1001
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Espinel-Bermúdez MC, Sánchez-García S, García-Peña C, Trujillo X, Huerta-Viera M, Granados-García V, Hernández-González S, Arias-Merino ED. [Associated factors with sarcopenia among Mexican elderly: 2012 National Health and Nutrition Survey]. Rev Med Inst Mex Seguro Soc 2018; 56:S46-S53. [PMID: 29624960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sarcopenia involves the loss of skeletal muscle mass and age-related functionality; it diminishes physical independence, health and quality of life. In 2016 it was added to the International Classification of Diseases (ICD-10). Information about the frequency of sarcopenia among Mexican older adults is scarce. The objective was to analyze associated factors with sarcopenia in Mexican older adults through the 2012 National Health and Nutrition Survey data. METHODS Cross-sectional study which included subjects of 60 years of age or more with simultaneous information on health and anthropometry questionnaires from the 2012 National Health and Nutrition Survey. Sarcopenia was diagnosed through a gait speed test and calf circumference. It was assessed the prevalence of sarcopenia and its association with sociodemographic characteristics and variables related to health, tobacco use and alcohol consumption. The analysis was performed with SPSS v. 16. RESULTS We analyzed a sample of 5046 older adults who represented 7 439 686 older adults nationwide. Among subjects 53.9% (n = 2718) were women (mean age 69.92 ± 7.56 years) and 46.1% (n = 2328), men (mean age 70.43 ± 7.73 years). Prevalence of presarcopenia was 8.70% and sarcopenia, 13.30%. CONCLUSION Sarcopenia was more prevalent in women and it increases with age. It has a significant relationship with falls, cognitive impairment, central obesity and high levels of marginalization.
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Affiliation(s)
| | - Sergio Sánchez-García
- Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud, Centro Médico Nacional Siglo XXI, Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento. Ciudad de México, México
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1002
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As'habi A, Najafi I, Tabibi H, Hedayati M. Prevalence of Sarcopenia and Dynapenia and Their Determinants in Iranian Peritoneal Dialysis Patients. Iran J Kidney Dis 2018; 12:53-60. [PMID: 29421778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/24/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Uremic sarcopenia and dynapenia are prevalent in chronic kidney disease patients, including dialysis patients. The present study was designed to determine the prevalence of sarcopenia and dynapenia and their determinants in peritoneal dialysis (PD) patients in Tehran, Iran. MATERIALS AND METHODS All eligible PD patients at the peritoneal dialysis centers of Tehran were included in this cross-sectional study. Skeletal muscle mass and muscle strength were assessed using bioelectrical impedance analysis and hand grip strength, respectively. Physical performance was determined by a 4-m walk gait speed test. RESULTS The prevalence rates of dynapenia and sarcopenia were 43.0% and 11.5% in the PD patients, respectively. There were significant associations between the prevalence of dynapenia and the age of patients (P = .03), physical activity level (P = .04), and the presence of diabetes mellitus (P = .005). In addition, a significant association was found between the prevalence of sarcopenia and sex (P = .009). CONCLUSIONS This study indicates that uremic sarcopenia and dynapenia are prevalent in PD patients in Tehran, Iran. These conditions may contribute to physical disability, decreased the quality of life, increased morbidity, and a high mortality rate. Therefore, prevention and treatment of uremic sarcopenia and dynapenia are necessary for Iranian PD patients.
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Affiliation(s)
| | | | - Hadi Tabibi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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1003
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Mohseni R, Aliakbar S, Abdollahi A, Yekaninejad MS, Maghbooli Z, Mirzaei K. Relationship between major dietary patterns and sarcopenia among menopausal women. Aging Clin Exp Res 2017; 29:1241-1248. [PMID: 28224473 DOI: 10.1007/s40520-016-0721-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 12/23/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Dietary habits have been associated with the prevalence of the sarcopenia and limited data are available in this field for menopausal women. This study focused on the relationship between dietary patterns and prevalence of the sarcopenia in menopausal women. METHODS This cross-sectional study was done in 250 menopausal women 45 years old or older. Dietary data were collected using a food-frequency questionnaire and physical activity was assessed by International Physical Activity Questionnaire (IPAQ). Height, weight, skeletal muscle mass, hand grip, and gait speed were measured and sarcopenia was defined based on European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. RESULTS Using factor analysis, two major dietary patterns were found: a Western pattern (high in commercial beverage, sugar and dessert, snacks, solid fat, potato, high fat dairy, legume, organ meat, fast food, and sweets) and a Mediterranean pattern (high in olive, low-fat dairy, vegetable, fish, nut, and vegetable oil). After adjusting for confounding variables, for the highest vs the lowest tertiles, the Odds Ratio (OR) for sarcopenia was 1.06 [95% confidence interval (CI), 0.47-2.37] in the Western pattern and 0.40 [95% confidence interval (CI), 0.17-0.89] in the Mediterranean pattern. CONCLUSIONS Our findings suggest that Mediterranean dietary pattern has a favorable role in the prevention of sarcopenia.
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Affiliation(s)
- Reza Mohseni
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sima Aliakbar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Afsoun Abdollahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Zhila Maghbooli
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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1004
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Marty E, Liu Y, Samuel A, Or O, Lane J. A review of sarcopenia: Enhancing awareness of an increasingly prevalent disease. Bone 2017; 105:276-286. [PMID: 28931495 DOI: 10.1016/j.bone.2017.09.008] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/13/2017] [Accepted: 09/15/2017] [Indexed: 02/07/2023]
Abstract
Sarcopenia is defined as an age associated decline in skeletal muscle mass. The pathophysiology of sarcopenia is multifactorial, with decreased caloric intake, muscle fiber denervation, intracellular oxidative stress, hormonal decline, and enhanced myostatin signaling all thought to contribute. Prevalence rates are as high as 29% and 33% in elderly community dwelling and long-term care populations, respectively, with advanced age, low body mass index, and low physical activity as significant risk factors. Sarcopenia shares many characteristics with other disease states typically associated with risk of fall and fracture, including osteoporosis, frailty, and obesity. There is no current universally accepted definition of sarcopenia. Diagnosing sarcopenia with contemporary operational definitions requires assessments of muscle mass, muscle strength, and physical performance. Screening is recommended for both elderly patients and those with conditions that noticeably reduce physical function. Sarcopenia is highly prevalent in orthopedic patient populations and correlates with higher hospital costs and rates of falling, fracture, and mortality. As no muscle building agents are currently approved in the United States, resistance training and nutritional supplementation are the primary methods for treating sarcopenia. Trials with various agents, including selective androgen receptor modulators and myostatin inhibitors, show promise as future treatment options. Increased awareness of sarcopenia is of great importance to begin reaching consensus on diagnosis and to contribute to finding a cure for this condition.
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Affiliation(s)
- Eric Marty
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
| | - Yi Liu
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
| | - Andre Samuel
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
| | - Omer Or
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States
| | - Joseph Lane
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, United States.
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1005
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Aguirre LE, Colleluori G, Dorin R, Robbins D, Chen R, Jiang B, Qualls C, Villareal DT, Armamento-Villareal R. Hypogonadal Men with Higher Body Mass Index have Higher Bone Density and Better Bone Quality but Reduced Muscle Density. Calcif Tissue Int 2017; 101:602-611. [PMID: 28856390 PMCID: PMC8091556 DOI: 10.1007/s00223-017-0316-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/11/2017] [Indexed: 10/19/2022]
Abstract
Although hypogonadism is a risk factor for bone loss and fractures, the different etiopathophysiology and hormonal profile of classical and obesity-induced hypogonadism may lead to differences in musculoskeletal profile. This is a cross-sectional study of hypogonadal men between 40 and 74 years old. Our outcomes include: areal bone mineral density (aBMD) and body composition by dual-energy X-ray absorptiometry; volumetric BMD (vBMD) and soft tissue composition of the tibia by peripheral quantitative computed tomography. Fracture risk assessment tool (FRAX) scores were evaluated. Testosterone, estradiol, luteinizing hormone, follicle stimulating hormone, sex hormone-binding globulin, C-telopeptide, osteocalcin, and sclerostin were measured. We divided the population into subgroups of BMI: group 1: BMI < 30; group 2: BMI ≥30 to <35 and group 3: BMI ≥ 35 kg/m2. One-hundred five men were enrolled. Spine and hip aBMD, and total and trabecular vBMD at the 4% tibia significantly increased with increasing BMI. Cortical thickness (330.7 ± 53.2, 343.3 ± 35.4, and 358.7 ± 38.2 mm, p = 0.04; groups 1, 2 and 3, respectively) and cortical area (5.3 ± 0.7, 5.5 ± 0.6, and 5.7 ± 0.6 mm, p = 0.01; groups 1, 2 and 3, respectively) at 38% tibia increased with increasing BMI. While absolute lean mass increased with increasing BMI, % lean mass and muscle density (70.2 ± 5.0, 71.3 ± 6.4, and 67.1 ± 5.1 mg/cm3; groups 1, 2 and 3, respectively) were lowest in group 3. Although severely obese hypogondal men have better BMD and bone quality, they have reduced muscle density, the significance of which remains to be determined.
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Affiliation(s)
- Lina E Aguirre
- Department of Medicine, New Mexico VA Health Care System, Albuquerque, NM, USA
- Biomedical Research of New Mexico, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Georgia Colleluori
- University Campus Bio-Medico of Rome, Rome, Italy
- Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Richard Dorin
- Department of Medicine, New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - David Robbins
- Department of Medicine, New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Rui Chen
- Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Bryan Jiang
- Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Clifford Qualls
- Department of Medicine, New Mexico VA Health Care System, Albuquerque, NM, USA
- Biomedical Research of New Mexico, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Dennis T Villareal
- Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Reina Armamento-Villareal
- Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA.
- Baylor College of Medicine, Houston, TX, USA.
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1006
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Im IJ, Choi HJ, Jeong SM, Kim HJ, Son JS, Oh HJ. The association between muscle mass deficits and arterial stiffness in middle-aged men. Nutr Metab Cardiovasc Dis 2017; 27:1130-1135. [PMID: 29170061 DOI: 10.1016/j.numecd.2017.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/25/2017] [Accepted: 10/01/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Early diagnosis of arteriosclerosis is fundamental for the prevention of cardiovascular morbidity and mortality. The current study was performed to identify major predictors of arteriosclerosis and to assess the association between arterial stiffness as measured by cardio-ankle vascular index (CAVI) and muscle mass deficit (MMD) estimated by bioelectrical impedance analysis (BIA) in middle-aged men. METHODS AND RESULTS Data were gathered from 3356 middle-aged men who visited a health promotion center. CAVI was measured as an index of arterial stiffness. Body composition analysis was performed using BIA. MMD was positively associated with CAVI in the regression model. The odds ratios for high-CAVI (≥9.0) rose with MMD grade in a dose-dependent manner after adjusting for age, lifestyle factors and current medication use. The estimated mean CAVI rose as MMD grade increased (P for trend >0.001). CONCLUSIONS MMD estimated from BIA was positively associated with arterial stiffness in middle-aged men. These findings show a close interaction between low muscle mass and cardiovascular risk.
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Affiliation(s)
- I J Im
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - H J Choi
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea.
| | - S M Jeong
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - H J Kim
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - J S Son
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - H J Oh
- Department of Family Medicine, Eulji University Hospital, Daejeon, Republic of Korea
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1007
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Davies B, García F, Ara I, Artalejo FR, Rodriguez-Mañas L, Walter S. Relationship Between Sarcopenia and Frailty in the Toledo Study of Healthy Aging: A Population Based Cross-Sectional Study. J Am Med Dir Assoc 2017; 19:282-286. [PMID: 29079029 DOI: 10.1016/j.jamda.2017.09.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Frailty and sarcopenia are correlates of musculoskeletal aging that represent a state of vulnerability increasing the risk of negative health outcomes. Standardized definitions are lacking for both, and sometimes both concepts are used interchangeably. However, no large study has assessed the coexistence of these 2 entities in a cohort of older community-dwelling people. METHODS Data were taken from the Toledo Study of Healthy Aging (TSHA), a study of community-dwelling elderly (≥65 years). The study population consists of 1611 participants with frailty and sarcopenia assessments. For sarcopenia, we used 3 criteria: European Working Group on Sarcopenia in Older People (EWGSOP), the Foundation for the National Institutes of Health (FNIH), and the FNIH fitted to the cut-off points of our population [standardized FNIH (sFNIH)]. Frailty was assessed according to the Fried criteria with cut-off points adjusted to our population. We used logistic regression to assess the relationship between sarcopenia and frailty and measures of diagnostic accuracy to evaluate the potential use of sarcopenia as a diagnostic marker for frailty. RESULTS The mean age of the population was 75.42 years (±5.86). Overall, 72 (4.5%) were frail. In addition, 352 (21.8%), 332 (20.6%), and 453 (28.1%) participants were considered sarcopenic according to the EWGSOP, FNIH, and sFNIH criteria, respectively. The prevalence of frailty among those with sarcopenia was 8.2% (29/352), 15.7% (52/332), and 10.4% (47/453). Moreover, among frail people, the prevalence of sarcopenia was 40.27%, 72.2%, and 65.3% according to the used criteria. Sarcopenia showed a low sensitivity (<10%) but high specificity (>97%) for the diagnosis of frailty, with a low intercorrelation (Cramer V = 0.16, 0.40, and 0.30) between the 3 criteria and frailty. Using multivariate logistic regression, frailty was associated with sarcopenia according to EWGSOP [odds ratio (OR) = 1.67, 95% confidence interval (CI) = 0.95, 2.96], FNIH (OR = 10.61, 95% CI = 5.8, 19.4), and sFNIH (OR = 6.63, 95% CI =3.5, 12.53). CONCLUSION Frailty and sarcopenia are distinct but related conditions. Sarcopenia is not a useful clinical biomarker of frailty, but its absence might be useful to exclude frailty.
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Affiliation(s)
- B Davies
- Fundación para la Investigación Biomédica Getafe University Hospital, Madrid, Spain
| | - F García
- Geriatrics Department, Virgen del Valle Hospital, Toledo, Spain; CIBER of Frailty and Healthy Aging-CIBERFES
| | - I Ara
- CIBER of Frailty and Healthy Aging-CIBERFES; Faculty of Sport Sciences, University of Castilla La Mancha, Spain
| | - F Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health-CIBERESP
| | - L Rodriguez-Mañas
- Fundación para la Investigación Biomédica Getafe University Hospital, Madrid, Spain; CIBER of Frailty and Healthy Aging-CIBERFES; Geriatrics Department, Getafe University Hospital, Madrid, Spain.
| | - S Walter
- Fundación para la Investigación Biomédica Getafe University Hospital, Madrid, Spain; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
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1008
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Tuzun S, Oner C, Dabak MR, Kasikci HO, Sargin M. Relation of Muscle Indices with Metabolic Parameters and C-Peptide in Type 2 Diabetes Mellitus. J Coll Physicians Surg Pak 2017; 27:673-677. [PMID: 29132475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the relation between bioimpedance measurements and metabolic parameters and C-peptide in patient with type 2 diabetes mellitus (DM). STUDY DESIGN Cross-sectional study. PLACE AND DURATION OF STUDY Kartal Dr Lutfi Kirdar Training and Research Hospital, Pendik Kaynarca Diabetes Center, Exercise and Metabolism Unit, between January and March 2015. METHODOLOGY Patients with DM, aged less than 65 years, were assessed for bioimpedance analysis, fasting plasma glucose (FPG), HbA1c, C-peptide levels, triglyceride levels, LDL-cholesterol, and HDL-cholesterol levels. Skeletal muscle index, total muscle index, skeletal muscle percentage, and total muscle percentage were used for muscle-related analyses. Mann-Whitney U-test or independent t-test were used to compare differences between two independent groups. Pearson correlation test or Spearman correlation test were used to find out correlation between variables. RESULTS Atotal of 359 DM patients were enrolled in the study. Mean age was 51.6 ±8.0 years, and 278 (77.7%) of the participants were females. After adjusting age and gender variables, there was no relation between muscle-related measurements and FPG, triglyceride, LDL-cholesterol (p>0.05). However, there was muscle-related indexes (MRI) positively correlation with C-peptide and inversely associated with HDL-cholesterol (p<0.05). CONCLUSION Muscle-related indices positively correlated with C-peptide, which showed endogenous insulin reserve.
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Affiliation(s)
- Sabah Tuzun
- Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Can Oner
- Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - M Resat Dabak
- Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Halim Omer Kasikci
- Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Sargin
- Department of Family Medicine, Istanbul Medeniyet University Medical School, Istanbul, Turkey
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1009
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Abstract
PURPOSE OF REVIEW The review summarizes recent epidemiological studies that examined the relationship between osteoporosis and sarcopenia to assess the impact of vitamin D status or supplementation on health outcomes related to these two medical conditions. RECENT FINDINGS Osteoporosis and sarcopenia are major public health problems, but whether these two diseases should be considered alone or combined into a single condition is not clear. No consensual definition of osteosarcopenia is largely accepted. Most observational studies demonstrate some relationship between muscle and bone health. Vitamin D status is generally lower in study participants with bone or muscle wasting. Studies on the effects of vitamin D supplementation on muscle or bone health have provided conflicting results, likely because of the heterogeneity between studies. However, the most positive results were observed in study participants with low vitamin D status and in studies that avoided massive boluses of vitamin D. SUMMARY More observational and interventional studies are needed to confirm the exact role of vitamin D in the pathophysiology and treatment of osteosarcopenia.
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Affiliation(s)
- Olivier Bruyère
- Department of Public Health, Epidemiology, and Health Economics
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
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1010
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Abstract
Hormonal alterations with aging contribute to the pathogenesis of several diseases. Androgens mediate their effects predominantly through binding to the androgen receptor (AR), a member of the ligand-dependent nuclear receptor superfamily. By androgen treatment, AR is recruited to specific genomic loci dependent on tissue specific pioneer factors to regulate target gene expression. Recent studies have revealed the epigenetic modulation by AR-associated histone modifiers and the roles of non-coding RNAs in AR signaling. Androgens are male sex hormone to induce differentiation of the male reproductive system required for the establishment of adult sexual function. As shown by several reports using AR knockout mouse models, androgens also have anabolic functions in several tissues such as bone, muscle and central nervous systems. Notably, AR has a central role in prostate cancer progression. Prostate cancer is the most frequently diagnosed cancer in men. Androgen-deprivation therapy for cancer patients and decline of serum androgen with aging promote several diseases associated with aging and quality of life of older men such as osteoporosis, sarcopenia and dementia. Thus, androgen replacement therapy for treating late onset hypogonadism (LOH) or new epigenetic regulators have the potential to overcome the symptoms caused by the low androgen, although adverse effects for cardiovascular diseases have been reported. Given the increasing longevity and consequent rise of age-related diseases and prostate cancer patients, a more understanding of the AR actions in male health remains a high research priority.
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Affiliation(s)
- Ken-Ichi Takayama
- Department of Functional Biogerontology, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo 173-0015, Japan
- Department of Geriatric Medicine, Graduate School of Medicine, the University of Tokyo, Japan
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1011
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Abstract
As the world's population ages, the prevalence of chronic diseases increases. Sarcopenia and osteoporosis are two conditions that are associated with aging, with similar risk factors that include genetics, endocrine function, and mechanical factors. Additionally, bone and muscle closely interact with each other not only anatomically, but also chemically and metabolically. Fat infiltration, a phenomenon observed in age-related bone and muscle loss, is highly prevalent and more severe in sarcopenic and osteoporotic subjects. Clinically, when individuals suffer a combination of both disorders, negative outcomes such as falls, fractures, loss of function, frailty, and mortality increase, thus generating significant personal and socio-economic costs. Therefore, it is suggested that when bone mineral density loss is synchronic with decreased muscle mass, strength, and function, it should be interpreted as a single diagnosis of osteosarcopenia, which may be preventable and treatable. Simple interventions such as resistance training, adequate protein and calcium dietary intake, associated with maintenance of appropriate levels of vitamin D, have a dual positive effect on bone and muscle, reducing falls, fractures, and, consequently, disability. It is essential that fracture prevention approaches-including postfracture management-involve assessment and treatment of both osteoporosis and sarcopenia. This is of particular importance as in older persons the combination of osteopenia/osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of institutionalization, falls, and fractures. This review summarizes osteosarcopenia epidemiology, pathophysiology, diagnosis, outcomes, and management strategies.
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Affiliation(s)
- H P Hirschfeld
- Department of Geriatrics and Gerontology, Federal University of São Paulo, 1500 Sena Madureira Avenue, São Paulo, Brazil
| | - R Kinsella
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Level 3 WCHRE Building, 176 Furlong Road, St. Albans, VIC, 3021, Australia
| | - G Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Level 3 WCHRE Building, 176 Furlong Road, St. Albans, VIC, 3021, Australia.
- Department of Medicine, Melbourne Medical School - Western Health, The University of Melbourne, St. Albans, VIC, 3021, Australia.
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1012
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Steihaug OM, Gjesdal CG, Bogen B, Kristoffersen MH, Lien G, Ranhoff AH. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study. PLoS One 2017; 12:e0184780. [PMID: 28902873 PMCID: PMC5597226 DOI: 10.1371/journal.pone.0184780] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 08/30/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. METHODS A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. RESULTS Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. CONCLUSIONS Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.
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Affiliation(s)
- Ole Martin Steihaug
- Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Clara Gram Gjesdal
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Bård Bogen
- Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway
- Bergen University College, Bergen, Norway
| | | | - Gunhild Lien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Anette Hylen Ranhoff
- Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- * E-mail:
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1013
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González-Montalvo JI, Alarcón T, Menéndez-Colino R, Ríos-Germán PP, Queipo R, Otero A. [Fequency of sarcopenia and characteristics of the patients studied using uniform EWGSOP criteria in Spanish studies]. Rev Esp Geriatr Gerontol 2017; 52:293-294. [PMID: 28209369 DOI: 10.1016/j.regg.2016.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Juan I González-Montalvo
- Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, España; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, España.
| | - Teresa Alarcón
- Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, España; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | - Rocío Menéndez-Colino
- Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | | | - Rocío Queipo
- Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, España; Departamento de Medicina Preventiva, Universidad Autónoma de Madrid, Madrid, España
| | - Angel Otero
- Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, España; Departamento de Medicina Preventiva, Universidad Autónoma de Madrid, Madrid, España
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1014
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Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications 2017; 31:1465-1473. [PMID: 28669464 DOI: 10.1016/j.jdiacomp.2017.05.003] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 12/14/2022]
Abstract
Diabetes increases the risk of physical dysfunction and disability. Diabetes-related complications and coexisting morbidities partially explain the deterioration in physical function. The decline in muscle mass, strength and function associated with diabetes leads to sarcopenia, frailty and eventually disability. Frailty acts as a mediator in the pathogenesis of disability in older people with diabetes and its measurement in routine daily practice is recommended. Frailty is a dynamic process which progresses from a robust condition to a pre-frail stage then frailty and eventually disability. Therefore, a multimodal intervention which includes adequate nutrition, exercise training, good glycaemic control and the use of appropriate hypoglycemic medications may help delay or prevent the progression to disability.
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Affiliation(s)
- Alan J Sinclair
- University of Aston and Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK.
| | - Ahmed H Abdelhafiz
- Department of Elderly Medicine, Rotherham General Hospital, Moorgate Road, Rotherham, UK
| | - Leocadio Rodríguez-Mañas
- Hospital Universitario de Getafe, Department of Geriatrics and School of Health Sciences, Universidad Europea de Madrid, Spain
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1015
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Abstract
Sarcopenia is an age-related syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength; it is a major contributor to the risk of physical frailty, functional impairment in older people, poor health-related quality of life and premature death. Many different definitions have been used to describe sarcopenia and have resulted in varying estimates of prevalence of the condition. The most recent attempts of definitions have tried to integrate information on muscle mass, strength and physical function and provide a definition that is useful in both research and clinical settings. This review focuses on the epidemiology of the three distinct physiological components of sarcopenia, and highlights the similarities and differences between their patterns of variation with age, gender, geography and time and the individual risk factors that cluster selectively with muscle mass, strength and physical function. Methods used to measure muscle mass, strength and physical functioning and how differences in these approaches can contribute to the varying prevalence rates will also be described. The evidence for this review was gathered by undertaking a systematic search of the literature. The descriptive characteristics of muscle mass, strength and function described in this review point to the urgent need for a consensual definition of sarcopenia incorporating these parameters.
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Affiliation(s)
- S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LE, UK.
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1016
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Abstract
PURPOSE OF REVIEW The aim of this study was to review the most recent aspects of nutrition and its impact on health-related quality of life (HRQOL) in patients with chronic hepatitis C (CHC). RECENT FINDINGS Low HRQOL scores have been found in all stages of hepatitis C virus (HCV) infection. Of the factors linked to HRQOL, three aspects should be emphasized, nutritional status, physical activity and mental health status. Regarding the nutrition and metabolic conditions, a broad spectrum of nutritional disorders may impact on HRQOL of patients with CHC. SUMMARY Malnutrition, which is a significant comorbidity in end-stage of all chronic liver diseases, has been recognized as a significant factor related to poor HRQOL. Of note, in individuals chronically infected with HCV, low muscle skeletal mass, an early indicator of undernourishment, precedes the development of cirrhosis. Because of the strict linkage between HRQOL, nutrition and physical activity, the assessment of the musculoskeletal system abnormalities in every patient with CHC, independently of the stage of the liver disease, is of utmost relevance. Maintenance of healthy skeletal muscle is essential to reduce the negative effects of sarcopenia on HRQOL. Otherwise, overweight/obesity and chronic HCV infection can cause insulin resistance, which has been associated with HRQOL impairment.
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Affiliation(s)
- Luciana D Silva
- aDepartment of Internal Medicine, Medical School bAmbulatory of Viral Hepatitis, Alfa Institute of Gastroenterology, Medical School cLaboratory of Research in Bacteriology, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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1017
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Han P, Yu H, Ma Y, Kang L, Fu L, Jia L, Chen X, Yu X, Hou L, Wang L, Zhang W, Yin H, Niu K, Guo Q. The increased risk of sarcopenia in patients with cardiovascular risk factors in Suburb-Dwelling older Chinese using the AWGS definition. Sci Rep 2017; 7:9592. [PMID: 28851881 PMCID: PMC5575090 DOI: 10.1038/s41598-017-08488-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 07/10/2017] [Indexed: 12/25/2022] Open
Abstract
The aim of the present study is to investigate the relationship between sarcopenia and cardiovascular risk factors (CVRF) in the Chinese elderly. A total of 1611 elderly individuals aged ≥60 years were enrolled in this study. The well-established CVRF of diabetes, hypertensions, and dyslipidemia were assessed. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Multiple logistic regression analyses and the linear regressions were used to evaluate the components of CVRF and the number of CVRF of elderly patients with sarcopenia. After adjusting for potential confounders, CVRF was associated with a high prevalence of sarcopenia in elderly Chinese populations. Furthermore, diabetes and hypertension, but not dyslipidemia, were found to be significantly associated with sarcopenia. The OR and 95% CI for sarcopenia of the participants with 1, 2, and 3 features of CVRF were 2.27(1.14-4.48), 4.13(1.80-9.46), and 4.90(1.01-23.81), respectively. A linear increase in the prevalence of sarcopenia was found to be associated with the number of CVRF components in the elderly population (P values for the trends < 0.001). Knowledge of known CVRF, particularly diabetes and hypertension, may help predict the risk for sarcopenia in the elderly.
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Affiliation(s)
- Peipei Han
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Li Kang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liye Jia
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Wang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Haifang Yin
- Department of Cell Biology and Research Center of Basic Medical Science, Tianjin Medical University, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute, Tianjin Medical University, Tianjin, China
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China.
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1018
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Williams GR, Deal AM, Muss HB, Weinberg MS, Sanoff HK, Guerard EJ, Nyrop KA, Pergolotti M, Shachar SS. Frailty and skeletal muscle in older adults with cancer. J Geriatr Oncol 2017; 9:68-73. [PMID: 28844849 DOI: 10.1016/j.jgo.2017.08.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 07/07/2017] [Accepted: 08/11/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Computerized tomography (CT) imaging is routine in oncologic care and can be used to measure muscle quantity and composition that may improve prognostic assessment of older patients. This study examines the association of single-slice CT-assessed muscle measurements with a frailty index in older adults with cancer. MATERIALS AND METHODS Using the Carolina Senior Registry, we identified patients with CT imaging within 60days ± of geriatric assessment (GA). A 36-item Carolina Frailty Index was calculated. Cross-sectional skeletal muscle area (SMA) and Skeletal Muscle Density (SMD) were analyzed from CT scan L3 lumbar segments. SMA and patient height (m2) were used to calculate skeletal muscle index (SMI). Skeletal Muscle Gauge (SMG) was calculated by multiplying SMI×SMD. RESULTS Of the 162 patients, mean age 73, 53% were robust, 27% pre-frail, and 21% frail. Significant differences were found between robust and frail patients for SMD (29.4 vs 24.1 HU, p<0.001) and SMG (1188 vs 922AU, p=0.003), but not SMI (41.9 vs 39.5cm2/m2, p=0.29). After controlling for age and gender, for every 5 unit decrease in SMD, the prevalence ratio of frailty increased by 20% (PR=1.20 [1.09, 1.32]) while the prevalence of frailty did not differ based on SMI. CONCLUSIONS Muscle mass (measured as SMI) was poorly associated with a GA-based frailty index. Muscle density, which reflects muscle lipid content, was more associated with frailty. Although frailty and loss of muscle mass are both age-related conditions that are predictive of adverse outcomes, our results suggest they are separate entities.
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Affiliation(s)
- Grant R Williams
- University of Alabama at Birmingham, Birmingham, AL, USA; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Allison M Deal
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Hyman B Muss
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Marc S Weinberg
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hanna K Sanoff
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Emily J Guerard
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; University of Wisconsin at Madison, Madison, WI, USA
| | - Kirsten A Nyrop
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Mackenzi Pergolotti
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Colorado State University, Fort Collins, CO, USA
| | - Shlomit Strulov Shachar
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Oncology, Rambam Health Care Campus, Haifa, Israel
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1019
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Kim J, Lee Y, Kye S, Chung YS, Kim JH, Chon D, Lee KE. Diet quality and osteosarcopenic obesity in community-dwelling adults 50 years and older. Maturitas 2017; 104:73-79. [PMID: 28923178 DOI: 10.1016/j.maturitas.2017.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 07/07/2017] [Accepted: 08/07/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the association between diet quality and osteosarcopenic obesity (OSO), low bone and muscle mass with concurrent high fat mass, in middle-aged and older adults. STUDY DESIGN Data were from a cross-sectional study of 2579 men and 3550 women aged 50 years and older who completed the Korea National Health and Nutritional Examination Survey from 2008 to 2010. MAIN OUTCOME MEASURES Data were collected using 24-h dietary recall, and diet quality was determined by the Diet Quality Index-International (DQI-I), on which higher scores denote better quality. Body composition was evaluated by dual-energy x-ray absorptiometry. The association between dietary quality and the number of body composition abnormalities (including OSO) was analyzed by multinomial logistic regression, adjusting for covariates. RESULTS In women, after controlling for covariates, higher scores on the DQI-I were associated with a significantly lower number of phenotypes associated with adverse body composition. Those in the highest tertile group of DQI-I were less likely to have OSO compared with those in the lowest tertile (odds ratio=0.54, 95% confidence interval: 0.32-0.92). In men, DQI-I scores were not associated with the number of body composition abnormalities. CONCLUSIONS Middle-aged and older women who eat a healthier diet, as determined by a high DQI-I score, are less likely to have multiple body composition abnormalities.
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Affiliation(s)
- Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea.
| | - Seunghee Kye
- Nutrition Education, Graduate School of Education, Gachon University, Sungnam, Republic of Korea
| | - Yoon-Sok Chung
- Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae-Hyun Kim
- Department of Health Administration, Dankook University, Cheonan, Republic of Korea; Institute of Health Promotion and Policy, Dankook University, Cheonan, Republic of Korea
| | - Doukyoung Chon
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Kyung Eun Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
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1020
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Phillips A, Strobl R, Vogt S, Ladwig KH, Thorand B, Grill E. Sarcopenia is associated with disability status-results from the KORA-Age study. Osteoporos Int 2017; 28:2069-2079. [PMID: 28386704 DOI: 10.1007/s00198-017-4027-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/29/2017] [Indexed: 12/27/2022]
Abstract
UNLABELLED We estimated the prevalence of sarcopenia and its impact on disability in older people. Sarcopenia was found to contribute to higher disability scores. However, our study was not able to show any influence of sarcopenia on the rate of functional decline. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not. INTRODUCTION The objectives of this study using data from a population-based cohort were to estimate the prevalence of sarcopenia in older people in Germany and to test the hypothesis that sarcopenia is associated with disability in older adults. METHODS Cross-sectional (n = 927) and longitudinal analyses (n = 859) of participants aged ≥65 years at baseline from southern Germany enrolled in the Cooperative Health Research in the Region Augsburg (KORA)-Age study (2009-2012). Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm which includes the presence of both low muscle mass and low muscle function (strength or performance). Disability status was measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI). The presence of disability was defined as HAQ-DI >0. Directed acyclic graphs (DAGs) were constructed to identify potential confounders. The effect of sarcopenia on disability was analyzed using linear mixed effect models with disability values as a continuous outcome. RESULTS The overall prevalence of sarcopenia was 5.7% (men 4.0%, women 7.5%) and increased with age. The 3-year incidence of disability was 32.7%. After adjustment for potential confounders, presence of sarcopenia was significantly associated with higher disability scores (0.142 [confidence interval 0.029-0.254]). CONCLUSION The prevalence of sarcopenia is consistent with estimates from other European studies using this algorithm. Our results suggest that sarcopenia can contribute to higher disability scores in older adults. However, our study was not able to show any influence of sarcopenia on the rate of functional decline using the EWGSOP diagnostic algorithm for sarcopenia. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not.
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Affiliation(s)
- A Phillips
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany.
| | - R Strobl
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany
| | - S Vogt
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - K-H Ladwig
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
- Department for Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - B Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - E Grill
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany
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1021
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Lee EY, Lee SJ, Kim KM, Seo DH, Lee SW, Choi HS, Kim HC, Youm Y, Kim CO, Rhee Y. Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women. Calcif Tissue Int 2017; 100:585-594. [PMID: 28275826 DOI: 10.1007/s00223-017-0239-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 01/12/2017] [Indexed: 01/03/2023]
Abstract
Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.
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Affiliation(s)
- Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su Jin Lee
- Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
| | - Kyoung Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Da Hea Seo
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seung Won Lee
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Han Sol Choi
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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1022
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Bouchi R, Fukuda T, Takeuchi T, Nakano Y, Murakami M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y. Association of sarcopenia with both latent autoimmune diabetes in adults and type 2 diabetes: a cross-sectional study. J Diabetes Complications 2017; 31:992-996. [PMID: 28347695 DOI: 10.1016/j.jdiacomp.2017.02.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/13/2017] [Accepted: 02/14/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND To investigate the association of both latent autoimmune diabetes in adults (LADA) and type 2 diabetes (T2DM) with muscle mass and function (sarcopenia). METHODS Japanese patients with LADA (N=20), T2DM (N=208), and control subjects (N=41) were included in this cross-sectional study. The definition of LADA was based on age of onset (≥30), positive glutamic acid decarboxylase autoantibodies, and insulin requirement within the first 6months after diagnosis. Sarcopenia was diagnosed by the criteria for Asians, using skeletal muscle index (male <7.0 and female <5.4) and grip strength (male <26.0kg and female <18.0kg). The odds ratio (OR) with a 95% confidence interval (CI) was estimated using logistic regression. RESULTS The prevalence of sarcopenia was higher in LADA (35.0%) than in either T2DM (13.3%) or control subjects (9.8%). LADA was significantly associated with an increased risk for sarcopenia in a multivariate model in which age and body mass index were incorporated (OR: 9.57, 95% CI: 1.86-49.27). In contrast, T2DM tended to be associated with an increased risk for sarcopenia (OR: 2.99, 95% CI: 0.83-10.80). CONCLUSIONS This study provides evidence that patients with LADA are at a high risk for sarcopenia compared to those with T2DM or to control subjects.
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Affiliation(s)
- Ryotaro Bouchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Tatsuya Fukuda
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Takato Takeuchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yujiro Nakano
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Masanori Murakami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Isao Minami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Hajime Izumiyama
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University.
| | - Koshi Hashimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
| | - Takanobu Yoshimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; CREST, Japan Agency for Medical Research and Development, Tokyo, Japan.
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1023
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Han E, Lee YH, Lee BW, Kang ES, Cha BS. Pre-sarcopenia is associated with renal hyperfiltration independent of obesity or insulin resistance: Nationwide Surveys (KNHANES 2008-2011). Medicine (Baltimore) 2017; 96:e7165. [PMID: 28658107 PMCID: PMC5500029 DOI: 10.1097/md.0000000000007165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Renal hyperfiltration is closely linked to cardiometabolic disorders, and it may increase the mortality risk of the general population. Despite the well-established association between cardiometabolic diseases and sarcopenia, the relationship between renal hyperfiltration and sarcopenia has not yet been assessed.This population-based, cross-sectional study used a nationally representative sample of 13,800 adults from the 2008 to 2011 Korea National Health and Nutrition Examination Survey. Renal hyperfiltration was defined as the age- and sex-specific glomerular filtration rate above the 90th percentile in subjects with normal kidney function (>60 mL/min/1.73 m). Appendicular skeletal muscle (ASM), measured by dual-energy x-ray absorptiometry, was used to assess pre-sarcopenia, which the international consensus defines as both ASM per se and ASM that was adjusted for the body mass index and the height.A total of 1402 (10.2%) participants were classified as having renal hyperfiltration. The prevalence of pre-sarcopenia ranged from 11.6% to 33.0%, by definition. Individuals with pre-sarcopenia had higher risks of renal hyperfiltration compared to those without pre-sarcopenia (10.9% vs 17.4%, P < .001; odds ratio [OR] = 1.71, 95% confidential interval [CI] = 1.48-1.99, P < .001). Multiple logistic regression analyses also demonstrated this independent association between pre-sarcopenia and renal hyperfiltration, following adjustment for confounding factors such as insulin resistance and obesity (OR = 1.84, 95% CI = 1.57-2.15, P < .001).In the general population of healthy individuals, pre-sarcopenia might be associated with renal hyperfiltration independent of obesity or insulin resistance.
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Affiliation(s)
- Eugene Han
- Department of Internal Medicine
- Graduate School
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Yong-ho Lee
- Department of Internal Medicine
- Graduate School
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul
| | - Byung-Wan Lee
- Department of Internal Medicine
- Graduate School
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul
| | - Eun Seok Kang
- Department of Internal Medicine
- Graduate School
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul
| | - Bong-Soo Cha
- Department of Internal Medicine
- Graduate School
- Institute of Endocrine Research, Yonsei University College of Medicine, Seoul
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1024
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Kemmler W, Teschler M, Weißenfels A, Sieber C, Freiberger E, von Stengel S. Prevalence of sarcopenia and sarcopenic obesity in older German men using recognized definitions: high accordance but low overlap! Osteoporos Int 2017; 28:1881-1891. [PMID: 28220197 DOI: 10.1007/s00198-017-3964-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/08/2017] [Indexed: 12/21/2022]
Abstract
UNLABELLED The relevance of sarcopenia and sarcopenic Obesity (SO) is rising in our aging societies. Applying recognized definitions to 965 community-dwelling Bavarian men 70 years+ resulted in a prevalence for sarcopenia between 3.7 and 4.9 and between 2.1 and 4.1% for SO. Despite this high consistency, the overlap between the definitions/approaches was <50%. INTRODUCTION The relevance of sarcopenia and sarcopenic obesity (SO) is rising steadily in the aging societies of most developed nations. However, different definitions, components, and cutoff points hinder the evaluation of the prevalence of sarcopenia and SO. The purpose of this contribution was to determine the prevalence of sarcopenia and SO in a cohort of community-dwelling German men 70+ applying established sarcopenia (European Working Group on Sarcopenia in Older People, Foundation National Institute of Health, International Working Group on Sarcopenia) and obesity definitions. Further, we addressed the overlap between the definitions. METHODS Altogether, 965 community-dwelling men 70 years and older living in Northern Bavaria, Germany, were assessed during the screening phase of the Franconian Sarcopenic Obesity project. Segmental multi-frequency bio-impedance analysis (BIA) was applied to determine weight and body composition. RESULTS Applying the definitions of EWGSOP, IWGS, and FNIH, 4.9, 3.8, and 3.7% of the total cohort were classified as sarcopenic, respectively. When further applying body fat to diagnose obesity, SO prevalence in the total cohort ranged from 4.1% (EWGSOP + body fat >25%) to 2.1% (IWGS + body fat >30%). Despite the apparently high consistency of the approaches with respect to prevalence, the overlap in individual sarcopenia diagnosis between the sarcopenia definitions was rather low (<50%). CONCLUSION The prevalence of sarcopenia and SO in community-dwelling German men 70 years+ is relatively low (<5%) independently of the definition used. However, consistency of individual sarcopenia diagnosis varies considerably between the three definitions. Since sarcopenia is now recognized as an independent condition by the International Classification of Diseases, a mandatory definition must be stated. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT2857660.
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Affiliation(s)
- W Kemmler
- Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany.
| | - M Teschler
- Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
| | - A Weißenfels
- Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
| | - C Sieber
- Institute of Biomedicine of Aging (IBA), Friedrich-Alexander University of Erlangen-Nürnberg, Kobergerstrasse 60, 90408, Nürnberg, Germany
| | - E Freiberger
- Institute of Biomedicine of Aging (IBA), Friedrich-Alexander University of Erlangen-Nürnberg, Kobergerstrasse 60, 90408, Nürnberg, Germany
| | - S von Stengel
- Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
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1025
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Abstract
: HIV infection, in many circumstances, can now be managed as a chronic disease due to the marked increase in life expectancy since the introduction of combination antiretroviral therapy (ART). As the patients who first had access to combination ART age into their 50s and 60s, the effects of chronic HIV infection on health have become an important research focus in HIV infection. People living with HIV appear to exhibit an earlier occurrence of some aging-related conditions compared to people without HIV, in part due to higher rates of comorbidities, high-risk behaviors (e.g. smoking, substance use), chronic immune activation, inflammation, and ART-specific factors. Some studies have even suggested an earlier-than-expected appearance of the 'geriatric syndromes,' which are complex medical syndromes of older adults that are associated with morbidity and mortality. The geriatric syndromes include a wide variety of disease processes ranging from incontinence and dementia to impairments in physical function. This review will focus on one geriatric syndrome, sarcopenia, in older HIV-infected populations, and its relation to other aging syndromes, including frailty and falls. The contribution of HIV itself, ART exposure, and specific comorbidities, and the importance of early recognition and prevention of these aging syndromes will be highlighted.
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Affiliation(s)
- Kellie L Hawkins
- aUniversity of Colorado, Aurora, Colorado bJohns Hopkins School of Medicine cJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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1026
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Abstract
The purpose of this study was to report age- and gender-specific distribution of the hand grip strength (HGS) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-3 (2015) survey and determine cut-off values for low muscle strength of HGS of Koreans. Of a total of 7,380 participants, 4,553 were subjected to measurements of HGS, including 1,997 men and 2,556 women with a mean age of 49.3 years (range, 19-80 years). The mean ages of men and women were 49.0 and 49.5 years, respectively. HGS was measured using a digital hand dynamometer. It was defined as maximal measured grip strength of the dominant hand. The cut-off value for low muscle strength was defined as the lower 20th percentile of HGS of the study population. Maximum grip strength of men was significantly higher than that of women (40.2 kg in men vs. 24.2 kg in women, P < 0.001). The mean HGS was increased from the age of 19 to 39 years. It was peaked in the age of 35 to 39 years range for both men and women. It was then decreased after 39 years. The cut-off values of HGS in male and female elderly healthy populations were 28.6 and 16.4 kg, respectively. These data might be used as reference values when evaluating sarcopenia and assessing hand injuries.
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Affiliation(s)
- Jun Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hana Choi
- Department of Rehabilitation Medicine, Dankook University Hospital, Cheonan, Korea
| | - Yong Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
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1027
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Lucassen EA, de Mutsert R, le Cessie S, Appelman-Dijkstra NM, Rosendaal FR, van Heemst D, den Heijer M, Biermasz NR. Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study. PLoS One 2017; 12:e0176685. [PMID: 28459884 PMCID: PMC5411054 DOI: 10.1371/journal.pone.0176685] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/16/2017] [Indexed: 01/27/2023] Open
Abstract
CONTEXT Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. OBJECTIVE To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. DESIGN, SETTING AND PARTICIPANTS Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). RESULTS After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09, 1.03-1.14), declined self-rated sleep quality (1.76, 1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51, 1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. CONCLUSIONS These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals.
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Affiliation(s)
- Eliane A. Lucassen
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden, Leiden University Medical Center, The Netherlands
- Department of Internal Medicine, The Hague, Medisch Centrum Haaglanden, The Netherlands
- * E-mail:
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden, Leiden University Medical Center, The Netherlands
| | - Saskia le Cessie
- Department of Medical Statistics, Leiden, Leiden University Medical Center, The Netherlands
| | | | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden, Leiden University Medical Center, The Netherlands
| | - Diana van Heemst
- Department of Gerontology and Geriatrics, Leiden, Leiden University Medical Center, The Netherlands
| | - Martin den Heijer
- Department of Clinical Epidemiology, Leiden, Leiden University Medical Centre, The Netherlands
- Department of Internal Medicine, Amsterdam, VU Medical Centre, The Netherlands
| | - Nienke R. Biermasz
- Department of Endocrinology, Leiden, Leiden University Medical Center, The Netherlands
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1028
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Harada K, Suzuki S, Ishii H, Aoki T, Hirayama K, Shibata Y, Negishi Y, Sumi T, Kawashima K, Kunimura A, Shimbo Y, Tatami Y, Kawamiya T, Yamamoto D, Morimoto R, Yasuda Y, Murohara T. Impact of Skeletal Muscle Mass on Long-Term Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease. Am J Cardiol 2017; 119:1275-1280. [PMID: 28215411 DOI: 10.1016/j.amjcard.2017.01.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 12/26/2022]
Abstract
Sarcopenia, defined as skeletal muscle loss and dysfunction, is attracting considerable attention as a novel risk factor for cardiovascular events. Although the loss of skeletal muscle is common in chronic kidney disease (CKD) patients, the relation between sarcopenia and cardiovascular events in CKD patients is not well defined. Therefore, we aimed to investigate the relation between skeletal muscle mass and major adverse cardiovascular events (MACE) in CKD patients. We enrolled 266 asymptomatic CKD patients (median estimated glomerular filtration rate: 36.7 ml/min/1.73 m2). To evaluate skeletal muscle mass, we used the psoas muscle mass index (PMI) calculated from noncontrast computed tomography. The patients were divided into 2 groups according to the cut-off value of PMI for MACE. There were significant differences in age and body mass index between the low and high PMI groups (median age: 73.5 vs 69.0 years, p = 0.002; median body mass index: 22.6 vs 24.2 kg/m2, p <0.001, respectively). During the follow-up period (median: 3.2 years), patients with low PMI had significantly higher risk of MACE than those with high PMI (31.7% and 11.2%, log-rank test, p <0.001). The Cox proportional hazard model showed that low PMI is an independent predictor of MACE in CKD patients (hazard ratio 3.98, 95% confidence interval 1.65 to 9.63, p = 0.0022). In conclusion, low skeletal muscle mass is an independent predictor of MACE in CKD patients. The assessment of skeletal muscle mass may be a valuable screening tool for predicting MACE in clinical practice.
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Affiliation(s)
- Kazuhiro Harada
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Susumu Suzuki
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshijiro Aoki
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenshi Hirayama
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohei Shibata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yosuke Negishi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Sumi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Kawashima
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayako Kunimura
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusaku Shimbo
- Department of Cardiology, Kariya Toyota General Hospital, Kariya, Japan
| | - Yosuke Tatami
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiki Kawamiya
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dai Yamamoto
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryota Morimoto
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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1029
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Granic A, Hill TR, Davies K, Jagger C, Adamson A, Siervo M, Kirkwood TBL, Mathers JC, Sayer AA. Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study. Nutrients 2017; 9:nu9040379. [PMID: 28406464 PMCID: PMC5409718 DOI: 10.3390/nu9040379] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/03/2017] [Accepted: 04/11/2017] [Indexed: 12/17/2022] Open
Abstract
Mixed reports exist about the role of 25-hydroxyvitamin D (25(OH)D) in muscle ageing and there are few prospective studies involving the very old (aged ≥ 85) who are at highest risk of low 25(OH)D, loss of muscle mass and strength, and physical performance decline. In the Newcastle 85+ Study (n = 845), we aimed to determine the association between 25(OH)D season-specific quartiles (hereafter SQ1–SQ4), grip strength (GS) and physical performance decline (Timed Up-and-Go Test, TUG) over 5 years using mixed models. In the time-only models with linear and quadratic slopes, SQ1 and SQ4 of 25(OH)D were associated with weaker GS initially in men (SQ1: β (SE) = −2.56 (0.96); SQ4: −2.16 (1.06)) and women (SQ1: −1.10 (0.52); SQ4: −1.28 (0.50)) (all p ≤ 0.04). In the fully adjusted models, only men in SQ1 had a significant annual decline in GS of 1.41 kg which accelerated over time (−0.40 (0.1)), (both p ≤ 0.003) compared with those in combined middle quartiles. Only women in SQ1 and SQ4 of 25(OH)D had worse TUG times initially, but the rate of TUG decline was not affected. Low baseline 25(OH)D may contribute to muscle strength decline in the very old and particularly in men.
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Affiliation(s)
- Antoneta Granic
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- School of Agriculture, Food and Rural Development, Kings Road, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
| | - Karen Davies
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Ashley Adamson
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
- Human Nutrition Research Centre, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
- Human Nutrition Research Centre, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Thomas B L Kirkwood
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Cell and Molecular Biosciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
- Human Nutrition Research Centre, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Avan A Sayer
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE4 5PL, UK.
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1030
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Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis. Maturitas 2017; 103:16-22. [PMID: 28778327 DOI: 10.1016/j.maturitas.2017.04.007] [Citation(s) in RCA: 187] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/21/2017] [Accepted: 04/03/2017] [Indexed: 02/05/2023]
Abstract
The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I2=27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the elderly.
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Affiliation(s)
- Ping Liu
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China
| | - Qiukui Hao
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China
| | - Shan Hai
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China
| | - Hui Wang
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China
| | - Li Cao
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China
| | - Birong Dong
- The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China.
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1031
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Sugie M, Harada K, Takahashi T, Nara M, Ishikawa J, Koyama T, Kim H, Tanaka J, Fujimoto H, Obuchi S, von Haehling S, Kyo S, Ito H. Relationship between skeletal muscle mass and cardiac function during exercise in community-dwelling older adults. ESC Heart Fail 2017; 4:409-416. [PMID: 29154420 PMCID: PMC5695195 DOI: 10.1002/ehf2.12158] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/21/2017] [Accepted: 02/25/2017] [Indexed: 12/24/2022] Open
Abstract
Aims This study aimed to investigate the relationship between skeletal muscle mass and cardiac functional parameters in older adults during cardiopulmonary exercise testing (CPET). Methods and results Sixty‐three Japanese community‐dwelling older adults were enrolled (20 men and 43 women; mean age 80 years, range 65–97 years). Cardiac functional parameters during exercise were assessed using CPET. Skeletal muscle mass index (SMI) was calculated by dividing the appendicular lean mass (measured using dual‐energy X‐ray absorptiometry) by height in metres squared. Subjects were divided into two groups: men with SMI ≥ 7.0 kg/m2 and women with SMI ≥ 5.4 kg/m2 (non‐sarcopenic group); or men with SMI < 7.0 kg/m2 and women with SMI < 5.4 kg/m2 (sarcopenic group). There were significant positive correlations between SMI and peak oxygen uptake (VO2) (r = 0.631, P < 0.001), and between SMI and peak VO2/heart rate (HR) (r = 0.683, P < 0.001). However, only peak VO2/HR significantly differed between groups in both sexes. Multiple linear regression analyses with peak VO2/HR as a dependent variable showed that SMI was the only independent determinant after adjusting for potential confounders. After 4 month follow‐up of 47 participants, there was still a significant positive correlation between SMI and peak VO2/HR (r = 0.567, P < 0.001), and between percent change of SMI and percent change of peak VO2/HR (r = 0.305, P < 0.05). Conclusions Peak VO2/HR, an index of stroke volume at peak exercise, was associated with SMI. This indicates that skeletal muscle mass might affect cardiac function during exercise.
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Affiliation(s)
- Masamitsu Sugie
- Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
- Department of Institute of GerontologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Kazumasa Harada
- Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Tetsuya Takahashi
- Department of Institute of GerontologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
- Tokyo University of TechnologyTokyoJapan
| | - Marina Nara
- Ochanomizu UniversityTokyoJapan
- Health Management Services Inc.TokyoJapan
| | - Joji Ishikawa
- Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Teruyuki Koyama
- Department of RehabilitationTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
- Department of Institute of GerontologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Hunkyung Kim
- Department of Institute of GerontologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Jun Tanaka
- Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Hajime Fujimoto
- Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Shuichi Obuchi
- Department of Institute of GerontologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, Institute of Innovative Clinical TrialsUniversity Medical Center GöttingenGöttingenGermany
| | - Syunei Kyo
- Department of Cardiac SurgeryTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
| | - Hideki Ito
- Department of Diabetes, Metabolism and EndocrinologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
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1032
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Dodds RM, Granic A, Davies K, Kirkwood TBL, Jagger C, Sayer AA. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study. J Cachexia Sarcopenia Muscle 2017; 8:229-237. [PMID: 27897431 PMCID: PMC5377385 DOI: 10.1002/jcsm.12157] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/13/2016] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Recognition that an older person has sarcopenia is important because this condition is linked to a range of adverse outcomes. Sarcopenia becomes increasingly common with age, and yet there are few data concerning its descriptive epidemiology in the very old (aged 85 years and above). Our aims were to describe risk factors for sarcopenia and estimate its prevalence and incidence in a British sample of the very old. METHODS We used data from two waves (2006/07 and 2009/10) of the Newcastle 85+ Study, a cohort born in 1921 and registered with a Newcastle/North Tyneside general practice. We assessed sarcopenia status using the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Grip strength was measured using a Takei digital dynamometer (Takei Scientific Instruments Ltd., Niigata, Japan), gait speed was calculated from the Timed Up and Go test, and lean mass was estimated using a Tanita-305 body fat analyzer. We used logistic regression to examine associations between risk factors for prevalent sarcopenia at baseline and incident sarcopenia at follow-up. RESULTS European Working Group on Sarcopenia in Older People sarcopenia was present in 21% of participants at baseline [149/719 participants, mean age 85.5 (0.4) years]. Many participants had either slow gait speed or weak grip strength (74.3%), and hence measurement of muscle mass was frequently indicated by the EWGSOP definition. Incidence data were available for 302 participants, and the incident rate was 3.7 cases per 100 person years at risk. Low Standardized Mini-Mental State Examination, lower occupational social class, and shorter duration of education were associated with sarcopenia at baseline, while low muscle mass was associated with incident sarcopenia. Low body mass index (BMI) was a risk factor for both in a graded fashion, with each unit decrease associated with increased odds of prevalent [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.21, 1.37] and incident (OR 1.20, 95% CI: 1.08, 1.33) sarcopenia. CONCLUSIONS To our knowledge, this is the first study to describe prevalence and incidence of EWGSOP sarcopenia in the very old. Low BMI was a risk factor for both current and future sarcopenia; indeed, there was some evidence that low BMI may be a reasonable proxy for low lean mass. Overall, the high prevalence of sarcopenia among the very old suggests that this group should be a focus for future research.
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Affiliation(s)
- Richard Matthew Dodds
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Antoneta Granic
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Karen Davies
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Thomas B. L. Kirkwood
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for Cell and Molecular BiosciencesNewcastle UniversityNewcastle upon TyneNE1 7RUTyne and WearUK
| | - Carol Jagger
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneTyne and WearUK
| | - Avan Aihie Sayer
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- MRC Lifecourse Epidemiology Unit, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- NIHR Collaboration for Leadership in Applied Health Research and Care WessexUniversity of SouthamptonSouthamptonHamphsireUK
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1033
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Ethgen O, Beaudart C, Buckinx F, Bruyère O, Reginster JY. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int 2017; 100:229-234. [PMID: 28012107 PMCID: PMC5313588 DOI: 10.1007/s00223-016-0220-9] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/10/2016] [Indexed: 11/25/2022]
Abstract
Sarcopenia is a major public health issue. To convince health policy makers of the emergency to invest in the sarcopenia field, it is of critical importance to produce reliable figures of the expected burden of sarcopenia in the coming years. Age- and gender-specific population projections were retrieved until 2045 from the Eurostat online database (28 European countries). Age- and gender-specific prevalences of sarcopenia were interpolated from a study that compared prevalence estimates according to the different diagnostic cutoffs of the EWGSOP proposed definition. The reported prevalence estimates were interpolated between 65 and 100 years. Interpolated age- and gender-specific estimates of sarcopenia prevalence were then applied to population projections until 2045. Using the definition providing the lowest prevalence estimates, the number of individuals with sarcopenia would rise in Europe from 10,869,527 in 2016 to 18,735,173 in 2045 (a 72.4% increase). This corresponds to an overall prevalence of sarcopenia in the elderly rising from 11.1% in 2016 to 12.9% in 2045. With the definition providing the highest prevalence estimates, the number of individuals with sarcopenia would rise from 19,740,527 in 2016 to 32,338,990 in 2045 (a 63.8% increase), corresponding to overall prevalence rates in the elderly of 20.2% and 22.3% for 2016 and 2045, respectively. We showed that the number of sarcopenic patients will dramatically increase in the next 30 years, making consequences of muscle wasting a major public health issue.
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Affiliation(s)
- O Ethgen
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - C Beaudart
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - F Buckinx
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium.
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1034
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Abstract
Frailty and sarcopenia are important concepts in the quest to prevent physical dependence, as geriatrics are shifting towards identifications of early stages of disability. Definitions of both sarcopenia and frailty are still developing, and both concepts clearly overlap in their physical aspects. Malnutrition (both undernutrition and obesity) plays a key role in the pathogenesis of frailty and sarcopenia. The quality of the diet along the lifespan has a close relation with the incidence of both entities, and nutritional interventions may be able to reduce the incidence or revert either of them. This brief review explores the role of energy and protein intake and other key nutrients on muscle function. Nutrition may be a key element of multimodal interventions for frailty and sarcopenia. The results of the "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) trial will offer key insights on the effect of such interventions in frail, sarcopenic older individuals.
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Affiliation(s)
- Alfonso J Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Ctra.Colmenar km 9,1, 28034, Madrid, Spain.
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, University of Erlangen-Nürnberg, Nuremberg, Germany
| | - Michael Drey
- Institute for Biomedicine of Aging, University of Erlangen-Nürnberg, Nuremberg, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, University of Erlangen-Nürnberg, Nuremberg, Germany
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1035
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Kalafateli M, Mantzoukis K, Choi Yau Y, Mohammad AO, Arora S, Rodrigues S, de Vos M, Papadimitriou K, Thorburn D, O'Beirne J, Patch D, Pinzani M, Morgan MY, Agarwal B, Yu D, Burroughs AK, Tsochatzis EA. Malnutrition and sarcopenia predict post-liver transplantation outcomes independently of the Model for End-stage Liver Disease score. J Cachexia Sarcopenia Muscle 2017; 8:113-121. [PMID: 27239424 PMCID: PMC4864202 DOI: 10.1002/jcsm.12095] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/23/2015] [Accepted: 11/02/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although malnutrition and sarcopenia are prevalent in cirrhosis, their impact on outcomes following liver transplantation is not well documented. METHODS The associations of nutritional status and sarcopenia with post-transplant infections, requirement for mechanical ventilation, intensive care (ICU) and hospital stay, and 1 year mortality were assessed in 232 consecutive transplant recipients. Nutritional status and sarcopenia were assessed using the Royal Free Hospital-Global Assessment (RFH-GA) tool and the L3-psoas muscle index (L3-PMI) on CT, respectively. RESULTS A wide range of RFH-SGA and L3-PMI were observed within similar Model for End-stage Liver Disease (MELD) sub-categories. Malnutrition and sarcopenia were independent predictors of all outcomes. Post-transplant infections were associated with MELD (OR = 1.055, 95%CI = 1.002-1.11) and severe malnutrition (OR = 6.55, 95%CI = 1.99-21.5); ventilation > 24 h with MELD (OR = 1.1, 95%CI = 1.036-1.168), severe malnutrition (OR = 8.5, 95%CI = 1.48-48.87) and suboptimal donor liver (OR = 2.326, 95%CI = 1.056-5.12); ICU stay > 5 days, with age (OR = 1.054, 95%CI = 1.004-1.106), MELD (OR = 1.137, 95%CI = 1.057-1.223) and severe malnutrition (OR = 7.46, 95%CI = 1.57-35.43); hospital stay > 20 days with male sex (OR = 2.107, 95%CI = 1.004-4.419) and L3-PMI (OR = 0.996, 95%CI = 0.994-0.999); 1 year mortality with L3-PMI (OR = 0.996, 95%CI = 0.992-0.999). Patients at the lowest L3-PMI receiving suboptimal grafts had longer ICU/hospital stay and higher incidence of infections. CONCLUSIONS Malnutrition and sarcopenia are associated with early post-liver transplant morbidity/mortality. Allocation indices do not include nutritional status and may jeopardize outcomes in nutritionally compromised individuals.
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Affiliation(s)
- Maria Kalafateli
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | | | - Yan Choi Yau
- Department of RadiologyRoyal Free Hospital London NHS Foundation TrustLondonUK
| | - Ali O. Mohammad
- Intensive Care UnitRoyal Free Hospital London NHS Foundation TrustLondonUK
- Department of Chest DiseasesMinia UniversityEgypt
| | - Simran Arora
- Nutrition and Dietetics DepartmentRoyal Free Hospital London NHS Foundation TrustLondonUK
| | - Susana Rodrigues
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - Marie de Vos
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | | | - Douglas Thorburn
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - James O'Beirne
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - David Patch
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - Massimo Pinzani
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - Marsha Y. Morgan
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
| | - Banwari Agarwal
- Intensive Care UnitRoyal Free Hospital London NHS Foundation TrustLondonUK
| | - Dominic Yu
- Department of RadiologyRoyal Free Hospital London NHS Foundation TrustLondonUK
| | - Andrew K. Burroughs
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUK
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1036
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Hwang YC, Cho IJ, Jeong IK, Ahn KJ, Chung HY. Differential association between sarcopenia and metabolic phenotype in Korean young and older adults with and without obesity. Obesity (Silver Spring) 2017; 25:244-251. [PMID: 27874274 DOI: 10.1002/oby.21694] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/06/2016] [Accepted: 09/13/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine whether sarcopenia was associated with metabolic phenotype in subjects with and without obesity. METHODS A total of 6,021 participants (2,592 men, 3,429 women) aged 30 to 93 years were assessed using data from the 2009 Korea National Health and Nutrition Examination Survey. Sarcopenia was defined as appendicular skeletal muscle mass divided by weight (%) that is <1 SD below the sex-specific mean for young adults. Metabolically unhealthy was defined as ≥2 components of metabolic syndrome or the presence of hypertension, diabetes, or cardiovascular disease. Obesity was defined as body mass index ≥25.0 kg/m2 . RESULTS Sarcopenia was associated with a metabolically unhealthy phenotype in nonobese men independent of age, smoking, regular physical activity, daily energy intake, total body fat, fasting insulin, non-HDL cholesterol, white blood cell count, ferritin level, and 25(OH) vitamin D level (OR per 1 SD increment (95% CI) 1.88 (1.28-2.75), P < 0.01), but this association was confounded by and not independent of total body fat in nonobese women. Sarcopenia was not associated with a metabolically unhealthy phenotype in subjects with obesity. CONCLUSIONS Sarcopenia was independently associated with a metabolically unhealthy phenotype in nonobese men, but this association was not evident in nonobese women or subjects with obesity.
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Affiliation(s)
- You-Cheol Hwang
- Department of Medicine, Division of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - In-Jin Cho
- Department of Medicine, Division of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - In-Kyung Jeong
- Department of Medicine, Division of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Kyu Jeung Ahn
- Department of Medicine, Division of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Ho Yeon Chung
- Department of Medicine, Division of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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1037
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Masanés F, Rojano I Luque X, Salvà A, Serra-Rexach JA, Artaza I, Formiga F, Cuesta F, López Soto A, Ruiz D, Cruz-Jentoft AJ. Cut-off Points for Muscle Mass - Not Grip Strength or Gait Speed - Determine Variations in Sarcopenia Prevalence. J Nutr Health Aging 2017; 21:825-829. [PMID: 28717813 DOI: 10.1007/s12603-016-0844-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The European Working Group on Sarcopenia in Older People (EWGSOP) has proposed different methods and cut-off points for the three parameters that define sarcopenia: muscle mass, muscle strength and physical performance. Although this facilitates clinical practice, it limits comparability between studies and leads to wide differences in published prevalence rates. The aim of this study was to assess how changes in cut-off points for muscle mass, gait speed and grip strength affected sarcopenia prevalence according to EWGSOP criteria. METHODS Cross-sectional analysis of elderly individuals recruited from outpatient clinics (n=298) and nursing homes (n=276). We measured muscle mass, grip strength and gait speed and assessed how changes in cut-off points changed sarcopenia prevalence in both populations. RESULTS An increase from 5.45 kg/m2 to 6.68 kg/m2 in the muscle mass index for female outpatients and nursing-home residents increased sarcopenia prevalence from 4% to 23% and from 9% to 47%, respectively; for men, for an increase from 7.25 kg/m2 to 8.87 kg/m2, the corresponding increases were from 1% to 22% and from 6% to 41%, respectively. Changes in gait speed and grip strength had a limited impact on sarcopenia prevalence. CONCLUSION The cut-off points used for muscle mass affect the reported prevalence rates for sarcopenia and, in turn, affect comparability between studies. The main factors influencing the magnitude of the change are muscle mass index distribution in the population and the absolute value of the cut-off points: the same difference between two references (e.g., 7.5 kg/m2 to 7.75 kg/m2 or 7.75 kg/m2 to 8 kg/m2) may produce different changes in prevalence. Changes in cut-off points for gait speed and grip strength had a limited impact on sarcopenia prevalence and on study comparability.
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Affiliation(s)
- F Masanés
- Xavier Rojano i Luque, Fundació Salut i Envelliment Universitat Autònoma de Barcelona. Institute for Biomedical Research Sant Pau. Barcelona, Spain,
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1038
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Harada A. [The effect of exercise and sports on musculoskeletal health in the elderly.]. Clin Calcium 2017; 27:117-123. [PMID: 28017954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There is insufficient information on the effect of exercise and sports on musculoskeletal health in the elderly. Although the effects of sports are still unclear, the effects of exercise could be significant. For example, exercise improves osteoporosis by increasing bone mineral density and ameliorates sarcopenia by increasing muscle mass, muscular strength, and walking speed. As a result, fall risk is reduced and fracture risk is also likely to improve. Tai Chi is reportedly effective for joint pain and stiffness, and may improve symptoms of osteoarthritis.
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1039
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Yoshimura N, Muraki S, Oka H, Iidaka T, Kodama R, Kawaguchi H, Nakamura K, Tanaka S, Akune T. Is osteoporosis a predictor for future sarcopenia or vice versa? Four-year observations between the second and third ROAD study surveys. Osteoporos Int 2017; 28:189-199. [PMID: 27885410 DOI: 10.1007/s00198-016-3823-0] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 10/26/2016] [Indexed: 11/25/2022]
Abstract
UNLABELLED In a 4-year follow-up study that enrolled 1099 subjects aged ≥60 years, sarcopenia prevalence was estimated at 8.2%. Moreover, the presence of osteoporosis was significantly associated with short-term sarcopenia occurrence, but the reciprocal relationship was not observed, suggesting that osteoporosis would increase the risk of osteoporotic fracture and sarcopenia occurrence. INTRODUCTION The present 4-year follow-up study was performed to clarify the prevalence, incidence, and relationships between sarcopenia (SP) and osteoporosis (OP) in older Japanese men and women. METHODS We enrolled 1099 participants (aged, ≥60 years; 377 men) from the second survey of the Research on Osteoarthritis/Osteoporosis against Disability (ROAD) study (2008-2010) and followed them up for 4 years. Handgrip strength, gait speed, skeletal muscle mass, and bone mineral density were assessed. SP was defined according to the Asian Working Group for Sarcopenia. OP was defined based on the World Health Organization criteria. RESULTS SP prevalence was 8.2% (men, 8.5%; women, 8.0%) in the second survey. In those with SP, 57.8% (21.9%; 77.6%) had OP at the lumbar spine L2-4 and/or femoral neck. SP cumulative incidence was 2.0%/year (2.2%/year; 1.9%/year). Multivariate regression analysis revealed that OP was significantly associated with SP occurrence within 4 years (odds ratio, 2.99; 95% confidence interval, 1.46-6.12; p < 0.01), but the reciprocal relationship was not significantly observed (2.11; 0.59-7.59; p = 0.25). CONCLUSIONS OP might raise the short-term risk of SP incidence. Therefore, OP would not only increase the risk for osteoporotic fracture but may also increase the risk for SP occurrence.
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Affiliation(s)
- N Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - S Muraki
- Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 113-8655, Japan
| | - T Iidaka
- Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - R Kodama
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - H Kawaguchi
- JCHO Tokyo Shinjuku Medical Center, Tokyo, 162-8542, Japan
| | - K Nakamura
- National Rehabilitation Center for Persons with Disabilities, Saitama, 359-0042, Japan
| | - S Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - T Akune
- National Rehabilitation Center for Persons with Disabilities, Saitama, 359-0042, Japan
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1040
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Powell M, Lara J, Mocciaro G, Prado CM, Battezzati A, Leone A, Tagliabue A, de Amicis R, Vignati L, Bertoli S, Siervo M. Association between ratio indexes of body composition phenotypes and metabolic risk in Italian adults. Clin Obes 2016; 6:365-375. [PMID: 27869360 DOI: 10.1111/cob.12165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/08/2016] [Accepted: 09/29/2016] [Indexed: 01/06/2023]
Abstract
The ratio between fat mass (FM) and fat-free mass (FFM) has been used to discriminate individual differences in body composition and improve prediction of metabolic risk. Here, we evaluated whether the use of a visceral adipose tissue-to-fat-free mass index (VAT:FFMI) ratio was a better predictor of metabolic risk than a fat mass index to fat-free mass index (FMI:FFMI) ratio. This is a cross-sectional study including 3441 adult participants (age range 18-81; men/women: 977/2464). FM and FFM were measured by bioelectrical impedance analysis and VAT by ultrasonography. A continuous metabolic risk Z score and harmonised international criteria were used to define cumulative metabolic risk and metabolic syndrome (MetS), respectively. Multivariate logistic and linear regression models were used to test associations between body composition indexes and metabolic risk. In unadjusted models, VAT:FFMI was a better predictor of MetS (OR 8.03, 95%CI 6.69-9.65) compared to FMI:FFMI (OR 2.91, 95%CI 2.45-3.46). However, the strength of association of VAT:FFMI and FMI:FFMI became comparable when models were adjusted for age, gender, clinical and sociodemographic factors (OR 4.06, 95%CI 3.31-4.97; OR 4.25, 95%CI 3.42-5.27, respectively). A similar pattern was observed for the association of the two indexes with the metabolic risk Z score (VAT:FFMI: unadjusted b = 0.69 ± 0.03, adjusted b = 0.36 ± 0.03; FMI:FFMI: unadjusted b = 0.28 ± 0.028, adjusted b = 0.38 ± 0.02). Our results suggest that there is no real advantage in using either VAT:FFMI or FMI:FFMI ratios as a predictor of metabolic risk in adults. However, these results warrant confirmation in longitudinal studies.
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Affiliation(s)
- M Powell
- School of Biomedical Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - J Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - G Mocciaro
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - C M Prado
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - A Battezzati
- International Center for the Assessment of Nutritional Status, (ICANS Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy
| | - A Leone
- International Center for the Assessment of Nutritional Status, (ICANS Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy
| | - A Tagliabue
- Human Nutrition and Eating Disorders Research Centre, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - R de Amicis
- International Center for the Assessment of Nutritional Status, (ICANS Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy
| | - L Vignati
- International Center for the Assessment of Nutritional Status, (ICANS Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy
| | - S Bertoli
- International Center for the Assessment of Nutritional Status, (ICANS Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milano, Italy
| | - M Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
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1041
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Izawa KP, Watanabe S, Oka K, Kasahara Y, Morio Y, Hiraki K, Hirano Y, Omori Y, Suzuki N, Kida K, Suzuki K, Akashi YJ. Respiratory muscle strength in relation to sarcopenia in elderly cardiac patients. Aging Clin Exp Res 2016; 28:1143-1148. [PMID: 26802002 DOI: 10.1007/s40520-016-0534-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Little information exists on the relation between respiratory muscle strength such as maximum inspiratory muscle pressure (MIP) and sarcopenia in elderly cardiac patients. The present study aimed to determine the differences in MIP, and cutoff values for MIP according to sarcopenia in elderly cardiac patients. METHODS We enrolled 63 consecutive elderly male patients aged ≥65 years with cardiac disease in this cross-sectional study. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People algorithm, and, accordingly, the patients were divided into two groups: the sarcopenia group (n = 24) and non-sarcopenia group (n = 39). The prevalence of sarcopenia in cardiac patients and MIP in the patients with and without sarcopenia were assessed to determine cutoff values of MIP. RESULTS After adjustment for body mass index, the MIP in the sarcopenia group was significantly lower than that in the non-sarcopenia group (54.7 ± 36.8 cmH2O; 95 % CI 42.5-72.6 vs. 80.7 ± 34.7 cmH2O; 95 % CI 69.5-92.0; F = 4.89, p = 0.029). A receiver-operating characteristic curve analysis of patients with and without sarcopenia identified a cutoff value for MIP of 55.6 cmH2O, with a sensitivity of 0.76, 1-specificity of 0.37, and AUC of 0.70 (95 % CI 0.56-0.83; p = 0.01) in the study patients. CONCLUSION Compared with elderly cardiac patients without sarcopenia, MIP in those with sarcopenia may be negatively affected. The MIP cutoff value reported here may be a useful minimum target value for identifying elderly male cardiac patients with sarcopenia.
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Affiliation(s)
- Kazuhiro P Izawa
- Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.
| | - Satoshi Watanabe
- Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Yusuke Kasahara
- Department of Rehabilitation Medicine, St. Marianna University Yokohama-city Seibu Hospital, Yokohama, Japan
| | - Yuji Morio
- Faculty of Medical Sciences, Shonan University of Medical Sciences, Yokohama, Japan
| | - Koji Hiraki
- Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Yasuyuki Hirano
- Department of Physical Therapy, Tokushima Bunri University, Tokushima, Japan
| | - Yutaka Omori
- Department of Rehabilitation, Visiting Nursing and Rehabilitation Network, Kawasaki, Japan
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Keisuke Kida
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kengo Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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1042
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Hyun YY, Lee KB, Rhee EJ, Park CY, Chang Y, Ryu S. Chronic kidney disease and high eGFR according to body composition phenotype in adults with normal BMI. Nutr Metab Cardiovasc Dis 2016; 26:1088-1095. [PMID: 27776918 DOI: 10.1016/j.numecd.2016.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/20/2016] [Accepted: 09/04/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Body composition contributes to the risk of chronic kidney disease (CKD) and glomerular hyperfiltration. In adults with normal body mass index (BMI), the relationships of body composition with CKD and high estimated glomerular filtration rate (eGFR) are largely unknown. METHODS AND RESULTS We analyzed 10,734 adults from the Korean National Health and Nutrition Examination Survey (KNHANES), whose body mass index (BMI) was within the normal range (18.5-24.9 kg/m2). Body composition was categorized into four phenotypes (normal, sarcopenia alone, obesity alone, and sarcopenic obesity) based on appendicular lean mass index (ALMI) and total body fat percentage (TBF%) measured by dual-energy X-ray absorptiometry (DXA). We examined the relationship of CKD and high eGFR (eGFR ≥ 120 ml/min per 1.73 m2) with body composition phenotypes. Sarcopenia alone (14.3%), obesity alone (16.0%), and sarcopenic obesity (10.7%) were prevalent. The association between sarcopenia alone and eGFR was J-shaped, while that between sarcopenic obesity and eGFR was U-shaped. In multivariate logistic regression analysis compared with the normal phenotype, sarcopenic obesity had an elevated odds ratio (OR) for CKD (OR: 1.59, 95% CI: 1.16-2.19). Sarcopenia alone (OR: 1.87; 95% CI: 1.41-2.47) and sarcopenic obesity (OR: 2.37, 95% CI: 1.68-3.36) had elevated OR for high eGFR. CONCLUSION These findings suggest that decreased muscle mass and coexistence with excess adiposity show associations with CKD and high eGFR even in adults with normal BMI. Body composition measured by DXA could provide information on the relationship of body composition with CKD and high eGFR.
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Affiliation(s)
- Y Y Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - K B Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - E J Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - C Y Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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1043
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Moon JH, Kim KM, Kim JH, Moon JH, Choi SH, Lim S, Lim JY, Kim KW, Park KS, Jang HC. Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults. PLoS One 2016; 11:e0166344. [PMID: 27832145 PMCID: PMC5104471 DOI: 10.1371/journal.pone.0166344] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/27/2016] [Indexed: 01/19/2023] Open
Abstract
Objective We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project’s recommended criteria for sarcopenia’s association with mortality among older Korean adults. Methods We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs. Results Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69–10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16–28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations. Conclusions New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values.
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Affiliation(s)
- Joon Ho Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
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1044
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Lino VTS, Rodrigues NCP, O’Dwyer G, Andrade MKDN, Mattos IE, Portela MC. Handgrip Strength and Factors Associated in Poor Elderly Assisted at a Primary Care Unit in Rio de Janeiro, Brazil. PLoS One 2016; 11:e0166373. [PMID: 27832209 PMCID: PMC5104380 DOI: 10.1371/journal.pone.0166373] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 10/27/2016] [Indexed: 01/08/2023] Open
Abstract
Introduction Sarcopenia is a condition diagnosed when the patient presents low muscle mass, plus low muscle strength or low physical performance. Muscle weakness in the oldest (dynapenia) is a major public health concern because it predicts future all-cause mortality and is associated with falls, disability, cardiovascular mortality and morbidity. Grip strength is a simple method for assessment of muscle function in clinical practice. Objective To estimate the grip strength and identify factors associated with handgrip strength variation in elderly people with low socioeconomic status. Methods Cross-sectional study based on a multidimensional assessment of primary care users that were 60 years or older. The sample size was calculated using an estimated prevalence of depression in older adults of 20%. A kappa coefficient of 0.6 with a 95% confidence interval was used to generate a conservative sample size of 180 individuals. Procedures: tests and scales to assess humor, cognition (MMSE), basic (ADL) and instrumental activities (IADL) of daily living, mobility (Timed Up and Go), strength, height, Body Mass Index (BMI) and social support were applied. Questions about falls, chronic diseases and self-rated health (SRH) were also included. Statistical Analysis: Mean, standard deviation and statistical tests were used to compare grip strength means by demographic and health factors. A multivariate linear model was used to explain the relationship of the predictors with grip strength. Results The group was composed predominantly by women (73%) with a very low level of education (mean 3 years of schooling), mean age of 73.09 (± 7.05) years old, good mobility and without IADL impairment. Mean grip strength of male and female were 31.86Kg (SD 5.55) and 21.69Kg (SD 4.48) [p- 0.0001], respectively. Low grip strength was present in 27.7% of women and 39.6% of men. As expected, men and younger participants had higher grip strength than women and older individuals. In the adjusted model, age (p- 0.03), female sex (p- 0.0001), mobility (p- 0.05), height (p- 0.03) and depression (p- 0.03) were independently associated with low grip strength. For every second more in the mobility test, there was a mean decrease of 0.08 Kg in the grip strength. Elders with depression had a mean reduction of 1.74Kg in the grip strength in relation to those in the comparison groups. There was an average reduction of 8.36Kg in the grip strength of elderly females relative to males. For each year of age after 60 years, it was expected an average reduction of 0.11 Kg in the grip strength. Conclusion our results suggest that low grip strength is associated with age, female sex, height, depression and mobility problems in poor elderly. Grip strength can be a simple, quick and inexpensive means of stratifying elders’ risk of sarcopenia in the primary care setting. Efforts should be made to recognize weaker persons and the conditions associated to low grip strength in order to target early interventions to prevent frailty and disability.
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Affiliation(s)
- Valéria Teresa Saraiva Lino
- Department of Primary Care, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | | | - Gisele O’Dwyer
- Department of Primary Care, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Inês Echenique Mattos
- Department of Epidemiology, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Margareth Crisóstomo Portela
- Department of Health Administration and Planning, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
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1045
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Bokshan SL, Han AL, DePasse JM, Eltorai AEM, Marcaccio SE, Palumbo MA, Daniels AH. Effect of Sarcopenia on Postoperative Morbidity and Mortality After Thoracolumbar Spine Surgery. Orthopedics 2016; 39:e1159-e1164. [PMID: 27536954 DOI: 10.3928/01477447-20160811-02] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 07/13/2016] [Indexed: 02/03/2023]
Abstract
Sarcopenia is the loss of muscle mass associated with aging and advanced disease. This study retrospectively examined patients older than 55 years (N=46) who underwent thoracolumbar spine surgery between 2003 and 2015. Each patient's comorbidity burden was determined using the Charlson Comorbidity Index, and the Mirza Surgical Invasiveness Index was used to measure procedural complexity. Sarcopenia was diagnosed by measuring the total cross-sectional area of the psoas muscle at the L4 vertebrae using perioperative computed tomography scans. Of the 46 patients assessed, 16 were in the lowest third for L4 total psoas area (sarcopenic). Average follow-up time was 5.2 years (range, 6 days to 12.7 years). The cohort of patients with sarcopenia was significantly older than the cohort without sarcopenia (mean age, 76.4 vs 69.9 years; P=.01) but did not have a significantly different mean Charlson Comorbidity Index (3.3 vs 2.0; P=.32) or mean Mirza Surgical Invasiveness Index (7.1 vs 7.0; P=.49). Patients with sarcopenia had a hospital length of stay 1.7-fold longer than those without sarcopenia (8.1 vs 4.7 days; P=.02) and a 3-fold increase in postoperative in-hospital complications (1.2 vs 0.4; P=.02), and they were more likely to require discharge to a rehabilitation or nursing facility (81.2% vs 43.3%; P=.006). Patients with sarcopenia had a significantly lower cumulative survival (log rank=0.007). All 4 deaths occurred among patients with sarcopenia. Patients with sarcopenia have a significantly increased risk of in-hospital complications, longer length of stay, increased rates of discharge to rehabilitation facilities, and increased mortality following thoracolumbar spinal surgery, making sarcopenia a useful perioperative risk stratification tool. [Orthopedics. 2016; 39(6):e1159-e1164.].
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1046
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Abstract
Sarcopenia is an age-associated loss of muscle mass and decline in muscle strength; it is common in older adults and is associated with significant morbidity and mortality. Despite its prevalence, there is currently no universally adopted definition of sarcopenia. In addition to low muscle mass measurements, recent research has recognized the importance of muscle strength and physical performance. Aging induces changes in body composition, such as an increase in visceral fat and reduced muscle mass. Recently, the new concept of sarcopenic obesity has emerged, reflecting a combination of sarcopenia and obesity. The rapidly increasing prevalence and serious consequences of sarcopenic obesity are recognized as a critical public health risk in the aging society. Sarcopenia and obesity share several pathophysiological mechanisms, and they may potentiate each other. The present paper reviews the definitions and techniques used to measure sarcopenia, as well as the health outcomes of sarcopenic obesity. It also highlights the role of diminished muscle mass and strength in cardiometabolic disease mortality. Additional research may be needed to promote the identification and management of sarcopenia and sarcopenic obesity in the elderly population.
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Affiliation(s)
- Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Correspondence to Kyung Mook Choi, M.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea Tel: +82-2-2626-3043 Fax: +82-2-2626-1096 E-mail:
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1047
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Hashimoto Y, Osaka T, Fukuda T, Tanaka M, Yamazaki M, Fukui M. The relationship between hepatic steatosis and skeletal muscle mass index in men with type 2 diabetes. Endocr J 2016; 63:877-884. [PMID: 27397679 DOI: 10.1507/endocrj.ej16-0124] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent cross-sectional studies revealed that sarcopenia is associated with non-alcoholic fatty liver disease (NAFLD) in general population. However, it remains to be elucidated that the association between skeletal muscle mass index (SMI) and hepatic steatosis in patients with type 2 diabetes. In this cross-sectional study of 145 Japanese patients (79 men and 66 women) with type 2 diabetes, we examined the correlation of SMI with hepatic steatosis. Skeletal muscle mass was estimated from bioimpedance analysis measurements and SMI (%) was defined as skeletal muscle mass (kg)/total body weight (kg) × 100. Controlled attenuation parameter (CAP) evaluated with transient elastography, was used for assessment of hepatic steatosis. In addition, we also investigated the association between SMI and prevalence of NAFLD, which was defined as CAP over 237.8 dm-1, using logistic regression analysis. Fifty-eight (74%) men and thirty-nine (60%) women had NAFLD. Multiple regression analysis demonstrated that SMI was independently correlated with CAP (β = -0.35, P = 0.007) in men after adjusting for age, body mass index, hemoglobin A1c, triglycerides/ HDL-C ratio, C-reactive protein and gamma-glutamyl transferase. On the other hand, SMI was not associated with CAP in women. Odds ratio per incremental 1% of SMI for prevalence of NAFLD was 0.80 (95% CI 0.64-0.97, P = 0.021) after adjusting for age, BMI, smoking statues, triglycerides/ HDL-C ratio, HbA1c, and gamma-glutamyl transferase in men. In conclusion, SMI was negatively associated with hepatic steatosis in men with type 2 diabetes.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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1048
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Wong SL. Reduced muscular strength among Canadians aged 60 to 79: Canadian Health Measures Survey, 2007 to 2013. Health Rep 2016; 27:11-17. [PMID: 27759871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Reduced muscular strength is associated with an increased risk of all-cause, cardiovascular and non-cardiovascular mortality, heart attack and stroke. At older ages, reduced strength is associated with impaired mobility, risk of falls, and disability. Various criteria are used to determine reduced strength. DATA AND METHODS Data on grip strength among 3,181 respondents aged 60 to 79 from the 2007 to 2013 Canadian Health Measures Survey were used to calculate the prevalence of reduced strength based on sex-specific percentile and t-score cut-points and cut-points of the Foundation for the National Institutes of Health. Logistic regression was used to identify significant associations between reduced strength and mobility, disability and self-rated health. RESULTS Based on stricter criteria, the prevalence of reduced strength among household residents aged 60 to 79 ranged from 3% to 5%; based on less strict criteria, the prevalence ranged from 10% to 18%. Compared with people with normal strength, those with reduced strength had higher odds of impaired mobility (ranging from 3.40 to 8.33, depending on the cut-point), poor or fair self-rated health (2.19 to 4.20), and moderate-to-severe disability (2.21 to 2.60). INTERPRETATION Estimates of the prevalence of reduced grip strength varied by cut-point. Reduced strength was significantly associated with impaired mobility, moderate-to-severe disability, and poor or fair self-rated health. Further research is required to determine if associations between reduced strength and other health outcomes vary by cut-point.
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Affiliation(s)
- Suzy L Wong
- Health Analysis Division, Statistics Canada, Ottawa, Ontario
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1049
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Han E, Lee YH, Kim G, Kim SR, Lee BW, Kang ES, Ahn CW, Cha BS. Sarcopenia is associated with albuminuria independently of hypertension and diabetes: KNHANES 2008-2011. Metabolism 2016; 65:1531-40. [PMID: 27621188 DOI: 10.1016/j.metabol.2016.07.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 07/04/2016] [Accepted: 07/04/2016] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Although sarcopenia is associated with metabolic disorders, its influence on albuminuria has not been determined. The aim of this study was to identify the relationship between sarcopenia and albuminuria in the general population. METHODS This was a population-based, cross-sectional study using a nationally representative sample of 2326 subjects aged ≥20years from the Korea National Health and Nutrition Examination Surveys of 2008-2011. Appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry was used to assess sarcopenia, which was defined as ASM divided by body mass index, as recommended by the international consensus meeting of the National Institutes of Health. Albuminuria was defined as an albumin-to-creatinine ratio of ≥30mg/g using random spot urine samples. RESULTS A total of 385 (16.5%) subjects were classified as having albuminuria. Sarcopenic subjects showed a higher proportion of albuminuria than subjects without sarcopenia (odds ratios [ORs]=2.17-3.26, all P<0.05) after stratification based on the presence of hypertension, diabetes, or metabolic syndrome and a higher homeostasis model assessment of insulin resistance (all P<0.001). The albuminuria risk was comparable between insulin-sensitive subjects with sarcopenia and insulin-resistant subjects with preserved muscle mass. A multiple logistic regression analysis also demonstrated that sarcopenia was independently associated with albuminuria (OR=1.61, 95% confidence interval [CI]=1.04-2.48, P<0.05). The association between sarcopenia and albuminuria remained strong in the elderly population (ORs=1.80-2.68, P<0.05), whereas it lost its significance in the younger age group. Furthermore, the risk of albuminuria was much higher in sarcopenic obese subjects than in other groups (OR=4.90, 95% CI=3.23-7.43, P<0.001). CONCLUSIONS Sarcopenia was associated with an increased risk of albuminuria independent of hypertension, diabetes, and metabolic syndrome. Sarcopenia and obesity had a synergistic impact on the increased risk of albuminuria. This suggests that sarcopenic obesity as well as sarcopenia alone may be considered as novel risk factors for albuminuria.
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Affiliation(s)
- Eugene Han
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - So Ra Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Woo Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bong-Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
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1050
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Mijnarends DM, Koster A, Schols JMGA, Meijers JMM, Halfens RJG, Gudnason V, Eiriksdottir G, Siggeirsdottir K, Sigurdsson S, Jónsson PV, Meirelles O, Harris T. Physical activity and incidence of sarcopenia: the population-based AGES-Reykjavik Study. Age Ageing 2016; 45:614-20. [PMID: 27189729 DOI: 10.1093/ageing/afw090] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 04/05/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND the prevalence of sarcopenia increases with age. Physical activity might slow the rate of muscle loss and therewith the incidence of sarcopenia. OBJECTIVE to examine the association of physical activity with incident sarcopenia over a 5-year period. DESIGN data from the population-based Age, Gene/Environment, Susceptibility-Reykjavik Study were used. SETTING people residing in the Reykjavik area at the start of the study. SUBJECTS the study included people aged 66-93 years (n = 2309). METHODS the amount of moderate-vigorous physical activity (MVPA) was assessed by a self-reported questionnaire. Sarcopenia was identified using the European Working Group on Sarcopenia in Older People algorithm, including muscle mass (computed tomography imaging), grip strength (computerised dynamometer) and gait speed (6 m). RESULTS mean age of the participants was 74.9 ± 4.7 years. The prevalence of sarcopenia was 7.3% at baseline and 16.8% at follow-up. The incidence proportion of sarcopenia over 5 years was 14.8% in the least-active individuals and 9.0% in the most-active individuals. Compared with the least-active participants, those reporting a moderate-high amount of MVPA had a significantly lower likelihood of incident sarcopenia (OR = 0.64, 95% CI 0.45-0.91). Participants with a high amount of MVPA had higher baseline levels of muscle mass, strength and walking speed, but baseline MVPA was not associated with the rate of muscle loss. CONCLUSION a higher amount of MVPA seems to contribute to counteracting the development of sarcopenia. To delay the onset of sarcopenia and its potential adverse outcomes, attention should be paid to increasing physical activity levels in older adults.
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Affiliation(s)
- Donja M Mijnarends
- CAPHRI/Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- CAPHRI/Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jos M G A Schols
- CAPHRI/Department of Health Services Research, Maastricht University, Maastricht, The Netherlands CAPHRI/Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Judith M M Meijers
- CAPHRI/Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Ruud J G Halfens
- CAPHRI/Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland Icelandic Heart Association Research Institute, Kopavogur, Iceland
| | | | | | | | - Pálmi V Jónsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland Department of Geriatrics, Landspitali National University Hospital, Reykjavik, Iceland
| | - Osorio Meirelles
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
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