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Kim J, Jeong HG, Lee MS, Pae CU, Patkar AA, Jeon SW, Shin C, Han C. Effect of Frailty on Depression among Patients with Late-life Depression: A Test of Anger, Anxiety, and Resilience as Mediators. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:253-262. [PMID: 38627072 PMCID: PMC11024698 DOI: 10.9758/cpn.23.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 04/20/2024]
Abstract
Objective While the association between depression and frailty in the elderly population has been investigated, the psychological factors that mediate such a relationship remain unknown. The identification of psychological factors in interventions for depression treatment in the elderly may assist in the treatment and care. We aimed to explore the mediating effects of anger, anxiety, and resilience on the link between frailty and depression symptoms in patients with late-life depression. Methods A sample of 203 older adults completed questionnaires that assessed depression, anger, resilience, and anxiety. To measure frailty, participants were evaluated using a self-rated health questionnaire, weight-adjusted waist index related to sarcopenia, and weight-adjusted handgrip strength to evaluate weakness. A mediation model was tested, hypothesizing that anger, anxiety, and resilience would partially mediate the strength of the frailty-depression link in the elderly. Results Only self-rated health showed a significant association with depressive symptoms in late-life depression. Our study demonstrated that frailty has both direct and indirect associations with depression, mediated by anger, resilience, and anxiety. Conclusion Given that anger, resilience, and anxiety influence the link between self-rated health and depression, interventions that lead to increased resilience and decreased anger and anxiety may be promising to reduce depressive symptoms in older adults with depression.
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Affiliation(s)
- Junhyung Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Department of Life Sciences, Korea University, Seoul, Korea
| | - Chi-Un Pae
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Cell Death Disease Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ashwin A. Patkar
- Department of Advance Psychiatry, Rush University Medical Center, Raleigh, NC, USA
| | - Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Korea
| | - Cheolmin Shin
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Dericioglu D, Methven L, Clegg ME. Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population. Proc Nutr Soc 2024:1-13. [PMID: 38557431 DOI: 10.1017/s0029665124002192] [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: 04/04/2024]
Abstract
Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.
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Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
| | - Lisa Methven
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading,Whiteknights, Reading RG6 6DZ, UK
| | - Miriam E Clegg
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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Rodríguez MP, Cabello-Verrugio C. Soluble Factors Associated with Denervation-induced Skeletal Muscle Atrophy. Curr Protein Pept Sci 2024; 25:189-199. [PMID: 38018212 DOI: 10.2174/0113892037189827231018092036] [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: 03/06/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 11/30/2023]
Abstract
Skeletal muscle tissue has the critical function of mechanical support protecting the body. In addition, its functions are strongly influenced by the balanced synthesis and degradation processes of structural and regulatory proteins. The inhibition of protein synthesis and/or the activation of catabolism generally determines a pathological state or condition called muscle atrophy, a reduction in muscle mass that results in partial or total loss of function. It has been established that many pathophysiological conditions can cause a decrease in muscle mass. Skeletal muscle innervation involves stable and functional neural interactions with muscles via neuromuscular junctions and is essential for maintaining normal muscle structure and function. Loss of motor innervation induces rapid skeletal muscle fiber degeneration with activation of atrophy-related signaling and subsequent disassembly of sarcomeres, altering normal muscle function. After denervation, an inflammation stage is characterized by the increased expression of pro-inflammatory cytokines that determine muscle atrophy. In this review, we highlighted the impact of some soluble factors on the development of muscle atrophy by denervation.
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Affiliation(s)
- Marianny Portal Rodríguez
- Laboratory of Muscle Pathology, Fragility, and Aging, Faculty of Life Sciences, Universidad Andres Bello, Santiago, 8370146, Chile
- Millennium Institute on Immunology and Immunotherapy, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
| | - Claudio Cabello-Verrugio
- Laboratory of Muscle Pathology, Fragility, and Aging, Faculty of Life Sciences, Universidad Andres Bello, Santiago, 8370146, Chile
- Millennium Institute on Immunology and Immunotherapy, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
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Reinbacher P, Draschl A, Smolle MA, Hecker A, Gaderer F, Lanner KB, Ruckenstuhl P, Sadoghi P, Leithner A, Nehrer S, Klestil T, Brunnader K, Bernhardt GA. The Impact of Obesity on the Health of the Older Population: A Cross-Sectional Study on the Relationship between Health-Related Quality of Life and Body Mass Index across Different Age Groups. Nutrients 2023; 16:51. [PMID: 38201881 PMCID: PMC10780898 DOI: 10.3390/nu16010051] [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: 11/05/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Obesity is strongly associated with mortality and morbidity, but there is a lack of data on its impact on health-related quality of life (HRQoL) across different age groups. Therefore, this study's objective was to determine the association between body mass index (BMI) and HRQoL in the Austrian adult population based on age groups using the 36-Item Short Form (SF-36) survey. METHODS The SF-36 survey was sent to 500 randomly assigned Austrian adults (response rate: 80.6%). This study assessed HRQoL subscale and component scores based on gender, level of education, smoking status, and alcohol consumption in 403 participants. RESULTS Increasing BMI is associated with a negative impact on all domains of physical health and social function. The study uncovered substantial variations in the impact of increasing BMI on HRQoL across different age groups, with a pronounced effect observed in the physical components, particularly among individuals aged 65-74. CONCLUSIONS BMI is negatively associated with the physical aspects of HRQoL and social function, affecting various adult age groups differently. Consequently, our results emphasize assessing different age groups and possible influencing factors on HRQoL, such as BMI, for further optimization in designing prevention programs against obesity.
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Affiliation(s)
- Patrick Reinbacher
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
| | - Alexander Draschl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Maria Anna Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Franz Gaderer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Kay-Bernd Lanner
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
| | - Paul Ruckenstuhl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Patrick Sadoghi
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Stefan Nehrer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Thomas Klestil
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Landesklinikum Baden-Mödling, 2340 Mödling, Austria
| | - Kevin Brunnader
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Gerwin A. Bernhardt
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
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Berezina TN, Rybtsov SA. Use of Personal Resources May Influence the Rate of Biological Aging Depending on Individual Typology. Eur J Investig Health Psychol Educ 2022; 12:1793-1811. [PMID: 36547027 PMCID: PMC9778189 DOI: 10.3390/ejihpe12120126] [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: 08/31/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Individual hobbies and interests, the ways of spending leisure time develop personal resources influencing health and wellbeing. The literature analysis helped selecting thirteen personal resources that also affect the rate of aging: sports, order, creativity, intellect, handwork, kindness, Humor, spirituality, risk, nature, achievements, optimism, communication. In 1632 people, (840 women and 792 men) personal resources were assessed using a questionnaire developed in-house. Biological age was determined by health indicators. The personal typology was determined by testing functional asymmetry, physique, interaction style, emotionality, profession, marital status, gender, age, and place of residence. The data were processed by correlation and cluster analysis and methods of automatic artificial neural networks (ANN). Personal resources were used as input continuous variables. Personality types were used as input categorical variables. The index of relative biological aging (RBA) was applied as an output continuous variable. We also calculated the correlation between the RBA index and the applied personal resources in different types of personalities. For most female types including investigative occupations, psychomotor emotionality, living in urban areas, asthenic physique, negative correlations were found between most personal resources and the aging index. In men, resources that slow down aging are found only for certain types: enterprising and conventional professions, ambidexter and left-handed, intellectual emotionality, athletic physique. In conclusion, with the help of the trained ANN, we selected personal resources that slow down aging. For women of all types, there are common resources reducing RBA index including nature, intellect, and achievements. For men, ANN was unable to find common resources that slow down aging. However, with an individual selection of resources, a trained neural network gives a favorable forecast of the ability to slow down the biological aging of a particular man by changing his hobbies and interests and ways of spending free time.
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Affiliation(s)
- Tatiana N. Berezina
- Department of Scientific Basis of Extreme Psychology, Moscow State University of Psychology and Education, 127051 Moscow, Russia
| | - Stanislav A. Rybtsov
- Center for Regenerative Medicine, University of Edinburgh, Edinburgh EH8 9YL, UK
- Correspondence:
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Kasović M, Štefan L, Kalčik Z. Acute Responses to Resistance Training on Body Composition, Muscular Fitness and Flexibility by Sex and Age in Healthy War Veterans Aged 50-80 Years. Nutrients 2022; 14:nu14163436. [PMID: 36014943 PMCID: PMC9416708 DOI: 10.3390/nu14163436] [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: 07/17/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Although evidence suggests that resistance training should be prescribed as a method to enhance or maintain physical fitness, these findings are mostly based on research on younger men. Studies investigating responses by sex and age to resistance training, especially in war veterans aged ≥50 years, are lacking. Therefore, the main purpose of this study was to examine whether a 4-week resistance training program would have similar effects on body composition, muscular fitness, and flexibility in men and women aged 50−80 years. Methods: Seven-hundred and sixty-four participants were recruited and categorized into two groups each of men and women aged 50−64 and 65−80 years. The training intervention lasted 4 weeks and consisted of three 60 min sessions per week. All participants were tested for each of the following physical fitness components: body composition, push-ups in 30 s, chair-stands in 30 s, sit-ups in 30 s, and a sit-and-reach test. Results: Over the intervention period of 4 weeks, body weight (p = 0.002) and the percent of fat mass (p < 0.001) decreased, while the percent of lean mass (p < 0.001) in push-ups in 30 s (p < 0.001), chair-stands in 30 s (p < 0.001), sit-ups in 30 s (p < 0.001), and sit-and-reach (p < 0.001) increased. Significant time*age interactions were shown for push-ups in 30 s (F1,763 = 4.348, p = 0.038) and chair-stands in 30 s (F1,763 = 9.552, p = 0.002), where men and women aged 50−64 years exhibited larger time-induced changes compared to their older (65−80 yr) counterparts. Effect sizes were similar between sex- and age-specific groups. Conclusions: The 4-week resistance training produced similar pronounced positive effects on body composition, muscular fitness, and flexibility, while men and women aged 50−64 years displayed significantly larger improvements in upper and lower muscular fitness compared with their 65−80-year-old counterparts.
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Affiliation(s)
- Mario Kasović
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, 10 000 Zagreb, Croatia
- Division of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, 625 00 Brno, Czech Republic
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, 10 000 Zagreb, Croatia
- Division of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, 625 00 Brno, Czech Republic
- Recruitment and Examination (RECETOX), Faculty of Science, Masaryk University, 625 00 Brno, Czech Republic
- Correspondence:
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Tey SL, Huynh DTT, Berde Y, Baggs G, How CH, Low YL, Cheong M, Chow WL, Tan NC, Chew STH. Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore. Sci Rep 2021; 11:23071. [PMID: 34845250 PMCID: PMC8630119 DOI: 10.1038/s41598-021-02274-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.
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Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore.
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Mumbai, India
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, OH, 43219, USA
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore, 529889, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Yen Ling Low
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore, 529889, Singapore
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore, 529889, Singapore
| | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore.,SingHealth Polyclinics, Singapore, 150167, Singapore
| | - Samuel Teong Huang Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore, 529889, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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Angelidi AM, Filippaios A, Mantzoros CS. Severe insulin resistance syndromes. J Clin Invest 2021; 131:142245. [PMID: 33586681 DOI: 10.1172/jci142245] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Severe insulin resistance syndromes are a heterogeneous group of rare disorders characterized by profound insulin resistance, substantial metabolic abnormalities, and a variety of clinical manifestations and complications. The etiology of these syndromes may be hereditary or acquired, due to defects in insulin potency and action, cellular responsiveness to insulin, and/or aberrations in adipose tissue function or development. Over the past decades, advances in medical technology, particularly in genomic technologies and genetic analyses, have provided insights into the underlying pathophysiological pathways and facilitated the more precise identification of several of these conditions. However, the exact cellular and molecular mechanisms of insulin resistance have not yet been fully elucidated for all syndromes. Moreover, in clinical practice, many of the syndromes are often misdiagnosed or underdiagnosed. The majority of these disorders associate with an increased risk of severe complications and mortality; thus, early identification and personalized clinical management are of the essence. This Review aims to categorize severe insulin resistance syndromes by disease process, including insulin receptor defects, signaling defects, and lipodystrophies. We also highlight several complex syndromes and emphasize the need to identify patients, investigate underlying disease mechanisms, and develop specific treatment regimens.
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Affiliation(s)
- Angeliki M Angelidi
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Andreas Filippaios
- Department of Medicine, Lowell General Hospital, Lowell, Massachusetts, USA
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts, USA
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Boo YY, Jutila OE, Cupp MA, Manikam L, Cho SI. The identification of established modifiable mid-life risk factors for cardiovascular disease which contribute to cognitive decline: Korean Longitudinal Study of Aging (KLoSA). Aging Clin Exp Res 2021; 33:2573-2586. [PMID: 33538990 PMCID: PMC8429388 DOI: 10.1007/s40520-020-01783-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/25/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We explored how different chronic diseases, risk factors, and protective factors highly associated with cardiovascular diseases (CVD) are associated with dementia or Mild Cognitive Impairment (MCI) in Korean elders, with a focus on those that manifest in mid-life. METHODS A CVD-free cohort (n = 4289) from the Korean Longitudinal Study of Aging was selected to perform Cox mixed-effects proportional hazard regressions. Eighteen control variables with strong associations to CVD were chosen as explanatory variables, and Mini-Mental State Examination (MMSE) score cut-off for dementia and MCI were used as outcome variables. RESULTS The statistically significant (P < 0.05) adverse factors that contribute in developing dementia were age (aHR 1.07, 1.05-1.09), Centre for Epidemiological Studies Depression Scale (CESD-10) (aHR 1.17, 1.12-1.23), diagnosis with cerebrovascular disease (aHR 3.73, 1.81-7.66), living with diabetes (aHR 2.30, 1.22-4.35), and living with high blood pressure (HBP) (aHR 2.05, 1.09-3.87). In contrast, the statistically significant protective factors against developing dementia were current alcohol consumption (aHR 0.67, 0.46-0.99), higher educational attainment (aHR 0.36, 0.26-0.56), and regular exercise (aHR 0.37, 0.26-0.51). The factors with a statistically significant adverse association with progression to MCI were age (aHR 1.02, 1.01-1.03) and CESD-10 (aHR 1.17, 1.14-1.19). In contrast, the statistically significant protective factors against developing MCI were BMI (aHR 0.96, 0.94-0.98), higher educational attainment (aHR 0.33, 0.26-0.43), and regular exercise (aHR 0.83, 0.74-0.92). CONCLUSION In lieu of the protective factor of MCI and dementia, implementing regular exercise routine well before mid-life and cognitive decline is significant, with adjustments made for those suffering from health conditions, so they can continue exercising despite their morbidity. Further attention in diabetes care and management is needed for patients who already show decline in cognitive ability as it is likely that their MCI impacts their ability to manage their existing chronic conditions, which may adversely affect their cognitive ability furthermore.
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Affiliation(s)
- Yebeen Ysabelle Boo
- Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK.
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK.
| | - Otto-Emil Jutila
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Meghan A Cupp
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Logan Manikam
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
| | - Sung-Il Cho
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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Yin L, Li N, Jia W, Wang N, Liang M, Yang X, Du G. Skeletal muscle atrophy: From mechanisms to treatments. Pharmacol Res 2021; 172:105807. [PMID: 34389456 DOI: 10.1016/j.phrs.2021.105807] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/03/2021] [Accepted: 08/07/2021] [Indexed: 02/07/2023]
Abstract
Skeletal muscle is a crucial tissue for movement, gestural assistance, metabolic homeostasis, and thermogenesis. It makes up approximately 40% of the total body weight and 50% of total protein. However, several pathological abnormalities (e.g., chronic diseases, cancer, long-term infection, aging) can induce an imbalance in skeletal muscle protein synthesis and degradation, which triggers muscle wasting and even leads to atrophy. Skeletal muscle atrophy is characterized by weakening, shrinking, and decreasing muscle mass and fiber cross-sectional area at the histological level. It manifests as a reduction in force production, easy fatigue and decreased exercise capability, along with a lower quality of life. Mechanistically, there are several pathophysiological processes involved in skeletal muscle atrophy, including oxidative stress and inflammation, which then activate signal transduction, such as the ubiquitin proteasome system, autophagy lysosome system, and mTOR. Considering the great economic and social burden that muscle atrophy can inflict, effective prevention and treatment strategies are essential but still limited. Exercise is widely acknowledged as the most effective therapy for skeletal muscle atrophy; unfortunately, it is not applicable for all patients. Several active substances for skeletal muscle atrophy have been discovered and evaluated in clinical trials, however, they have not been marketed to date. Knowledge is being gained on the underlying mechanisms, highlighting more promising treatment strategies in the future. In this paper, the mechanisms and treatment strategies for skeletal muscle atrophy are briefly reviewed.
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Affiliation(s)
- Lin Yin
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China
| | - Na Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China
| | - Weihua Jia
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China
| | - Nuoqi Wang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China
| | - Meidai Liang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China
| | - Xiuying Yang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China.
| | - Guanhua Du
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines and Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking Union Medical College, 1 Xian Nong Tan Street, Beijing 100050, PR China.
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11
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Berezina TN, Rybtsov S. Acceleration of Biological Aging and Underestimation of Subjective Age Are Risk Factors for Severe COVID-19. Biomedicines 2021; 9:913. [PMID: 34440116 PMCID: PMC8389586 DOI: 10.3390/biomedicines9080913] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 02/08/2023] Open
Abstract
In an epidemic, it is important to have methods for reliable and rapid assessment of risk groups for severe forms of the disease for their priority vaccination and for the application of preventive lockdown measures. The aim of this study was to investigate risk factors for severe forms of COVID-19 in adults using indicators of biological and subjective aging. Longitudinal studies evaluated the severity of the disease and the number of cases. Respondents (447) were divided into "working group" and "risk group" (retirees with chronic diseases). During the lockdown period (in mid-2020), accelerated aging was observed in the group of workers (by 3.9-8 years for men and an increase at the tendency level for women). However, the respondents began to feel subjectively younger (by 3.3-7.2 years). In the risk group, there were no deviations from the expected biopsychological aging. The number of cases at the end of 2020 was 31% in workers and 0% in the risk group. Reasonably, the risk group followed the quarantine rules more strictly by 1.5 times. In working men, indicators of relative biological and relative subjective aging (measured in both 2019 and mid-2020) significantly influenced the incidence at the end of 2020. In women, only the indicators obtained in mid-2020 had a significant impact. The relative biological aging of an individual tested in the middle of 2020 had a direct impact on the risk of infection (p < 0.05) and on the probability of death (p < 0.0001). On the contrary, an increase in the relative subjective (psychological) aging index reduced the risk of infection (at the tendency level, p = 0.06) and the risk of death (p < 0.0001). Both the risk of infection and the risk of death increased with calendar age at the tendency level. Conclusions: Indicators of individual relative biological and subjective aging affect the probability of getting COVID-19 and its severity. The combination of high indicators of biological aging and underestimated indicators of subjective aging is associated with increased chances of developing severe forms of the disease.
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Affiliation(s)
- Tatiana N. Berezina
- Department of Scientific Basis of Extreme Psychology, Moscow State University of Psychology and Education, Shelepikhinskaya Naberezhnaya, 2A/1, Office 207, 123290 Moscow, Russia
| | - Stanislav Rybtsov
- Centre for Regenerative Medicine, Institute for Regeneration and Repair, University of Edinburgh, 5 Little France Drive, Edinburgh EH16 4UU, UK
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12
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Kim NH, Park Y, Kim NH, Kim SG. Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults. Age Ageing 2021; 50:780-786. [PMID: 33035293 DOI: 10.1093/ageing/afaa208] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Age-related changes in body composition include decreased muscle mass and preserved or increased fat mass. There is no anthropometric index to assess both muscle and fat mass. METHODS Using a cross-sectional sample of 602 participants aged ≥65 years from the Ansan Geriatric study, we evaluated the association of weight-adjusted waist index (WWI) with muscle and fat mass and compared these with body mass index (BMI) and waist circumference (WC). WWI was calculated as WC (cm) divided by the square root of body weight (kg). Body composition was measured using bioelectrical impedance analysis, dual-energy X-ray absorptiometry and abdominal computed tomography. RESULTS WWI positively correlated with total abdominal fat area (TFA) (r = 0.421, P < 0.001), visceral fat area (VFA) (r = 0.264, P < 0.001), and percentage of total tissue fat (r = 0.465, P < 0.001), but negatively correlated with appendicular skeletal muscle mass (ASM) (r = -0.511, P < 0.001) and ASM/height2 (r = -0.324, P < 0.001). Mean ASM was highest in the first quartile of WWI (17.85 kg/m2) and showed a decreasing trend, with the lowest value in the fourth WWI quartile (13.21 kg/m2, P for trend <0.001). In contrast, mean TFA was lowest in the first quartile and highest in the fourth WWI quartile (P for trend <0.001). The probability of combined low muscle mass and high fat mass was >3× higher in the fourth WWI quartile than in the lowest quartile (odds ratio 3.22, 95% confidence interval 1.32-7.83). CONCLUSIONS WWI is an anthropometric index positively associated with fat mass and negatively associated with muscle mass in older adults.
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Affiliation(s)
- Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yousung Park
- Department of Statistics, Korea University, Seoul, South Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
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13
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Santos M, Freitas SV, Dias D, Costa J, Coutinho M, Sousa CA, da Silva ÁM. Presbylarynx: Does Body Muscle Mass Correlate With Vocal Atrophy? A Prospective Case Control Study. Laryngoscope 2020; 131:E226-E230. [PMID: 32401382 DOI: 10.1002/lary.28685] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/19/2020] [Accepted: 03/27/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To analyze the potential association between body muscle mass and presbylarynx. METHODS Study performed on subjects referred to the otorhinolaryngology department in a tertiary center between January and September 2019 . Based on endoscopic findings of the larynx, the patients were subdivided into two main groups: presbylarynx versus no presbylarynx. Data regarding gender, body composition, self-assessment of vocal complaints, and functional assessment were collected. STUDY DESIGN Case control, prospective, observational and cross-sectional. RESULTS The study population included a total of 115 Caucasian subjects (43 males; 72 females). Presbylarynx was identified in 43 patients (37, 39%) with no statistically predilection by gender (P = .668). The mean age of the patients with presbylarynx was slightly higher, but differences between groups were not statistically significant (P = .072). Results showed an association between functional impairment (score 4 of Katz Index and score 5 of Functional Ambulation Classification) and presence of presbylarynx (P < .001). Additionally, a positive association between the absence of presbylarynx and sport activity was also observed (P < .001). The mean value of muscle mass between presbylarynx and no presbylarynx groups was statistically different (P < .01), with a lower mean for subjects with presbylarynx. CONCLUSION This case control prospective study confirms that the general age-related degeneration of body muscle mass might play an important role in the course of presbylarynx. In the future, preventing strategies based on regular sport activities and improvements on functional status can play an important role in the management of aging voice. LEVEL OF EVIDENCE 2b Laryngoscope, 131:E226-E230, 2021.
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Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Susana V Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - David Dias
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Joana Costa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Miguel Coutinho
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Cecília A Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Álvaro M da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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14
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Cebula A, Tyka AK, Tyka A, Pałka T, Pilch W, Luty L, Mucha D. Physiological response and cardiorespiratory adaptation after a 6-week Nordic Walking training targeted at lipid oxidation in a group of post-menopausal women. PLoS One 2020; 15:e0230917. [PMID: 32236147 PMCID: PMC7112189 DOI: 10.1371/journal.pone.0230917] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/11/2020] [Indexed: 01/10/2023] Open
Abstract
This study examined the effects of a 6-week Nordic Walking (NW) training, at the intensity corresponding to the dominance of lipid metabolism, on the levels of selected physiological indices, the haemodynamic indices of the cardiovascular system and physical fitness in sedentary women older than 55 years of age. In addition, the physiological response of the female body to the walking effort on treadmill with poles (NW) and without poles (W) was compared and the influence of training on this response was determined. A single group study with a pre-test/post-test study design was conducted. Eighteen women performed NW controlled intensity training 3 times a week for 6 weeks. Body composition, resting blood pressure (BP), heart rate (HR), maximum oxygen uptake (VO2max) as well as circulatory and respiratory indices in two graded walking efforts on mechanical treadmill NW and W were measured before and after training period. The intensity of workouts, which considered the dominance of lipid metabolism, was determined individually, based on the dynamics of changes in the level of physiological indices during the graded intensity NW. After the course of training, body mass, fat mass, resting BP and HR decreased significantly (p < 0.05). HR and respiratory exchange ratio recorded during NW and W at 1.75 m.s-1 walking speed decreased, while the oxygen pulse increased (p < 0.05). VO2max increased significantly (p < 0.05). Before and after the training period HR, oxygen uptake per minute, and energy expenditure during NW were significantly higher than in W (p < 0.05). The study showed that 6-week NW training at the intensity corresponding to the dominance of lipid metabolism can provide improvement in body composition, cardiovascular function and physical performance in previously sedentary women. NW compared to the regular walk with the same speed revealed higher energy expenditure.
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Affiliation(s)
- Agata Cebula
- Department of Biological Regeneration and Posture Correction, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
- * E-mail:
| | - Anna Katarzyna Tyka
- Department of Recreation and Biological Regeneration, Faculty of Tourism and Leisure, University of Physical Education, Krakow, Poland
| | - Aleksander Tyka
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Tomasz Pałka
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Wanda Pilch
- Department of Biochemistry and Basic of Cosmetology, Faculty of Cosmetology, University of Physical Education, Krakow, Poland
| | - Lidia Luty
- Department of Statistics and Econometrics, University of Agriculture, Krakow, Poland
| | - Dariusz Mucha
- Department of Biological Regeneration and Posture Correction, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
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15
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Clark JL, Loader TB, Anderson HD, Zahradka P, Taylor CG. Regular Black Bean Consumption Is Necessary to Sustain Improvements in Small-Artery Vascular Compliance in the Spontaneously Hypertensive Rat. Nutrients 2020; 12:nu12030685. [PMID: 32138293 PMCID: PMC7146454 DOI: 10.3390/nu12030685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 01/02/2023] Open
Abstract
Edible legume seeds, such as lentils, have been shown to modulate the structural and functional properties of hypertensive blood vessels, however, the effects of dried beans have not been similarly evaluated. To determine whether beans could attenuate hypertension-induced vascular changes (remodeling and stiffness) in relation to their phytochemical content, spontaneously hypertensive rats (SHR) were fed diets containing black beans (BB; high phytochemical content as indicated by their dark seed coat colour) or navy (white) beans (NB; low phytochemical content) for eight weeks. An additional follow-up phase was included to determine how long the alterations in vascular properties are maintained after bean consumption is halted. Assessments included blood pressure (BP), pulse wave velocity (PWV), vessel compliance (small-artery) and morphology (large-artery), and body composition. Neither BBs nor NBs altered BP or PWV in SHR. SHR-BB demonstrated greater medial strain (which is indicative of greater elasticity) at higher intraluminal pressures (80 and 140 mmHg) compared to SHR-NB. BB consumption for 8 weeks enhanced vascular compliance compared to SHR-NB, as demonstrated by a rightward shift in the stress-strain curve, but this improvement was lost within 2 weeks after halting bean consumption. BB and NB increased lean mass after 8 weeks, but halting BB consumption increased fat mass. In conclusion, regular consumption of BBs may be appropriate as a dietary anti-hypertensive strategy via their positive actions on vascular remodeling and compliance.
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Affiliation(s)
- Jaime L. Clark
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.L.C.); (T.B.L.); (P.Z.)
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
| | - Tara B. Loader
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.L.C.); (T.B.L.); (P.Z.)
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
| | - Hope D. Anderson
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
- Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
| | - Peter Zahradka
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.L.C.); (T.B.L.); (P.Z.)
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
| | - Carla G. Taylor
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.L.C.); (T.B.L.); (P.Z.)
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada;
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
- Correspondence: ; Tel.: +1-204-258-1361
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16
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Khalil R. Ubiquitin-Proteasome Pathway and Muscle Atrophy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:235-248. [DOI: 10.1007/978-981-13-1435-3_10] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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