The effect of blood glucose regulation on sarcopenia parameters in obese and diabetic patients

Sex Differences of Sarcopenia in an Elderly Asian Population: The Prevalence and Risk Factors

The loss of muscle mass is widespread in age-related health phenomena in the elderly population. This study examined the prevalence of sarcopenia in a community-dwelling elderly population according to gender. The study also identified gender-specific risk factors in older people aged 75-84 years old. One thousand two hundred and ninety-three participants aged between 75 and 84 years from the National Health and Nutrition Examination Surveys in Korea were investigated. The prevalence of sarcopenia in males and females in the weighted-value sample was 41.2% (95%CI: 35.8-46.8) and 37.2% (32.7-41.9), respectively. Gender-specific clinical risk factors in males were height, weight, body mass index, waist circumference, skeletal muscle mass index, fasting glucose, and triglyceride levels. Height, weight, body mass index, waist circumference, skeletal muscle mass index, and total cholesterols were clinical risk factors for females. These outcomes would be crucial to primary care clinicians and health care professionals when patients require a referral for early detection and treatment. Health care professionals and clinicians can quickly identify potential sarcopenic patients by acknowledging the gender-specific prevalence and risk factors.

Gender-Specific Risk Factors and Prevalence for Sarcopenia among Community-Dwelling Young-Old Adults

Sarcopenia in the elderly is a serious global public health problem. Numerous sarcopenia studies classified their subjects into a single group, but health conditions and body composition vary according to age. This study examined the prevalence of sarcopenia according to gender and assessed the gender-specific risk factors in young-old adults. In this study, 2697 participants in Korea aged from 65 to 74 years were analyzed from Korea National Health and Nutrition Examination Surveys. The prevalence of sarcopenia in males and females was 19.2% (CI 95%: 16.4–22.3) and 26.4% (23.7–29.4), respectively. The risk factors in men were age, body mass index (BMI), waist circumference (WC), skeletal muscle index (SMI), fasting glucose (FG), triglyceride, and systolic blood pressure (SBP). Their odd ratios were 1.447, 0.102, 1.494, 0.211, 0.877, 1.012, and 1.347. The risk factors in women were age, height, weight, BMI, WC, SMI, and fasting glucose with values of 1.489, 0.096, 0.079, 0.158, 0.042, and 1.071, respectively. The prevalence of sarcopenia was higher in females than in males. Overall, the clinical risk factors in males were age, height, BMI, WC, SMI, FG, triglyceride, and SBP. Age, height, weight, BMI, WC, SMI, and FG were the risk factors for women.

Effects of an isometric exercise training program on muscular strength, ankle mobility, and balance in patients with diabetic peripheral neuropathy in the lower legs in South Africa

Background

Patients who suffer from diabetic peripheral neuropathy in the lower leg experience a greater risk of falls due to a decrease in strength of the lower extremities.

Methods

Fourteen participants, diagnosed with diabetic peripheral neuropathy or nocturnal allodynia in either one or both extremities, volunteered to participate in this study. Participants were purposively selected from two private Podiatry practices based on their signs and symptoms, age, gender, and doctor’s clearance to participate in any form of physical activity. Dependent variables included isometric muscle strength of the hip, knee and ankle, range of motion of the ankle in plantarflexion and dorsiflexion and an assessment of balance, which were measured pre- and post-intervention. The researcher developed a scientifically based exercise intervention program to target the entire kinetic chain, and to develop a standard isometric protocol for patients with DPN. The intervention program consisted of a combination of ankle, hip, and knee specific rehabilitation. The intervention took place 3 times a week for 45 min per session.

Results

The Mann-Whitney test was used to evaluate the differences in dependent variables from pre- to post-intervention. The level of significance was set at p<0.05. Notable increases were observed in range of motion in ankle plantarflexion and in balance time in the intervention group, post-intervention.

Conclusions

Although many of the changes noted were insignificant, the trends indicated an improvement in the intervention group over the 10-week intervention period. These improvements can be considered clinically important.

Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: A cross-sectional study

We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO.Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients.The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher (P < .05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased (P < .05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r = 0.303, P = .004 vs. r = -0.491, P < .001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965-1.338, P = .002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity = 78.1%, sensitivity = 75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P = .055).This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO.

Development of Taiwan Risk Score for Sarcopenia (TRSS) for Sarcopenia Screening among Community-Dwelling Older Adults

The SARC-F questionnaire has been suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as a first-step screening tool for sarcopenia. However, the sensitivity to SARC-F is low among community-dwelling older adults. Therefore, this study aimed to develop a new prediction model for sarcopenia screening in the community setting. We conducted a cross-sectional analysis of data from the Taiwan Integration of Health and Welfare (TIHW) study. Covariates including comorbidities, socioeconomic status, social support, health behaviors, body composition, and serum biomarkers were collected for analysis. Sarcopenia was defined using handgrip strength and gait speed cut-off values suggested by the Asian Working Group for Sarcopenia. Risk scores for sarcopenia were estimated by stepwise logistic regression. Among 1025 participants (mean age, 71.95 ± 6.89 years), 179 (17.5%) had sarcopenia. Seven items, including age, female sex, receiving social assistance pension, absence of exercise, being underweight, abnormal fasting glucose levels, and abnormal creatinine levels were selected for the Taiwan Risk Scores for Sarcopenia (TRSS) with a cutoff value of 76 (sensitivity, 71.8%; specificity, 71.1%) and area under the curve (AUC) of 0.757. Our results suggested that the TRSS model could be applied cost-effectively in the community for early detection of sarcopenia.