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Nakamura K, Kinugasa Y, Sota T, Hirai M, Kato M, Yamamoto K. The water imbalance of skeletal muscle and muscle weakness in patients with heart failure. ESC Heart Fail 2024. [PMID: 38992950 DOI: 10.1002/ehf2.14950] [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: 09/21/2023] [Revised: 04/26/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024] Open
Abstract
AIMS A high extracellular water (ECW) to intracellular water (ICW) ratio of skeletal muscle as assessed by bioelectrical impedance analysis is reportedly associated with loss of muscle strength. However, the validity of this index for heart failure (HF), which is likely associated with changes in the water distribution, is unclear. METHODS AND RESULTS This study involved 190 patients with HF. The total ECW and ICW of both upper and lower extremities were measured, and a high ECW/ICW ratio was defined as an ECW/ICW ratio higher than the median (≥0.636 for men, ≥0.652 for women). Low muscle strength was defined as reduced handgrip strength according to the criteria established by the Asian Working Group for Sarcopenia. Patients with a high ECW/ICW ratio had a lower handgrip strength (21.1 ± 8.1 kg vs. 27.6 ± 9.3 kg, P ≤ 0.05) and 6 min walk distance (329 ± 116 m vs. 440 ± 114 m) than those with a low ECW/ICW ratio. An increasing ECW and/or decreasing ICW was associated with a higher ECW/ICW ratio and a lower handgrip strength (P < 0.05). In the multivariate logistic regression analysis, a high ECW/ICW ratio and low skeletal muscle mass were independently associated with low muscle strength (P < 0.05). CONCLUSIONS A high ECW/ICW ratio in limb muscles, that is, the water imbalance of increasing ECW and/or decreasing ICW, is useful in assessing muscle quality in patients with HF.
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Affiliation(s)
- Kensuke Nakamura
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Takeshi Sota
- Division of Rehabilitation, Tottori University Hospital, Yonago, Japan
| | - Masayuki Hirai
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masahiko Kato
- Department of Pathobiological Science and Technology, School of Health Science; Major in Clinical Laboratory Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan
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Lin CL, Yu NC, Wu HC, Liu YC, Chiu IY, Lin WC, Chien WC. Associated factors of low muscle mass in community-dwelling patients with type 2 diabetes. Medicine (Baltimore) 2024; 103:e38629. [PMID: 38905419 PMCID: PMC11191938 DOI: 10.1097/md.0000000000038629] [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: 11/21/2023] [Accepted: 05/29/2024] [Indexed: 06/23/2024] Open
Abstract
This study aims to analyze the prevalence of low muscle mass (LMM) and its associated factors among community-dwelling patients with type 2 diabetes (T2D). A retrospective design was employed to analyze the body composition of 2404 adults with T2D aged 18 years and older. LMM was defined as a skeletal muscle index < 7.0 kg/m2 for males and skeletal muscle index < 5.7 kg/m2 for females by bioelectrical impedance analyzer (InBody 770, Korea). Multivariable logistic regression was used to identify the factors related to LMM. The overall prevalence of LMM was 28%. After adjusting for multivariate odds ratios, factors significantly associated with LMM in patients with diabetes include being older than 75 years, female, having a body mass index of <18 kg/m2, and increased percent body fat. We recommend regular LMM evaluations for T2D patients with the previously mentioned characteristics as part of diabetes care.
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Affiliation(s)
- Chia-Ling Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | | | - Hsueh-Ching Wu
- Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | | | | | | | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan
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Zhang X, Zhang L, Liu Y, Liu L, Wang J, Wang C, Zhang S, Cheng G, Wang L. Predictive Roles of Basal Metabolic Rate and Muscle Mass in Lung Function among Patients with Obese Asthma: A Prospective Cohort Study. Nutrients 2024; 16:1809. [PMID: 38931162 PMCID: PMC11206345 DOI: 10.3390/nu16121809] [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: 04/08/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The metabolic-status-related mechanisms underlying the deterioration of the lung function in obese asthma have not been completely elucidated. OBJECTIVE This study aimed to investigate the basal metabolic rate (BMR) in patients with obese asthma, its association with the lung function, and its mediating role in the impact of obesity on the lung function. METHODS A 12-month prospective cohort study (n = 598) was conducted in a real-world setting, comparing clinical, body composition, BMR, and lung function data between patients with obese (n = 282) and non-obese (n = 316) asthma. Path model mediation analyses for the BMR and skeletal muscle mass (SMM) were conducted. We also explored the effects of the BMR on the long-term lung function in patients with asthma. RESULTS Patients with obese asthma exhibited greater airway obstruction, with lower FEV1 (1.99 vs. 2.29 L), FVC (3.02 vs. 3.33 L), and FEV1/FVC (65.5 vs. 68.2%) values compared to patients with non-obese asthma. The patients with obese asthma also had higher BMRs (1284.27 vs. 1210.08 kcal/d) and SMM (23.53 vs. 22.10 kg). Both the BMR and SMM mediated the relationship between obesity and the lung function spirometers (FEV1, %FEV1, FVC, %FVC, and FEV1/FVC). A higher BMR or SMM was associated with better long-term lung function. CONCLUSIONS Our study highlights the significance of the BMR and SMM in mediating the relationship between obesity and spirometry in patients with asthma, and in determining the long-term lung function. Interventions for obese asthma should focus not only on reducing adiposity but also on maintaining a high BMR.
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Affiliation(s)
- Xin Zhang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
| | - Li Zhang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
| | - Ying Liu
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
| | - Lei Liu
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
| | - Ji Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changyong Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shuwen Zhang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
| | - Gaiping Cheng
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lei Wang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; (X.Z.)
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Li N, Huang F, Wang N, Lin S, Yuan Y, Zhu P. Effectiveness of a mHealth platform-based lifestyle integrated multicomponent exercise ( PF-Life) program to reverse pre-frailty in community-dwelling older adults: a randomized controlled trial study protocol. Front Public Health 2024; 12:1389297. [PMID: 38912262 PMCID: PMC11190369 DOI: 10.3389/fpubh.2024.1389297] [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: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
Background Pre-frailty represents an ideal window of opportunity to potentially prevent frailty and disability. Early and effective interventions to delay or reverse pre-frailty are public health imperative. The present trial aims to evaluate the effectiveness and underlying mechanisms of mobile health (mHealth) platform-supported lifestyle-integrated multicomponent exercise (PF-Life) to reverse pre-frailty in community-dwelling older adults. Methods This is an open-label, prospective, two-arm parallel randomized controlled trial with allocation concealment and outcome assessment blinding. We aim to recruit 140 pre-frail community-dwelling older adults who will be randomized into two groups. The control group will receive a health education program, while the intervention group will receive PF-Life training as planned for 1 year. The proportion of pre-frailty, functional performance (muscular strength, aerobic capacity, flexibility, and balance), body composition, and physical activity will be measured at pre-intervention, post-intervention, and 12-month follow-up. Inflammatory biomarkers will also be collected to explore the underlying mechanisms. Discussion This is the first study to evaluate the effects of a novel digital lifestyle-integrated multicomponent exercise for pre-frail older people. The results of this trial will provide much-needed information on the short-and long-term effects of PF-Life based on functional performance and body composition. Meanwhile, inflammatory biomarkers and physical activity levels will be used to elucidate the underlying mechanisms of PF-Life. The findings from this trial will provide evidence for the effectiveness of lifestyle multicomponent exercise intervention supported by the mHealth platform that may reverse or even halt the onset of frailty. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=176477, identifier ChiCTR2200063431.
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Affiliation(s)
- Na Li
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, China
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Feng Huang
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Provincial Center for Geriatrics, Fuzhou, China
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Nan Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Siyang Lin
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yin Yuan
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
| | - Pengli Zhu
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China
- Fujian Provincial Center for Geriatrics, Fuzhou, China
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
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Freer CL, George ES, Tan SY, Abbott G, Scott D, Daly RM. Prevalence of Sarcopenia and Its Defining Components in Non-alcoholic Fatty Liver Disease Varies According to the Method of Assessment and Adjustment: Findings from the UK Biobank. Calcif Tissue Int 2024; 114:592-602. [PMID: 38678512 PMCID: PMC11090922 DOI: 10.1007/s00223-024-01212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/14/2024] [Indexed: 05/01/2024]
Abstract
Sarcopenia may increase non-alcoholic fatty liver disease (NAFLD) risk, but prevalence likely varies with different diagnostic criteria. This study examined the prevalence of sarcopenia and its defining components in adults with and without NAFLD and whether it varied by the method of muscle mass assessment [bioelectrical impedance (BIA) versus dual-energy X-ray absorptiometry (DXA)] and adjustment (height2 versus BMI). Adults (n = 7266) in the UK Biobank study (45-79 years) with and without NAFLD diagnosed by MRI, were included. Sarcopenia was defined by the 2018 European Working Group on Sarcopenia in Older People definition, with low appendicular skeletal muscle mass (ASM) assessed by BIA and DXA and adjusted for height2 or BMI. Overall, 21% of participants had NAFLD and the sex-specific prevalence of low muscle strength (3.6-7.2%) and sarcopenia (0.1-1.4%) did not differ by NAFLD status. However, NAFLD was associated with 74% (males) and 370% (females) higher prevalence of low ASM when adjusted for BMI but an 82% (males) to 89% (females) lower prevalence when adjusted for height2 (all P < 0.05). The prevalence of impaired physical function was 40% (males, P = 0.08) to 123% (females, P < 0.001) higher in NAFLD. In middle-aged and older adults, NAFLD was not associated with a higher prevalence of low muscle strength or sarcopenia but was associated with an increased risk of impaired physical function and low muscle mass when adjusted for BMI. These findings support the use of adiposity-based adjustments when assessing low muscle mass and the assessment of physical function in NAFLD.
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Affiliation(s)
- Christine L Freer
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Elena S George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Lee JH, Kim HJ, Han S, Park SJ, Sim M, Lee KH. Reliability and Agreement Assessment of Sarcopenia Diagnosis through Comparison of Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry. Diagnostics (Basel) 2024; 14:899. [PMID: 38732314 PMCID: PMC11083379 DOI: 10.3390/diagnostics14090899] [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: 03/12/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
A unified diagnostic criterion has yet to be established for sarcopenia. Therefore, we analyzed the reliability and validity of sarcopenia diagnosis using bioelectrical impedance analysis (BIA) compared with the gold standard, dual-energy X-ray absorptiometry (DEXA), and evaluated the predictive accuracy of BIA for diagnosis. The clinical trial, involving a total of 239 participants, was conducted between December 2018 and September 2019 on healthy volunteers without significant medical histories. The participants underwent health assessments, followed by sequential DEXA and BIA measurements. In both the low and normal appendicular skeletal muscle (ASM) groups, there were significant differences in the right arm, left arm, right leg, left leg, ASM, and ASM index (ASMI) between DEXA and BIA across all age groups (p < 0.05). BIA tended to overestimate compared to DEXA, but ASMI values for males and females were consistent with the criteria for sarcopenia. Bland-Altman analysis showed that each segment in both the low and normal ASM groups fell within the limits of agreement (LOA). The diagnosis of sarcopenia using BIA was significantly different from that using DEXA. However, it exhibited a significantly high correlation, fell within the LOA, and demonstrated high predictive accuracy. BIA can be considered an effective tool for diagnosing sarcopenia.
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Affiliation(s)
- Jung Hun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (J.H.L.); (H.J.K.)
| | - Hee Jin Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (J.H.L.); (H.J.K.)
| | - Sanghun Han
- MEDIANA Co., Ltd., Wonju 26365, Republic of Korea; (S.H.); (S.J.P.); (M.S.)
| | - Seong Jun Park
- MEDIANA Co., Ltd., Wonju 26365, Republic of Korea; (S.H.); (S.J.P.); (M.S.)
| | - Myongheon Sim
- MEDIANA Co., Ltd., Wonju 26365, Republic of Korea; (S.H.); (S.J.P.); (M.S.)
| | - Kang Hyun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (J.H.L.); (H.J.K.)
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Ellison KM, Ehrlicher SE, El Zein A, Sayer RD. Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference. Obes Sci Pract 2024; 10:e744. [PMID: 38476295 PMCID: PMC10928253 DOI: 10.1002/osp4.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/07/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
Background Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC). Aims The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM). Materials & Methods Baseline data were collected from 28 adults (mean = 61.4 ± 6.9 years, 64.3% female) with obesity (BMI 38.6 ± 5.0 kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement. Results Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3 cm). Discussion Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC. Conclusion Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.
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Affiliation(s)
- Katie M. Ellison
- Department of Nutrition SciencesThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Sarah E. Ehrlicher
- Department of Nutrition SciencesThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Aseel El Zein
- Department of Family and Community MedicineThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - R. Drew Sayer
- Department of Family and Community MedicineThe University of Alabama at BirminghamBirminghamAlabamaUSA
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Rezaei S, Eslami R, Tartibian B. The effects of TRX suspension training on sarcopenic biomarkers and functional abilities in elderlies with sarcopenia: a controlled clinical trial. BMC Sports Sci Med Rehabil 2024; 16:58. [PMID: 38409184 PMCID: PMC10898163 DOI: 10.1186/s13102-024-00849-x] [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: 05/13/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Sarcopenia is an age-related progressive loss of muscle mass and strength that can be modulated by resistance training. This study aimed to investigate the effects of TRX Suspension Training (TST) on serum levels of neuromuscular and growth factors and functional indices in elderly men with sarcopenia, an age-related condition characterized by progressive muscle mass and strength loss. METHODS Nineteen sarcopenic elderly men (age = 74.87 ± 4.58 years) were randomly assigned into two groups, the TST group (n = 10) and the control group (n = 9). Serum concentrations of regulatory muscle markers, anthropometric and body composition indices, and functional tests were evaluated at baseline and after 8 weeks. The training protocol consisted of eight weeks of TRX exercises, with three weekly sessions. RESULTS After 8 weeks of training, growth factors such as Follistatin (FST) (P = 0.001), 22 kDa C-terminal agrin fragment (CAF) (P = 0.031), and growth differentiation factor 15 (GDF15) (P = 0.049) increased significantly in the training group in comparison to the control group and Myostatin (MSTN) (P = 0.002) had a significant decrease. However, there was no significant difference in ASMM/m2 (P = 0.527), SMM/m2 (P = 0.621), or Body fat mass (P = 0.433) within or between groups. In addition, the TRX Suspension Training had a significant effect on the functional tests and improved gait speed (P = 0.037), chair stand (P = 0.016), and TUG (P = 0.016) as well as Handgrip strength (P = 0.035). CONCLUSION Our findings highlight the efficacy of TRX Suspension Training in enhancing the serum levels of muscle growth factors and functional capacities among elderly individuals with sarcopenia. Therefore, considering the ongoing COVID-19 pandemic, this protocol can prove beneficial for this demographic group. TRIAL REGISTRY Iranian Registry of Clinical Trials identifier: IRCT20230727058944N1, prospectively registered 20-09-2023, https://en.irct.ir/trial/71635.
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Affiliation(s)
- Sohrab Rezaei
- Exercise Physiology Department, Faculty of Sport Science, Allameh Tabataba'i University, Tehran, Iran
| | - Rasoul Eslami
- Exercise Physiology Department, Faculty of Sport Science, Allameh Tabataba'i University, Tehran, Iran.
| | - Bakhtyar Tartibian
- Exercise Physiology Department, Faculty of Sport Science, Allameh Tabataba'i University, Tehran, Iran
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Suzuki Y, Shimizu Y, Soma Y, Matsuda T, Hada Y, Koda M. Effectiveness of a Remote Monitoring-Based Home Training System for Preventing Frailty in Older Adults in Japan: A Preliminary Randomized Controlled Trial. Geriatrics (Basel) 2024; 9:20. [PMID: 38392107 PMCID: PMC10888319 DOI: 10.3390/geriatrics9010020] [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: 11/10/2023] [Revised: 01/24/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
This study examined whether SUKUBARA®, a remotely managed training system that we developed, could improve skeletal muscle mass and muscle strength in community-dwelling older adults. SUKUBARA® is a composite exercise program that combines lower-load resistance training and balance exercises. Participants were instructed to exercise while watching individually assigned videos on YouTube, such that the research administrators could verify the viewing records of each participant. Fifteen participants (69 ± 4 years) were randomly assigned to the intervention (eight participants; the RT group) or the control group (seven participants; the CO group). The primary endpoint was a change in fat-free mass (FFM; kg), whereas the secondary endpoints included a change in knee extension strength (KES; Nm/kg). Correlation analyses were conducted to examine the relationship between FFM and KES. During the 12-week intervention period, significant differences were observed between the RT and CO groups in the changes in FFM (0.5 ± 0.5 vs. -0.1 ± 0.5) and KES (0.20 ± 0.22 vs. 0.02 ± 0.13), and significant positive correlations were found between the changes. Thus, SUKUBARA®-based interventions have the potential to improve muscle hypertrophy and enhance muscle strength among community-dwelling older adults. Thus, SUKUBARA® -based interventions show promise in improving muscle hypertrophy and enhance muscle strength among community-dwelling older adults. However, appropriately powered future research is needed to replicate these findings.
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Affiliation(s)
- Yasuhiro Suzuki
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba 305-8576, Ibaraki, Japan
- Tsukuba Therapist Society for Diabetes Mellitus Prevention, Tsukuba 305-8576, Ibaraki, Japan
- Biomedical Science and Engineering Research Center, Hakodate Medical Association Nursing and Rehabilitation Academy, Hakodate 040-0081, Hokkaido, Japan
- Department of Internal Medicine (Endocrinology and Metabolism), Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Yuichiro Soma
- Department of Orthopedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Takaaki Matsuda
- Department of Internal Medicine (Endocrinology and Metabolism), Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Masao Koda
- Department of Orthopedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
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Qaisar R, Iqbal MS, Karim A, Muhammad T, Ahmad F. A leaky gut contributes to reduced sarcopenia-related quality of life (SarQoL) in geriatric older adults. Qual Life Res 2024; 33:551-559. [PMID: 37930557 DOI: 10.1007/s11136-023-03547-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The sarcopenia quality-of-life (SarQoL) questionnaire is designed to evaluate the quality of life of sarcopenic patients. A pathological increase in intestinal permeability leads to several systemic diseases, but its contribution to SarQoL is unknown. METHODS We recruited controls (n = 84, age = 74.6 ± 4.9 years) and sarcopenic (n = 55, age = 76.1 ± 4.2 years) men for validating and adapting a Pashto version of SarQoL. We measured the scores for seven domains of SarQoL, body composition, and handgrip strength (HGS). We also measured plasma zonulin as a marker of increased intestinal permeability. RESULTS The Pashto SarQoL exhibited adequate discriminative ability, construct validity, internal consistency, and test-retest reliability, without exhibiting the floor and ceiling effect. Sarcopenic patients had higher plasma zonulin and lower scores on SarQoL domains for physical and mental health, locomotion, body composition, functionality, activities of daily living, leisure, and fear, and cumulative SarQoL scores than controls. Plasma zonulin exhibited significant coefficients of determination with Pashto SarQoL domains for locomotion (r2 = 0.217), functionality (r2 = 0.101), activities of daily living (r2 = 0.302), and cumulative SarQoL scores (r2 = 0.168). We also found high efficacies of zonulin in diagnosing low scores for functionality (AUC = 0.785, 95% C.I = 0.708-0.863), activities of daily living (AUC = 0.785, 95% C.I = 0.708-0.863), and cumulative SarQoL scores (AUC = 0.821, 95% C.I = 0.751-0.891). CONCLUSION Altogether, SarQoL appears reliable in measuring the quality of life in sarcopenic patients. A leaky gut has a potential contribution to reduced SarQoL in sarcopenia.
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Affiliation(s)
- Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
- Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - M Shahid Iqbal
- Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar, 25124, Pakistan
| | - Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Tahir Muhammad
- Department of Biochemistry, Gomal Medical College, Dera Ismail Khan, Pakistan
| | - Firdos Ahmad
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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11
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Liu C, Cheng L, Ye W, Lin L. Risk factors for sarcopenia in patients with head and neck cancer. Head Neck 2024; 46:346-352. [PMID: 38031723 DOI: 10.1002/hed.27585] [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: 04/17/2023] [Revised: 09/25/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE Sarcopenia is a common condition among patients with cancer. To better understand the prevalence of sarcopenia in patients with head and neck cancer (HNC), we analysed the risk factors of sarcopenia and developed a theoretical foundation for further development of sarcopenia prevention and treatment strategies. METHODS Six hundred and seventeen patients with HNC were recruited for this cross-sectional observational study, and the data were analyzed using logistic regression analyses. The bioelectrical impedance analysis (BIA) was used to measure skeletal muscle mass, and sarcopenia was diagnosed according to the 2019 diagnostic criteria of the Asian Sarcopenia Working Group (AWGS). RESULTS Among the 617 patients enrolled in the study, 115 (18.6%) had sarcopenia. The prevalence of sarcopenia was 29.1% in males and 8% in females. In the multivariate analysis, older age (OR = 12.266, 95% CI: 3.864-38.934, p < 0.01), body fat (OR = 1.775, 95% CI: 1.511-2.084, p < 0.01), and sex (OR = 138.659, 95% CI: 42.382-453.642, p < 0.01) were independent risk factors for sarcopenia. Body mass index (BMI) (OR = 0.137, 95% CI: 0.09-0.21, p < 0.01), and total body water/fat free mass (TBW/FFM) (OR = 0.122, 95% CI: 0.031-0.474, p < 0.01) were protective factors for sarcopenia; we observed that sarcopenia decreased with increasing BMI and TBW/FFM. CONCLUSIONS Male sex, advanced age, and excess body fat were identified as risk factors for sarcopenia in patients with HNC, whereas a higher BMI and TBW/FFM acted as protective factors against sarcopenia in these patients.
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Affiliation(s)
- Chen Liu
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Clinical Nutrition, The Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling Cheng
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Internal Medicine of Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Wenfeng Ye
- Department of Clinical Nutrition, The Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lizhu Lin
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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12
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Lee S, Yoon S, Kim S, Lee W, Chun S, Min WK. Skeletal Muscle Mass Measurement via Bioelectrical Impedance Analysis as an Aid to Screen for Chronic Kidney Disease in Routine Health Checkups. Ann Lab Med 2024; 44:100-102. [PMID: 37665292 PMCID: PMC10485860 DOI: 10.3343/alm.2024.44.1.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/18/2023] [Accepted: 07/05/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Seunghoo Lee
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sangpil Yoon
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sollip Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woochang Lee
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sail Chun
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won-Ki Min
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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13
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Liu J, Chen X. Comparison between bioelectrical impedance analyses and dual-energy X-ray absorptiometry for accuracy in assessing appendicular skeletal muscle mass and diagnosing sarcopenia in hospitalized Chinese older adults. Medicine (Baltimore) 2023; 102:e35250. [PMID: 37773822 PMCID: PMC10545164 DOI: 10.1097/md.0000000000035250] [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: 04/15/2023] [Accepted: 08/24/2023] [Indexed: 10/01/2023] Open
Abstract
The aim of this study was to compare bioelectrical impedance analysis (BIA) with dual-energy X-ray absorptiometry (DXA) and investigate the accuracy of BIA in assessing appendicular skeletal muscle mass (ASM) and diagnosing sarcopenia. A total of 90 elderly patients hospitalized in the Affiliated Hospital of Hangzhou Normal University from 2019 to 2020 were collected, including 42 males and 48 females. All patients underwent BIA and DXA examinations. Pearson correlation and Bland-Altman analysis were used to compare the differences between BIA and DXA in assessing ASM and diagnosing sarcopenia. ASM measured by BIA was higher than ASM measured by DXA, and there was statistical significance for all differences (P < .001); Pearson correlation analysis showed that ASM measured by BIA and DXA was positively correlated in both male (R = 0.94) and female (R = 0.97) patients (P < .001); Bland-Altman analysis showed that there was a high consistency between ASM detected by BIA and DXA; The detection rate of low muscle mass and sarcopenia by BIA and DXA was not statistically significant (P > .05). BIA (InBody720) has high accuracy in assessing ASM and diagnosing sarcopenia in hospitalized Chinese older adults, and has the advantages of convenient use, no radiation, and easy promotion, so it can be used as an early screening tool in primary hospitals lacking DXA.
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Affiliation(s)
- Jianping Liu
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xiaoliang Chen
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
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14
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Min JY, Min KB. Comparisons of Two Bioelectrical Impedance Devices and Manual versus Sensor-Based Short Physical Performance Batteries for Assessment of Muscle Mass and Physical Performance. SENSORS (BASEL, SWITZERLAND) 2023; 23:6026. [PMID: 37447873 DOI: 10.3390/s23136026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
The assessment of muscle mass and physical performance is essential for the diagnosis of sarcopenia. This study examined the validity of bioimpedance analysis (BIA) and a sensor-based short physical performance battery (SPPB) device for analyzing appendicular skeletal muscle mass (ASM) and physical performance. Forty-one older adults were measured for ASM and physical performance with two BIA devices (InBody770 vs. T-SCAN PLUS III) and two SPPB devices (manual mSPPB vs. sensor-based sSPPB). Validity statistics included the intraclass correlation coefficient (ICC) and Bland-Altman plots to examine the agreement of data from the BIA (InBody770 vs. T-SCAN PLUS III) and the SPPBs (mSPPB vs. sSPPB). There was a significant ICC for skeletal muscle mass between the T-SCAN PLUS III and InBody770 devices (ICC = 0.8822; p < 0.0001). The mSPPB and sSPPB values showed agreement across all components: 0.8654 for the total scores, 0.8879 for the walking speed, 0.8889 for the chair stand, and 0.6863 for the standing balance. No systemic bias was observed between the two methods for the BIA and SPPB devices. Measurements using the T-SCAN PLUS III and sSPPB seem to be highly correlated with the InBody770 and mSPPB devices in older adults and may be valid for assessing muscle mass and physical performance.
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Affiliation(s)
- Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 08826, Republic of Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
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15
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Haigis D, Wagner S, Thiel A, Nieß AM. Bioelectrical impedance analysis in the BaSAlt cohort-study: the phase angle as an additional parameter for sarcopenia quantification among German nursing home residents? Eur Geriatr Med 2023:10.1007/s41999-023-00780-3. [PMID: 37052833 PMCID: PMC10100613 DOI: 10.1007/s41999-023-00780-3] [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: 02/06/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE Sarcopenia is characterized by the loss of muscle mass, strength, and physical functioning. The bioelectrical impedance analysis (BIA) is a simplify method for the measurement of muscle quantity and quality. But there is a lack of evidence in the interpretation of the muscle quality parameter phase angle (PhA), which was recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). We hypothesize that the PhA shows differences between sarcopenia categorized groups and can be used as an additional parameter for sarcopenia quantification among residents of nursing homes (NH). METHODS Based on EWGSOP2 specifications, 78 residents from five German NH was categorized into sarcopenia groups. Group comparisons with Kruskal-Wallis tests, Dunn-Bonferroni post-hoc-Tests, and correlations with Spearman coefficients were conducted with the muscle quality parameter PhA. RESULTS Significant group differences by Kruskal-Wallis test for PhA was detected (H = 8.150, p = 0.017). The Dunn-Bonferroni post-hoc-Test showed significant results by group comparison for "confirmed/ severe sarcopenia" (4.1° [3.1-5.0]) with "no sarcopenia" (4.6° [3.7-11.2]; p =0 .049) and "probable sarcopenia" (4.7° [3.4-13.5]; p = 0.016), respectively. CONCLUSIONS There is a limitation for differentiation in preliminary stage of sarcopenia among multimorbid NH residents by PhA. Moreover, further research for specific cut-off-values and the individual sarcopenia progression monitoring by PhA are needed. TRIAL REGISTRATION No. AZ A2.5.4-096_aa (Date of approval: July 2019).
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Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076, Tübingen, Germany.
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074, Tübingen, Germany.
| | - Silas Wagner
- Department of Sports Medicine, University Hospital of Tuebingen, 72076, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074, Tübingen, Germany
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074, Tübingen, Germany
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074, Tübingen, Germany
| | - Andreas M Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074, Tübingen, Germany
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16
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Jang DH, Park SM, Lee DK, Kim DW, Im CW, Jo YH, Lee KJ. Lower limb muscle matters in patients with hypoxic brain injury following out-of-hospital cardiac arrest. Acute Crit Care 2023; 38:104-112. [PMID: 36935539 PMCID: PMC10030248 DOI: 10.4266/acc.2022.01389] [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: 10/31/2022] [Accepted: 01/18/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND There are conflicting results regarding the association between body mass index and the prognosis of cardiac arrest patients. We investigated the association of the composition and distribution of muscle and fat with neurologic outcomes at hospital discharge in successfully resuscitated out-of-hospital cardiac arrest (OHCA) patients. METHODS This prospective, single-centre, observational study involved adult OHCA patients, conducted between April 2019 and June 2021. The ratio of total skeletal muscle, upper limb muscle, lower limb muscle, and total fat to body weight was measured using InBody S10, a bioimpedance analyser, after achieving the return of spontaneous circulation. Restricted cubic spline curves with four knots were used to examine the relationship between total skeletal muscle, upper limb muscle, and lower limb muscle relative to total body weight and neurologic outcome at discharge. Multivariable logistic regression analysis was performed to assess an independent association. RESULTS A total of 66 patients were enrolled in the study. The proportion of total muscle and lower limb muscle positively correlated with the possibility of having a good neurologic outcome. The proportion of lower limb muscle showed an independent association in the multivariable analysis (adjusted odds ratio, 2.29; 95% confidence interval, 1.06-13.98), and its optimal cut-off value calculated through receiver operating characteristic curve analysis was 23.1%, which can predict a good neurological outcome. CONCLUSIONS A higher proportion of lower limb muscle to body weight was independently associated with the probability of having a good neurologic outcome in OHCA patients.
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Affiliation(s)
- Dong-Hyun Jang
- Department of Public Healthcare Service, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Min Park
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Keon Lee
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Won Kim
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Chang Woo Im
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kui Ja Lee
- Department of Emergency Medical Services, Kyungdong University, Wonju, Korea
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17
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Nuzzo JL. Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations. J Strength Cond Res 2023; 37:494-536. [PMID: 36696264 DOI: 10.1519/jsc.0000000000004329] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
ABSTRACT Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.
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Affiliation(s)
- James L Nuzzo
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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18
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Shiroma K, Tanabe H, Takiguchi Y, Yamaguchi M, Sato M, Saito H, Tanaka K, Masuzaki H, Kazama JJ, Shimabukuro M. A nutritional assessment tool, GNRI, predicts sarcopenia and its components in type 2 diabetes mellitus: A Japanese cross-sectional study. Front Nutr 2023; 10:1087471. [PMID: 36819693 PMCID: PMC9928854 DOI: 10.3389/fnut.2023.1087471] [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: 11/02/2022] [Accepted: 01/02/2023] [Indexed: 02/04/2023] Open
Abstract
Background There are few reports evaluating the relationship between undernutrition and the risk of sarcopenia in type 2 diabetes mellitus (T2DM) patients. Objective We investigated whether undernutritional status assessed by the geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) were associated with the diagnosis of sarcopenia. Methods This was a cross-sectional study of Japanese individuals with T2DM. Univariate or multivariate logistic regression analysis was performed to assess the association of albumin, GNRI, and CONUT with the diagnosis of sarcopenia. The optimal cut-off values were determined by the receiver operating characteristic (ROC) curve to diagnose sarcopenia. Results In 479 individuals with T2DM, the median age was 71 years [IQR 62, 77], including 264 (55.1%) men. The median duration of diabetes was 17 [11, 23] years. The prevalence of sarcopenia was 41 (8.6%) in all, 21/264 (8.0%) in men, and 20/215 (9.3%) in women. AUCs were ordered from largest to smallest as follows: GNRI > albumin > CONUT. The cut-off values of GNRI were associated with a diagnosis of sarcopenia in multiple logistic regression analysis (odds ratio 9.91, 95% confidential interval 5.72-17.2), P < 0.001. The superiority of GNRI as compared to albumin and CONUT for detecting sarcopenia was also observed in the subclasses of men, women, body mass index (BMI) < 22, and BMI ≥ 22. Conclusions Results showed that GNRI shows a superior diagnostic power in the diagnosis of sarcopenia. Additionally, its optimal cut-off points were useful overall or in the subclasses. Future large and prospective studies will be required to confirm the utility of the GNRI cut-off for undernutrition individuals at risk for sarcopenia.
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Affiliation(s)
- Kaori Shiroma
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan,Department of Health and Nutrition, Faculty of Health and Nutrition, Okinawa University, Okinawa, Japan
| | - Hayato Tanabe
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshinori Takiguchi
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mizuki Yamaguchi
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masahiro Sato
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Haruka Saito
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenichi Tanaka
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes, and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), University of the Ryukyus, Okinawa, Japan
| | - Junichiro J. Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan,*Correspondence: Michio Shimabukuro ✉
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Epidemiological, mechanistic, and practical bases for assessment of cardiorespiratory fitness and muscle status in adults in healthcare settings. Eur J Appl Physiol 2023; 123:945-964. [PMID: 36683091 PMCID: PMC10119074 DOI: 10.1007/s00421-022-05114-y] [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: 07/26/2022] [Accepted: 12/08/2022] [Indexed: 01/24/2023]
Abstract
Given their importance in predicting clinical outcomes, cardiorespiratory fitness (CRF) and muscle status can be considered new vital signs. However, they are not routinely evaluated in healthcare settings. Here, we present a comprehensive review of the epidemiological, mechanistic, and practical bases of the evaluation of CRF and muscle status in adults in primary healthcare settings. We highlight the importance of CRF and muscle status as predictors of morbidity and mortality, focusing on their association with cardiovascular and metabolic outcomes. Notably, adults in the best quartile of CRF and muscle status have as low as one-fourth the risk of developing some of the most common chronic metabolic and cardiovascular diseases than those in the poorest quartile. The physiological mechanisms that underlie these epidemiological associations are addressed. These mechanisms include the fact that both CRF and muscle status reflect an integrative response to the body function. Indeed, muscle plays an active role in the development of many diseases by regulating the body's metabolic rate and releasing myokines, which modulate metabolic and cardiovascular functions. We also go over the most relevant techniques for assessing peak oxygen uptake as a surrogate of CRF and muscle strength, mass, and quality as surrogates of muscle status in adults. Finally, a clinical case of a middle-aged adult is discussed to integrate and summarize the practical aspects of the information presented throughout. Their clinical importance, the ease with which we can assess CRF and muscle status using affordable techniques, and the availability of reference values, justify their routine evaluation in adults across primary healthcare settings.
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Kojima K, Shindoh J, Matsumura M, Okubo S, Hashimoto M. A preoperative risk score based on multifrequency bioelectrical impedance analysis in patients undergoing liver resection. Langenbecks Arch Surg 2023; 408:44. [PMID: 36662311 DOI: 10.1007/s00423-023-02806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE To investigate if body composition parameters measured by bioelectrical impedance analysis (BIA) and are reportedly correlated with clinical outcomes of patients undergoing digestive tract surgery could be useful for reliably evaluating the perioperative risk in patients undergoing hepatectomy. METHODS Consecutive 200 patients who underwent BIA before hepatectomy were retrospectively reviewed. A risk prediction model for postoperative morbidity was created using the initial 100 patients, and its performance was validated using the remaining 100 patients. RESULTS Based on the correlation with postoperative morbidity, a novel risk prediction model, the protein-edema score, was created using net protein weight and extracellular water/total body water ratio measured through BIA. The protein-edema score (score 0 vs. ≥ 1) showed a reproducible correlation with Clavien-Dindo 2 or greater postoperative morbidity in the validation set (17.7% vs. 46.4%, P = 0.002) as observed in the training set (18.8% vs. 49.0%, P = 0.002) after statistical adjustment. Similar tendency was also confirmed in Clavien-Dindo 3a or greater postoperative morbidity (5.9% vs. 18.2%, P = 0.037) and postoperative refractory ascites (5.5% vs. 17.4%, P = 0.037) in the validation set. CONCLUSIONS The protein-edema score created based on BIA is significantly correlated with postoperative morbidity in patients undergoing liver resection.
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Affiliation(s)
- Kazutaka Kojima
- Hepatobiliary-pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Junichi Shindoh
- Hepatobiliary-pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
- Okinaka Memorial Institute for Medical Diseases, Toranomon Hospital, Tokyo, Japan.
| | - Masaru Matsumura
- Hepatobiliary-pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Satoshi Okubo
- Hepatobiliary-pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Masaji Hashimoto
- Hepatobiliary-pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
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Effects of Initial Combinations of Gemigliptin Plus Metformin Compared with Glimepiride Plus Metformin on Gut Microbiota and Glucose Regulation in Obese Patients with Type 2 Diabetes: The INTESTINE Study. Nutrients 2023; 15:nu15010248. [PMID: 36615904 PMCID: PMC9824054 DOI: 10.3390/nu15010248] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
The efficacy and safety of medications can be affected by alterations in gut microbiota in human beings. Among antidiabetic medications, incretin-based therapy such as dipeptidyl peptidase 4 inhibitors might affect gut microbiomes, which are related to glucose metabolism. This was a randomized, controlled, active-competitor study that aimed to compare the effects of combinations of gemigliptin−metformin vs. glimepiride−metformin as initial therapies on gut microbiota and glucose homeostasis in drug-naïve patients with type 2 diabetes. Seventy drug-naïve patients with type 2 diabetes (mean age, 52.2 years) with a glycated hemoglobin (HbA1c) level ≥7.5% were assigned to either gemigliptin−metformin or glimepiride−metformin combination therapies for 24 weeks. Changes in gut microbiota, biomarkers linked to glucose regulation, body composition, and amino acid blood levels were investigated. Although both treatments decreased the HbA1c levels significantly, the gemigliptin−metformin group achieved HbA1c ≤ 7.0% without hypoglycemia or weight gain more effectively than did the glimepiride−metformin group (59% vs. 24%; p < 0.05). At the phylum level, the Firmicutes/Bacteroidetes ratio tended to decrease after gemigliptin−metformin therapy (p = 0.065), with a notable depletion of taxa belonging to Firmicutes, including Lactobacillus, Ruminococcus torques, and Streptococcus (all p < 0.05). However, regardless of the treatment modality, a distinct difference in the overall gut microbiome composition was noted between patients who reached the HbA1c target goal and those who did not (p < 0.001). Treatment with gemigliptin−metformin resulted in a higher achievement of the glycemic target without hypoglycemia or weight gain, better than with glimepiride−metformin; these improvements might be related to beneficial changes in gut microbiota.
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Nahas PC, de Branco FMS, Azeredo CM, Rinaldi AEM, de Oliveira EP. Serum uric acid is not associated with appendicular muscle mass index in young and middle-aged adults: Results from NHANES 2011-2012. Clin Nutr ESPEN 2022; 52:262-269. [PMID: 36513464 DOI: 10.1016/j.clnesp.2022.08.034] [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: 05/24/2022] [Revised: 07/25/2022] [Accepted: 08/31/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Recent studies have evaluated the association between uric acid (UA) and muscle mass in older adults; however, little is known about this relationship in young and middle-aged individuals. Our aim was to investigate whether serum UA is associated with appendicular muscle mass index (AMMI) in young and middle-aged individuals. We also aimed to evaluate whether this association is sex-specific. METHODS A cross-sectional study was performed with young and middle-aged individuals aged from 20 to 59 years from National Health and Nutrition Examination Survey (NHANES) 2011-2012. A total of 2255 individuals (1440 young and 815 middle-aged individuals; 1167 men and 1088 women) were evaluated. Body composition was assessed by Dual Energy X-ray absorptiometry (DXA) and AMMI was calculated using the arms plus legs lean mass divided by the height squared. UA levels were measured by colorimetric method. Regression analyzes were performed to evaluate whether AMMI is associated with the tertiles of UA levels after adjustments for potential confounders. RESULTS In the unadjusted analyzes, serum UA was positively associated with AMMI for total sample, young, and middle-aged individuals of both sexes. However, after adjustments for confounders, UA levels were no longer associated with AMMI independent of the age-rage and sex. CONCLUSION Serum UA is not associated with AMMI in young or middle-aged individuals independent of the sex.
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Affiliation(s)
- Paula C Nahas
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Flávia M S de Branco
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Catarina M Azeredo
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Ana Elisa M Rinaldi
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Erick P de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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23
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Lopes S, Fontes T, Tavares RG, Rodrigues LM, Ferreira-Pêgo C. Bioimpedance and Dual-Energy X-ray Absorptiometry Are Not Equivalent Technologies: Comparing Fat Mass and Fat-Free Mass. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13940. [PMID: 36360820 PMCID: PMC9657485 DOI: 10.3390/ijerph192113940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Bioimpedance (BIA) is the most frequently used technology for body composition assessment at a daily clinical level, mostly due to its low price and user-friendly operation. However, many doubts persist regarding its physiological meaning and applicability. The present study aimed to compare one BIA system and the Dual-Energy X-ray Absorptiometry (DXA) for the characterization of body composition in a previously selected cohort of healthy adult participants. A descriptive observational cross-sectional study included a final sample of 121 participants, 93 women and 28 men, with a mean age of 28.26 ± 9.72 years old and a mean body mass index (BMI) of 22.68 ± 3.13 kg/m2. Statistics involved paired t-tests and agreement analysis by the Bland-Altman method. BIA underestimated the percent body fat (%BF) by 5.56% and overestimated Fat-Free Mass (FFM) by 2.90 kg. A strong positive correlation between both technologies was found for FFM (r = 0.980) and the %BF (r = 0.932), but the disagreement was statistically significant (p < 0.001). Although DXA and BIA seem to correlate, these technologies are not congruent. Therefore, the risk of (mis)interpretation and bias is clear with BIA, potentially impacting the nutritional planning of clinical dietitians and the further results of its patients.
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24
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Lee H, Kim S, Kim BS, Kim M, Yang J, Bae H, Won CW. Sexual Difference in Effect of Long Sleep Duration on Incident Sarcopenia after Two Years in Community-Dwelling Older Adults. Ann Geriatr Med Res 2022; 26:264-274. [PMID: 36200291 PMCID: PMC9535369 DOI: 10.4235/agmr.22.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/21/2022] [Indexed: 11/01/2022] Open
Abstract
Background: Sarcopenia, a progressive and generalized skeletal muscle disorder involving an accelerated loss of muscle mass and muscle function, is a common condition in older individuals. This study aimed to determine whether sleep latency and duration were independently associated with incident sarcopenia and to explore sex differences in these associations. Methods: This 2-year longitudinal analysis of cohort study data included community-dwelling participants of the 2016–2017 Korea Frailty and Aging Cohort Study aged 70–84 years at baseline survey who completed the 2-year follow-up survey. Logistic regression was used to calculate the odds ratios (ORs) for sarcopenia and sarcopenia components. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia guidelines. Results: Among 1,353 non-sarcopenic participants in the baseline survey, 1,160 (85.8%) and 193 (14.2%) were classified as non-sarcopenic and sarcopenic, respectively, after 2 years. Long sleep duration (>8 hours per night) was associated with incident sarcopenia in male—OR=2.41 (95% confidence interval [CI], 1.13–5.17) after adjusting for confounding factors. Long sleep duration was specifically associated with the development of low skeletal muscle mass and low muscle strength in male—adjusted OR=2.16 (95% CI, 1.02–4.61) and adjusted OR=2.70 (95% CI, 1.13–6.43), respectively. In female, compared to normal sleep duration, the adjusted ORs for long and short sleep duration for sarcopenia were 2.093 (95% CI, 0.753–5.812; p=0.157) and 0.852 (95% CI, 0.520–1.393; p=0.522), respectively, which were not significant.Conclusion: In male, long sleep duration was associated with incident sarcopenia, specifically the development of low muscle mass and low muscle strength, but not with low physical performance.
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Affiliation(s)
- Hyona Lee
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Byung Sung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, Kyung Hee University, Seoul, Korea
| | - Jisoo Yang
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hanhee Bae
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
- Corresponding Author: Chang Won Won, MD, PhD Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Kyungheedaero 23, Dongdaemun-gu, Seoul, 02447, Korea E-mail:
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25
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Impact of Using Population-Specific Cut-Points, Self-Reported Health, and Socio-Economic Parameters to Predict Sarcopenia: A Cross-Sectional Study in Community-Dwelling Kosovans Aged 60 Years and Older. J Clin Med 2022; 11:jcm11195579. [PMID: 36233448 PMCID: PMC9572927 DOI: 10.3390/jcm11195579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
The age-related decline of muscle strength, mass, and physical performance (sarcopenia) has been raising concerns among the scientific and healthcare communities. This decline may differ between populations, age groups, and sexes. Therefore, we aimed to explore sarcopenia together with the impact of health and socio-economic parameters in mature Kosovans. A cross-sectional study was conducted on community-dwelling adults aged ≥ 60 years (n = 240, 47.1% female) from the Prishtina region. Sarcopenia was identified using the following criteria: (i) the European Working Group in Sarcopenia for Older People (EWGSOP1), (ii) the revised EWGSOP2 algorithms, and (iii) sex-specific cut-points derived from the Kosovan population. In males, pre-sarcopenia/probable sarcopenia was detected from the EWGSOP1, EWGSOP2 and Kosovan-specific criteria at values of 3.1%, 5.5%, and 28.3%; sarcopenia was detected at 1.6%, 5.5%, and 0.0%, and severe sarcopenia was detected at 4.7%, 2.4%, and 4.7%, respectively. Pre-sarcopenia was lower in females (0.9%, 5.3%, 16.8%), with no cases of sarcopenia or severe sarcopenia detected by either algorithm. Sarcopenic males were older, had a lower weight, BMI, skeletal muscle mass, performance score, nutritional status (p < 0.001), educational level (p = 0.035), and higher malnourishment risk (p = 0.005). It is notable that high overweight and obesity levels were also detected (93.8% of females, 77.1% of males). This study highlights the importance of using population-specific cut-points when diagnosing sarcopenia, as otherwise its occurrence may be underestimated, especially in obese persons. Age, body composition, physical performance, health, and socio-economic conditions can influence the occurrence of sarcopenia.
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26
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Dietzel R, Wiegmann S, Borucki D, Detzer C, Zeiner KN, Schaumburg D, Buehring B, Buttgereit F, Armbrecht G. Prevalence of sarcopenia in patients with rheumatoid arthritis using the revised EWGSOP2 and the FNIH definition. RMD Open 2022; 8:rmdopen-2022-002600. [PMID: 36180102 PMCID: PMC9528715 DOI: 10.1136/rmdopen-2022-002600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
Objective In rheumatoid arthritis (RA), chronic inflammation can enhance the development of sarcopenia with a depletion of muscle mass, strength and performance. Currently, a consensus definition for sarcopenia and solid results for the prevalence of sarcopenia in patients with RA are lacking. Methods In this cross-sectional study, 289 patients ≥18 years with RA were recruited. Dual X-ray absorptiometry was performed to measure appendicular lean mass. Assessment of muscle function included grip strength, gait speed and chair rise time. Prevalence of sarcopenia was defined using the updated European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) definition. In addition, the RA study population was compared with existing data of healthy controls (n=280). Results 4.5% of patients (59.4±11.3 years) and 0.4% of controls (62.9±11.9 years) were affected by sarcopenia according to the EWGSOP2 definition. Body weight (OR 0.92, 95% CI 0.86 to 0.97), body mass index (BMI) (OR 0.70, 95% CI 0.57 to 0.87), C reactive protein (CRP) (OR 1.05, 95% CI 1.01 to 1.10), disease duration (OR 1.08, 95% CI 1.02 to 1.36), current medication with glucocorticoids (OR 5.25, 95% CI 2.14 to 24.18), cumulative dose of prednisone equivalent (OR 1.04, 95% CI 1.02 to 1.05) and Health Assessment Questionnaire (HAQ) (OR 2.50, 95% CI 1.27 to 4.86) were associated with sarcopenia in patients with RA. In contrast, the prevalence was 2.8% in patients compared with 0.7% in controls when applying the FNIH definition, and body height (OR 0.75, 95% CI 0.64 to 0.88), BMI (OR 1.20, 95% CI 1.02 to 1.41), CRP (OR 1.06, 95% CI 1.01 to 1.11) and HAQ (OR 2.77, 95% CI 1.17 to 6.59) were associated with sarcopenia. Conclusion Sarcopenia is significantly more common in patients with RA compared with controls using the EWGSOP2 criteria. The FNIH definition revealed sarcopenia in individuals with high BMI and fat mass, regardless of the presence of RA. Trial registration number It was registered at the German Clinical Trials Registry (DRKS) as well as WHO Clinical Trials Registry (ICTRP) (DRKS00011873, registered on 16 March 2017).
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Affiliation(s)
- Roswitha Dietzel
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Wiegmann
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Diana Borucki
- Deutsche Rheuma-Liga Bundesverband e.V, Bonn, Germany
| | | | - Kim Nikola Zeiner
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Désirée Schaumburg
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bjoern Buehring
- Bergisches Rheuma-Zentrum, Krankenhaus St. Josef, Wuppertal, Germany.,Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriele Armbrecht
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
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Saito H, Matsue Y, Maeda D, Kasai T, Kagiyama N, Endo Y, Zoda M, Mizukami A, Yoshioka K, Hashimoto T, Ishikawa K, Minamino T. Prognostic values of muscle mass assessed by dual-energy X-ray absorptiometry and bioelectrical impedance analysis in older patients with heart failure. Geriatr Gerontol Int 2022; 22:610-615. [PMID: 35751442 DOI: 10.1111/ggi.14424] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/23/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to compare bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA) in measuring skeletal muscle mass (MM), and its prognostic implications in old patients with heart failure. METHODS We prospectively evaluated MM measured by both BIA and DEXA in 226 hospitalized elderly (≥65 years) patients with heart failure. The cut-off values proposed by the Asian Working Group in Sarcopenia were used to define low MM. The prognostic endpoint was all-cause death. RESULTS The median age of the cohort was 82 years (interquartile range: 75-87), and 51.8% of patients were men. According to the BIA and DEXA, 177 (78.3%) and 120 (53.1%) patients were diagnosed with low MM, respectively, and the two assessment tools showed poor agreement (Cohen's kappa coefficient: 0.294). During the follow-up, 32 patients (14.2%) died; only low MM defined by DEXA (hazard ratio 2.45, 95% confidence interval 1.05-5.72, P = 0.039), but not BIA (hazard ratio 1.03, 95% confidence interval 0.35-3.06, P = 0.955), was associated with poor prognosis after adjusting for pre-existing risk factors. Moreover, low MM defined by DEXA (net reclassification improvement: 0.58, P < 0.001), but not BIA (net reclassification improvement: -0.005, P = 0.975), provides incremental prognostic predictability when considered with pre-existing risk factors and brain natriuretic peptide level at discharge. CONCLUSIONS In elderly hospitalized patients with heart failure, low MM defined by DEXA and BIA show significant discordance. The MM defined by DEXA, but not BIA, provides additional prognostic value to pre-existing prognostic models. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Masato Zoda
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Akira Mizukami
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | - Kenji Yoshioka
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | | | - Kazuya Ishikawa
- Department of Diagnostic Radiology, Kameda Medical Center, Chiba, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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28
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Yamaguchi K, Nakagawa K, Yoshimi K, Ariya C, Nakane A, Okumura T, Tohara H. Higher extracellular water/total body water ratio is associated with lower tongue and grip strength: a cross-sectional study. J Prosthodont Res 2022; 67:231-237. [PMID: 35732420 DOI: 10.2186/jpr.jpr_d_21_00296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to investigate the relationship between tongue factors (tongue strength and tongue volume), systemic factors (grip strength and walking speed), and the extracellular water/total body water ratio. METHODS This cross-sectional study included community-dwelling adults. Body water composition and skeletal muscle mass index were measured using bioelectrical impedance analysis. Moreover, tongue grip strength, tongue volume, occlusal support condition (Eichner classification), and walking speed were measured. Multiple linear regression analysis was performed to investigate the relationship between the tongue and systemic factors as dependent variables and body water composition. RESULTS We included 171 community-dwelling adults (62 men and 109 women) aged 70.0 years (interquartile range: 8). Tongue strength (r=-0.22, p=0.004) and grip strength (r=-0.39, p<0.001) were correlated with the extracellular water/total body water ratio. In multiple linear regression analysis, tongue strength was associated with the extracellular water/total body water ratio (β=-0.20, p=0.034), and grip strength was associated with the extracellular water/total body water ratio (β=-0.12, p=0.047), sex, body mass index, skeletal muscle mass index, and occlusal support condition. CONCLUSIONS A higher extracellular water/total body water ratio indicates lower tongue and grip strength. Dentists and dental hygienists should be aware of systemic factors present in patients with lower tongue and grip strength. These findings may lead to further medical investigations and diagnosis of other systemic diseases.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Chantaramanee Ariya
- Department of Preventive Dentistry, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanlok 65000, Thailand
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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29
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Zhang X, Deng K, Yuan Y, Liu L, Zhang S, Wang C, Wang G, Zhang H, Wang L, Cheng G, Wood LG, Wang G. Body Composition-Specific Asthma Phenotypes: Clinical Implications. Nutrients 2022; 14:nu14122525. [PMID: 35745259 PMCID: PMC9229860 DOI: 10.3390/nu14122525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Previous studies have indicated the limitations of body mass index for defining disease phenotypes. The description of asthma phenotypes based on body composition (BC) has not been largely reported. Objective: To identify and characterize phenotypes based on BC parameters in patients with asthma. Methods: A study with two prospective observational cohorts analyzing adult patients with stable asthma (n = 541 for training and n = 179 for validation) was conducted. A body composition analysis was performed for the included patients. A cluster analysis was conducted by applying a 2-step process with stepwise discriminant analysis. Logistic regression models were used to evaluate the association between identified phenotypes and asthma exacerbations (AEs). The same algorithm for cluster analysis in the independent validation set was used to perform an external validation. Results: Three clusters had significantly different characteristics associated with asthma outcomes. An external validation identified the similarity of the participants in training and the validation set. In the training set, cluster Training (T) 1 (29.4%) was “patients with undernutrition”, cluster T2 (18.9%) was “intermediate level of nutrition with psychological dysfunction”, and cluster T3 (51.8%) was “patients with good nutrition”. Cluster T3 had a decreased risk of moderate-to-severe and severe AEs in the following year compared with the other two clusters. The most important BC-specific factors contributing to being accurately assigned to one of these three clusters were skeletal muscle mass and visceral fat area. Conclusion: We defined three distinct clusters of asthma patients, which had distinct clinical features and asthma outcomes. Our data reinforced the importance of evaluating BC to determining nutritional status in clinical practice.
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Affiliation(s)
- Xin Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (K.D.); (C.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Ke Deng
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (K.D.); (C.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Yulai Yuan
- Department of Respiratory Medicine, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646699, China;
| | - Lei Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (K.D.); (C.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Shuwen Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Changyong Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (K.D.); (C.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Gang Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Institute of Environmental Medicine, Karolinska Institute, 11883 Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 11883 Stockholm, Sweden
| | - Hongping Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Lei Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (X.Z.); (L.L.); (S.Z.); (G.W.); (H.Z.); (L.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
| | - Gaiping Cheng
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu 610044, China;
| | - Lisa G. Wood
- Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW 2308, Australia;
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610044, China; (K.D.); (C.W.)
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu 610213, China
- Correspondence:
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30
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Sueyoshi Y, Ogawa T, Koike M, Hamazato M, Hokama R, Tokashiki S, Nakayama Y. Improved activities of daily living in elderly patients with increased skeletal muscle mass during vertebral compression fracture rehabilitation. Eur Geriatr Med 2022; 13:1221-1228. [PMID: 35698005 DOI: 10.1007/s41999-022-00663-z] [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: 08/01/2021] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE We hypothesized that elderly patients with greater skeletal muscle mass have better activities of daily living (ADLs) than those with less skeletal muscle mass. The aim of this study was to evaluate the relationship between ADL improvement and changes in skeletal muscle mass among older patients ≥ 80 years of age who were undergoing rehabilitation for vertebral compression fracture (VCF). METHODS This case-control study was conducted at a rehabilitation hospital. The participants were 149 patients aged ≥ 80 years undergoing VCF rehabilitation. Patients were divided into two groups based on changes in their skeletal muscle mass index (SMI) during the hospitalization period: one group with increased SMI and the other without increased SMI. Between-group and multivariate analyses were performed to evaluate the factors associated with SMI increase. RESULTS The functional independence measure (FIM) gain was significantly higher in the group with SMI increase (36.0 [27.0-52.5], p = 0.016) than in the group without SMI increase (29.0 [19.0-41.0]). SMI gain was significantly associated with motor FIM gain (coefficient, 4.857; 95% confidence interval, 1.311-8.403; p = 0.008). Motor FIM and MMSE on admission, the necessity of assistance in ADL before the injury, and Charlson Comorbidity Index, were also significantly associated with motor FIM gain. CONCLUSIONS This study indicated that rehabilitation to gain skeletal muscle was effective in improving ADLs in elderly patients with VCF. We might encourage older patients with VCFs to undertake rehabilitation for the purpose of building skeletal muscle and improving their ADLs, and to not refrain from such rehabilitation due to old age and fractures.
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Affiliation(s)
- Yuki Sueyoshi
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
| | - Takahiro Ogawa
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan.
| | - Masaki Koike
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
| | - Mayumi Hamazato
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
| | - Ryota Hokama
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
| | - Satoko Tokashiki
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
| | - Yuki Nakayama
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa City, Okinawa, 904-2151, Japan
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31
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Predictive ability of hand-grip strength and muscle mass on functional prognosis in stroke rehabilitation patients. Nutrition 2022; 102:111724. [DOI: 10.1016/j.nut.2022.111724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/14/2022] [Accepted: 04/23/2022] [Indexed: 11/19/2022]
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Yuenyongchaiwat K, Akekawatchai C. Prevalence and incidence of sarcopenia and low physical activity among community-dwelling older Thai people: a preliminary prospective cohort study 2-year follow-up. PeerJ 2022; 10:e13320. [PMID: 35480559 PMCID: PMC9037122 DOI: 10.7717/peerj.13320] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/01/2022] [Indexed: 01/13/2023] Open
Abstract
Background Sarcopenia, defined as a loss of muscle mass, has become a major health problem in older people. Few prospective studies report the incidence and risk of sarcopenia. Therefore, this study aimed to explore the prevalence of sarcopenia at the baseline and follow-up after 2 years in community-dwelling older Thai individuals. Methods In 2019, 330 older people were recruited from a community-dwelling population, and these participants were requested to present again in 2021. Sarcopenia was diagnosed using the criteria for the Asia Working Group for Sarcopenia (AWGS). All participants were asked to perform a 6-meter walk test, handgrip strength test, and bioelectric impedance assessment, and complete the Global Physical Activity Questionnaire. Results The study found that the prevalence of sarcopenia was 65 (19.70%) in 330 older people in 2019, and 44 of 205 participants (21.46%) were reported to have sarcopenia after 2 years. The incidence of sarcopenia was noted to be 2.44% in 2021. Analysis with ANOVA and pairwise comparisons showed that the reversibility of sarcopenia was attributed to high level of physical activity in the 2-year follow-up group (p = 0.014, 95% CI [-1753.25--195.49]). Further, participants with moderate and high physical activity had a reduced incidence of sarcopenia (odds ratio = 9.00 and 14.47, respectively). Therefore, low physical activity in older people led to the development of sarcopenia from the baseline to the 2-year follow-up, indicating that increased physical activity may be useful in reversing sarcopenia, as suggested in the 2-year follow-up study. Low physical activity could be a risk factor for the incidence of sarcopenia. Hence, the prevention of sarcopenia could promote health improvement through moderate to high physical activity.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, Klong Luang, Pathumthani, Thailand
- Thammasat University Research Unit in Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Klong Luang, Pathumthani, Thailand
| | - Chareeporn Akekawatchai
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Klong Luang, Pathumtani, Thailand
- Thammasat University Research Unit in Diagnostic Molecular Biology of Chronic Diseases related to Cancer (DMB-CDC), Klong Luang, Pathumtani, Thailand
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Yamamoto H, Takeshima F, Haraguchi M, Akazawa Y, Matsushima K, Kitayama M, Ogihara K, Tabuchi M, Hashiguchi K, Yamaguchi N, Miyaaki H, Kondo H, Nakao K. High serum concentrations of growth differentiation factor-15 and their association with Crohn's disease and a low skeletal muscle index. Sci Rep 2022; 12:6591. [PMID: 35449185 PMCID: PMC9023473 DOI: 10.1038/s41598-022-10587-0] [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: 09/14/2021] [Accepted: 04/05/2022] [Indexed: 12/26/2022] Open
Abstract
Sarcopenia comprises a low skeletal muscle index (SMI) and low muscle strength (MS) or low physical function. Many sarcopenia biomarkers have been reported. With Crohn’s disease (CD), a low SMI is predictive of intestinal complications. Therefore, many CD studies have reported that sarcopenia is defined by SMI alone. This study investigated the sarcopenia frequency by assessing the SMI and MS of Japanese patients with CD and biomarkers predicting a low SMI. We evaluated the SMI using a bioelectrical impedance analysis, handgrip strength, and C-reactive protein, albumin, interleukin-6, tumor necrosis factor-α, growth differentiation factor (GDF)-8, and GDF-15 levels as biomarker candidates for 78 CD patients at our hospital. Sarcopenia and a low SMI were observed in 7.7% and 42.3% of the patients, respectively. There was a significant difference in the GDF-15 levels of the low SMI group and normal group according to the multivariate analysis (P = 0.028; odds ratio [OR], 1.001; 95% confidence interval [CI] 1.000–1.002). When evaluated by sex, males exhibited a negative correlation between the GDF-15 level and SMI (Pearson’s r = − 0.414; P = 0.0031), and the multivariate analysis indicated a significant difference in the GDF-15 levels (P = 0.011; OR, 1.001; 95% CI 1.000–1.002). GDF-15 levels may indicate a low SMI with CD.
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Affiliation(s)
- Hiroyuki Yamamoto
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.
| | - Fuminao Takeshima
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.,Department of Internal Medicine, Nagasaki Prefecture Goto Central Hospital, Nagasaki, Japan
| | - Masafumi Haraguchi
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Yuko Akazawa
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.,Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Kayoko Matsushima
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Moto Kitayama
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Kumi Ogihara
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Maiko Tabuchi
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | | | - Naoyuki Yamaguchi
- Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan
| | - Hisamitsu Miyaaki
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Hisayoshi Kondo
- Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
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Ogawa T, Koike M. Independent factors that attenuate the effectiveness of fracture rehabilitation in improving activities of daily living in female patients aged 80 years and above. Aging Clin Exp Res 2022; 34:793-800. [PMID: 34623628 DOI: 10.1007/s40520-021-01992-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/27/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Some factors, such as cognitive impairment, can attenuate the effectiveness of rehabilitation. We hypothesized that handgrip strength (HGS) might be one of the independent factors affecting the activities of daily living (ADL) improvements in patients with fractures. AIMS This study aimed to evaluate the relationship between HGS and improvement in ADL during rehabilitation, and to assess the factors affecting ADL improvement among older patients ≥ 80 years with fractures. METHODS This longitudinal study was conducted at a rehabilitation hospital among 427 females aged ≥ 80 years, who underwent fracture rehabilitation. Patients were divided into two groups based on their HGS. Analysis of comparison between the two groups and multivariate linear regression analyses were performed with respect to functional independence measure (FIM) gain during rehabilitation. RESULTS FIM gain was significantly lower in the weak HGS group (31.5 [20.0-41.0]) than in the strong HGS group (35.0 [27.5-47.0], p = 0.011). In multivariate linear regression analyses, HGS was significantly associated with FIM gain (coefficient: 0.683, 95% confidence intervals 0.302-1.064, p < 0.001). In addition, Mini-Mental State Examination, necessity of assistance in ADL before injury, length of hospital stays for rehabilitation, and period of rehabilitation per day were significantly associated with FIM gain. CONCLUSIONS Weak HGS, cognitive impairment, and necessity of assistance in ADL before injury could be independent factors that attenuate the effectiveness of fracture rehabilitation to improve ADL in old female patients. We encourage such patients to undertake more rehabilitation for improving their ADL, and not refrain from rehabilitation due to old age and fracture.
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Affiliation(s)
- Takahiro Ogawa
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan.
| | - Masaki Koike
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
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35
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Lim S, Sohn M, Shin Y, Ferrannini E. Initial combination of metformin, sitagliptin, and empagliflozin in drug-naïve patients with type 2 diabetes: Safety and metabolic effects. Diabetes Obes Metab 2022; 24:757-762. [PMID: 34908220 DOI: 10.1111/dom.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Minji Sohn
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Yujin Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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36
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Moon SW, Lee SH, Woo A, Leem AY, Lee SH, Chung KS, Kim EY, Jung JY, Kang YA, Park MS, Kim YS, Kim CO, Kim SY. Reference values of skeletal muscle area for diagnosis of sarcopenia using chest computed tomography in Asian general population. J Cachexia Sarcopenia Muscle 2022; 13:955-965. [PMID: 35170229 PMCID: PMC8978009 DOI: 10.1002/jcsm.12946] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diagnostic cutoff points for sarcopenia in chest computed tomography (CT) have not been established although CT is widely used for investigating skeletal muscles. This study aimed to determine reference values for sarcopenia of thoracic skeletal muscles acquired from chest CT scans and to analyse variables related to sarcopenia using the cutoff values determined in a general Asian population. METHODS We retrospectively reviewed chest CT scans of 4470 participants (mean age 54.8 ± 9.9 years, 65.8% male) performed at a check-up centre in South Korea (January 2016-August 2017). To determine cutoffs, 335 participants aged 19-39 years (mean age 35.2 ± 3.6 years, 75.2% male) were selected as the healthy and younger reference group, and 4135 participants aged ≥40 years (mean age 56.4 ± 8.4 years, 65.1% male) were selected as the study group. We measured the following: cross-sectional area (CSA) of the pectoralis, intercostalis, paraspinal, serratus, and latissimus muscles at the 4th vertebral region (T4CSA ); T4CSA divided by height2 (T4MI); pectoralis muscle area (PMCSA ); and PMCSA divided by height2 (PMI) at the 4th vertebral region. Sarcopenia cutoff was defined as sex-specific values of less than -2 SD below the mean from the reference group. RESULTS In the reference group, T4CSA , T4MI, PMCSA , and PMI cutoffs for sarcopenia were 100.06cm2 , 33.69cm2 /m2 , 29.00cm2 , and 10.17cm2 /m2 in male, and 66.93cm2 , 26.01cm2 /m2 , 18.29cm2 , and 7.31cm2 /m2 in female, respectively. The prevalence of sarcopenia in the study group measured with T4CSA , T4MI, PMCSA and PMI cutoffs were 11.4%, 8.7%, 8.5%, and 10.1%, respectively. Correlations were observed between appendicular skeletal mass divided by height2 measured by bioelectrical impedance analysis (BIA) and T4CSA (r = 0.82; P < 0.001)/T4MI (r = 0.68; P < 0.001), and ASM/height2 measured by BIA and PMCSA (r = 0.72; P < 0.001)/PMI (r = 0.63; P < 0.001). In the multivariate logistic regression models, sarcopenia defined by T4CSA /T4MI were related to age [odds ratio (95% confidence interval), P-values: 1.09 (1.07-1.11), <0.001/1.05 (1.04-1.07), <0.001] and diabetes [1.60 (1.14-2.25), 0.007/1.47 (1.01-2.14), 0.043]. Sarcopenia defined by PMCSA /PMI were related to age [1.09 (1.08-1.10), <0.001/1.05 (1.03-1.06), <0.001], male sex [0.23 (0.18-0.30), <0.001/0.47 (0.32-0.71), <0.001], diabetes [2.30 (1.73-3.05), <0.001/1.63 (1.15-2.32), 0.007], history of cancer [2.51 (1.78-3.55), <0.001/1.61 (1.04-2.48), 0.033], and sufficient physical activity [0.67 (0.50-0.89), 0.007/0.74 (0.56-0.99), 0.042]. CONCLUSIONS The reference cutoff values of a general population reported here will enable sex-specific standardization of thoracic muscle mass quantification and sarcopenia assessment.
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Affiliation(s)
- Sung Woo Moon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea.,Division of Geriatrics and Integrated Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Ala Woo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Ah Young Leem
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Su Hwan Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Kyung Soo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Eun Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Ji Ye Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Young Ae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Moo Suk Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Young Sam Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
| | - Chang Oh Kim
- Division of Geriatrics and Integrated Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Song Yee Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Seodaemun-gu, Korea
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Unveiling genetic variants for age-related sarcopenia by conducting a genome-wide association study on Korean cohorts. Sci Rep 2022; 12:3501. [PMID: 35241739 PMCID: PMC8894365 DOI: 10.1038/s41598-022-07567-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
Sarcopenia is an age-related disorder characterised by a progressive decrease in skeletal muscle mass. As the genetic biomarkers for sarcopenia are not yet well characterised, this study aimed to investigate the genetic variations related to sarcopenia in a relatively aged cohort, using genome-wide association study (GWAS) meta-analyses of lean body mass (LBM) in 6961 subjects. Two Korean cohorts were analysed, and subgroup GWAS was conducted for appendicular skeletal muscle mass (ASM) and skeletal muscle index. The effects of significant single nucleotide polymorphisms (SNPs) on gene expression were also investigated using multiple expression quantitative trait loci datasets, differentially expressed gene analysis, and gene ontology analyses. Novel genetic biomarkers were identified for LBM (rs1187118; rs3768582) and ASM (rs6772958). Their related genes, including RPS10, NUDT3, NCF2, SMG7, and ARPC5, were differently expressed in skeletal muscle tissue, while GPD1L was not. Furthermore, the 'mRNA destabilisation' biological process was enriched for sarcopenia. Our study identified RPS10, NUDT3, and GPD1L as significant genetic biomarkers for sarcopenia. These genetic loci were related to lipid and energy metabolism, suggesting that genes involved in metabolic dysregulation may lead to the pathogenesis of age-related sarcopenia.
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Yoshioka M, Kosaki K, Matsui M, Okabe N, Saito C, Yamagata K, Kuro-O M, Maeda S. Association of circulating calciprotein particle levels with skeletal muscle mass and strength in middle-aged and older adults. Hypertens Res 2022; 45:900-910. [PMID: 35241816 DOI: 10.1038/s41440-022-00870-y] [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: 06/13/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/09/2022]
Abstract
Calciprotein particles (CPPs) are tiny mineral-protein aggregates consisting of calcium-phosphate and fetuin-A. Recent studies have suggested that CPPs may contribute to the pathogenesis of chronic inflammation and arteriosclerosis. Reduced skeletal muscle mass and strength reportedly contribute independently to increased serum phosphate levels. This finding suggests that reduced skeletal muscle mass and strength can endogenously induce an increase in circulating CPP levels. Therefore, we investigated the potential association between circulating CPP levels and skeletal muscle mass and strength in middle-aged and older adults. One hundred eighty-two middle-aged and older adults (age, 46-83 years) were included in this cross-sectional study (UMIN000034741). Circulating CPP levels were measured using the gel filtration method. Appendicular skeletal muscle mass was assessed using multifrequency bioelectrical impedance analysis with a tetrapolar eight-point tactile electrode system. The skeletal muscle mass index was calculated from appendicular skeletal muscle mass and height. Handgrip and knee extension strengths were used as measures of skeletal muscle strength. The skeletal muscle mass index was negatively correlated with circulating CPP levels (r = -0.31; P < 0.05). This association remained significant after adjustment for potential covariates (β = -0.34; P < 0.05). In contrast, skeletal muscle strength, represented by handgrip strength and knee extension strength, was not significantly associated with circulating CPP levels. In middle-aged and older adults, a lower skeletal muscle mass index was independently associated with higher circulating CPP levels. The present results suggest that maintaining skeletal muscle mass may prevent an increase in circulating CPP levels.
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Affiliation(s)
- Masaki Yoshioka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,Japan Society for the Promotion of Science, 5-3-1 Kouzimachi, Chiyoda-ku, Tokyo, 102-8472, Japan
| | - Keisei Kosaki
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Masahiro Matsui
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,Japan Society for the Promotion of Science, 5-3-1 Kouzimachi, Chiyoda-ku, Tokyo, 102-8472, Japan
| | - Naoya Okabe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Chie Saito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,R&D Center for Smart Wellness City Policies, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Makoto Kuro-O
- Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan. .,Faculty of Sport Sciences, Waseda University, 2-579-15 Tokorozawa, Saitama, 359-1192, Japan.
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Relative Lean Body Mass and Waist Circumference for the Identification of Metabolic Syndrome in the Korean General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413186. [PMID: 34948793 PMCID: PMC8700886 DOI: 10.3390/ijerph182413186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022]
Abstract
Lean body mass (LBM) comprises organs and muscle, which are the primary determinants of energy expenditure and regulation of glucose and lipid metabolism. Excessive abdominal fat is associated with metabolic abnormality. Little is known about the relationship between metabolic abnormality and LBM and waist circumference (WC), especially in the Asian general population. The aim of this study was to clarify this relationship. We performed a cross-sectional study with 499,648 subjects who received health check-ups at 16 health promotion centers in 13 Korean cities between January 2018 and October 2019. The subjects were categorized into four groups: (a) High (H)-RLBM (relative lean body mass)/Normal (N)-WC, (b) High-RLBM/Abnormal (A)-WC, (c) Low (L)-RLBM/Normal-WC, and (d) Low-RLBM/Abnormal-WC. RLBM was calculated using fat mass data that were estimated via bioelectrical impedance analysis. L-RLBM/A-WC was significantly associated with metabolically unhealthy status (OR: 4.40, 95% CI: 4.326–4.475) compared to H-RLBM/N-WC. L-RLBM/N-WC (OR: 2.170, 95% CI: 2.122–2.218) and H-RLBM/A-WC (OR: 2.713, 95% CI: 2.659–2.769) were also significantly related to metabolic unhealthy status. The cut-offs of RLBM for predicting metabolic syndrome (MetS) were 74.9 in males and 66.4 in females (p < 0.001). L-RLBM and A-WC are associated with metabolic abnormality in the Korean general population. RLBM is an anthropometric index that can be used to predict MetS in primary health care.
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40
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Yuenyongchaiwat K, Boonsinsukh R. Type 2 Diabetes Mellitus Related to Decreased Peripheral and Respiratory Muscle Strength in Sarcopenic Thai Elderly. Curr Aging Sci 2021; 14:235-241. [PMID: 34269671 PMCID: PMC9912336 DOI: 10.2174/1874609814666210715141903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/11/2021] [Accepted: 05/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Age is related to a decline in muscle mass and physical function in both respiratory and peripheral muscle strength, which could lead to mobility and mortality. In addition, older people have suffered from one or multiple chronic conditions in particular in type 2 Diabetes Mellitus (type 2 DM). However, a few studies have reported the relationship between sarcopenic elderly and respiratory and peripheral muscle strengths in type 2DM. OBJECTIVE To explore the prevalence of sarcopenia in type 2 DM elderly people among community- dwelling patients and the relationships with peripheral and respiratory muscle loss in sarcopenic type 2 DM older patients. METHODS A total of 330 older individuals were recruited from community-dwelling centers. Respiratory muscle and quadriceps muscle were assessed. According to the defined criteria for sarcopenia (defined by Asian Working Group for Sarcopenia), muscle mass, gait speed (six-meter walk test), and handgrip strength were examined. RESULTS Of 330 elderly people, 82 volunteers had a history of type 2 DM. Participants with type 2DM had a risk for sarcopenia (odds ratio= 2.324, 95% CI=1.251-4.317). The prevalence of sarcopenia was 25.61% among older participants with type 2 DM. In addition, decreased respiratory muscle strength and quadriceps muscle strength were observed in type 2 DM with sarcopenia compared to type 2 DM with non-sarcopenia. These relationships also remained after controlling for age and sex. CONCLUSION Sarcopenia in type 2 DM leads to a decrease in respiratory muscle and peripheral muscle strength.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18, Paholyothin Road, Klong Luang, Rangsit, Pathumthani, 12120, Thailand;,Research Unit for Physical Therapy in Cardio-Respiratory System, Thammasat University, Pathumthani, Thailand; ,Address correspondence to this author at the Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18, Paholyothin Road, Klong Luang, Rangsit, Pathumthani, 12120, Thailand; Tel: +66 (0)29869213; Fax+66 (0)2516-5379; E-mail
| | - Rumpa Boonsinsukh
- Faculty of Physical Therapy, Srinakharinwirot University, Bangkok, Thailand
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Park SS, Lim S, Kim H, Kim KM. Comparison of Two DXA Systems, Hologic Horizon W and GE Lunar Prodigy, for Assessing Body Composition in Healthy Korean Adults. Endocrinol Metab (Seoul) 2021; 36:1219-1231. [PMID: 34911173 PMCID: PMC8743584 DOI: 10.3803/enm.2021.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/14/2021] [Accepted: 11/19/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Dual-energy X-ray absorptiometry (DXA) is the most widely used method for evaluating muscle masses. The aim of this study was to investigate the agreement between muscle mass values assessed by two different DXA systems. METHODS Forty healthy participants (20 men, 20 women; age range, 23 to 71 years) were enrolled. Total and regional body compositional values for fat and lean masses were measured consecutively with two DXA machines, Hologic Horizon and GE Lunar Prodigy. Appendicular lean mass (ALM) was calculated as the sum of the lean mass of four limbs. RESULTS In both sexes, the ALM values measured by the GE Lunar Prodigy (24.8±4.3 kg in men, 15.8±2.9 kg in women) were significantly higher than those assessed by Hologic Horizon (23.0±4.0 kg in men, 14.8±3.2 kg in women). Furthermore, BMI values or body fat (%), either extremely higher or lower levels, contributed greater differences between two systems. Bland-Altman analyses revealed a significant bias between ALM values assessed by the two systems. Linear regression analyses were performed to develop equations to adjust for systematic differences (men: Horizon ALM [kg]=0.915×Lunar Prodigy ALM [kg]+0.322, R2=0.956; women: Horizon ALM [kg]=1.066×Lunar Prodigy ALM [kg]-2.064, R2=0.952). CONCLUSION Although measurements of body composition including muscle mass by the two DXA systems correlated strongly, significant differences were observed. Calibration equations should enable mutual conversion between different DXA systems.
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Affiliation(s)
- Seung Shin Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Hoyoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin,
Korea
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Ogawa T, Onaga A, Oshiro N, Oshiro A, Kitagawa Y, Taira Y, Nakahodo S, Oshiro K. Older patients with less skeletal muscle mass gain more skeletal muscle in rehabilitation wards after fractures. Eur Geriatr Med 2021; 13:615-622. [PMID: 34850373 DOI: 10.1007/s41999-021-00596-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 11/21/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND We hypothesized that old patients could increase skeletal muscle mass after fractures by exercise rehabilitation, even if they have a low initial muscle mass. AIM This study aimed to evaluate the relationship between skeletal muscle mass and skeletal muscle changes in older patients after fractures. METHODS This case-control study took place in rehabilitation wards and included 807 patients aged ≥ 65 years with fractures. Patients were divided into two groups based on the skeletal muscle index (SMI) on admission by the sarcopenia cut-off points: low SMI group included patients with SMI < 7.0 for men and < 5.7 for women and high SMI group included patients with SMI ≥ 7.0 for men and ≥ 5.7 for women. Analysis of comparison between the two groups and multivariate logistic regression analyses were performed. RESULTS The SMI gain was significantly higher in the low SMI group (0.20) than in the high SMI group (0.00, p < 0.001). There were also the differences in age, BMI, mini nutritional assessment short form, Charlson comorbidity index, length of hospital stay, and protein intake. The SMI on admission was significantly associated with increased SMI after rehabilitation (odds ratio 0.569, 95% confidence interval 0.455‒0.710). Length from onset to transfer to the hospital, hospital stay, and period of exercise therapy were also significantly associated with increased SMI. CONCLUSIONS We found that older patients with low SMI after fracture gained more skeletal muscle mass than those with high SMI following exercise rehabilitation. In addition, SMI on admission was one of the factors independently associated with increased SMI.
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Affiliation(s)
- Takahiro Ogawa
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan.
| | - Anri Onaga
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - Nami Oshiro
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - Ayumi Oshiro
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - You Kitagawa
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - Yasuko Taira
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - Shiori Nakahodo
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
| | - Kurumi Oshiro
- Chuzan Hospital Clinical Education and Research Center, 6-2-1 Matsumoto, Okinawa city, Okinawa, 904-2151, Japan
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Carvalho do Nascimento PR, Bilodeau M, Poitras S. How do we define and measure sarcopenia? A meta-analysis of observational studies. Age Ageing 2021; 50:1906-1913. [PMID: 34537833 DOI: 10.1093/ageing/afab148] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE this study aimed to investigate how sarcopenia has been defined and measured in the literature reporting its prevalence, and how different definitions and measurement tools can affect prevalence estimates. DESIGN systematic review and meta-analysis. SETTING AND PARTICIPANTS community-dwelling older people. METHODS meta-analysis of data collected from observational studies. We performed an electronic search in five databases to identify studies reporting the prevalence of sarcopenia. We used descriptive statistics to present data pertaining sarcopenia definition and measurement tools, and the quality-effects model for meta-analysis of pooled prevalence. RESULTS we found seven different operational definitions for sarcopenia and a variety of tools applied to assess the sarcopenic markers; muscle mass, muscle strength and physical performance. The prevalence of sarcopenia varied between the definitions with general estimates ranging from 5% based on the European Working Group on Sarcopenia in Older People (EWGSOP1) criterion to 17% with the International Working Group on Sarcopenia. According to the tool used to assess muscle mass, strength and physical performance, prevalence values also varied within definitions extending from 1 to 7%, 1 to 12% and 0 to 22%, respectively. CONCLUSION AND IMPLICATIONS the criteria used to define sarcopenia, as well as the measurement tools applied to assess sarcopenic markers have influence in the prevalence of sarcopenia. The establishment of a unique definition for sarcopenia, the use of methods that guarantee an accurate evaluation of muscle mass and the standardisation of measurement tools are necessary to allow a proper diagnosis and comparison of sarcopenia prevalence among populations.
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Affiliation(s)
- Paulo R Carvalho do Nascimento
- University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Martin Bilodeau
- University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Stéphane Poitras
- University of Ottawa, Faculty of Health Sciences, School of Rehabilitation Sciences, Ottawa, ON, Canada
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Okabe T, Suzuki M, Goto H, Iso N, Cho K, Hirata K, Shimizu J. Sex Differences in Age-Related Physical Changes among Community-Dwelling Adults. J Clin Med 2021; 10:jcm10204800. [PMID: 34682922 PMCID: PMC8538508 DOI: 10.3390/jcm10204800] [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] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 12/25/2022] Open
Abstract
The prevalence of physical functioning limitations is positively correlated with age in both men and women. However, whether the appearance of deterioration differs depending on physical function and sex remains unclear. This study aimed to clarify the modes of age-related changes in physical function and sex differences in middle-aged and older adults. This study comprised 124 (46 men and 78 women) healthy adults aged 30 years or older and examined gender differences in physical function. The results of this study showed that one-leg standing time had the highest rate of age-related decline in both men and women, followed by knee extension strength, skeletal muscle mass, the 5 m walking test, and the timed up and go test. The sex-specific points showed a high rate of decline in trunk forward bending in men and a high rate of decline in forced expiratory volume (1 s) and gradual rate of decline in the bone area ratio in women. After middle age, it is desirable to start monitoring and training balance, muscle function, and walking. Men require early intervention for flexibility, and women require early intervention for respiratory function and continued intervention for bone mineral density.
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Herda AA, Cleary CJ. Agreement between multifrequency BIA and DXA for assessing segmental appendicular skeletal muscle mass in older adults. Aging Clin Exp Res 2021; 34:2789-2795. [PMID: 34655429 DOI: 10.1007/s40520-021-02000-z] [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: 08/22/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Aging presents changes in muscle mass that may lead to sarcopenia. Identifying safe, quick, and accessible methods to assess muscle mass is imperative. AIMS The purpose of this investigation was to compare the assessments of appendicular skeletal muscle mass (ASMM), fat-free mass (FFM), and fat mass (FM) between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). METHODS Seventy-three healthy, community-dwelling, physically active males (n = 19) and females (n = 54) (BMI = 27.1 ± 4.3 kg m-2) between the ages of 55-85 years underwent total-body BIA and DXA. ASMM was estimated via BIA from a previously published regression equation while DXA ASMM was calculated as the sum of the measured total arm lean mass and total leg lean mass. Paired-samples t tests with a significance level of p < 0.05 were conducted, while agreement between the methods was assessed via Bland-Altman plots. RESULTS In comparison to DXA, the chosen BIA equation overestimated ASMM (21.61 ± 5.82 kg vs. 18.82 ± 4.81 kg) and FFM (49.57 ± 9.94 kg vs. 46.22 ± 10.11 kg) and underestimated FM (24.59 ± 8.28 kg vs. 27.13 ± 10.01 kg), all p < 0.001. Visual inspection of the Bland-Altman plots revealed wide limits of agreement. Female participants were more clustered around the mean than male participants. DISCUSSION The multifrequency BIA device and chosen ASMM estimation equation resulted in wide limits of agreement and significantly different comparisons to the reference method of DXA. CONCLUSION Future research should continue to investigate and validate methodologies to screen older individuals for characteristics of aging-related diseases, such as sarcopenia.
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Kang MG, Kang SJ, Roh HK, Jung HY, Kim SW, Choi JY, Kim KI. Accuracy and Diversity of Wearable Device-Based Gait Speed Measurement Among Older Men: Observational Study. J Med Internet Res 2021; 23:e29884. [PMID: 34633293 PMCID: PMC8546531 DOI: 10.2196/29884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background Gait speed measurements are widely used in clinical practice, as slow gait is a major predictor of frailty and a diagnostic criterion for sarcopenia. With the development of wearable devices, it is possible to estimate the gait speed in daily life by simply wearing the device. Objective This study aims to accurately determine the characteristics of daily life gait speed and analyze their association with sarcopenia. Methods We invited community-dwelling men aged >50 years who had visited the outpatient clinic at a tertiary university hospital to participate in the study. Daily life gait speed was assessed using a wearable smart belt (WELT) for a period of 4 weeks. Data from participants who wore the smart belt for at least 10 days during this period were included. After 4 weeks, data from a survey about medical and social history, usual gait speed measurements, handgrip strength measurements, and dual-energy x-ray absorptiometry were analyzed. Results A total of 217,578 daily life gait speed measurements from 106 participants (mean age 71.1, SD 7.6 years) were analyzed. The mean daily life gait speed was 1.23 (SD 0.26) m/s. The daily life gait speed of the participants varied according to the time of the day and day of the week. Daily life gait speed significantly slowed down with age (P<.001). Participants with sarcopenia had significantly lower mean daily life gait speed (mean 1.12, SD 0.11 m/s) than participants without sarcopenia (mean 1.23, SD 0.08 m/s; P<.001). Analysis of factors related to mean daily life gait speed showed that age and skeletal muscle mass of the lower limbs were significantly associated characteristics. Conclusions More diverse and accurate information about gait speed can be obtained by measuring daily life gait speed using a wearable device over an appropriate period, compared with one-time measurements performed in a laboratory setting. Importantly, in addition to age, daily life gait speed is significantly associated with skeletal muscle mass of the lower limbs.
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Affiliation(s)
- Min-Gu Kang
- Department of Internal Medicine, Chonnam National University Bitgoeul Hospital, Gwangju, Republic of Korea
| | - Seong-Ji Kang
- Graduate School of Health Science and Management, Yonsei University, Seoul, Republic of Korea.,WELT Corp, Ltd, Seoul, Korea, Seoul, Republic of Korea
| | - Hye-Kang Roh
- WELT Corp, Ltd, Seoul, Korea, Seoul, Republic of Korea
| | | | - Sun-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jung-Yeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7-17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179254. [PMID: 34501843 PMCID: PMC8431661 DOI: 10.3390/ijerph18179254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 12/04/2022]
Abstract
To investigate the associations between body fat percentage (BF%) with childhood blood pressure (BP) levels and elevated BP (EBP) risks, and further examine the validity of bioelectrical impedance analysis (BIA), we conducted a cross-sectional study of 1426 children and adolescents aged 7–17 years in Beijing, 2020. EBP, including elevated systolic BP (ESBP) and elevated diastolic BP (EDBP), was defined based on the age- and sex-specific 90th BP reference values of children and adolescents in China. BF% was measured by dual-energy X-ray absorptiometry (DEXA) and BIA devices, and was divided into four quartiles. Log-binomial models were applied to calculate odds ratios (ORs) and 95% confidence intervals (95%CI). Girls tended to have higher BF% levels than boys (p < 0.05). There was 41.0% of girls who developed EBP. High BF% was associated with increased BP levels with ORs of 0.364 (95%CI = 0.283–0.444) for SBP, 0.112 (95%CI = 0.059–0.165) for DBP, and 1.043 (95%CI = 1.027–1.059) for EBP, while the effects were more pronounced in girls and older-aged children. BIA devices agreed well with BF% assessment obtained by DEXA. High BF% might have negative effects on childhood BP. Convenient measurements of body fat might help to assess childhood obesity and potential risks of hypertension.
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48
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ACTN3 Genotypes and Their Relationship with Muscle Mass and Function of Kosovan Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179135. [PMID: 34501725 PMCID: PMC8431689 DOI: 10.3390/ijerph18179135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/21/2021] [Accepted: 08/27/2021] [Indexed: 12/21/2022]
Abstract
Maintaining muscle mass and function is important throughout the lifestyle. While environmental factors such as physical activity and healthy nutrition are well investigated, the contribution of genetic factors is still controversial. Therefore, we aimed to investigate the impact of a common ACTN3 polymorphism (rs1815739) on body composition, handgrip strength, knee extensor peak torque, and physical performance (gait speed, 30-s arm curl, 30-s chair stand) in Kosovan adults. In total, 308 participants (160 females and 148 males, age range from 40 to 91 years) took part in this cross-sectional study. Genomic DNA was extracted from saliva and assessed for ACTN3 genotype distribution (41.5% of RR, 53.9% of RX and 4.6% of XX). Genotype allocation did not account for differences in any of the variables. Interestingly, female XX carriers were taller (p = 0.025) and had a higher isokinetic knee extension peak torque (p = 0.024) than the RX+RR group. In males, XX carriers were also taller (p = 0.049) and had a lower BMI (p = 0.026), but did not differ in any of the strength and performance parameters. These results indicate that the ACTN3 R577X polymorphism might exert a sex-specific impact on knee extensor peak torque and BMI.
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Minohara T, Noso S, Babaya N, Hiromine Y, Taketomo Y, Niwano F, Makutani Y, Yoshida S, Yasutake S, Imamura S, Ikegami H. Associations between genetic loci related to lean mass and body composition in type 2 diabetes. Geriatr Gerontol Int 2021; 21:932-938. [PMID: 34390125 PMCID: PMC9290739 DOI: 10.1111/ggi.14259] [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] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 01/22/2023]
Abstract
Aim Several genetic loci related to lean mass have been identified in healthy individuals by genome‐wide association studies; however, the contribution of these loci to body composition in type 2 diabetes remains to be investigated. Here, we aimed to clarify the genetic determinants of body composition in individuals with type 2 diabetes. Methods A total of 176 Japanese outpatients (70 women and 106 men) with type 2 diabetes were studied using a cross‐sectional design. Body composition was measured using bioimpedance analysis with a commercially available device (InBody770). Single‐nucleotide polymorphisms in IRS1 (rs2943656), HSD17B11 (rs9991501), VCAN (rs2287926), ADAMTSL3 (rs4842924) and FTO (rs9936385) were evaluated by genotyping. The contributions of single‐nucleotide polymorphisms to body composition were examined, considering known clinical determinants. Results Sex, body composition and age were identified as clinical predictors. IRS1 rs2934656 was identified as an independent predictor of skeletal muscle mass (β = 0.11, P = 0.026), and ADAMTSL3 rs4842924 was an independent predictor of body fat mass (β = 0.15, P = 0.0095) and appendicular lean mass (β = −0.13, P = 0.017). Conclusions The findings clarified the contribution of genetic factors – IRS1 and ADAMTSL3 – to interindividual variation in body composition, independent of clinical factors, in type 2 diabetes patients. These data will contribute to the establishment of effective methods for the prediction, prevention, and intervention of sarcopenia and frailty in diabetes patients. Geriatr Gerontol Int 2021; 21: 932–938.
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Affiliation(s)
- Tatsuro Minohara
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shinsuke Noso
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Naru Babaya
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshihisa Hiromine
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasunori Taketomo
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Fumimaru Niwano
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yukako Makutani
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Sawa Yoshida
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Sara Yasutake
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shuzo Imamura
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroshi Ikegami
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan
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Cohen-Cesla T, Azar A, Hamad RA, Shapiro G, Stav K, Efrati S, Beberashvili I. Usual nutritional scores have acceptable sensitivity and specificity for diagnosing malnutrition compared to GLIM criteria in hemodialysis patients. Nutr Res 2021; 92:129-138. [PMID: 34304058 DOI: 10.1016/j.nutres.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/31/2022]
Abstract
Diagnosing malnutrition by the recently published Global Leadership Initiative on Malnutrition (GLIM) criteria requires using modern techniques for body composition measurements. We hypothesized that the prevalence of malnutrition identified by usual nutritional scores and according to GLIM criteria may be close to each other due to the number of components shared between them. Our aim was to compare the concurrent validity of four nutritional scores, malnutrition-inflammation score (MIS), objective score of nutrition on dialysis, geriatric nutritional index (GNRI), and nutritional risk index against the GLIM criteria for malnutrition in maintenance hemodialysis patients. This prospective observational study was performed on 318 maintenance hemodialysis outpatients (37% women) with a mean age of 68.7 ± 13.1 years and a median dialysis vintage of 21 months. According to the GLIM criteria, 45.9% of these patients were diagnosed with malnutrition. Nutritional scores, dietary intake and body composition parameters were measured. All nutritional scores showed a strong association with malnutrition in multivariable logistic regression models. In discriminating the nutritional risk, the ROC AUC was largest for GNRI (0.70, 95% CI: 0.65-0.75; P< .001). Nutritional risk index and MIS showed high specificity but lower sensitivity compared to GNRI and objective score of nutrition on dialysis. Compared to MIS, GNRI had better concurrent validity (higher sensitivity and acceptable specificity) but was inferior to MIS in terms of relation to certain etiologic and phenotypic components of the GLIM criteria (specifically, to dietary intake and decrease in dry weight). In summary, of the nutritional scores tested, GNRI is the most sensitive score in identifying malnutrition diagnosed by GLIM criteria, but MIS is more specific and better in predicting the individual components of the GLIM criteria.
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Affiliation(s)
- Tamar Cohen-Cesla
- Internal Department D, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ada Azar
- Nutrition Department, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ramzia Abu Hamad
- Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Gregory Shapiro
- Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Kobi Stav
- Urology Department, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Shai Efrati
- Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ilia Beberashvili
- Nephrology Division, Yitzhak Shamir Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel.
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