particularly gratifying, as it provides opportunities to optimize an older patient's function and quality of life at a time in life when these often become foremost therapeutic priorities.
Collapse
Affiliation(s)
| | - Daniel E Forman
- University of Pittsburgh, University of Pittsburgh Medical Center and VA Pittsburgh Geriatric, Research, Education and Clinical Center (GRECC), Pittsburgh, PA, USA
| |
Collapse
|
29
|
do Nascimento RA, Vieira MCA, Dos Santos Aguiar Gonçalves RS, Moreira MA, de Morais MSM, da Câmara SMA, Maciel ÁCC. Cutoff points of adiposity anthropometric indices for low muscle mass screening in middle-aged and older healthy women. BMC Musculoskelet Disord 2021; 22:713. [PMID: 34416881 PMCID: PMC8379807 DOI: 10.1186/s12891-021-04532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/20/2021] [Indexed: 12/25/2022] Open
Abstract
Background The reduction of female sex hormones causes changes in the contractile properties of muscles as well as infiltration of fat in the muscle tissue. This results in a consequent decline in muscle strength. These changes are related to higher levels of functional impairment and physical disability. In this sense, several anthropometric indices have been used to quantify body and visceral fat. Thus, the objective of this paper is to propose cutoff points for adiposity anthropometric indices in order to identify low muscle mass, as well as to analyze the relationship between these indices and low muscle mass in middle-aged and older women. Methods Cross-sectional analytical study carried out in the Northeast of Brazil. The sample was formed by 593 women between 40—80 years old. Data collection included anthropometric assessment (BMI: Body Mass Index – WC: Waist Circumference – WHR: Waist-to-hip Ratio – WHtR: Waist-to-height Ratio – CI: Conicity Index – BAI: Body Adiposity Index – VAI: Visceral Adiposity Index – LAP: Lipid Accumulation Product), bioimpedance test and biochemical dosage. Moreover, sociodemographic data and practice of physical activity were collected. Descriptive statistics, Student's t-test, ROC curves, chi-squared and logistic regression were performed. Results The participants had a mean age of 53.11 (8.89) years, BMI of 28.49 (5.17) kg/m2 and WC of 95.35 (10.39). The prevalence of low muscle mass was 19.4%. Based on sensitivity and specificity of adiposity anthropometric indices, cutoff points were developed to identify the presence of low muscle mass (p < 0.05), except for VAI. After logistic regression, WC (OR = 6.2; CI 95%: 1.4—28.1), WHR (OR = 1.8; CI: 1.0—3.4), WHtR (OR = 5.0; CI 95%: 1.0—23.7) and BAI (OR = 14.5; CI 95%: 6.6—31.7) were associated with low muscle mass. Conclusions All anthropometric indices, except VAI, showed adequate accuracy in identifying low muscle mass in women, especially those that took into account WC. This suggests that they can become accessible and also be cost-effective strategies for assessing and managing health outcomes related to muscle mass analysis.
Collapse
Affiliation(s)
- Rafaela Andrade do Nascimento
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil.
| | - Mariana Carmem Apolinário Vieira
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil
| | | | - Mayle Andrade Moreira
- Physiotherapy Department of Federal, University of Ceará, 949 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza, CEP: 60430-110, Brazil
| | - Maria Socorro Medeiros de Morais
- Health Sciences Center of Federal, University of Rio Grande Do Norte, General Gustavo Cordeiro de Farias St, Petrópolis, Natal, RN, CEP 59012-570, Brazil
| | | | - Álvaro Campos Cavalcanti Maciel
- Physiotherapy, Department of Federal, University of Rio Grande Do Norte, 3000 Senador Salgado Filho Avenue, S/N, Lagoa Nova, Natal, RN, CEP: 59072-970, Brazil
| |
Collapse
|
30
|
Fully Automated Deep Learning Tool for Sarcopenia Assessment on CT: L1 Versus L3 Vertebral Level Muscle Measurements for Opportunistic Prediction of Adverse Clinical Outcomes. AJR Am J Roentgenol 2021; 218:124-131. [PMID: 34406056 DOI: 10.2214/ajr.21.26486] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND. Sarcopenia is associated with adverse clinical outcomes. CT-based skeletal muscle measurements for sarcopenia assessment are most commonly performed at the L3 vertebral level. OBJECTIVE. The purpose of this article is to compare the utility of fully automated deep learning CT-based muscle quantitation at the L1 versus L3 level for predicting future hip fractures and death. METHODS. This retrospective study included 9223 asymptomatic adults (mean age, 57 ± 8 [SD] years; 4071 men, 5152 women) who underwent unenhanced low-dose abdominal CT. A previously validated fully automated deep learning tool was used to assess muscle for myosteatosis (by mean attenuation) and myopenia (by cross-sectional area) at the L1 and L3 levels. Performance for predicting hip fractures and death was compared between L1 and L3 measures. Performance for predicting hip fractures and death was also evaluated using the established clinical risk scores from the fracture risk assessment tool (FRAX) and Framingham risk score (FRS), respectively. RESULTS. Median clinical follow-up interval after CT was 8.8 years (interquartile range, 5.1-11.6 years), yielding hip fractures and death in 219 (2.4%) and 549 (6.0%) patients, respectively. L1-level and L3-level muscle attenuation measurements were not different in 2-, 5-, or 10-year AUC for hip fracture (p = .18-.98) or death (p = .19-.95). For hip fracture, 5-year AUCs for L1-level muscle attenuation, L3-level muscle attenuation, and FRAX score were 0.717, 0.709, and 0.708, respectively. For death, 5-year AUCs for L1-level muscle attenuation, L3-level muscle attenuation, and FRS were 0.737, 0.721, and 0.688, respectively. Lowest quartile hazard ratios (HRs) for hip fracture were 2.20 (L1 attenuation), 2.45 (L3 attenuation), and 2.53 (FRAX score), and for death were 3.25 (L1 attenuation), 3.58 (L3 attenuation), and 2.82 (FRS). CT-based muscle cross-sectional area measurements at L1 and L3 were less predictive for hip fracture and death (5-year AUC ≤ 0.571; HR ≤ 1.56). CONCLUSION. Automated CT-based measurements of muscle attenuation for myosteatosis at the L1 level compare favorably with previously established L3-level measurements and clinical risk scores for predicting hip fracture and death. Assessment for myopenia was less predictive of outcomes at both levels. CLINICAL IMPACT. Alternative use of the L1 rather than L3 level for CT-based muscle measurements allows sarcopenia assessment using both chest and abdominal CT scans, greatly increasing the potential yield of opportunistic CT screening.
Collapse
|
31
|
Evans K, Abdelhafiz D, Abdelhafiz AH. Sarcopenic obesity as a determinant of cardiovascular disease risk in older people: a systematic review. Postgrad Med 2021; 133:831-842. [PMID: 34126036 DOI: 10.1080/00325481.2021.1942934] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Aging is associated with body composition changes that include a reduction of muscle mass or sarcopenia and an increase in visceral obesity. Thus, aging involves a muscle-fat imbalance with a shift toward more fat and less muscle. Therefore, sarcopenic obesity, defined as a combination of sarcopenia and obesity, is a global health phenomenon due to the increased aging of the population combined with the increased epidemic of obesity. Previous studies have shown inconsistent association between sarcopenic obesity and the risk of cardiovascular disease (CVD). AIMS To systematically review the recent literature on the CVD risks associated with sarcopenic obesity and summarizes ways of diagnosis and prevention. METHODS A systematic review of studies that reported the association between sarcopenic obesity and CVD risk in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. RESULTS Risk factors of sarcopenic obesity included genetic factors, aging, malnutrition, sedentary lifestyle, hormonal deficiencies and other molecular changes. The muscle-fat imbalance with increasing age results in an increase in the pro-inflammatory adipokines secreted by adipocytes and a decline in the anti-inflammatory myokines secreted by myocytes. This imbalance promotes and perpetuates a chronic low-grade inflammatory state that is characteristic of sarcopenic obesity. After application of exclusion criteria, only 12 recent studies were included in this review. The recent studies have shown a consistent association between sarcopenic obesity and cardiovascular disease risk although most of the studies are of cross-sectional design that does not confirm a causal relationship. In addition, most of the population studied were of Asian origin which may limit the generalizability of the results. Non-pharmacological interventions by exercise training and adequate nutrition appear to be useful in maintenance of muscle strength and muscle mass in combination with a reduction of adiposity to promote healthy aging. CONCLUSIONS Sarcopenic obesity appears to increase the risk of CVD in older people; however, future prospective studies of diverse population are still required. Although non-pharmacologic interventions are useful in reducing the risk of sarcopenic obesity, novel specific pharmacologic agents are lacking.
Collapse
Affiliation(s)
- Katherine Evans
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham UK
| | | | - Ahmed H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Rotherham UK
| |
Collapse
|
32
|
Lu YW, Tsai YL, Chou RH, Kuo CS, Chang CC, Huang PH, Lin SJ. Serum creatinine to cystatin C ratio is associated with major adverse cardiovascular events in patients with obstructive coronary artery disease. Nutr Metab Cardiovasc Dis 2021; 31:1509-1515. [PMID: 33810966 DOI: 10.1016/j.numecd.2021.01.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Sarcopenia is a clinical syndrome that features muscle atrophy and weakness, and has been associated with cardiovascular events and poor clinical outcomes. Recently, the sarcopenia index (SI) was developed as a simple screening tool based upon the serum creatinine to cystatin C (CysC) ratio. We investigated the association between SI and the prevalence of major adverse cardiovascular events (MACE) in patients with obstructive CAD. METHODS & RESULTS Between January 2010 and December 2018, patients with angina pectoris and obstructive CAD requiring coronary artery intervention were enrolled. Serum levels of CysC and other biomarkers were assessed. Patients were divided into two groups according to the SI ([Cr/CysC] x 100). Demographic characteristics and clinical outcomes of the two groups were evaluated. A total of 427 patients (79.6% men, mean age 69.55 ± 12.04 years) were enrolled. Patients with SI < 120 (n = 214, 28%) were older, more likely to be of the female gender, and to have more hypertension and congestive heart failure (all p < 0.05). The prevalence of major adverse cardiovascular events (MACE) composed of myocardial infarction, stroke, and all-cause mortality was higher in patients with lower SI (p = 0.026). After adjusting for potential confounding factors, multivariate Cox regression (hazard ratio 2.08, p = 0.045) and Kaplan-Meier analyses (log-rank p = 0.0371) revealed that lower SI was significantly associated with a higher prevalence of MACE. CONCLUSIONS Serum creatinine to cystatin C ratio (SI) may be a useful surrogate marker to predict the future prevalence of MACE in patients with obstructive CAD.
Collapse
Affiliation(s)
- Ya-Wen Lu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Lin Tsai
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ruey-Hsing Chou
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chin-Sung Kuo
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Chun-Chin Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan
| |
Collapse
|
33
|
Takata T, Mae Y, Yamada K, Taniguchi S, Hamada S, Yamamoto M, Iyama T, Isomoto H. Skeletal muscle mass is associated with erythropoietin response in hemodialysis patients. BMC Nephrol 2021; 22:134. [PMID: 33863297 PMCID: PMC8052822 DOI: 10.1186/s12882-021-02346-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/01/2021] [Indexed: 01/25/2023] Open
Abstract
Background Hyporesponsiveness to erythropoietin stimulating agent (ESA) is associated with poor outcomes in patients with chronic kidney disease. Although ESA hyporesponsiveness and sarcopenia have a common pathophysiological background, clinical evidence linking them is scarce. The purpose of the study was to investigate the relationship between ESA responsiveness and skeletal muscle mass in hemodialysis patients. Methods This cross-sectional study analyzed 70 patients on maintenance hemodialysis who were treated with ESA. ESA responsiveness was evaluated by erythropoietin resistance index (ERI), calculated as a weekly dose of ESA divided by body weight and hemoglobin (IU/kg/week/dL), and a weekly dose of ESA/hemoglobin (IU/week/dL). A dose of ESA is equivalated to epoetin β. Correlations between ESA responsiveness and clinical parameters including skeletal muscle mass were analyzed. Results Among the 70 patients, ERI was positively correlated to age (p < 0.002) and negatively correlated to height (p < 0.001), body weight (p < 0.001), BMI (p < 0.001), skeletal muscle mass (p < 0.001), transferrin saturation (TSAT) (p = 0.049), and zinc (p = 0.006). In the multiple linear regression analysis, TSAT, zinc, and skeletal muscle mass were associated with ERI and weekly ESA dose/hemoglobin. Conclusions Skeletal muscle mass was the independent predictor for ESA responsiveness as well as TSAT and zinc. Sarcopenia is another target for the management of anemia in patients with hemodialysis.
Collapse
Affiliation(s)
- Tomoaki Takata
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan.
| | - Yukari Mae
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| | - Kentaro Yamada
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| | | | - Shintaro Hamada
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| | - Marie Yamamoto
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| | - Takuji Iyama
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| | - Hajime Isomoto
- Division of Gastroenterology and Nephrology, Faculty of Medicine, , Tottori University, 36-1 Nishimachi, Tottori , 683-8504, Yonago, Japan
| |
Collapse
|
34
|
Pahk K, Kim EJ, Kwon HW, Joung C, Seo HS, Kim S. Association of Inflammatory Metabolic Activity of Psoas Muscle and Acute Myocardial Infarction: A Preliminary Observational Study with 18F-FDG PET/CT. Diagnostics (Basel) 2021; 11:diagnostics11030511. [PMID: 33805700 PMCID: PMC7999462 DOI: 10.3390/diagnostics11030511] [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: 02/14/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
Inflamed skeletal muscle promotes chronic inflammation in atherosclerotic plaques, thereby contributing to the increased risk of coronary artery disease (CAD). In this study, we evaluated the metabolic activity of psoas muscle, using 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), and its association with carotid artery inflammation and acute myocardial infarction (AMI). In total, 90 participants (32 AMI, 33 chronic stable angina (CSA), and 25 control) were enrolled in this prospective study. Metabolic activity of skeletal muscle (SM) was measured by using maximum standardized uptake value (SUVmax) of psoas muscle, and corresponding psoas muscle area (SM area) was also measured. Carotid artery inflammation was evaluated by using the target-to background ratio (TBR) of carotid artery. SM SUVmax was highest in AMI, intermediate in CSA, and lowest in control group. SM SUVmax was significantly correlated with carotid artery TBR and systemic inflammatory surrogate markers. Furthermore, SM SUVmax was independently associated with carotid artery TBR and showed better predictability than SM area for the prediction of AMI. Metabolic activity of psoas muscle assessed by 18F-FDG PET/CT was associated with coronary plaque vulnerability and synchronized with the carotid artery inflammation in the participants with CAD. Furthermore, it may also be useful to predict AMI.
Collapse
Affiliation(s)
- Kisoo Pahk
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.P.); (H.W.K.)
| | - Eung Ju Kim
- Department of Cardiovascular Center, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Hyun Woo Kwon
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.P.); (H.W.K.)
| | - Chanmin Joung
- Institute for Inflammation Control, Korea University, Seoul 02841, Korea;
| | - Hong Seog Seo
- Department of Cardiovascular Center, Korea University Guro Hospital, Seoul 08308, Korea;
- Correspondence: (H.S.S.); (S.K.); Tel.:+82-2-2626-3018 (H.S.S.); +82-2-920-5540 (S.K.)
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.P.); (H.W.K.)
- Correspondence: (H.S.S.); (S.K.); Tel.:+82-2-2626-3018 (H.S.S.); +82-2-920-5540 (S.K.)
| |
Collapse
|
35
|
Ferreira JMM, Cunha P, Carneiro A, Vila I, Cunha C, Silva C, Longatto-Filho A, Mesquita A, Cotter J, Mansilha A, Correia-Neves M. Sarcopenia as a Prognostic Factor in Peripheral Arterial Disease: Descriptive Review. Ann Vasc Surg 2021; 74:460-474. [PMID: 33556522 DOI: 10.1016/j.avsg.2021.01.076] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/02/2021] [Accepted: 01/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Determine the influence of sarcopenia on the prognosis of peripheral arterial disease (PAD). METHODS A systematic search of the PubMed and Cochrane Library databases was performed with the keywords and medical subject heading (MesH): "muscle, skeletal", "sarcopenia", "prognosis", "duration of stay", "death", "mortality", "patient readmission", "length of stay", "peripheral arterial disease", "intermittent claudication" and "critical limb ischemia". Papers published from January 2010 to October 2020 in English, French, Spanish and Portuguese were eligible for inclusion. The primary outcome was overall survival. Secondary outcomes included post-operative complications, amputation, length of hospital stay and hospital readmission. RESULTS Of 1071 papers, 8 articles and 1511 patients were included (68.96% male, mean age 71.83 years). Five papers found an inverse relationship between SM area and mortality. Matsubara (2015) found that the 5-year overall survival rates were lower for patients with sarcopenia (23.5% ± 0.18% vs 77.5% ± 0.09% P = 0.001). Matsubara (2016) registered 3-year cardiovascular event-free survival rates of 43.1% and 91.2% for patients with and without sarcopenia (P < 0.01). Juszczak (2018) found that survival was lower in patients with reduced total psoas area. Taniguchi (2019) found that 3-year overall survival rate was 60% for patients with sarcopenia and 87% for patients without sarcopenia (P < 0.05). Shimazoe (2019) concluded sarcopenia was a significant predictor of overall survival. Distinctly, Nyers (2017) concluded that higher ratio bilateral psoas area to L4 vertebral body was associated with an increased risk of death. Two other studies analyzed other characteristics of the SM (density and strength). McDermott (2012) and found that lower calf muscle density and strength were associated with an increase in mortality. Sugai (2019) concluded that patients with major cardiovascular and limb events had a lower SM density. CONCLUSIONS Lower SM area and mass seem to be associated with a higher mortality in PAD patients.
Collapse
Affiliation(s)
- Joana Margarida Magalhães Ferreira
- Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - Pedro Cunha
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | | | - Isabel Vila
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Cristina Cunha
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Cristina Silva
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Adhemar Longatto-Filho
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal; Department of Pathology (LIM-14), University of São Paulo School of Medicine, São Paulo, Brazil; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Amílcar Mesquita
- Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Jorge Cotter
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Armando Mansilha
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Vascular Surgery Department, Hospital de São João, Porto, Portugal
| | - Margarida Correia-Neves
- Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
36
|
Derstine BA, Holcombe SA, Ross BE, Wang NC, Su GL, Wang SC. Optimal body size adjustment of L3 CT skeletal muscle area for sarcopenia assessment. Sci Rep 2021; 11:279. [PMID: 33431971 PMCID: PMC7801425 DOI: 10.1038/s41598-020-79471-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/09/2020] [Indexed: 12/16/2022] Open
Abstract
Measurements of skeletal muscle cross-sectional area (SMA) at the level of the third lumbar (L3) vertebra derived from clinical computed tomography (CT) scans are commonly used in assessments of sarcopenia, the loss of skeletal muscle mass and function associated with aging. As SMA is correlated with height and Body Mass Index (BMI), body size adjustment is necessary to fairly assess sarcopenic low muscle mass in individuals of different height and BMI. The skeletal muscle index, a widely used measure, adjusts for height as [Formula: see text] but uses no BMI adjustment. There is no agreed upon standard for body size adjustment. We extracted L3 SMA using non-contrast-enhanced CT scans from healthy adults, split into 'Under-40' and 'Over-40' cohorts. Sex-specific allometric analysis showed that height to the power of one was the optimal integer coefficient for height adjusted SMA in both males and females. We computed two height-adjusted measures [Formula: see text] and [Formula: see text], comparing their Pearson correlations versus age, height, weight, and BMI separately by sex and cohort. Finally, in the 'Under-40' cohort, we used linear regression to convert each height-adjusted measure into a z-score ([Formula: see text], [Formula: see text]) adjusted for BMI. [Formula: see text] was less correlated with height in both males and females ([Formula: see text], [Formula: see text] and [Formula: see text], [Formula: see text]) than [Formula: see text] ([Formula: see text] and [Formula: see text], [Formula: see text]). [Formula: see text] was uncorrelated with BMI and weight, and minimally correlated with height in males and females ([Formula: see text], [Formula: see text] and [Formula: see text], [Formula: see text]). The final [Formula: see text] equation was: [Formula: see text], where [Formula: see text], [Formula: see text], [Formula: see text], and sex = 1 if male, 0 if female. We propose [Formula: see text] for optimal height adjustment and the [Formula: see text] score for optimal height and BMI adjustment. By minimizing correlations with height and BMI, the [Formula: see text] score produces unbiased assessments of relative L3 skeletal muscle area across the full range of body sizes.
Collapse
|
37
|
Takahashi F, Hashimoto Y, Kaji A, Sakai R, Okamura T, Kitagawa N, Okada H, Nakanishi N, Majima S, Senmaru T, Ushigome E, Hamaguchi M, Asano M, Yamazaki M, Fukui M. Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne) 2021; 12:783363. [PMID: 34858351 PMCID: PMC8632440 DOI: 10.3389/fendo.2021.783363] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sarcopenia has reportedly been associated with increased risk of mortality in general populations. However, few studies have investigated the association between sarcopenia and mortality in older people with type 2 diabetes mellitus (T2D). This study aimed to investigate the effect of sarcopenia on incident all-cause mortality in older people with T2D. METHODS Low muscle strength were set at handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass index (SMI), evaluated using the impedance body composition analyzer, were set at SMI <7.0 kg/m2 for men and <5.7 kg/m2 for women. People who had both low muscle strength and low SMI were diagnosed with sarcopenia. Due to a low incidence of all-cause mortality, the propensity score was used. The propensity score was evaluated using multivariable logistic regression models with the following parameters: age, sex, duration of diabetes, history of heart disease, history of cancer, smoking, exercise, alcohol, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 receptor agonist, insulin, corticosteroid, hypertension, body mass index, glycosylated hemoglobin A1c, triglycerides, and creatinine, and the C-statistic was 0.89. RESULTS In this prospective cohort study, 396 people with an average age and duration of diabetes of 71.3 (6.3) years and 16.3 (11.3) years, respectively, were included. Of those included, 14.6% had sarcopenia. During the average 40.5 (16.5) months of follow-up, 13 people (6 out of the 338 without sarcopenia and 7 out of the 58 with sarcopenia) died. Incident rate were 5.1/1000 person years of follow-up in people without sarcopenia and 41.3/1000 person years of follow-up in people with sarcopenia. According to Cox regression analysis, sarcopenia was associated with all-cause mortality (adjusted hazard ratio: 6.12, 95% confidence interval: 1.52-24.7, p = 0.011). CONCLUSION Sarcopenia is associated with incident all-cause mortality in older outpatients with T2D.
Collapse
Affiliation(s)
- Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- *Correspondence: Yoshitaka Hashimoto,
| | - Ayumi Kaji
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- Department of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Saori Majima
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| |
Collapse
|
38
|
Lee MJ, Kim HK, Kim EH, Bae SJ, Kim KW, Kim MJ, Choe J. Association Between Muscle Quality Measured by Abdominal Computed Tomography and Subclinical Coronary Atherosclerosis. Arterioscler Thromb Vasc Biol 2020; 41:e128-e140. [PMID: 33356388 DOI: 10.1161/atvbaha.120.315054] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Low muscle mass was known to be associated with cardiovascular diseases. However, only few studies investigated the association between muscle quality and subclinical coronary atherosclerosis. Thus, we evaluated whether muscle quality measured by abdominal computed tomography is associated with the risk of coronary artery calcification. Approach and Results: We conducted a cross-sectional study on 4068 subjects without cardiovascular disease who underwent abdominal and coronary computed tomography between 2012 and 2013 during health examinations. The cross-sectional area of the skeletal muscle was measured at the L3 level (total abdominal muscle area) and segmented into normal attenuation muscle area, low attenuation muscle area, and intramuscular adipose tissue. We calculated the normal attenuation muscle area/total abdominal muscle area index, of which a higher value reflected a higher proportion of good quality muscle (normal attenuation muscle area) and a lower proportion of myosteatosis (low attenuation muscle area and intramuscular adipose tissue). In women, as the normal attenuation muscle area/total abdominal muscle area quartiles increased, the odds ratios (95% CIs) for significant coronary artery calcification (>100) consistently decreased (0.44 [0.24-0.80], 0.39 [0.19-0.81], 0.34 [0.12-0.98]; P=0.003) after adjusting for cardiovascular risk factors including visceral fat area and insulin resistance. In men, the odds ratios in the Q2 group were significantly lower than those in the Q1, but the association was attenuated in Q3-4 after adjustment. CONCLUSIONS A higher proportion of good quality muscle was strongly associated with a lower prevalence of significant coronary artery calcification after adjustment, especially in women. Poor skeletal muscle quality may be an important risk factor for subclinical coronary atherosclerosis.
Collapse
Affiliation(s)
- Min Jung Lee
- Health Screening and Promotion Center (M.J.L., H.-K.K., E.H.K., S.J.B., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center (M.J.L., H.-K.K., E.H.K., S.J.B., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Hee Kim
- Health Screening and Promotion Center (M.J.L., H.-K.K., E.H.K., S.J.B., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Jin Bae
- Health Screening and Promotion Center (M.J.L., H.-K.K., E.H.K., S.J.B., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology (K.W.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Biomedical Research Center, Asan Institute for Life Sciences, Seoul, Republic of Korea (K.W.K.)
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics (M.-J.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaewon Choe
- Health Screening and Promotion Center (M.J.L., H.-K.K., E.H.K., S.J.B., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
39
|
Kim CH, Rhee TM, Woo Park K, Soon Park C, Kang J, Han JK, Yang HM, Kang HJ, Koo BK, Kim HS. Association Between Low Muscle Mass and Prognosis of Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention. J Am Heart Assoc 2020; 10:e018554. [PMID: 33372526 PMCID: PMC7955465 DOI: 10.1161/jaha.120.018554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Low muscle mass has been associated with poor prognosis in certain chronic diseases, but its clinical significance in patients with coronary artery disease is unclear. We assessed the clinical significance of 2 easily measured surrogate markers of low muscle mass: the ratio of serum creatinine to serum cystatin C (Scr/Scys), and the ratio of estimated glomerular filtration rate by Scys to Scr (eGFRcys/eGFRcr). Methods and Results Patients with coronary artery disease undergoing percutaneous coronary intervention were prospectively enrolled from a single tertiary center, and Scr and Scys levels were simultaneously measured at admission. Best cut‐off values for Scr/Scys and eGFRcys/eGFRcr to discriminate 3‐year mortality were determined; 1.0 for men and 0.8 for women in Scr/Scys, and 1.1 for men and 1.0 for women in eGFRcys/eGFRcr. The prognostic values on 3‐year mortality and the additive values of 2 markers on the predictive model were compared. In 1928 patients enrolled (mean age 65.2±9.9 years, 70.8% men), the risk of 3‐year mortality increased proportionally according to the decrease of the surrogate markers. Both Scr/Scys‐ and eGFRcys/eGFRcr‐based low muscle mass groups showed significantly higher risk of death, after adjusting for possible confounders. They also increased predictive power of the mortality prediction model. Low Scr/Scys values were associated with high mortality rate in patients who were ≥65 years, nonobese, male, had renal dysfunction at baseline, and presented with acute myocardial infarction. Conclusions Serum surrogate markers of muscle mass, Scr/Scys, and eGFRcys/eGFRcr may have clinical significance for detecting patients with coronary artery disease at high risk for long‐term mortality.
Collapse
Affiliation(s)
- Chi-Hoon Kim
- Sejong General HospitalSejong Heart Institute Bucheon Republic of Korea
| | - Tae-Min Rhee
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Kyung Woo Park
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Chan Soon Park
- Korea Advanced Institute of Science and Technology Daejeon Republic of Korea
| | - Jeehoon Kang
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Jung-Kyu Han
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Han-Mo Yang
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Hyun-Jae Kang
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea
| |
Collapse
|
40
|
Shimada K. Loss of Skeletal Muscle Mass and Poor Prognosis in Patients with ST-Segment Elevation Myocardial Infarction: Underling Mechanisms and Therapeutic Strategies. J Atheroscler Thromb 2020; 27:1257-1260. [PMID: 32581189 PMCID: PMC7840161 DOI: 10.5551/jat.ed135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine.,Sportology Center, Juntendo University Graduate School of Medicine
| |
Collapse
|
41
|
Waist-height ratio and waist are the best estimators of visceral fat in type 1 diabetes. Sci Rep 2020; 10:18575. [PMID: 33122731 PMCID: PMC7596092 DOI: 10.1038/s41598-020-75667-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023] Open
Abstract
Visceral fat is associated with cardiovascular and kidney disease. However, the relationship between body composition and anthropometric measures in type 1 diabetes is unknown. Using z-statistics, we ranked the ability of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR) and a body shape index (ABSI) to capture measures of body composition from 603 Dual-energy-X-Ray-Absorptiometry scans of adults with type 1 diabetes. Albuminuria was defined as urinary albumin excretion rate of at least 30 mg/24 h. Women with albuminuria had higher visceral fat mass % (VFM%) (0.9 vs. 0.5%, p = 0.0017) and lower appendicular lean mass % (AppLM%) (25.4 vs 26.4%, p = 0.03) than those without. Men with albuminuria had higher VFM% (1.5 vs. 1.0%, p = 0.0013) and lower AppLM% (30.0 vs 32.3, p < 0.0001) than those without. In men, WHtR estimated VFM% best (z-statistics = 21.1), followed by WC (z = 19.6), BMI (z = 15.1), WHR (z = 14.6) and ABSI (z = 10.1). In women, the ranking was WC (z = 28.9), WHtR (z = 27.3), BMI (z = 20.5), WHR (z = 12.7) and ABSI (z = 10.5). Overall, the ranking was independent of albuminuria. Adults with type 1 diabetes and albuminuria have greater VFM% and lower AppLM% than those without. WHtR and WC best estimate the VFM% in this population, independently of albuminuria and sex.
Collapse
|
42
|
Bielecka-Dabrowa A, Ebner N, Dos Santos MR, Ishida J, Hasenfuss G, von Haehling S. Cachexia, muscle wasting, and frailty in cardiovascular disease. Eur J Heart Fail 2020; 22:2314-2326. [PMID: 32949422 DOI: 10.1002/ejhf.2011] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
The last several years have seen increasing interest in understanding cachexia, muscle wasting, and physical frailty across the broad spectrum of patients with cardiovascular illnesses. This interest originally started in the field of heart failure, but has recently been extended to other areas such as atrial fibrillation, coronary artery disease, peripheral artery disease as well as to patients after cardiac surgery or transcatheter aortic valve implantation. Tissue wasting and frailty are prevalent among many of the affected patients. The ageing process itself and concomitant cardiovascular illness decrease lean mass while fat mass is relatively preserved, making elderly patients particularly prone to develop wasting syndromes and frailty. The aim of this review is to provide an overview of the available knowledge of body wasting and physical frailty in patients with cardiovascular illness, particularly focussing on patients with heart failure in whom most of the available data have been gathered. In addition, mechanisms of wasting and possible therapeutic targets are discussed.
Collapse
Affiliation(s)
- Agata Bielecka-Dabrowa
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.,Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
| | - Nicole Ebner
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | | | - Junishi Ishida
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| |
Collapse
|
43
|
Pelà G, Tagliaferri S, Perrino F, Bussolati G, Longobucco Y, Zerbinati L, Adorni E, Calvani R, Cesari M, Cherubini A, Bernabei R, Di Bari M, Landi F, Marzetti E, Lauretani F, Maggio M. Interaction of Skeletal and Left Ventricular Mass in Older Adults with Low Muscle Performance. J Am Geriatr Soc 2020; 69:148-154. [PMID: 32964435 DOI: 10.1111/jgs.16812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND It was recently hypothesized the existence of "cardiac-skeletal muscle axis." However, the relationship between skeletal muscle mass (SMM) and left ventricular mass (LVM) has never been investigated in the specific group of older individuals with low skeletal mass and physical performance. We tested this hypothesis in the SPRINT-T (Sarcopenia and Physical Frailty IN older people: multicomponenT Treatment strategies Trial) population using LVM as independent variable and SMM as dependent variable. METHODS SMM was assessed by dual-energy X-ray absorptiometry scan and expressed as appendicular lean mass (ALM), and LVM was estimated through echocardiography. Low ALM was defined according to Foundation for the National Institutes of Health Sarcopenia Project criteria, and Short Physical Performance Battery (SPPB) was used to assess physical performance. RESULTS The population consisted of 100 persons (33 men and 67 women), aged 70 years or older (mean age = 79 ± 5 years) with low ALM and SPPB ranged between 3 and 9, suggestive of physical frailty. Charlson Comorbidity Index median score was 0. Mean value of LVM was 193 ± 67 g, indexed LVM/body surface area (LVM/BSA) was 112 ± 33 g/m2, and cardiac output (CO) was 65 ± 19 L/min. ALM was strongly and positively correlated with LVM (r = 0.54602; P < .0001), LVM/BSA (r = 0.30761; P < .002), CO (r = 0.49621; P < .0001), body mass index (BMI) (r = 0.52461; P < .0001), sex (r = 0.77; P < .001), fat mass (r = 0.38977; P < .0001), and hemoglobin (Hb) (r = 0.26001; P < .01). In the multivariate analysis, LVM (β = .019 ± .005; P < .0001), CO (β = .038 ± .016; P = .019), BMI (β = .286 ± .051; P < .0001), and Hb (β = .544 ± .175; P = .0025) remained associated to ALM. CONCLUSIONS In a sample of older persons with low muscle mass and physical performance, LVM was positively and significantly correlated with ALM, independently from blood pressure, physical activity, and other potential confounders. Future studies are needed to address the effect of interventions targeting LVM and SMM.
Collapse
Affiliation(s)
- Giovanna Pelà
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General and Specialistic Medicine, University-Hospital of Parma, Parma, Italy
| | - Sara Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Felice Perrino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giacomo Bussolati
- Department of Geriatric and Rehabilitation Medicine-Geriatric Clinic Unit, University Hospital of Parma, Parma, Italy
| | - Yari Longobucco
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luna Zerbinati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elisa Adorni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Geriatrics, Neurosciences, Orthopedics, Ear/Nose/Throat, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Unit of Geriatrics, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Geriatrics, Neurosciences, Orthopedics, Ear/Nose/Throat, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
- Unit of Geriatrics - Geriatrics Intensive Care Unit, Department of Medicine and Geriatrics, Careggi Hospital, Firenze, Italy
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Geriatrics, Neurosciences, Orthopedics, Ear/Nose/Throat, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Geriatrics, Neurosciences, Orthopedics, Ear/Nose/Throat, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Fulvio Lauretani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Geriatric and Rehabilitation Medicine-Geriatric Clinic Unit, University Hospital of Parma, Parma, Italy
| | - Marcello Maggio
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Geriatric and Rehabilitation Medicine-Geriatric Clinic Unit, University Hospital of Parma, Parma, Italy
| |
Collapse
|
44
|
Prevalence and significance of sarcopenia in multiple myeloma patients undergoing autologous hematopoietic cell transplantation. Bone Marrow Transplant 2020; 56:225-231. [PMID: 32732941 PMCID: PMC7855279 DOI: 10.1038/s41409-020-01008-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/09/2020] [Accepted: 07/21/2020] [Indexed: 02/08/2023]
Abstract
Sarcopenia, defined as loss of muscle mass, can occur with aging. We conducted a single-center retrospective analysis to evaluate the impact of muscle quality in multiple myeloma (MM), a hematologic cancer of older adults, undergoing autologous hematopoietic cell transplantation (autoHCT). Healthy muscle was quantified by measuring the percent of high-density muscle within the L3 psoas muscle using a novel computed tomography method in 142 eligible patients. Early post-transplant complications were assessed in the first 100 days after transplant. Sarcopenia, defined as ≤80% high-density muscle, was found in 72 (51%) patients. Sarcopenic obesity, defined as sarcopenia and a BMI≥30, was found in 32 (23%) patients. One or more early complications occurred in 22 (16%) patients. Cardiovascular events accounted for 36% of all complications. Patients with sarcopenia had more cardiac complications (12.5%) than patients without (2.9%, p=0.03). Multivariate analysis revealed increased BMI at transplant, but not sarcopenia, was associated with worse OS (hazard ratio: 1.11, 95% confidence interval: 1.02–1.22, p=0.02). Our analysis suggests that sarcopenia is prevalent in MM and associated with increased early post-transplant cardiovascular complications in MM. Obesity, regardless of sarcopenia, is associated with worse survival in MM. Our study generates hypothesis-generating data to risk-stratify patients being considered for autoHCT.
Collapse
|
45
|
Paris MT, Bell KE, Mourtzakis M. Myokines and adipokines in sarcopenia: understanding cross-talk between skeletal muscle and adipose tissue and the role of exercise. Curr Opin Pharmacol 2020; 52:61-66. [PMID: 32668398 DOI: 10.1016/j.coph.2020.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022]
Abstract
Detrimental age-associated changes in skeletal muscle and adipose tissue increase the risk of sarcopenia. Age-related changes in myokines, such as myostatin and irisin, as well as adipokines, such as leptin and adiponectin, contribute to cross-talk between muscle and adipose tissue. These age-related changes in myokines and adipokines have important implications for sarcopenia, however, recent literature highlights discrepancies in these relationships. Exercise may alter serum profiles and muscle receptor expression of these factors, but future work is needed to determine whether these changes in myokines and adipokines relate to improvements in muscle mass and function. Here, we describe myokine-mediated and adipokine-mediated interactions between muscle and adipose tissue, and discuss the fundamental importance of these cytokines to understanding the development of sarcopenia.
Collapse
Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada.
| |
Collapse
|
46
|
He W, Peng N, Chen Q, Xiang T, Wang P, Pang J. The relationships among the skeletal muscle mass index, cardiorespiratory fitness and the prevalence of coronary artery disease in the elderly population. Arch Gerontol Geriatr 2020; 90:104107. [PMID: 32502884 DOI: 10.1016/j.archger.2020.104107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Few studies have investigated the association between cardiorespiratory fitness (CRF) impairment and coronary artery disease (CAD) and the mediating mechanism. Therefore, we investigated the impact of skeletal muscle mass (SMM) on the relationship between CRF and coronary artery disease (CAD) in elderly people. METHODS In this cross-sectional study, 109 elderly patients with coronary artery stenosis ≥50% were included in the CAD group, and 148 patients with coronary artery stenosis <50% were included as controls. Mediation analyses were performed to determine the role of the skeletal muscle index (SMI) in the relationship between CRF and the prevalence of CAD. A receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of CRF markers and the SMI. RESULTS The oxygen pulse, VO2 max, and MET max were significantly associated with the SMI. In the multiple logistic regression analyses, the oxygen pulse and SMI were both independently correlated with the prevalence of CAD. The mediation analyses showed that the SMI affects the relationship between CRF markers (oxygen pulse, VO2 max, and MET max) and the prevalence of CAD. The receiver operating characteristic (ROC) curve analysis showed that when CRF and the SMI are considered together, the predictive power for CAD is stronger than that of the CRF alone. CONCLUSION Enhancing CRF can facilitate improvement in SMM and decrease the prevalence of CAD in the elderly population. The addition of the SMI to CRF markers may increase the predictive value of CAD.
Collapse
Affiliation(s)
- Wuyang He
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Nanxin Peng
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Qingwei Chen
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
| | - Tingting Xiang
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Peng Wang
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jun Pang
- Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| |
Collapse
|
47
|
Papaconstantinou D, Vretakakou K, Paspala A, Misiakos EP, Charalampopoulos A, Nastos C, Patapis P, Pikoulis E. The impact of preoperative sarcopenia on postoperative complications following esophagectomy for esophageal neoplasia: a systematic review and meta-analysis. Dis Esophagus 2020; 33:doaa002. [PMID: 32193528 DOI: 10.1093/dote/doaa002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/15/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022]
Abstract
Esophageal cancer is characterized by profound changes in body composition due to dysphagia and generalized cachexia. Sarcopenia or muscle wasting is a component of cachexia associated with poor postoperative performance status. The skeletal muscle index (SMI) calculated by computed tomography scans at the level of the third lumbar vertebra is an easily quantifiable and reproducible measure of sarcopenia. The aim of this meta-analysis is to investigate the impact of preoperative sarcopenia (low SMI) on postoperative complications after esophagectomy for neoplastic lesions. In this context, a comprehensive literature search was undertaken to identify studies reporting short-term postoperative outcomes in relation to their preoperative SMI values. Cumulative risk ratios (RR) and risk differences (RD) and their respective 95% confidence intervals (CIs) were calculated using a random-effect model. A total of 11 studies incorporating 1,979 total patients (964 patients with sarcopeniaversus 1,015 without sarcopenia) were included in the final analysis. The results demonstrated a significant increase in overall morbidity (RR 1.16, 95% CI 1.01-1.33), respiratory complications (RR 1.64, 95% CI 1.21-2.22) and anastomotic leaks (RR 1.39, 95% CI 1.10-1.76) in patients with sarcopenia. No statistically significant difference was noted in overall mortality (RD 0, 95% CI -0.02-0.02) or Clavien-Dindo grade III or greater complications (RR 1.17, 95% CI 0.96-1.42). The above results demonstrate the validity of the SMI as a predictive factor for post-esophagectomy complications. Although the risk associated with sarcopenia is not prohibitive for surgery, patients with low SMI require closer vigilance during their postoperative course due to the increased propensity for respiratory and anastomotic complications.
Collapse
Affiliation(s)
- Dimitrios Papaconstantinou
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Konstantina Vretakakou
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Anna Paspala
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Evangelos P Misiakos
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Anestis Charalampopoulos
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Constantinos Nastos
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Paul Patapis
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| | - Emmanouil Pikoulis
- Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Chaidari, Greece
| |
Collapse
|