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Chen LK. Unique compositional signature, pathophysiology and clinical implications of sarcopenic obesity. Arch Gerontol Geriatr 2024; 124:105501. [PMID: 38821729 DOI: 10.1016/j.archger.2024.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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Stoffel E, Hwang SY, Qian X, Geller B, Morelli G, Zhang W. Sarcopenia is an independent risk factor for short-term mortality in patients undergoing transjugular intrahepatic portosystemic shunt. Eur J Gastroenterol Hepatol 2024; 36:1010-1015. [PMID: 38808872 DOI: 10.1097/meg.0000000000002790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Sarcopenia is common in patients with cirrhosis and is a risk factor for increased mortality. Transjugular intrahepatic portosystemic shunt (TIPS) placement has been utilized in cirrhosis patients with decompensation . We investigated the role of sarcopenia in predicting mortality in patients undergoing TIPS. METHODS We conducted a single-center retrospective study of 232 patients with cirrhosis who underwent TIPS between January 2010 and December 2015. Sarcopenia was defined by the psoas muscle index (PMI) cutoff value, calculated based on dynamic time-dependent outcomes using X-tile software. Kaplan-Meier analysis demonstrated the difference in survival in the sarcopenia group versus the non-sarcopenia group. . Univariate and multivariate analyses were used to identify the relationship between sarcopenia and post-TIPS mortality during a follow-up period of 1 year. RESULTS For TIPS indications, 111 (47.84%) patients had refractory ascites, 69 (29.74%) patients had variceal bleeding, 12 (5.17%) patients had ascites, and 40 (17.24%) for other indications. The mean PMI was 4.40 ± 1.55. Sarcopenia was defined as a PMI value of <4.36 in males, and <3.23 in females. Sarcopenia was present in 96 (41.38%) of patients. . Kaplan-Meier analysis showed thatsarcopenia is associated with worse survival (log-rank P < 0.01). Multivariate Cox regression analysis showed that sarcopenia is independently associated with worse survival during the 1-year follow-up period with an hazard ratio of 2.435 (95% CI 1.346-4.403) ( P < 0.01), after adjusting for age, BMI, indications for TIPS, etiology for cirrhosis, and MELD score and stratified by sex. CONCLUSION Sarcopenia is an independent risk factor for 1-year mortality in patients undergoing TIPS and should be considered when patients are evaluated as a candidate for TIPS.
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Affiliation(s)
- Elina Stoffel
- Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York City, New York
| | - Soo Young Hwang
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- University of Maryland Medical System, Baltimore, Maryland
| | - Xia Qian
- Department of Radiology, University of Florida, Gainesville, Florida
- Department of Pathology, Beth Israel Deaconess Hospital, Boston, Massachusetts
| | - Brian Geller
- Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida, USA
| | - Giuseppe Morelli
- Department of Radiology, University of Florida, Gainesville, Florida
| | - Wei Zhang
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Franco MF, Leme DEDC, Coimbra IB, Coimbra AMV. Prevalence and factors associated with sarcopenia among Brazilian older adults: An exploratory network analysis. Arch Gerontol Geriatr 2024; 123:105438. [PMID: 38608545 DOI: 10.1016/j.archger.2024.105438] [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: 02/06/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES This study aimed to verify the prevalence of sarcopenia and its associations with sociodemographic, clinical and psychological factors in community-dwelling older adults. STUDY DESIGN A randomized cross-sectional study was extracted from a probabilistic cluster conducted on individuals aged 65 years or older residing in the community. METHODS Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Associations were analyzed using networks based on mixed graphical models. Predictability indices of the estimated networks were assessed using the proportion of explained variance for numerical variables and the proportion of correct classification for categorical variables. RESULTS The study included 278 participants, with a majority being female (61 %). The prevalence of sarcopenia was 39.57 %. Among those with sarcopenia, 67 % were women and 33 % were men. In the network model, age, race, education, family income, bone mass, depression, cardiovascular disease, diabetes, total cholesterol levels and rheumatism were associated with sarcopenia. The covariates demonstrated a high accuracy (62.9 %) in predicting sarcopenia categories. CONCLUSION The prevalence of sarcopenia was high, especially in women. In addition, network analysis proved useful in visualizing complex relationships between sociodemographic and clinical factors with sarcopenia. The results suggest early screening of sarcopenia for appropriate treatment of this common geriatric syndrome in older adults in Brazil.
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Affiliation(s)
| | | | - Ibsen Bellini Coimbra
- Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
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Mirzai S, Persits I, Martens P, Estep JD, Wilson Tang WH, Chen PH. Skeletal muscle quantity and quality evaluation in heart failure: comparing thoracic versus abdominopelvic CT approaches. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03169-w. [PMID: 38963592 DOI: 10.1007/s10554-024-03169-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/22/2024] [Indexed: 07/05/2024]
Abstract
Given the critical role of skeletal muscle in healthy aging, low muscle mass (myopenia) and quality (myosteatosis) can be used as predictors of poor functional and cardiometabolic outcomes. Myopenia is also a part of sarcopenia and malnutrition diagnostic criteria. However, there is limited evidence for using chest computed tomography (CT) to evaluate muscle health. We aimed to compare chest CT landmarks to the widely used L3 vertebra for single-slice skeletal muscle evaluation in patients with heart failure (HF). Patients admitted for acute decompensated HF between January 2017 and December 2018 were retrospectively analyzed. Body composition measurements were made on CT of the chest and abdomen/pelvis with or without contrast one month before discharge. Skeletal muscle index (SMI) and intermuscular adipose tissue percentage (IMAT%) were calculated at several thoracic levels (above the aortic arch, T8, and T12) and correlated to the widely used L3 level. A total of 200 patients were included, 89 (44.5%) female. The strongest correlation of thoracic SMI (for muscle quantity) and IMAT% (for muscle quality) with L3 was at the T12 level (r = 0.834, p < 0.001 and r = 0.757, p < 0.001, respectively). Cutoffs to identify low muscle mass for T12 SMI (derived from the lowest sex-stratified L3 SMI tertile) were 31.1 cm²/m² in men and 26.3 cm²/m² in women. SMI and IMAT% at T12 had excellent correlations with the widely used L3 level for muscle quantity and quality evaluation in patients with HF.
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Affiliation(s)
- Saeid Mirzai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ian Persits
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Pieter Martens
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jerry D Estep
- Department of Cardiology, Cleveland Clinic Florida, Weston, FL, USA
| | - W H Wilson Tang
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Po-Hao Chen
- Section of Musculoskeletal Imaging, Diagnostics Institute, Cleveland Clinic, Cleveland, OH, USA.
- Section of Musculoskeletal Imaging Diagnostics Institute, Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic, 9500 Euclid Avenue, Desk JJ36, Cleveland, OH, 44195, USA.
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Sánchez Amador L, Becerra Fernández A, Aguilar Vilas MV, Rodríguez Torres R, Alonso Rodríguez MC. Body composition and risk for sarcopenia in transgender women. Nutrition 2024; 123:112398. [PMID: 38521048 DOI: 10.1016/j.nut.2024.112398] [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: 11/28/2023] [Revised: 01/18/2024] [Accepted: 02/13/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES Body composition and strength of cisgender (cis) individuals are well established. However, those for transgender women (trans women) undergoing gender-affirming hormone therapy remain unclear. This study aimed to detect possible body composition and strength variations related to sarcopenia. METHODS This was a cross-sectional comparative study of 37 trans women, 34 cis men, and 34 cis women. Body composition was measured in all individuals by bioelectrical impedance analysis; prehensile strength by dynamometry was studied in trans women. RESULTS In this study, trans women had higher body mass index values than cis individuals (P < 0.01). Fat mass was 41% higher for trans women than cis men. Muscle mass (MM) was lower in trans women than cis men (-10%), and higher than cis women (24%). Bone mass was lower in trans women than cis men and higher in cis women (P < 0.01). Trans women's prehensile strengths were 25.26 kg for the right hand and 24.8 kg for the left. Appendicular skeletal muscle mass was 23.63 kg, and appendicular skeletal muscle mass index was 8.14 kg. CONCLUSION Trans women undergoing gender-affirming hormone therapy show a tendency to adapt body compartments to those of cis women with increased fat mass and reduced muscle mass. Prehensile strength in trans women was close to the cutoff points for sarcopenia risk. Nutrition, physical activity, strength, and body composition are important to avoid the possible risk for sarcopenia. More studies along these lines are necessary, especially in older adults.
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Affiliation(s)
- Laura Sánchez Amador
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain.
| | - Antonio Becerra Fernández
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain; Department of Biomedical Sciences, Faculty of Pharmacy, University of Alcala, Alcalá de Henares, Madrid, Spain
| | - María Victorina Aguilar Vilas
- Food, Nutrition and Public Health Strategies Research Group, University of Alcala, Alcalá de Henares, Madrid, Spain; Department of Biomedical Sciences, Faculty of Pharmacy, University of Alcala, Alcalá de Henares, Madrid, Spain
| | - Rosa Rodríguez Torres
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Madrid, Spain
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Jauregui-Zunzunegui S, Rodríguez-Artalejo F, Tellez-Plaza M, García-Esquinas E. Glyphosate exposure, muscular health and functional limitations in middle-aged and older adults. ENVIRONMENTAL RESEARCH 2024; 251:118547. [PMID: 38452917 DOI: 10.1016/j.envres.2024.118547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Glyphosate is the most widely used herbicide worldwide, both in domestic and industrial settings. Experimental research in animal models has demonstrated changes in muscle physiology and reduced contractile strength associated with glyphosate exposure, while epidemiological studies have shown associations between glyphosate exposure and adverse health outcomes in critical biological systems affecting muscle function. METHODS This study used data from a nationally representative survey of the non-institutionalized U.S. general population (NHANES, n = 2132). Urine glyphosate concentrations were determined by ion chromatography with tandem mass spectrometry. Hand grip strength (HGS) was measured using a Takei Dynamometer, and relative strength estimated as the ratio between HGS in the dominant hand and the appendicular lean mass (ALM) to body mass index (ALMBMI) ratio. Low HGS and low relative HGS were defined as 1 sex-, age- and race-specific SD below the mean. Physical function limitations were identified as significant difficulty or incapacity in various activities. RESULTS In fully-adjusted models, the Mean Differences (MD) and 95% confidence intervals [95%CI] per doubling increase in glyphosate concentrations were -0.55 [-1.09, -0.01] kg for HGS in the dominant hand, and -0.90 [-1.58. -0.21] kg for HGS/ALMBMI. The Odds Ratios (OR) [95% CI] for low HGS, low relative HGS and functional limitations by glyphosate concentrations were 1.27 [1.03, 1.57] for low HGS; 1.43 [1.05; 1.94] for low relative HGS; 1.33 [1.08, 1.63] for stooping, crouching or kneeling difficulty; 1.17 [0.91, 1.50] for lifting or carrying items weighting up to 10 pounds difficulty; 1.21 [1.01, 1.40] for standing up from armless chair difficulty; and 1.47 [1.05, 2.29] for ascending ten steps without pause difficulty. CONCLUSIONS Glyphosate exposure may be a risk factor for decreased grip strength and increased physical functional limitations. More studies investigating the influence of this and other environmental pollutants on functional aging are needed.
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Affiliation(s)
- Sara Jauregui-Zunzunegui
- Department of Preventive Medicine and Public Health, Hospital Universitario Nuestra Señora de Candelaria, Spain.
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food, CEI UAM+CSIC, Madrid, Spain.
| | - María Tellez-Plaza
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain.
| | - Esther García-Esquinas
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain.
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Theodorou SJ, Theodorou DJ, Kigka V, Gkiatas I, Fotopoulos A. DXA-based appendicular composition measures in healthy aging Caucasian Greek women: a cross-sectional study. Rheumatol Int 2024:10.1007/s00296-024-05622-4. [PMID: 38860993 DOI: 10.1007/s00296-024-05622-4] [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: 02/11/2024] [Accepted: 05/26/2024] [Indexed: 06/12/2024]
Abstract
As the global population of older persons increases, age-related medical conditions will have a greater impact on public health. DXA-derived bone and soft tissue metrics are associated with adverse clinical events in aging persons. This study aims to investigate the regional body composition of the appendices by whole-body DXA scans, and the age-related relationships between measures of bone and soft tissue in healthy Caucasian females of a Greek origin residing in the Mediterranean area. Body composition of the legs and the arms was analyzed, and lean mass (LM) and fat mass (FM) metrics were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the legs and arms was achieved between ages 20-30 and 41-50 years, respectively. The overall BMD reduction with age was for the legs 43% and the arms 32.2% (p < 0.001). Peak %LM of the legs and the arms was achieved between ages 20-30. The overall reduction of %LM with age was for the legs 22.5% (p < 0.001) and arms 6.6% (p < 0.05). Peak %FM of the legs and arms was attained between ages 31-40 and 61-70, respectively. The overall %FM reduction with age was for the legs and arms 7.5% and 1.9% (p > 0.05). In appendicular sites, Greek women reach peak values of bone mass in the legs first, in early adulthood. Bone loss predominates in the legs as women age. Also, with advancing age Greek women show preferential significant decreases of %LM and %FM in the legs as opposed to the arms. Although variation in appendicular bone and soft tissue metrics is present, the implications of variable biological crosstalks among the tissue components as women age may ultimately lay the foundation for future clinical trials aimed at healthy aging.
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Affiliation(s)
| | - Daphne J Theodorou
- Department of Radiology, General Hospital of Ioannina and National Healthcare System, Ioannina, Greece
| | - Vassiliki Kigka
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Ioannis Gkiatas
- Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Andreas Fotopoulos
- Department of Nuclear Medicine, University of Ioannina, Ioannina, Greece
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Sato R, Vatic M, Peixoto da Fonseca GW, Anker SD, von Haehling S. Biological basis and treatment of frailty and sarcopenia. Cardiovasc Res 2024:cvae073. [PMID: 38828887 DOI: 10.1093/cvr/cvae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 12/20/2022] [Indexed: 06/05/2024] Open
Abstract
In an ageing society, the importance of maintaining healthy life expectancy has been emphasized. As a result of age-related decline in functional reserve, frailty is a state of increased vulnerability and susceptibility to adverse health outcomes with a serious impact on healthy life expectancy. The decline in skeletal muscle mass and function, also known as sarcopenia, is key in the development of physical frailty. Both frailty and sarcopenia are highly prevalent in patients not only with advanced age but also in patients with illnesses that exacerbate their progression like heart failure (HF), cancer, or dementia, with the prevalence of frailty and sarcopenia in HF patients reaching up to 50-75% and 19.5-47.3%, respectively, resulting in 1.5-3 times higher 1-year mortality. The biological mechanisms of frailty and sarcopenia are multifactorial, complex, and not yet fully elucidated, ranging from DNA damage, proteostasis impairment, and epigenetic changes to mitochondrial dysfunction, cellular senescence, and environmental factors, many of which are further linked to cardiac disease. Currently, there is no gold standard for the treatment of frailty and sarcopenia, however, growing evidence supports that a combination of exercise training and nutritional supplement improves skeletal muscle function and frailty, with a variety of other therapies being devised based on the underlying pathophysiology. In this review, we address the involvement of frailty and sarcopenia in cardiac disease and describe the latest insights into their biological mechanisms as well as the potential for intervention through exercise, diet, and specific therapies.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Guilherme Wesley Peixoto da Fonseca
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Stefan D Anker
- Department of Cardiology (CVK) of German Heart Center Charité; German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
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Yuan J, Jia P. Prediabetes and diabetes were attributed to the prevalence and severity of sarcopenia in middle-aged and elderly adults. Diabetol Metab Syndr 2024; 16:122. [PMID: 38825679 PMCID: PMC11145839 DOI: 10.1186/s13098-024-01355-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/20/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Sarcopenia and diabetes are both prevalent health problems worldwide. However, little is known about the relationship between prediabetes and the prevalence and severity of sarcopenia. Therefore, the current study aimed to explore the association between glucose status and the components of sarcopenia, including low muscle mass (LMM), low muscle strength (LMS) and low gait speed (LGS) in US adults. METHODS Data from the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 4002 participants aged ≥ 50 years with available information on glucose status (NGR: 1939 cases; prediabetes: 1172 cases; diabetes: 891 cases) and sarcopenia were included in this study. Sarcopenia was defined according to the Foundation for National Institute of Health criteria. Muscle mass, muscle strength and gait speed were used to evaluate sarcopenia and its severity. Weighed multivariable logistic regression were used to explore the association between glucose status and the components of sarcopenia. The hypothetical population attributable fraction (PAF) for the glucose status was also calculated. RESULTS The mean age of the cohort was 63.01 ± 9.89 years, with 49.4% being male. Multiple logistic regression analysis suggested that diabetes was an independent risk factor for sarcopenia (OR = 5.470, 95% CI 1.551-19.296) and showed a marginal association with severe sarcopenia (OR = 10.693, 95% CI 0.955-119.73) compared to NGR in men, but not in women. Additionally, prediabetes was independently associated with severe sarcopenia (OR = 3.647, 95% CI 1.532-8.697), LMS (OR = 1.472, 95% CI 1.018-2.127) and LGS (OR = 1.673, 95% CI 1.054-2.655) in the entire cohort. When stratifying by gender, we further observed that prediabetes was significantly associated with LMS in men (OR = 1.897, 95% CI 1.019-3.543) and related to LMM (OR = 3.174, 95% CI 1.287-7.829) and LGS (OR = 2.075, 95% CI 1.155-3.727) in women. HbA1c was positively associated with the prevalence of sarcopenia in men (OR = 1.993, 95% CI 1.511-2.629). PAF showed that diabetes accounted for 16.3% of observed sarcopenia cases. Maintaining NGR in the entire population could have prevented 38.5% of sarcopenia cases and 50.9% of severe sarcopenia cases. CONCLUSIONS Prediabetes and diabetes were independently associated with the prevalence and severity of sarcopenia in US population. Slowing down the progression of hyperglycemia could have prevented a significant proportion of sarcopenia cases.
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Affiliation(s)
- Jing Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Pu Jia
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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El Assar M, Rodríguez-Sánchez I, Álvarez-Bustos A, Rodríguez-Mañas L. Biomarkers of frailty. Mol Aspects Med 2024; 97:101271. [PMID: 38631189 DOI: 10.1016/j.mam.2024.101271] [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: 11/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Several biomarkers have been proposed to identify frailty, a multisystemic age-related syndrome. However, the complex pathophysiology and the absence of a consensus on a comprehensive and universal definition make it challenging to pinpoint a singular biomarker or set of biomarkers that conclusively characterize frailty. This review delves into the main laboratory biomarkers, placing special emphasis on those associated with various pathways closely tied to the frailty condition, such as inflammation, oxidative stress, mitochondrial dysfunction, metabolic and endocrine alterations and microRNA. Additionally, we provide a summary of different clinical biomarkers encompassing different tools that have been proposed to assess frailty. We further address various imaging biomarkers such as Dual Energy X-ray Absorptiometry, Bioelectrical Impedance analysis, Computed Tomography and Magnetic Resonance Imaging, Ultrasound and D3 Creatine dilution. Intervention to treat frailty, including non-pharmacological ones, especially those involving physical exercise and nutrition, and pharmacological interventions, that include those targeting specific mechanisms such as myostatin inhibitors, insulin sensitizer metformin and with special relevance for hormonal treatments are mentioned. We further address the levels of different biomarkers in monitoring the potential positive effects of some of these interventions. Despite the availability of numerous biomarkers, their performance and usefulness in the clinical arena are far from being satisfactory. Considering the multicausality of frailty, there is an increasing need to assess the role of sets of biomarkers and the combination between laboratory, clinical and image biomarkers, in terms of sensitivity, specificity and predictive values for the diagnosis and prognosis of the different outcomes of frailty to improve detection and monitoring of older people with frailty or at risk of developing it, being this a need in the everyday clinical practice.
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Affiliation(s)
- Mariam El Assar
- Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Alejandro Álvarez-Bustos
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, Spain.
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Dikmeer A, Unsal P, Burkuk S, Ozturk Y, Koca M, Guclu S, Balci C, Dogu BB, Cankurtaran M, Akata D, Halil M. Cutoff values for appendicular skeletal muscle mass using dual-energy x-ray absorptiometry in a reference group of Turkish adults. Nutr Clin Pract 2024; 39:626-633. [PMID: 37823418 DOI: 10.1002/ncp.11083] [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: 03/26/2023] [Revised: 08/20/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The aim of this study is to determine cutoff values for different appendicular skeletal muscle mass index (ASMI) methods measured by dual-energy x-ray absorptiometry (DXA) in a reference group of the Turkish population. METHODS Body composition analyses were performed with DXA, and appendicular skeletal muscle mass (ASM) was adjusted to body size as ASMI using height squared (ASM/ht2), weight (ASM/wt), and body mass index (BMI) (ASM/BMI). Sex-specific cutoff values were obtained as 1 and 2 standard deviations (SDs) below the mean values of ASM/ht2, ASM/wt, and ASM/BMI. RESULTS A total of 207 (106 women and 101 men) healthy adults were enrolled. Sex-specific cutoff values based on 1 SD below the mean values of ASM, ASM/ht2, ASM/BMI, and ASM/wt were 14.44, 5.45, 0.61, and 24.07 in women and 22.63, 7.22, 0.90, and 29.04 in men, respectively; 2 SDs below the mean values of ASM, ASM/ht2, ASM/BMI, and ASM/wt were 11.96, 4.65, 0.51, and 21.75 in women and 19.26, 6.40, 0.78, and 26.55 in men, respectively. ASM, ASM/BMI, ASM/ht2, and ASM/wt were statistically significant positively correlated with handgrip strength (r = 0.81, r = 0.78, r = 0.73, and r = 0.67, respectively; P < 0.001). CONCLUSION In this study, ASM/BMI was found to be the most suitable ASM adjustment method to predict muscle strength.
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Affiliation(s)
- Ayse Dikmeer
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pelin Unsal
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Suna Burkuk
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yelda Ozturk
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Koca
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Simay Guclu
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Cafer Balci
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu B Dogu
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Halil
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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12
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Mulinacci G, Pirola L, Gandola D, Ippolito D, Viganò C, Laffusa A, Gallo C, Invernizzi P, Danese S, Massironi S. Ultrasound muscle assessment for sarcopenia detection in inflammatory bowel disease: A prospective study. United European Gastroenterol J 2024; 12:562-573. [PMID: 38549182 PMCID: PMC11176911 DOI: 10.1002/ueg2.12566] [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: 12/10/2023] [Accepted: 03/08/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population. METHODS 153 consecutive patients were included, 100 in the training cohort and 53 in the study cohort. Three superficial muscles (rectus femoris = RF, rectus abdominis = RA, and biceps brachii = BB) were selected for the detection of sarcopenia using muscle ultrasound (US). The training cohort consisted of consecutive patients with or without IBD and was used to evaluate the feasibility and inter- and intra-observer variability of the US measurement. The study cohort consisted of only IBD patients and served to test US diagnostic accuracy. In the latter, muscle US, bioelectrical impedance analysis (BIA), and magnetic resonance imaging (MRI) were used to measure muscle parameters. RESULTS Sarcopenia prevalence in IBD patients was 50%. Muscle US showed excellent inter-rater and intra-rater reliability (ICC >0.95) and a good diagnostic accuracy in detecting sarcopenia compared to BIA with area under the receiver operating characteristic curve (AUROC) values of 80% and 85% for RA and BB thickness, respectively. Moreover, an Ultrasound Muscle Index (USMI) was defined as the sum of the RA, BB, and RF thickness divided by the square of the patient's height, resulting in an AUROC of 81%. Muscle thresholds for sarcopenia were detected, with RA and USMI values correlated with the highest positive (84.3%) and negative (99%) predictive values, respectively. Additionally, the agreement between the US and MRI measurements of RA was excellent (ICC 0.96). CONCLUSIONS The findings of this study emphasize the potential of muscle US as a reliable diagnostic tool for assessing sarcopenia in IBD patients. This research has significant implications for disease management in IBD patients and underscores the need for further investigations to validate these findings in larger cohorts.
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Affiliation(s)
- Giacomo Mulinacci
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Lorena Pirola
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
| | - Davide Gandola
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
- Division of RadiologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
| | - Davide Ippolito
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
- Division of RadiologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
| | - Chiara Viganò
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
| | - Alice Laffusa
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Camilla Gallo
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Pietro Invernizzi
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
- Department of Medicine and SurgeryUniversity of Milano BicoccaMilanItaly
| | - Silvio Danese
- Gastroenterology and EndoscopyIRCCS San Raffaele HospitalMilanItaly
- Vita‐Salute San Raffaele UniversityMilanItaly
| | - Sara Massironi
- Division of GastroenterologyFondazione IRCCS San Gerardo dei TintoriMonzaItaly
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13
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Kim JH. Machine-learning classifier models for predicting sarcopenia in the elderly based on physical factors. Geriatr Gerontol Int 2024; 24:595-602. [PMID: 38744528 DOI: 10.1111/ggi.14895] [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: 08/02/2023] [Revised: 03/25/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
AIM As the size of the elderly population gradually increases, musculoskeletal disorders, such as sarcopenia, are increasing. Diagnostic techniques such as X-rays, computed tomography, and magnetic resonance imaging are used to predict and diagnose sarcopenia, and methods using machine learning are gradually increasing. This study aimed to create a model that can predict sarcopenia using physical characteristics and activity-related variables without medical diagnostic equipment, such as imaging equipment, for the elderly aged 60 years or older. METHODS A sarcopenia prediction model was constructed using public data obtained from the Korea National Health and Nutrition Examination Survey. Models were built using Logistic Regression, Support Vector Machine (SVM), XGBoost, LightGBM, RandomForest, and Multi-layer Perceptron Neural Network (MLP) algorithms, and the feature importance of the models trained with the algorithms, except for SVM and MLP, was analyzed. RESULTS The sarcopenia prediction model built with the LightGBM algorithm achieved the highest test accuracy, of 0.848. In constructing the LightGBM model, physical characteristic variables such as body mass index, weight, and waist circumference showed high importance, and activity-related variables were also used in constructing the model. CONCLUSIONS The sarcopenia prediction model, which consisted of only physical characteristics and activity-related factors, showed excellent performance. This model has the potential to assist in the early detection of sarcopenia in the elderly, especially in communities with limited access to medical resources or facilities. Geriatr Gerontol Int 2024; 24: 595-602.
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Affiliation(s)
- Jun-Hee Kim
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
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14
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Zhuang CL, Wu HF, Jiang HJ, Zhang FM, Shi HP, Yu Z, Shen X, Chen XL, Wang SL. Muscle attenuation, not skeletal muscle index, is an independent prognostic factor for survival in gastric cancer patients with overweight and obesity. Nutrition 2024; 122:112391. [PMID: 38460446 DOI: 10.1016/j.nut.2024.112391] [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: 08/06/2023] [Revised: 12/19/2023] [Accepted: 02/04/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES Skeletal muscle index (SMI) is insufficient for evaluating muscle in obesity, and muscle attenuation (MA) may be a preferred indicator. This study aimed to investigate whether MA has greater prognostic value than SMI in gastric cancer patients with overweight and obesity. METHODS Clinical parameters of 1312 patients with gastric cancer who underwent radical gastrectomy were prospectively collected between 2013 and 2019. MA and SMI were analyzed by computed tomography scan. Overweight/obesity was defined as body mass index (BMI) ≥24 kg/m2. The hazard ratio (HR) for death was calculated using Cox regression analysis. RESULTS Among all patients, 405 were identified as overweight and obese, and 907 were identified as normal and underweight. MA was inversely associated with BMI and visceral fat area. Among the 405 patients with overweight and obesity, 212 patients (52%) were diagnosed with low MA. In the overweight/obese group, MA was an independent predictor for overall survival (HR, 1.610; P = 0.021) in multivariate Cox regression analyses, whereas SMI did not remain in the model. In the normal/underweight group, both low MA (HR, 1.283; P = 0.039) and low SMI (HR, 1.369; P = 0.008) were independent factors of overall survival. Additionally, 318 patients were identified as having visceral obesity in the overweight/obese group, and low MA was also an independent prognostic factor for survival in these patients (HR, 1.765; P = 0.013). CONCLUSION MA had a higher prognostic value than SMI in overweight and obese patients with gastric cancer after radical gastrectomy.
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Affiliation(s)
- Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hao-Fan Wu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hao-Jie Jiang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Feng-Min Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Lei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Su-Lin Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
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15
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Qadah RM, Al-Sharman A, Shalash RJ, Arumugam A. Are accelerometer-measured sitting and physical activity times associated with muscle mass and strength in healthy young adults in the UAE? Heliyon 2024; 10:e30899. [PMID: 38770340 PMCID: PMC11103532 DOI: 10.1016/j.heliyon.2024.e30899] [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: 12/23/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
Background A high prevalence of obesity, sedentary behavior, and physical inactivity could affect muscle mass and strength in young adults in the United Arab Emirates (UAE). Therefore, we investigated the association of sex, body mass index (BMI), and accelerometer-measured sitting and physical activity (PA) times with skeletal muscle mass index (SMI), hand grip, and thigh muscle strength in healthy young adults in the UAE. Methods In this cross-sectional study, 156 healthy young adults (age 21.68 ± 3.01 years, BMI 25.40 ± 4.79 kg/m2, 52.6 % women) were included. BMI and muscle mass were recorded using a bioelectrical impedance analyzer. Maximum hand grip strength and thigh muscle torque were assessed using the Jamar-smart hand-dynamometer and Biodex System-4-Pro, respectively. Participants wore a triaxial Fibion accelerometer on their anterior thigh for >10 h per day for 4-7 days to measure their sitting and PA times. Multiple linear regression analyses were used. Results Participants spent most of their time sitting (11.37 ± 1.10 h), followed by standing (2.92 ± 0.86 h), walking (1.58 ± 0.55 h), and vigorous intensity PA (4.79 ± 5.85 min) per 16-h day. Sex (p < 0.001) and BMI (p < 0.001) were negatively associated with all muscle mass and strength variables. Men had more muscle mass and strength than women. As BMI increased, muscle mass and muscle strength decreased. Accelerometer-measured sitting and walking times were negatively associated with concentric hamstrings (p = 0.044) and quadriceps torques (p = 0.031), respectively. Conclusion Sex, BMI, and accelerometer-measured sitting and walking times were associated with muscle mass and/or muscle strength in healthy young adults. Women and those with a high BMI need interventions to improve their muscle mass and strength. The paradox regarding the association of PA with muscle mass and strength in younger adults may be due to possible influences from other factors (e.g., resistance training, dietary intakes, etc.) superseding that of accelerometer-measured PA.
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Affiliation(s)
- Raneen Mohammed Qadah
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alham Al-Sharman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Health Promotion Research Group -Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reime Jamal Shalash
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Science and Engineering, University of Sharjah, Sharjah, United Arab Emirates
- Adjunct Faculty, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Jiang Q, Ma Z, Sun J, Li Y. Association of dietary inflammatory indices with sarcopenia and all-cause mortality in COPD patients. Front Nutr 2024; 11:1395170. [PMID: 38846543 PMCID: PMC11153795 DOI: 10.3389/fnut.2024.1395170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/29/2024] [Indexed: 06/09/2024] Open
Abstract
Background Sarcopenia frequently occurs as a comorbidity in individuals with COPD. However, research on the impact of Appendicular Skeletal Muscle Mass (ASM) on survival in COPD patients is scarce. Moreover, there is a lack of research on the association between dietary pro-inflammatory capacity and sarcopenia in COPD. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering the years 1999 to 2006 and 2011 to 2018. We aimed to investigate the relationship between the Dietary Inflammatory Index (DII) and sarcopenia prevalence among adults diagnosed with COPD in the United States. Furthermore, we sought to explore the relationship between sarcopenia, ASMI, and all-cause mortality. The study included a total of 1,429 eligible adult participants, divided into four groups based on quartiles of DII, with adjustments for sample weights. Methodologically, we used multivariable logistic regression analyses and to examine the association between DII and sarcopenia. Additionally, we used restricted cubic spline (RCS) tests to evaluate potential non-linear relationships. To assess the effect of sarcopenia on overall all-cause mortality, we used Kaplan-Meier models and Cox proportional hazards models. Moreover, we used RCS analyses to investigate potential non-linear relationships between ASMI and all-cause mortality. Subgroup analyses were conducted to confirm the reliability of our study findings. Results In our COPD participant cohort, individuals with higher DII scores were more likely to be female, unmarried, have lower educational attainment, and show lower ASMI. Using multivariable logistic regression models, we found a positive association between the highest quartile of DII levels and sarcopenia incidence [Odds Ratio (OR) 2.37; 95% Confidence Interval (CI) 1.26-4.48; p = 0.01]. However, analysis of RCS curves did not show a non-linear relationship between DII and sarcopenia. Throughout the entire follow-up period, a total of 367 deaths occurred among all COPD patients. Kaplan-Meier survival curves showed a significantly higher all-cause mortality rate among individuals with concurrent sarcopenia (p < 0.0001). Cox proportional hazards model analysis showed a 44% higher risk of all-cause mortality among COPD patients with sarcopenia compared to those without sarcopenia [Hazard Ratio (HR): 1.44; 95% CI 1.05-1.99; p < 0.05]. Additionally, our final RCS analyses revealed a significant non-linear association between ASMI levels and all-cause mortality among COPD patients, with a turning point identified at 8.32 kg/m2. Participants with ASMI levels above this inflection point had a 42% lower risk of all-cause mortality compared to those with ASMI levels below it (HR 0.58; 95% CI 0.48-0.7). Conclusion We observed a significant association between concurrent sarcopenia and an increased risk of all-cause mortality in COPD patients within the United States. Moreover, ASMI demonstrated a non-linear association with all-cause mortality, with a critical threshold identified at 8.32 kg/m2. Our findings also revealed an association between DII and the presence of sarcopenia. Consequently, further investigations are warranted to explore the feasibility of dietary DII adjustments as a means to mitigate muscle wasting and enhance the prognosis of COPD.
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Affiliation(s)
- Qi Jiang
- Department of Respiratory Medicine, The First Hospital of Jilin University, Jilin, China
| | - Zheru Ma
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, Jilin, China
| | - Jing Sun
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Jilin, China
| | - Yang Li
- Department of Respiratory Medicine, The First Hospital of Jilin University, Jilin, China
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17
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Tang H, Li R, Li R, Lian R, Chen X, Jiang W, Jiang J, Yang M. Sarcopenic obesity in nursing home residents: a multi-center study on diagnostic methods and their association with instrumental activities of daily living. BMC Geriatr 2024; 24:446. [PMID: 38773403 PMCID: PMC11110436 DOI: 10.1186/s12877-024-04955-w] [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: 01/29/2024] [Accepted: 04/08/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Sarcopenic obesity (SO) in nursing home residents is rarely studied. We aimed to evaluate and compare the prevalence and consistency of different SO diagnostic methods and to investigate which criterion demonstrated a stronger association with instrumental activities of daily living (IADL) disability. METHODS We consecutively recruited older adults aged ≥ 60 years, residing in 15 nursing homes in Zigong City, China. Sarcopenia obesity was defined according to the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity criteria (SOESPEN), recommending skeletal muscle mass (SMM) adjusted by body weight (SMM/W) to identify low muscle mass. Further, we adapted ESPEN criteria (SOESPEN-M) by employing SMM adjusted by body mass index (SMM/BMI). RESULTS We included 832 participants (median age 73.0 years, 296 women). The prevalence of SOESPEN and SOESPEN-M was 43.5% and 45.3%, respectively. SOESPEN showed good consistency with SOESPEN-M (Cohen's kappa = 0.759). More than one-third of participants in the normal weight group were diagnosed with SOESPEN or SOESPEN-M. Even within the underweight group, the prevalence of SOESPEN and SOESPEN-M was 8.9% and 22.2%, respectively. Participants with IADL disability had significantly lower SMM/W and SMM/BMI, but higher fat mass percentage of body weight (FM%) than participants without IADL disability. After full adjustment for potential confounders, SOESPEN-M (OR 1.68, 95% CI 1.21 to 2.32), but not SOESPEN (OR 1.28, 95% CI 0.93 to 1.75), remained significantly associated with IADL disability. CONCLUSIONS Both SOESPEN and SOESPEN-M showed a high prevalence among nursing home residents, even among individuals with underweight or normal weight. While SOESPEN had a good consistency with SOESPEN-M, only SOESPEN-M was independently associated with IADL disability. Screening and diagnosis of SO should be conducted in nursing home residents irrespective of BMI.
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Affiliation(s)
- Huiyu Tang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Runjie Li
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ruicen Li
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rongna Lian
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyan Chen
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Wenhua Jiang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaojiao Jiang
- Rehabilitation Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Ming Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
- West China Hospital, National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, China.
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18
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Othman MB, Takeda R, Sekita M, Okazaki K, Sakamoto K. Amber (Succinite) Extract Enhances Glucose Uptake through the Up-Regulation of ATP and Down-Regulation of ROS in Mouse C2C12 Cells. Pharmaceuticals (Basel) 2024; 17:586. [PMID: 38794156 PMCID: PMC11124190 DOI: 10.3390/ph17050586] [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: 03/25/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024] Open
Abstract
Traditionally, amber (Succinite) has been used to alleviate all types of pain, skin allergies, and headaches. However, no studies have been conducted on its antidiabetic and antioxidant effects. In this study, differentiated skeletal muscle C2C12 cells were used to demonstrate the protective effects of amber (AMB) against H2O2-induced cell death. In addition, the effects of AMB on glucose uptake and ATP production were investigated. Our results showed that AMB at 10, 25, and 50 μg/mL suppressed the elevation of ROS production induced by H2O2 in a dose-dependent manner. Moreover, AMB enhanced glucose utilization in C2C12 cells through the improvement of ATP production and an increase in PGC-1α gene expression resulting in an amelioration of mitochondrial activity. On the other hand, AMB significantly increased the gene expression of glucose transporters GLUT4 and GLUT1. Our finding suggests that AMB can be used as a natural supplement for diabetes treatment and for the promotion of skeletal muscle function.
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Affiliation(s)
- Mahmoud Ben Othman
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8572, Japan;
| | - Reiko Takeda
- Kohaku Bio Technology Co., Ltd., Morioka 020-8551, Japan; (R.T.); (M.S.); (K.O.)
| | - Marie Sekita
- Kohaku Bio Technology Co., Ltd., Morioka 020-8551, Japan; (R.T.); (M.S.); (K.O.)
| | - Kazuma Okazaki
- Kohaku Bio Technology Co., Ltd., Morioka 020-8551, Japan; (R.T.); (M.S.); (K.O.)
| | - Kazuichi Sakamoto
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8572, Japan;
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19
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Stoodley IL, Berthon BS, Scott HA, Williams EJ, Baines PJ, Knox H, Wood S, Paradzayi B, Cameron-Smith D, Wood LG. Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults. Nutrients 2024; 16:1380. [PMID: 38732628 PMCID: PMC11085115 DOI: 10.3390/nu16091380] [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: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.
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Affiliation(s)
- Isobel L. Stoodley
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Bronwyn S. Berthon
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hayley A. Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Evan J. Williams
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Penelope J. Baines
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hannah Knox
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Sophie Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Beauty Paradzayi
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
| | - David Cameron-Smith
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive, #07-02 MD6, Singapore 117599, Singapore;
| | - Lisa G. Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
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20
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Persits I, Mirzai S, Sarnaik KS, Volk MC, Yun J, Harb S, Puri R, Kapadia S, Krishnaswamy A, Chen PH, Reed G, Tang WHW. Low Muscle Mass by Preprocedural Computed Tomography Is Associated With Worse Short-Term Outcomes in Transcatheter Aortic Valve Replacement Recipients. Am J Cardiol 2024; 217:86-93. [PMID: 38432333 DOI: 10.1016/j.amjcard.2024.02.028] [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: 10/28/2023] [Revised: 02/03/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
Low muscle mass (LMM) is associated with worse outcomes in various clinical situations. Traditional frailty markers have been used for preoperative risk stratification in patients who underwent transcatheter aortic valve replacement (TAVR). However, preoperative imaging provides an opportunity to directly quantify skeletal muscle mass to identify patients at higher risk of procedural complications. We reviewed all TAVR recipients from January to December 2018 and included subjects with preprocedural chest computed tomography. Multi-slice automated measurements of skeletal muscle mass were made from the ninth to twelfth thoracic vertebrae and normalized by height squared to obtain skeletal muscle index (cm2/m2). LMM was defined as the lowest gender-stratified skeletal muscle index tertile. Strength testing was collected during pre-TAVR evaluation. Primary outcome was a composite of perioperative complications, 1-year rehospitalization, or 1-year mortality. In our cohort, 238 patients met inclusion criteria, and 80 (33.6%) were identified to have LMM. Patients with LMM were older with lower body mass index, decreased grip strength, lower hemoglobin A1c, and higher N-terminal pro-brain natriuretic peptide. They had greater rates of the composite outcome and 2-year all-cause mortality, which remained significant on multivariable adjustment (hazard ratio 1.71, 95% confidence interval 1.05 to 2.78, p = 0.030 and hazard ratio 2.31, 95% confidence interval 1.02 to 5.24, p = 0.045, respectively) compared with patients without LMM; there was no significant difference in 5-year all-cause mortality. In conclusion, LMM was associated with an increase in the primary composite outcome and 2-year all-cause mortality in TAVR recipients. Using automatic muscle processing software on pre-TAVR computed tomography scans may serve as an additional preoperative risk stratification tool.
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Affiliation(s)
- Ian Persits
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Saeid Mirzai
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio; Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Kunaal S Sarnaik
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - James Yun
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Serge Harb
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rishi Puri
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Kapadia
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amar Krishnaswamy
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Po-Hao Chen
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Grant Reed
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - W H Wilson Tang
- Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
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21
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Dlamini M, Khathi A. Investigating the Effects of Diet-Induced Prediabetes on Skeletal Muscle Strength in Male Sprague Dawley Rats. Int J Mol Sci 2024; 25:4076. [PMID: 38612885 PMCID: PMC11012655 DOI: 10.3390/ijms25074076] [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: 03/06/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Type 2 diabetes mellitus, a condition preceded by prediabetes, is documented to compromise skeletal muscle health, consequently affecting skeletal muscle structure, strength, and glucose homeostasis. A disturbance in skeletal muscle functional capacity has been demonstrated to induce insulin resistance and hyperglycemia. However, the modifications in skeletal muscle function in the prediabetic state are not well elucidated. Hence, this study investigated the effects of diet-induced prediabetes on skeletal muscle strength in a prediabetic model. Male Sprague Dawley rats were randomly assigned to one of the two groups (n = 6 per group; six prediabetic (PD) and six non-pre-diabetic (NPD)). The PD group (n = 6) was induced with prediabetes for 20 weeks. The diet that was used to induce prediabetes consisted of fats (30% Kcal/g), proteins (15% Kcal/g), and carbohydrates (55% Kcal/g). In addition to the diet, the experimental animals (n = 6) were supplied with drinking water that was supplemented with 15% fructose. The control group (n = 6) was allowed access to normal rat chow, consisting of 35% carbohydrates, 30% protein, 15% fats, and 20% other components, as well as ordinary tap water. At the end of week 20, the experimental animals were diagnosed with prediabetes using the American Diabetes Association (ADA) prediabetes impaired fasting blood glucose criteria (5.6-6.9 mmol/L). Upon prediabetes diagnosis, the animals were subjected to a four-limb grip strength test to assess skeletal muscle strength at week 20. After the grip strength test was conducted, the animals were euthanized for blood and tissue collection to analyze glycated hemoglobin (HbA1c), plasma insulin, and insulin resistance using the homeostatic model of insulin resistance (HOMA-IR) index and malondialdehyde (MDA) concentration. Correlation analysis was performed to examine the associations of skeletal muscle strength with HOMA-IR, plasma glucose, HbA1c, and MDA concentration. The results demonstrated increased HbA1c, FBG, insulin, HOMA-IR, and MDA concentrations in the PD group compared to the NPD group. Grip strength was reduced in the PD group compared to the NPD group. Grip strength was negatively correlated with HbA1c, plasma glucose, HOMA-IR, and MDA concentration in the PD group. These observations suggest that diet-induced prediabetes compromises muscle function, which may contribute to increased levels of sedentary behavior during prediabetes progression, and this may contribute to the development of hyperglycemia in T2DM.
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Affiliation(s)
| | - Andile Khathi
- Department of Human Physiology, School of Laboratory Medicine, Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa;
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22
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Mustafa YF. Harmful Free Radicals in Aging: A Narrative Review of Their Detrimental Effects on Health. Indian J Clin Biochem 2024; 39:154-167. [PMID: 38577147 PMCID: PMC10987461 DOI: 10.1007/s12291-023-01147-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/21/2023] [Indexed: 04/06/2024]
Abstract
The production of harmful free radicals (H-FRs), especially those with oxygen or nitrogen atoms, depends on both internal and environmental causes. The negative effects of H-FRs are greatly alleviated by antioxidant protection. The harmful impact of oxidative stress, or OS, is brought on by a disparity between the defense mechanisms of the body and the creation of H-FRs. Aging is characterized by a slow decline in tissue and organ competence. Age-mediated pathologies start as an aberrant accumulation of H-FRs, which inhibit cells' capacity to divide, repair, and operate, based on the OS theorem of aging. The natural outcome of this situation is apoptosis. These conditions may include skeletal muscle dysfunction, cancer, cardiovascular, chronic hepatitis, chronic renal, and chronic pulmonary disorders. Given the substantial role that OS plays in the progression of many of these illnesses, antioxidant-based therapy may have a favorable impact on how these diseases progress. To ascertain the true efficacy of this therapy strategy, more research is necessary. The aim of this study is to provide an overview of the literature on this challenging issue that is attracting interest.
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Affiliation(s)
- Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
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23
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Kwaśny A, Uchmanowicz I, Juárez-Vela R, Młynarska A, Łokieć K, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in heart failure: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:176-187. [PMID: 37226867 DOI: 10.1093/eurjcn/zvad050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
AIMS A nutritional status is related to the length of hospitalization and in-hospital mortality of patients with heart failure (HF). The aim of this study is to assess the prognostic impact of nutritional status and body mass index (BMI) on in-hospital mortality among patients with HF relative to their sex. METHODS AND RESULTS We conducted a retrospective study and analysis of 809 medical records of patients admitted to the Institute of Heart Disease of the University Clinical Hospital in Wroclaw (Poland). Women were statistically significantly older than men (74.67 ± 11.15 vs. 66.76 ± 17.78; P < 0.001). In unadjusted model, significant predictors of the odds of in-hospital mortality for men were underweight (OR = 14.81, P = 0.001) and the risk of malnutrition (OR = 8.979, P < 0.001). In the case of women, none of the traits analysed was significant. In age-adjusted model, significant independent predictors of the odds of in-hospital mortality in the case of men were BMI < 18.5 (OR = 15.423, P = 0.001) and risk of malnutrition (OR = 5.557, P = 0.002). In the case of women, none of the nutritional status traits analysed were significant. In multivariable-adjusted model in men, significant independent predictors of the odds of in-hospital mortality were BMI < 18.5 (OR = 15.978, P = 0.007) compared with having normal body weight and the risk of malnutrition (OR = 4.686, P = 0.015). In the case of women, none of the nutritional status traits analysed were significant. CONCLUSION Both underweight and the risk of malnutrition are direct predictors of the odds of in-hospital mortality in men, but not in women. The study did not find a relationship between nutritional status and in-hospital mortality in women.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, The Academy of Business and Health Science, 90-361 Lodz, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
| | - Agnieszka Młynarska
- Department Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
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24
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Tan LF, Chan YH, Denishkrshna A, Merchant RA. Association between different skeletal muscle mass indices, physical function, and inflammation in obese pre-frail older adults. Arch Gerontol Geriatr 2024; 118:105289. [PMID: 38043454 DOI: 10.1016/j.archger.2023.105289] [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: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES There is lack of consensus on measurement of muscle mass and quality in obese older adults. We aim to evaluate the association of four muscle mass indices (appendicular skeletal muscle mass (ASM) over height2(ASMIht), ASM/weight (ASMwt), ASM/body fat percentage (ASMbfp)and ASM/body mass index (BMI) ASMIbmi) with physical function and inflammation in pre-frail obese older adults. METHODS Cross-sectional study of 407 community dwelling pre-frail older adults. Data on demographics, cognition, and physical function(gait speed, handgrip strength (HGS) and Short Physical Performance Battery (SPPB) test), body composition and inflammation biomarkers were collected. Participants were analysed based on BMI tertiles(T1 lowest,T3 highest). RESULTS The mean age was 72.67 years, mean BMI 25.42 kg/m2 and 59.5 % were females. Participants in T3 had a mean BMI of 30.75 kg/m2, younger with lower education levels, multimorbidity, polypharmacy and lower prevalence of sarcopenia. In BMI T3, ASMIbmi was significantly associated with EQ-5D index (β 0.53, 95 % CI 0.04 to 1.03, p = 0.033),HGS (β 5.28, 95 % CI 0.27 to 10.29, p = 0.039), SPPB (β 2.19, 95 % CI 0.47 to 3.91, p = 0.013) and IL-6 (β -4.13, 95 % CI -7.46 to -0.81, p = 0.017). ASMIwt was associated with EQ-5D index (β 0.17, 95 % CI 0.02 - 0.33, p = 0.047). ASMbfp was associated with HGS (β 6.97, 95 % CI 0.051 to 13.92, p = 0.049). There was significant association of HGS with all muscle mass indices in BMI T2, and ASMbfpin BMI T1. CONCLUSION ASMIbmi was significantly associated with SPPB, HGS, EQ-5D index and IL-6 in BMI T3. ASMbfp was associated with HGS in all the tertiles. Our results need further validation at population level.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore
| | - Yiong Huak Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - A Denishkrshna
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Reshma Aziz Merchant
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore.
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25
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Herder C, Maalmi H, Saatmann N, Zaharia OP, Strassburger K, Burkart V, Norman K, Roden M. Correlates of Skeletal Muscle Mass and Differences Between Novel Subtypes in Recent-Onset Diabetes. J Clin Endocrinol Metab 2024; 109:e1238-e1248. [PMID: 37831076 PMCID: PMC10876398 DOI: 10.1210/clinem/dgad605] [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: 07/12/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Low skeletal muscle mass (SMM) is associated with long-standing diabetes but little is known about SMM in newly diagnosed diabetes. OBJECTIVE We aimed to identify correlates of SMM in recent-onset diabetes and to compare SMM between novel diabetes subtypes. METHODS SMM was normalized to body mass index (SMM/BMI) in 842 participants with known diabetes duration of less than 1 year from the German Diabetes Study (GDS). Cross-sectional associations between clinical variables, 79 biomarkers of inflammation, and SMM/BMI were assessed, and differences in SMM/BMI between novel diabetes subtypes were analyzed with different degrees of adjustment for confounders. RESULTS Male sex and physical activity were positively associated with SMM/BMI, whereas associations of age, BMI, glycated hemoglobin A1c, homeostatic model assessment for β-cell function, and estimated glomerular filtration rate with SMM/BMI were inverse (all P < .05; model r2 = 0.82). Twenty-three biomarkers of inflammation showed correlations with SMM/BMI after adjustment for sex and multiple testing (all P < .0006), but BMI largely explained these correlations. In a sex-adjusted analysis, individuals with severe autoimmune diabetes had a higher SMM/BMI whereas individuals with severe insulin-resistant diabetes and mild obesity-related diabetes had a lower SMM/BMI than all other subtypes combined. However, differences were attenuated after adjustment for the clustering variables. CONCLUSION SMM/BMI differs between diabetes subtypes and may contribute to subtype differences in disease progression. Of note, clinical variables rather than biomarkers of inflammation explain most of the variation in SMM/BMI.
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Affiliation(s)
- Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Haifa Maalmi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Nina Saatmann
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Klaus Strassburger
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin 13347, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal 14558, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal 14558, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin 10785, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
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26
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Chung C, Kim AR, Kim D, Kwon H, Lee SH, Jang IY, Jo MW, Kang DY, Lee SW. Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases. Sci Rep 2024; 14:3018. [PMID: 38321153 PMCID: PMC10847123 DOI: 10.1038/s41598-024-53583-2] [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] [Received: 07/19/2023] [Accepted: 02/02/2024] [Indexed: 02/08/2024] Open
Abstract
Rehabilitation improves symptoms, quality of life, and survival in patients with chronic respiratory or cardiovascular disease. We evaluated smartphone application-based rehabilitation programs for patients with chronic respiratory or cardiovascular diseases. This was a single-center prospective single arm study. Participants underwent smartphone application-based pulmonary or cardiac rehabilitation for 12 weeks. A total of 93 participants were recruited, and 75 visited after rehabilitation. Their median age was 67.0 (interquartile range, 60.0-70.8) years, and 60 (80.0%) were men. For patients with chronic respiratory disease (n = 41), VO2peak (median 13.7 to 15.4 ml/kg/min, P = 0.049), chronic obstructive pulmonary disease assessment test (median 14 to 6, P < 0.001), Euro-QoL 5-Dimension 5-Level (EQ-5D-5L) index (median 0.795 to 0.862, P = 0.001), and Health-related Quality of Life Instrument with 8 Items (HINT-8) index (median 0.784 to 0.855, P < 0.001) were significantly improved. For patients with chronic cardiovascular disease (n = 34), VO2peak (median 21.8 to 23.3, P = 0.007), EQ-5D-5L index (median 0.871 to 1.000, P = 0.037), and HINT-8 index (median 0.890 to 0.903, P < 0.001) were significantly improved. The smartphone application-based rehabilitation program improved exercise capacity and quality of life in patients with chronic respiratory or cardiovascular disease.Trial registration: https://clinicaltrials.gov/ct2/show/NCT05383950 (20/05/2022).
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Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Ah-Ram Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Dongbum Kim
- LifeSemantics Corp., Seoul, Republic of Korea
| | - Hee Kwon
- LifeSemantics Corp., Seoul, Republic of Korea
| | - Seong Ho Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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27
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Mirzai S, Sarnaik KS, Persits I, Martens P, Estep JD, Chen P, Tang WHW. Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study. J Am Heart Assoc 2024; 13:e030991. [PMID: 38258654 PMCID: PMC11056110 DOI: 10.1161/jaha.123.030991] [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: 05/14/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Sarcopenia and hypoalbuminemia have been identified as independent predictors of increased adverse outcomes, including mortality and readmissions, in hospitalized older adults with acute decompensated heart failure (ADHF). However, the impact of coexisting sarcopenia and hypoalbuminemia on morbidity and death in adults with ADHF has not yet been investigated. We aimed to investigate the combined effects of lower muscle mass (LMM) as a surrogate for sarcopenia and hypoalbuminemia on in-hospital and postdischarge outcomes of patients hospitalized for ADHF. METHODS AND RESULTS A total of 385 patients admitted for ADHF between 2017 and 2020 at a single institution were retrospectively identified. Demographic and clinical data were collected, including serum albumin levels at admission and discharge. Skeletal muscle indices were derived from semi-automated segmentation software analysis on axial chest computed tomography at the twelfth vertebral level. Our analysis revealed that patients who had LMM with admission hypoalbuminemia experienced increased diagnoses of infection and delirium with longer hospital length of stay and more frequent discharge to a facility. Upon discharge, 27.9% of patients had higher muscle mass without discharge hypoalbuminemia (reference group), 9.7% had LMM without discharge hypoalbuminemia, 38.4% had higher muscle mass with discharge hypoalbuminemia, and 24.0% had LMM with discharge hypoalbuminemia; mortality rates were 37.6%, 51.4%, 48.9%, and 63.2%, respectively. 1- and 3-year mortality risks were highest in those with LMM and discharge hypoalbuminemia; this relationship remained significant over a median 23.6 (3.1-33.8) months follow-up time despite multivariable adjustments (hazard ratio, 2.03 [95% CI, 1.31-3.16]; P=0.002). CONCLUSIONS Hospitalization with ADHF, LMM, and hypoalbuminemia portend heightened mortality risk.
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Affiliation(s)
- Saeid Mirzai
- Section on Cardiovascular Medicine, Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNCUSA
- Department of Internal MedicineCleveland ClinicClevelandOHUSA
| | | | - Ian Persits
- Department of Internal MedicineCleveland ClinicClevelandOHUSA
| | - Pieter Martens
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute, Cleveland ClinicClevelandOHUSA
| | - Jerry D. Estep
- Department of CardiologyCleveland Clinic FloridaWestonFLUSA
| | - Po‐Hao Chen
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland ClinicClevelandOHUSA
| | - W. H. Wilson Tang
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute, Cleveland ClinicClevelandOHUSA
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28
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Li DCW, Rudloff S, Langer HT, Norman K, Herpich C. Age-Associated Differences in Recovery from Exercise-Induced Muscle Damage. Cells 2024; 13:255. [PMID: 38334647 PMCID: PMC10854791 DOI: 10.3390/cells13030255] [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: 12/31/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Understanding the intricate mechanisms governing the cellular response to resistance exercise is paramount for promoting healthy aging. This narrative review explored the age-related alterations in recovery from resistance exercise, focusing on the nuanced aspects of exercise-induced muscle damage in older adults. Due to the limited number of studies in older adults that attempt to delineate age differences in muscle discovery, we delve into the multifaceted cellular influences of chronic low-grade inflammation, modifications in the extracellular matrix, and the role of lipid mediators in shaping the recovery landscape in aging skeletal muscle. From our literature search, it is evident that aged muscle displays delayed, prolonged, and inefficient recovery. These changes can be attributed to anabolic resistance, the stiffening of the extracellular matrix, mitochondrial dysfunction, and unresolved inflammation as well as alterations in satellite cell function. Collectively, these age-related impairments may impact subsequent adaptations to resistance exercise. Insights gleaned from this exploration may inform targeted interventions aimed at enhancing the efficacy of resistance training programs tailored to the specific needs of older adults, ultimately fostering healthy aging and preserving functional independence.
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Affiliation(s)
- Donna Ching Wah Li
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
| | - Stefan Rudloff
- Department of Geriatrics and Medical Gerontology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | | | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
- Department of Geriatrics and Medical Gerontology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
| | - Catrin Herpich
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
- Department of Geriatrics and Medical Gerontology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
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Yerrakalva D, Hajna S, Khaw KT, Griffin SJ, Brage S. Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study. Int J Behav Nutr Phys Act 2024; 21:10. [PMID: 38279174 PMCID: PMC10811887 DOI: 10.1186/s12966-023-01547-6] [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: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006-2011) and follow-up (2012-2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. RESULTS Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). CONCLUSION Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
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Chen Z, Hu D, Wu D, Song C, Sun J, Liu W. Association between serum copper levels and muscle mass: results from NHANES 2011-2016. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:6847-6856. [PMID: 38153578 DOI: 10.1007/s11356-023-31599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
Copper is essential for various biological processes. However, excess copper has several adverse health effects. The effects of serum copper on muscle mass are poorly understood. This study aimed to investigate the association between serum copper levels and muscle mass in the US population. We utilized National Health and Nutrition Examination Survey (NHANES) data between 2011 and 2016 for analysis. Data on serum copper, muscle mass (measured using the appendicular skeletal muscle mass index (ASMI)), and covariates were extracted and analyzed. Weighted multivariate linear regression analyses and smooth curve fittings were performed to investigate the association between serum copper levels and ASMI. Subgroup analyses stratified according to age and sex were performed. In the presence of nonlinearity, threshold effect analysis was performed using a two-piecewise linear regression model. A total of 3860 participants were included in the final analysis. Serum copper levels were negatively associated with ASMI in the fully adjusted model. Furthermore, by comparing participants in the highest and lowest tertiles of serum copper levels, we found that the ASMI decreased by 0.292 kg/m2. In the sex-stratified subgroup analysis, we observed an inverse association between serum copper levels and the ASMI in both men and women. When stratified by age, the association remained significant among participants < 40 years of age, but not among those ≥ 40 years old. Smooth curve fitting revealed a nonlinear relationship between serum copper and ASMI, with an inflection point identified at 150.6 μg/dL. Our study revealed an inverse relationship between serum copper levels and muscle mass. This finding improves the current knowledge on the impact of serum copper on muscle loss and highlights the importance of serum copper homeostasis in muscle health.
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Affiliation(s)
- Zhi Chen
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China
| | - Dingxiang Hu
- School of Health, Fujian Medical University, Fuzhou, 350108, Fujian, China
| | - Dingwei Wu
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China
| | - Chenyang Song
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China
| | - Jun Sun
- Department of Emergency, Zhaotong Traditional Chinese Medicine Hospital, Zhaotong, 657000, Yunnan, China
| | - Wenge Liu
- Department of Orthopedics, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
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31
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Kwon RJ, Cho YH, Park EJ, Lee SY, Choi JI, Lee YI, Lee SR, Son SM. Association between pulse pressure and low muscle mass in Korean adults: A nationwide cross-sectional study. Medicine (Baltimore) 2023; 102:e36644. [PMID: 38206714 PMCID: PMC10754618 DOI: 10.1097/md.0000000000036644] [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: 10/03/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024] Open
Abstract
Sarcopenia is characterized by a loss of muscle mass and strength and is associated with a high risk of cardiovascular events and increased mortality. Pulse pressure (PP) serves as a marker for changes in heart structure and function, as well as arterial stiffness. A high PP also increases the risk of cardiovascular disease and all-cause mortality. However, the relationship between PP and sarcopenia is poorly understood. We used the data of participants of the Korea National Health and Nutrition Examination Survey (KNHANES) of 2008 to 2011. Participants were divided into a control group (PP < 40 mm Hg) and a high-PP group (PP ≥ 40 mm Hg). PP was calculated by subtracting the diastolic blood pressure (DBP) from the systolic blood pressure (SBP), and the low muscle index was assessed using appendicular skeletal muscle mass (ASM) normalized by body mass index (BMI). Multiple logistic regression analyses were performed to examine the association between PP and the prevalence of low muscle mass, adjusting for potential confounders. The high-PP group had a higher age, SBP, DBP, and prevalence of hypertension, diabetes and hyperlipidemia than the control group. The high-PP group had a higher prevalence of low muscle mass than the control group in all models. A high PP is significantly associated with a higher prevalence of low muscle mass. Therefore, PP monitoring may help identify individuals at risk of sarcopenia and guide interventions to improve health outcomes.
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Affiliation(s)
- Ryuk Jun Kwon
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Young Hye Cho
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Family Medicine, Pusan National University School of Medicine, Yangsan, South Korea
| | - Eun-Ju Park
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Sang Yeoup Lee
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
- Department of Family Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jung-In Choi
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Young-In Lee
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Sae Rom Lee
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Soo Min Son
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
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32
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Garrett TJ, Puchowicz MA, Park EA, Dong Q, Farage G, Childress R, Guingab J, Simpson CL, Sen S, Brogdon EC, Buchanan LM, Raghow R, Elam MB. Effect of statin treatment on metabolites, lipids and prostanoids in patients with Statin Associated Muscle Symptoms (SAMS). PLoS One 2023; 18:e0294498. [PMID: 38100464 PMCID: PMC10723679 DOI: 10.1371/journal.pone.0294498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/02/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Between 5-10% of patients discontinue statin therapy due to statin-associated adverse reactions, primarily statin associated muscle symptoms (SAMS). The absence of a clear clinical phenotype or of biomarkers poses a challenge for diagnosis and management of SAMS. Similarly, our incomplete understanding of the pathogenesis of SAMS hinders the identification of treatments for SAMS. Metabolomics, the profiling of metabolites in biofluids, cells and tissues is an important tool for biomarker discovery and provides important insight into the origins of symptomatology. In order to better understand the pathophysiology of this common disorder and to identify biomarkers, we undertook comprehensive metabolomic and lipidomic profiling of plasma samples from patients with SAMS who were undergoing statin rechallenge as part of their clinical care. METHODS AND FINDINGS We report our findings in 67 patients, 28 with SAMS (cases) and 39 statin-tolerant controls. SAMS patients were studied during statin rechallenge and statin tolerant controls were studied while on statin. Plasma samples were analyzed using untargeted LC-MS metabolomics and lipidomics to detect differences between cases and controls. Differences in lipid species in plasma were observed between cases and controls. These included higher levels of linoleic acid containing phospholipids and lower ether lipids and sphingolipids. Reduced levels of acylcarnitines and altered amino acid profile (tryptophan, tyrosine, proline, arginine, and taurine) were observed in cases relative to controls. Pathway analysis identified significant increase of urea cycle metabolites and arginine and proline metabolites among cases along with downregulation of pathways mediating oxidation of branched chain fatty acids, carnitine synthesis, and transfer of acetyl groups into mitochondria. CONCLUSIONS The plasma metabolome of patients with SAMS exhibited reduced content of long chain fatty acids and increased levels of linoleic acid (18:2) in phospholipids, altered energy production pathways (β-oxidation, citric acid cycle and urea cycles) as well as reduced levels of carnitine, an essential mediator of mitochondrial energy production. Our findings support the hypothesis that alterations in pro-inflammatory lipids (arachidonic acid pathway) and impaired mitochondrial energy metabolism underlie the muscle symptoms of patients with statin associated muscle symptoms (SAMS).
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Affiliation(s)
- Timothy J. Garrett
- Southeast Center for Integrated Metabolomics (SECIM), Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Michelle A. Puchowicz
- Pediatrics-Obesity, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Edwards A. Park
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Qingming Dong
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Gregory Farage
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Richard Childress
- Endocrine Section, Memphis Veteran’s Affairs Medical Center, Memphis, Tennessee, United States of America
| | - Joy Guingab
- Southeast Center for Integrated Metabolomics (SECIM), Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Claire L. Simpson
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Elizabeth C. Brogdon
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Logan M. Buchanan
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Rajendra Raghow
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
| | - Marshall B. Elam
- Department of Pharmacology, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
- Cardiology Section, Memphis Veteran’s Affairs Medical Center, Memphis, Tennessee, United States of America
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Okada M, Hama Y, Futatsuya R, Sasaki Y, Noritake K, Yamaguchi K, Matsuzaki M, Kubota C, Hosoda A, Minakuchi S. Association between Masticatory Performance, Nutritional Intake, and Frailty in Japanese Older Adults. Nutrients 2023; 15:5075. [PMID: 38140333 PMCID: PMC10746083 DOI: 10.3390/nu15245075] [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: 10/28/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The older adult population in Japan is expected to increase. Therefore, long-term care and frailty prevention are important. However, the relationship between masticatory performance, nutritional intake, and frailty remains unclear. This cross-sectional study aimed to examine energy, protein, and vitamin D intake and its association with frailty and masticatory performance in older adults. Patients between January 2022 and January 2023 were recruited and divided into robust and frail groups. Masticatory performance, nutrition, frailty, and other data, such as age and sex, were evaluated through onsite measurements and a questionnaire. Logistic regression analysis was conducted with frailty as a dependent variable and masticatory performance as an independent variable, adjusting for age, sex, skeletal muscle mass, living alone, energy intake, protein-energy ratio, and vitamin D intake. No significant differences were observed between the groups regarding age or sex. The robust group showed significantly better results for protein-energy ratio, vitamin D intake, and subjective and objective masticatory performance than the frail group. Logistic regression analysis revealed a significant correlation between skeletal muscle mass, protein-energy ratio, and objective masticatory performance with frailty. Masticatory performance was associated with frailty, independent of the intake of nutrients such as energy, protein, and vitamin D.
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Affiliation(s)
- Mitsuzumi Okada
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yohei Hama
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Ryota Futatsuya
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yoshiyuki Sasaki
- Clinical Dental Research Promotion Unit, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo 113-8549, Japan;
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University Hospital, Tokyo 113-8549, Japan;
| | - Kohei Yamaguchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Mayuko Matsuzaki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Chieko Kubota
- Department of Oral Health Sciences, Meikai University, Chiba 279-8550, Japan;
| | - Akemi Hosoda
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University, Tokyo 141-8648, Japan;
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
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Cezón-Serrano N, Arnal-Gómez A, Arjona-Tinaut L, Cebrià I Iranzo MÀ. Functional and emotional impact of COVID-19 lockdown on older adults with sarcopenia living in a nursing home: A 15-month follow-up. Nurs Health Sci 2023; 25:597-608. [PMID: 37705366 DOI: 10.1111/nhs.13050] [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: 01/27/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023]
Abstract
This study aimed to detect the functional and emotional impact of COVID-19 lockdown on institutionalized older adults with sarcopenia during a 15-month follow-up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC-F questionnaire were included. Assessments were performed pre-lockdown (T1), 12 months (T2) after, and at a 15-month follow-up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up-and-Go test. Emotional assessments included Short-Form Health Survey, Geriatric Depression Scale-Short Form, and the Mini-Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducted.
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Affiliation(s)
- Natalia Cezón-Serrano
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Laura Arjona-Tinaut
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Maria Àngels Cebrià I Iranzo
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), Valencia, Spain
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Coronado-Zarco R, de León AOG. Muscle quality an evolving concept. J Frailty Sarcopenia Falls 2023; 8:254-260. [PMID: 38046437 PMCID: PMC10690134 DOI: 10.22540/jfsf-08-254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 12/05/2023] Open
Abstract
Muscle quality concept can be analyzed from a morphological and functional perspectives that include relation between these properties. Morphological muscle quality considers muscle composition, architectural and structural properties. Functional muscle quality has been defined as a ratio between muscle strength or power per unit of muscle mass or area. Biological and adaptative changes to ageing must be considered when interpretation of muscle quality assessment is done in a clinical or research context. One of the conditions that requires an adequate homologation in terminology is sarcopenia, to establish definition and cut-off points.
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Affiliation(s)
- Roberto Coronado-Zarco
- Rehabilitation Medicine, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra”, Mexico
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36
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Damm M, Efremov L, Jalal M, Nadeem N, Dober J, Michl P, Wohlgemuth WA, Wadsley J, Hopper AD, Krug S, Rosendahl J. Body composition parameters predict survival in pancreatic cancer-A retrospective multicenter analysis. United European Gastroenterol J 2023; 11:998-1009. [PMID: 37987099 PMCID: PMC10720684 DOI: 10.1002/ueg2.12489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/31/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Parameters to adapt individual treatment strategies for patients with pancreatic ductal adenocarcinoma (PDAC) are urgently needed. The present study aimed to evaluate body composition parameters as predictors of overall survival (OS) in PDAC patients. METHODS Measurements of body composition parameters were performed on computed tomography scans at diagnosis. Height-standardized and Body Mass Index- and sex-adjusted regression formulas deriving cut-offs from a healthy population were used. The Kaplan-Meier method with the log-rank test was performed for survival analysis. Independent prognostic factors were identified with uni- and multivariable Cox regression analyses. RESULTS In total, 354 patients were analyzed. In a multivariable Cox model, besides tumor stage and resection status, only myosteatosis (HR 1.53; 95% CI 1.10-2.14, p = 0.01) was an independent prognostic factor of OS among body composition parameters. Subgroup analyses revealed that the prognostic impact of myosteatosis was higher in patients ≤68 years of age, with advanced tumor stages and patients without curative intended resection. CONCLUSIONS The analysis of one of the largest Caucasian cohorts to date, demonstrated myosteatosis to be an independent prognostic factor of OS in PDAC. To improve outcomes, prospective trials aiming to investigate the utility of an early assessment of myosteatosis with subsequent intervention by dieticians, sports medicine physicians, and physiotherapists are warranted.
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Affiliation(s)
- Marko Damm
- Department of Internal Medicine I, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Ljupcho Efremov
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Radiation Oncology, Martin-Luther-University, Halle (Saale), Germany
| | - Mustafa Jalal
- Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK
| | - Nabeegh Nadeem
- Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK
| | - Johannes Dober
- Department of Radiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Patrick Michl
- Department of Internal Medicine I, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - Walter A Wohlgemuth
- Department of Radiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Andrew D Hopper
- Department of Infection and Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Sebastian Krug
- Department of Internal Medicine I, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - Jonas Rosendahl
- Department of Internal Medicine I, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Coskun M, Sendur HN, Cerit MN, Babayeva A, Cerit ET, Yalcin MM, Altinova AE, Akturk M, Karakoc MA, Toruner FB. Assessment of forearm muscles with ultrasound shear wave elastography in patients with acromegaly. Pituitary 2023; 26:716-724. [PMID: 37899388 DOI: 10.1007/s11102-023-01352-1] [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] [Accepted: 08/24/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE The effects of acromegaly on soft tissues, bones and joints are well-documented, but information on its effects on muscle mass and quality remains limited. The primary goal of this study is to assess the sonoelastographic features of forearm muscles in patients with acromegaly. METHOD Forty-five patients with acromegaly and 45 healthy controls similar in terms of gender, age, and body mass index (BMI) were included in a single-center, multidisciplinary, cross-sectional study. The body composition was analyzed using bioelectrical impedance analysis (BIA), and height-adjusted appendicular skeletal muscle index (hSMI) was calculated. The dominant hand's grip strength was also measured. Two radiologists specialized in the musculoskeletal system employed ultrasound shear wave elastography (SWE) to assess the thickness and stiffness of brachioradialis and biceps brachii muscles. RESULTS The acromegaly group had significantly higher thickness of both the biceps brachii (p = 0.034) and brachioradialis muscle (p = 0.046) than the control group. However, the stiffness of the biceps brachii (p = 0.001) and brachioradialis muscle (p = 0.001) was lower in the acromegaly group than in the control group. Disease activity has not caused a significant difference in muscle thickness and stiffness in the acromegaly group (p > 0.05). The acromegaly group had a higher hSMI (p = 0.004) than the control group. The hand grip strength was similar between the acromegaly and control group (p = 0.594). CONCLUSION The patients with acromegaly have an increased muscle thickness but decreased muscle stiffness in the forearm muscles responsible for elbow flexion. Acromegaly can lead to a permanent deterioration of the muscular structure regardless of the disease activity.
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Affiliation(s)
- Meric Coskun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey.
| | - Halit Nahit Sendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey
| | - Afruz Babayeva
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Ethem Turgay Cerit
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Muhittin Yalcin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Alev Eroglu Altinova
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mujde Akturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Mehmet Ayhan Karakoc
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
| | - Fusun Balos Toruner
- Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey
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Bergaoui J, Latiri I, Chaouch H, Ben Abdallah J, Mrad S, Maatamri W, Letaief A, Ben Saad H. Evaluation of muscle strength and quality in North African patients with chronic hepatitis B: A pilot case control study. Libyan J Med 2023; 18:2204564. [PMID: 37096573 PMCID: PMC10132249 DOI: 10.1080/19932820.2023.2204564] [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: 04/26/2023] Open
Abstract
Early detection of alteration of muscle strength, quantity, and quality, and sarcopenia is useful in non-cirrhotic chronic hepatitis B (NC-CHB) patients. Studies, which explored the handgrip strength (HGS) are scarce with questionable results, and no previous case-control study explored the presence of sarcopenia.The aim of this study was to assess the muscle strength [i.e.; HGS absolute (HGSA), HGSA/body mass index (BMI)], muscle quantity [i.e.; appendicular skeletal muscle (ASM), ASM/height2, ASM/total body weight (TBW), ASM/BMI], and muscle quality [i.e.; HGSA/total muscle mass (TMM), HGSA/ASM] of NC-CHB patients.This was a case-control study. Cases (n = 26) were untreated NC-CHB patients, and controls (n = 28) were 'apparently' healthy participants. Muscle mass was estimated via the TMM (kg) and ASM (kg). Muscle strength was evaluated via the HGS data [i.e.; HGSA (kg), HGSA/BMI (m2)]. Six variants of HGSA were determined: highest values for the dominant and non-dominant hands, highest value between the two hands, averages of the three measurements for the two hands, and the average of the highest values of the two hands. Muscle quantity was expressed in three relative variants (ASM/height2, ASM/TBW, and ASM/BMI). Muscle quality was evaluated via relative HGS data adjusted by muscle mass (i.e.; HGSA/TMM, HGSA/ASM). Probable and confirmed sarcopenia were retained in front of low muscle strength, and low muscle strength and muscle quantity or quality, respectively.There were no significant differences between controls and NC-CHB patients in values of muscle i) Strength whatever the HGS' mode of expression (e.g.; HGSA/BMI: 1.59 ± 0.54 vs. 1.53 ± 0.54 m2, p = 0.622, respectively), ii) Quantity (e.g.; ASM/BMI: 0.79 ± 0.24 vs. 0.77 ± 0.23 m2, p = 0.883), and iii) Quality (e.g.; HGSA/ASM: 2.00 ± 0.25 vs. 2.01 ± 0.41, p = 0.952, respectively). One NC-CHB participant had a confirmed sarcopenia.To conclude, both controls and NC-CHB patients had similar HGS values. Only one NC-CHB patient had a confirmed sarcopenia.
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Affiliation(s)
- Jihene Bergaoui
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
| | - Imed Latiri
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
- Faculty of Medicine of Sousse, Department of Physiology, Sousse University, Sousse, Tunisia
| | - Houda Chaouch
- Department of Infectious Diseases, Viral Hepatitis Research Unit (UR12SP35), Hospital Farhat HACHED, Sousse, Tunisia
| | - Jihene Ben Abdallah
- Biochemistry Research Laboratory (LR18ES47), Hospital Farhat HACHED, Sousse, Tunisia
| | - Sawssen Mrad
- Biochemistry Research Laboratory (LR18ES47), Hospital Farhat HACHED, Sousse, Tunisia
| | - Wided Maatamri
- Haematological laboratory, Hospital Farhat HACHED, Sousse, Tunisia
| | - Amel Letaief
- Department of Infectious Diseases, Viral Hepatitis Research Unit (UR12SP35), Hospital Farhat HACHED, Sousse, Tunisia
| | - Helmi Ben Saad
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
- Faculty of Medicine of Sousse, Department of Physiology, Sousse University, Sousse, Tunisia
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Sjöblom S, Suuronen J, Rikkonen T, Honkanen R, Kröger H, Sirola J. The diagnostic cut-off points for components of sarcopenia in Finnish Caucasian women: A retrospective cross-sectional study. J Frailty Sarcopenia Falls 2023; 8:211-220. [PMID: 38046438 PMCID: PMC10690131 DOI: 10.22540/jfsf-08-211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives To determine the diagnostic cut-off values of components for sarcopenia in Caucasian women. Methods The present retrospective cross-sectional study based on the REFERENCE sample included 400 healthy women aged 20 to 40 years, and the OSTPRE sample included 344 women aged 63 to 75. The subjects of the OSTPRE population were re-measured five and ten years later after the baseline. Both samples underwent grip strength (GS), quadriceps strength (QS), and total-body DXA (TB-DXA) measurements, from which Relative Skeletal Muscle Mass Index (RSMI) was calculated. Results In the REFERENCE population, the -1 SD / -2 SD cut-off points were for RSMI 5.8 kg/m2 / 5.1 kg/m2, for GS 32.0 kg / 26.4 kg, and for QS 39.8 kg / 29.8 kg. The prevalence of under -2 SD distributions in REFERENCE were: RSMI 1.8%, GS 1.3%, and QS 2.0%, and in OSTPRE (15/20/25 years measurements): RSMI 1.2 %/1.9 %/0.5 %, GS 52.2%/42.3%/48.8%, and QS 47.4%/55.2%/not available. The distributions of GS and QS were statistically significantly different between REFERENCE and all OSTPRE measurement points (p<0.001 in Chi-squared). Conclusions The diagnostic cut-offs for components of sarcopenia are RSMI 5.1 kg/m2, grip strength 26.4 kg, and quadriceps strength 29.8 kg in Finnish Caucasian women.
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Affiliation(s)
- Samu Sjöblom
- Kuopio Musculoskeletal Research Unit (KMRU) Mediteknia Building, University of Eastern Finland, Kuopio, Finland
| | - Juha Suuronen
- Kuopio Musculoskeletal Research Unit (KMRU) Mediteknia Building, University of Eastern Finland, Kuopio, Finland
| | - Toni Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU) Mediteknia Building, University of Eastern Finland, Kuopio, Finland
| | - Risto Honkanen
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | | | - Joonas Sirola
- Kuopio Musculoskeletal Research Unit (KMRU) Mediteknia Building, University of Eastern Finland, Kuopio, Finland
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Liu Y, Tian L. Research progress on the predictive role of sarcopenia in the course and prognosis of inflammatory bowel disease. PeerJ 2023; 11:e16421. [PMID: 38025672 PMCID: PMC10676082 DOI: 10.7717/peerj.16421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Sarcopenia is a syndrome characterized by a progressive and extensive decrease in skeletal muscle quality and function. With the development of imaging technology in recent years, the understanding and research on the pathogenesis, diagnosis, and evaluation of sarcopenia have gradually improved. More than one-third of patients with inflammatory bowel disease (IBD) have sarcopenia (Ryan et al., 2019), and as a new and unique body composition evaluation index, it is critical for predicting the clinical course, prognosis and postoperative complications of patients with IBD. However, there are limited research summarizing the prevalence of sarcopenia among IBD. Furthermore, there is a scarcity of studies establishing the precise criteria for diagnosing sarcopenia in these patients. This article summarizes the evaluation of sarcopenia and its recent advancements in predicting the course and prognosis of IBD.
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Affiliation(s)
- Yang Liu
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Linglin Tian
- Department of Gastroenterology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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Mizuno T, Matsui Y, Tomida M, Suzuki Y, Ishizuka S, Watanabe T, Takemura M, Nishita Y, Tange C, Shimokata H, Imagama S, Otsuka R, Arai H. Relationship between quadriceps muscle computed tomography measurement and motor function, muscle mass, and sarcopenia diagnosis. Front Endocrinol (Lausanne) 2023; 14:1259350. [PMID: 38047116 PMCID: PMC10693452 DOI: 10.3389/fendo.2023.1259350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Background The quadriceps muscle is one of the human body's largest and most clinically important muscles and is evaluated using mid-thigh computed tomography (CT); however, its relationship with motor function and sarcopenia remains unclear. Herein, we investigated the relationship between the cross-sectional area (CSA) of the quadriceps muscle, CT attenuation value (CTV), dual-energy X-ray absorptiometry muscle mass measurements, and muscle strength and motor function to evaluate the relationship between muscle mass loss and motor function decline, determine the diagnostic ability for sarcopenia, and confirm the usefulness of quadriceps muscle CT evaluation. Methods A total of 472 middle-aged and older community dwellers (254 men and 218 women) aged ≥40 years (mean age: 62.3 years) were included in this study. The quantity and quality of the quadriceps muscle were assessed using CSA and CTV (CSA×CTV) as a composite index multiplied by quality and quantity. Age-adjusted partial correlations by sex with eight motor functions (knee extension muscle strength, power, normal walking speed, fast walking speed, grip strength, sit-up ability, balance ability, and reaction time) were evaluated, including correction methods for height, weight, and body mass index (BMI). Further, the accuracy of sarcopenia diagnosis was evaluated using appendicular muscle mass with dual-energy X-ray absorptiometry measurements, grip strength, and walking speed as the gold standard, and receiver operating characteristic curves were plotted to evaluate diagnostic performance. Results In men, CSA and CSA×CTV were significantly associated with seven of the eight motor functions (p<0.05), excluding only balance ability. BMI-corrected CSA was significantly correlated with all eight motor functions in men and women (p<0.05). In the diagnosis of sarcopenia based on skeletal muscle index, CSA (area under the curve (AUC) 0.935) and CSA×CTV (AUC 0.936) and their correction by height (CSA/height (AUC 0.917) and CSA×CTV/height (AUC 0.920)) were highly accurate and useful for diagnosis in men but moderately accurate in women (CSA (AUC 0.809), CSA×CTV (AUC 0.824), CSA/height (AUC 0.799), CSA×CTV/height (AUC 0.814)). Conclusion The present results showed that a single CT image of the quadriceps muscle at the mid-thigh is useful for diagnosing sarcopenic changes, such as loss of muscle mass, muscle weakness, and muscle function.
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Affiliation(s)
- Takafumi Mizuno
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and GerontologyObu, Obu, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and GerontologyObu, Obu, Japan
| | - Makiko Tomida
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
- Graduate School of Humanities and Social Sciences, Nagoya City University, Nagoya, Japan
| | - Yasuo Suzuki
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and GerontologyObu, Obu, Japan
- Faculty of Health Sciences, Department of Human Care Engineering, Nihon Fukushi University, Mihama, Japan
| | - Shinya Ishizuka
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tsuyoshi Watanabe
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and GerontologyObu, Obu, Japan
| | - Marie Takemura
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and GerontologyObu, Obu, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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Mirzai S, Persits I, Martens P, Chen PH, Estep JD, Tang WHW. Significance of Adipose Tissue Quantity and Distribution on Obesity Paradox in Heart Failure. Am J Cardiol 2023; 207:339-348. [PMID: 37774476 DOI: 10.1016/j.amjcard.2023.08.136] [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: 05/15/2023] [Revised: 08/12/2023] [Accepted: 08/20/2023] [Indexed: 10/01/2023]
Abstract
Obesity is a predictor of the development of systolic and diastolic heart failure (HF), but once established, patients with HF and obesity have better outcomes than their leaner counterparts, a phenomenon termed the "obesity paradox." We sought to investigate the impact of adipose tissue quantity and distribution, measured by way of computed tomography, on outcomes in patients with HF. Patients admitted for acute decompensated HF between January 2017 to December 2018 were retrospectively analyzed. Body composition measurements were made on computed tomography of the abdomen/pelvis. Visceral, subcutaneous, and intermuscular adipose tissues were measured at the mid-third lumbar vertebra, along with skeletal muscle and waist circumference. Paracardial (pericardial and epicardial) adipose tissue was measured at the mid-eight thoracic vertebra. Visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI), along with skeletal muscle index, were indexed for patient height. A total of 200 patients were included, 44.5% female. Body mass index and waist circumference did not significantly predict outcomes. Patients with high SATI (highest sex-stratified tertile) had significantly better survival (hazard ratio 0.58, 95% confidence interval 0.39 to 0.87, p = 0.009), whereas high VATI was nonsignificant. Patients were further divided into 4 groups based on both VATI and SATI. One- and 4-year mortality risks were lowest in those with low VATI high SATI compared with the other groups; this persisted after multivariable adjustment for covariates, including albumin and skeletal muscle index. In conclusion, the "obesity paradox" appears to be largely driven by subcutaneous adipose tissue, independent of nutrition or skeletal muscle.
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Affiliation(s)
- Saeid Mirzai
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Internal Medicine
| | | | - Pieter Martens
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute
| | - Po-Hao Chen
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jerry D Estep
- Department of Cardiology, Cleveland Clinic Florida, Weston, Florida
| | - W H Wilson Tang
- Kaufman Center for Heart Failure Treatment and Recovery, Heart Vascular and Thoracic Institute.
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Kim HJ, Jung DW, Williams DR. Age Is Just a Number: Progress and Obstacles in the Discovery of New Candidate Drugs for Sarcopenia. Cells 2023; 12:2608. [PMID: 37998343 PMCID: PMC10670210 DOI: 10.3390/cells12222608] [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: 10/23/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Sarcopenia is a disease characterized by the progressive loss of skeletal muscle mass and function that occurs with aging. The progression of sarcopenia is correlated with the onset of physical disability, the inability to live independently, and increased mortality. Due to global increases in lifespan and demographic aging in developed countries, sarcopenia has become a major socioeconomic burden. Clinical therapies for sarcopenia are based on physical therapy and nutritional support, although these may suffer from low adherence and variable outcomes. There are currently no clinically approved drugs for sarcopenia. Consequently, there is a large amount of pre-clinical research focusing on discovering new candidate drugs and novel targets. In this review, recent progress in this research will be discussed, along with the challenges that may preclude successful translational research in the clinic. The types of drugs examined include mitochondria-targeting compounds, anti-diabetes agents, small molecules that target non-coding RNAs, protein therapeutics, natural products, and repositioning candidates. In light of the large number of drugs and targets being reported, it can be envisioned that clinically approved pharmaceuticals to prevent the progression or even mitigate sarcopenia may be within reach.
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Affiliation(s)
| | - Da-Woon Jung
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
| | - Darren Reece Williams
- New Drug Targets Laboratory, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea;
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Zhou T, Ye J, Lin Y, Wang W, Feng S, Zhuo S, Zhong B. Impact of skeletal muscle mass evaluating methods on severity of metabolic associated fatty liver disease in non-elderly adults. Br J Nutr 2023; 130:1373-1384. [PMID: 36896599 PMCID: PMC10511683 DOI: 10.1017/s0007114523000399] [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: 09/28/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 03/11/2023]
Abstract
The study aimed to explore the relationships of skeletal muscle mass with disease severity in metabolic-associated fatty liver disease (MAFLD) patients with different methods. Consecutive subjects undergoing bioelectrical impedance analysis were included. The steatosis grade and liver fibrosis were evaluated by MRI-derived proton density fat fraction and two-dimensional shear wave elastography. The appendicular skeletal muscle mass (ASM) was adjusted by height2 (ASM/H2), weight (ASM/W) and BMI (ASM/BMI). Overall, 2223 subjects (50·5 %, MAFLD; 46·9 %, male) were included, with the mean age 37·4 ± 10·6 years. In multivariate logistic regression analysis, the subjects with the lowest quartile (Q1) of ASM/W or ASM/BMI had higher risk ratios for MAFLD (OR (95 % CI) in male: 2·57 (1·35, 4·89), 2·11(1·22, 3·64); in female: 4·85 (2·33, 10·01), 4·81 (2·52, 9·16), all P < 0·05, all for Q1 v. Q4). The MAFLD patients with lower quartiles of ASM/W had the higher risk OR for insulin resistance (IR), both in male and female (2·14 (1·16, 3·97), 4·26 (1·29, 14·02) for Q4 v. Q1, both P < 0·05). While the significant OR were not observed when ASM/H2 and ASM/BMI were used. There were significant dose-dependent associations between decreased ASM/W as well as ASM/BMI and moderate-severe steatosis (2·85(1·54, 5·29), 1·90(1·09, 3·31), both P < 0·05) in male MAFLD patients. In conclusion, ASM/W is superior to ASM/H2 and ASM/BMI in predicting the degree of MAFLD. A lower ASM/W is associated with IR and moderate-severe steatosis in non-elderly male MAFLD.
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Affiliation(s)
- Ting Zhou
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou510080, People’s Republic of China
| | - Junzhao Ye
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou510080, People’s Republic of China
| | - Yansong Lin
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou510080, People’s Republic of China
| | - Wei Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, Guangdong510080, People’s Republic of China
| | - Shiting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, Guangdong510080, People’s Republic of China
| | - Shuyu Zhuo
- Department of Nutrition, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou, Guangdong510080, People’s Republic of China
| | - Bihui Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan II Road, Yuexiu District, Guangzhou510080, People’s Republic of China
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Kwon HE, Ko N, Yuk D, Choi SW, Koh SE. Improved Muscle Mass and Function With Protein Supplementation in Older Adults With Sarcopenia: A Meta-Analysis. Ann Rehabil Med 2023; 47:358-366. [PMID: 37907227 PMCID: PMC10620490 DOI: 10.5535/arm.23076] [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: 06/19/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE : To systematically review the effects of protein supplementation in older adults with sarcopenia. METHODS : A systematic literature search was conducted in PubMed, Cochrane Library, and Embase databases until May 2023. The inclusion criteria were as follows: (1) randomized controlled trials with a quantitative study design; (2) studies with a study group of older adults with sarcopenia; (3) studies comparing muscle mass, muscle strength, and performance of older adults with sarcopenia after protein supplementation; and (4) studies published up to May 2023. RESULTS : Six retrospective comparative studies, including 715 patients, met the inclusion criteria. The nutritional supplementation group exhibited significant improvement in appendicular skeletal muscle mass (standardized mean difference [SMD]=0.41; 95% confidence interval [CI], 0.24-0.58; p<0.001; I2=1%), while handgrip strength (SMD=0.37; 95% CI, -0.32-1.07; p=0.29; I2=94%) and Short Physical Performance Battery (SPPB) (SMD=0.35; 95% CI, -0.47-1.18; p=0.40; I2=94%) showed a tendency for improvement. CONCLUSION : Nutritional supplementation with protein increased appendicular muscle mass in older adults with sarcopenia and improved handgrip strength and SPPB scores.
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Affiliation(s)
- Hyo Eun Kwon
- Department of Rehabilitation Medicine, Konkuk University Medical Center, and Konkuk University School of Medicine, Konkuk University, Seoul, Korea
| | - Nayeon Ko
- Department of Rehabilitation Medicine, Konkuk University Medical Center, and Konkuk University School of Medicine, Konkuk University, Seoul, Korea
| | - Doyoung Yuk
- Department of Rehabilitation Medicine, Konkuk University Medical Center, and Konkuk University School of Medicine, Konkuk University, Seoul, Korea
| | - Seo Won Choi
- Department of Rehabilitation Medicine, Konkuk University Medical Center, and Konkuk University School of Medicine, Konkuk University, Seoul, Korea
| | - Seong-Eun Koh
- Department of Rehabilitation Medicine, Konkuk University Medical Center, and Konkuk University School of Medicine, Konkuk University, Seoul, Korea
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Chung C, Kim AR, Jang IY, Jo MW, Lee S, Kim D, Kwon H, Kang DY, Lee SW. Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases: a randomised controlled trial study protocol. BMJ Open 2023; 13:e072698. [PMID: 37730392 PMCID: PMC10514628 DOI: 10.1136/bmjopen-2023-072698] [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: 02/12/2023] [Accepted: 07/27/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Rehabilitation is well known to improve clinical symptoms and decrease the risk of mortality in patients with chronic respiratory or cardiovascular diseases. We will evaluate the efficacy of smartphone application-based rehabilitation programmes in patients with chronic respiratory or cardiovascular diseases. METHODS AND ANALYSIS This single-centre single-blind randomised controlled trial will recruit a total of 162 participants from Asan Medical Center (81 patients each for pulmonary and cardiac rehabilitation, respectively). Participants will be assigned to the pulmonary or cardiac rehabilitation groups based on their underlying disease. Participants will be allocated randomly into the intervention or control groups at the ratio of 2:1 (54 and 27 patients). The intervention group will be provided with a smartphone application and undergo smartphone application-based rehabilitation for 12 weeks. The control group will receive the usual outpatient medical treatment without rehabilitation. Participants will be evaluated at baseline and at the end of the rehabilitation. The primary outcomes will be exercise capacity, such as maximal oxygen consumption on cardiopulmonary exercise test for both groups, chronic obstructive pulmonary disease assessment test for the pulmonary rehabilitation group, and Health-related Quality of Life Instrument with 8 Items questionnaires for the cardiac rehabilitation group. The secondary outcomes will include quality of life questionnaires, symptom scores, pulmonary function test and limb muscle test. ETHICS AND DISSEMINATION The study protocol was approved by the Institutional Review Board of Asan Medical Center. Written informed consent will be obtained from all participants prior to inclusion. The findings from this study will be disseminated through peer-reviewed scientific journals and conferences. TRIAL REGISTRATION NUMBER NCT05610358.
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Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea (the Republic of)
| | - Ah-Ram Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Min-Woo Jo
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Seongho Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Dongbum Kim
- LifeSemantics Corp, Seoul, Korea (the Republic of)
| | - Hee Kwon
- LifeSemantics Corp, Seoul, Korea (the Republic of)
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
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Li YS, Liu YL, Wang JJ, Haghbin N, Wang XH, Jiang WR, Qiu HN, Xia LF, Wu F, Lin CY, Li JB, Lin JN. Relationships Between Body Composition and Cognitive Impairment in Hospitalised Middle-Aged Type 2 Diabetic Patients. Diabetes Metab Syndr Obes 2023; 16:2389-2400. [PMID: 37581116 PMCID: PMC10423571 DOI: 10.2147/dmso.s418111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/29/2023] [Indexed: 08/16/2023] Open
Abstract
Objective The aim of this study was to elucidate the relationship between specific body composition and the risk of Cognitive Impairment (CI) in middle-aged Type 2 Diabetes Mellitus (T2DM) patients. Methods This cross-sectional study included 504 hospitalized patients with T2DM from the Department of Endocrinology and Metabolism of the Tianjin Union Medical Center. Subjects were grouped by sex, and cognitive status was assessed using the Montreal Cognitive Assessment (MoCA). The relationship between body composition and cognitive ability was investigated with the use of linear regression analysis. The association between body composition and CI risk was determined by logistic regression analysis. Results The prevalence of CI was 39.3% in middle-aged T2DM patients. After adjusting for age, education, marriage status, carotid atherosclerosis, cerebrovascular disease and hemoglobin, multiple linear regression analysis showed that lean mass index (LMI), body mass index (BMI) and appendicular skeletal muscle index (SMI) were significant predictors for the MoCA scores in men (p < 0.05). In addition, BMI (OR 0.913, 95% CI 0.840-0.992) and LMI (OR 0.820, 95% CI 0.682-0.916) were independent protective factors for CI in males. After adjusted for age, education, marriage status, dietary control of diabetes and cerebrovascular disease, visceral obesity (VO, OR 1.950, 95% CI 1.033-3.684) and abdominal obesity (AO, OR 2.537, 95% CI 1.191-5.403) were risk factors for CI in female patients. Conclusion The results suggest that there may be different mechanisms underlying the relationship of body compositions and cognitive performance between middle-aged male and female patients with T2DM. In addition, our finding of potential determinants of cognitive impairment may facilitate the development of intervention programs for middle-aged type 2 diabetic patients. Nevertheless, more large prospective studies looking at cognition and changes in body composition over time are needed in the future to further support their association.
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Affiliation(s)
- Yao-Shuang Li
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, People’s Republic of China
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Yan-Lan Liu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Jun-Jia Wang
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
- Tianjin Union Medical Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Nahal Haghbin
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiao-He Wang
- Institute of Non-Communicable Diseases Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, People’s Republic of China
| | - Wei-Ran Jiang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hui-Na Qiu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Long-Fei Xia
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, People’s Republic of China
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Fan Wu
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
- Tianjin Union Medical Center, School of Medicine, Nankai University, Tianjin, People’s Republic of China
| | - Chen-Ying Lin
- Tianjin Union Medical Center, Tianjin Medical University, Tianjin, People’s Republic of China
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Jing-Bo Li
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
| | - Jing-Na Lin
- Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, People’s Republic of China
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Shi S, Chen W, Jiang Y, Chen K, Liao Y, Huang K. A more accurate method to estimate muscle mass: A new estimation equation. J Cachexia Sarcopenia Muscle 2023; 14:1753-1761. [PMID: 37203296 PMCID: PMC10401528 DOI: 10.1002/jcsm.13254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 03/21/2023] [Accepted: 04/15/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Measurement of muscle mass is important in the diagnosis of sarcopenia. Current measurement equipment are neither cost-effective nor standardized and cannot be used in a variety of medical settings. Some simple measurement tools have been proposed that are subjective and unvalidated. We aimed to develop and validate a new estimation equation in a more objective and standardized way, based on current proven variables that accurately reflect muscle mass. METHODS Cross-sectional analysis with The National Health and Nutrition Examination Survey database for equation development and validation. Overall, 9875 participants were included for development (6913 participants) and validation (2962 participants), for whom the database included demographic data, physical measurements, and main biochemical indicators. Appendicular skeletal muscle mass (ASM) was estimated by dual-energy x-ray absorptiometry (DXA) and low muscle mass was defined by reference to five international diagnostic criteria. Linear regression was used to estimate the logarithm of the actual ASM from demographic data, physical measurements, and biochemical indicators. RESULTS This study of 9875 participants comprised 4492 females (49.0%), with a weighted mean (SE) age of 41.83 (0.36) years and range of 12 to 85 years. The estimated ASM equations performed well in the validation data set. The variability in estimated ASM was low compared with the actual ASM (R2 : Equation 1 = 0.91, Equation 4 = 0.89), with low bias (median difference: Equation 1 = -0.64, Equation 4 = 0.07; root mean square error: Equation 1 = 1.70 [1.69-1.70], Equation 4 = 1.85 [1.84-1.86]), high precision (interquartile range of the differences: Equation 1 = 1.87, Equation 4 = 2.17), and high efficacy in diagnosing low muscle mass (area under the curve: Equation 1 = 0.91 to 0.95, Equation 4 = 0.90 to 0.94). CONCLUSIONS The estimated ASM equations are accurate and simple and can be routinely applied clinically to estimate ASM and thus assess sarcopenia.
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Affiliation(s)
- Shanshan Shi
- Longyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
| | - Weihua Chen
- Longyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
| | - Yizhou Jiang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Kaihong Chen
- Longyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
| | - Ying Liao
- Longyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
| | - Kun Huang
- Center of Statistical Science, Department of Industrial EngineeringTsinghua UniversityBeijingChina
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Salagre D, Raya Álvarez E, Cendan CM, Aouichat S, Agil A. Melatonin Improves Skeletal Muscle Structure and Oxidative Phenotype by Regulating Mitochondrial Dynamics and Autophagy in Zücker Diabetic Fatty Rat. Antioxidants (Basel) 2023; 12:1499. [PMID: 37627494 PMCID: PMC10451278 DOI: 10.3390/antiox12081499] [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: 06/05/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Obesity-induced skeletal muscle (SKM) inflexibility is closely linked to mitochondrial dysfunction. The present study aimed to evaluate the effects of melatonin on the red vastus lateralis (RVL) muscle in obese rat models at the molecular and morphological levels. Five-week-old male Zücker diabetic fatty (ZDF) rats and their age-matched lean littermates (ZL) were orally treated either with melatonin (10 mg/kg body weight (BW)/24 h) (M-ZDF and M-ZL) or non-treated (control) (C-ZDF and C-ZL) for 12 weeks. Western blot analysis showed that mitochondrial fission, fusion, and autophagy were altered in the C-ZDF group, accompanied by reduced SIRT1 levels. Furthermore, C-ZDF rats exhibited depleted ATP production and nitro-oxidative stress, as indicated by increased nitrites levels and reduced SOD activity. Western blotting of MyH isoforms demonstrated a significant decrease in both slow and fast oxidative fiber-specific markers expression in the C-ZDF group, concomitant with an increase in the fast glycolytic fiber markers. At the tissue level, marked fiber atrophy, less oxidative fibers, and excessive lipid deposition were noted in the C-ZDF group. Interestingly, melatonin treatment partially restored mitochondrial fission/fusion imbalance in the RVL muscle by enhancing the expression of fission (Fis1 and DRP1) markers and decreasing that of fusion (OPA1 and Mfn2) markers. It was also found to restore autophagy, as indicated by increased p62 protein level and LC3BII/I ratio. In addition, melatonin treatment increased SIRT1 protein level, mitochondrial ATP production, and SOD activity and decreased nitrites production. These effects were associated with enhanced oxidative phenotype, as evidenced by amplified oxidative fiber-specific markers expression, histochemical reaction for NADH enzyme, and muscular lipid content. In this study, we showed that melatonin might have potential therapeutic implications for obesity-induced SKM metabolic inflexibility among patients with obesity and T2DM.
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Affiliation(s)
- Diego Salagre
- Department of Pharmacology, BioHealth Institute Granada (IBs Granada), Neuroscience Institute (CIBM), School of Medicine, University of Granada, 18016 Granada, Spain; (D.S.)
| | - Enrique Raya Álvarez
- Department of Rheumatology, University Hospital Clinic San Cecilio, 18016 Granada, Spain
| | - Cruz Miguel Cendan
- Department of Pharmacology, BioHealth Institute Granada (IBs Granada), Neuroscience Institute (CIBM), School of Medicine, University of Granada, 18016 Granada, Spain; (D.S.)
| | - Samira Aouichat
- Department of Pharmacology, BioHealth Institute Granada (IBs Granada), Neuroscience Institute (CIBM), School of Medicine, University of Granada, 18016 Granada, Spain; (D.S.)
| | - Ahmad Agil
- Department of Pharmacology, BioHealth Institute Granada (IBs Granada), Neuroscience Institute (CIBM), School of Medicine, University of Granada, 18016 Granada, Spain; (D.S.)
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Lee MK, Ryu H, Van JY, Kim MJ, Jeong HH, Jung WK, Jun JY, Lee B. The Role of Macrophage Populations in Skeletal Muscle Insulin Sensitivity: Current Understanding and Implications. Int J Mol Sci 2023; 24:11467. [PMID: 37511225 PMCID: PMC10380189 DOI: 10.3390/ijms241411467] [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: 06/16/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Insulin resistance is a crucial factor in the development of type 2 diabetes mellitus (T2DM) and other metabolic disorders. Skeletal muscle, the body's largest insulin-responsive tissue, plays a significant role in the pathogenesis of T2DM due to defects in insulin signaling. Recently, there has been growing evidence that macrophages, immune cells essential for tissue homeostasis and injury response, also contribute to the development of skeletal muscle insulin resistance. This review aims to summarize the current understanding of the role of macrophages in skeletal muscle insulin resistance. Firstly, it provides an overview of the different macrophage populations present in skeletal muscle and their specific functions in the development of insulin resistance. Secondly, it examines the underlying mechanisms by which macrophages promote or alleviate insulin resistance in skeletal muscle, including inflammation, oxidative stress, and altered metabolism. Lastly, the review discusses potential therapeutic strategies targeting macrophages to improve skeletal muscle insulin sensitivity and metabolic health.
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Affiliation(s)
- Min-Kyeong Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea; (M.-K.L.); (H.R.)
| | - Heeyeon Ryu
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea; (M.-K.L.); (H.R.)
| | - Ji Yun Van
- Department of Smart Green Technology Engineering, Pukyong National University, Busan 48513, Republic of Korea; (J.Y.V.)
| | - Myeong-Jin Kim
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea; (M.-K.L.); (H.R.)
| | - Hyeon Hak Jeong
- Department of Smart Green Technology Engineering, Pukyong National University, Busan 48513, Republic of Korea; (J.Y.V.)
| | - Won-Kyo Jung
- Division of Biomedical Engineering and Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, Republic of Korea;
| | - Joo Yun Jun
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA;
| | - Bonggi Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea; (M.-K.L.); (H.R.)
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